On 28 November, Cyclone Ditwah swept across Sri Lanka accompanied by intense rainfall and destructive winds, producing widespread devastation throughout the island. Extensive flooding overwhelmed low-lying areas while unstable slopes triggered multiple landslides. Numerous villages were submerged, leading to the loss of hundreds of lives and the disappearance of many others. As of early this month (December), more than one million individuals across all 25 Districts continue to be affected. Some displaced from their homes, others confined to overcrowded shelters, and many still lacking reliable access to safe water, food, and essential medications. Several healthcare institutions in severely affected areas remain overwhelmed, disrupting routine service delivery and emergency operations.
In the wake of such a large-scale disaster, families faced not only the destruction of property but also heightened risks of malnutrition, communicable diseases, and psychological distress. At this stage, protecting health and overall well-being becomes critically important. The danger does not subside when floodwaters recede. In fact, this post-flood period is when outbreaks of infectious diseases frequently begin. In the complex environment created by Ditwah, simple and evidence-based preventive actions can significantly reduce morbidity and mortality.
Ensure that all water used for consumption is safe
Floodwaters often become contaminated with solid waste, sewage effluent, faecal matter, agricultural chemicals, and industrial pollutants. Therefore, water exposed to flooding should never be used for drinking, brushing teeth, preparing meals, or washing fruits and vegetables.
Recommended precautions include: Boiling water for at least one full minute; Storing boiled water in clean, covered containers; Using commercially bottled water when safe sources are unavailable; and Avoiding the use of wells, tube wells, and small surface-water sources, as contamination during floods is extremely common.
Safe water is the primary defence against diarrhoea, hepatitis A, dysentery, and other waterborne infections.
If your household uses a well that has been affected by flooding, it must be pumped out, cleaned, and chlorinated before consumption. For guidance on chlorination procedures, contact your area Public Health Inspector (PHI).
Minimise exposure to floodwater
Avoid wading through floodwater whenever possible. If movement through water is unavoidable: Wear appropriate footwear (closed shoes or boots); Avoid deep or fast-moving water; and Remain vigilant for submerged electrical wires, debris, and uncovered manholes.
Floodwater may conceal sharp objects, animal waste, and pathogenic organisms. Even minor wounds can become infected, increasing the risk of leptospirosis (rat fever).
Individuals exposed to floodwater are strongly advised to obtain the prophylaxis Doxycycline to prevent leptospirosis. Consult your Medical Officer of Health (MOH), Public Health Midwife (PHM), or PHI for assistance. Prophylaxis is available free of charge at the MOH.
Protect children, elderly persons, and pets
Children may be curious during floods, but floodwater is unsafe for any form of play. Keep vulnerable individuals indoors, dry, and warm.
Health risks from floodwater include: Diarrhoea, Skin infections, Helminthic (parasitic worm) infections, Fever, and Accidental injuries.
Preventive measures are far more effective than treatment.
Food safety and kitchen hygiene
Contaminated food is a major cause of illness during and after floods. Adhere to the following: Discard any food that has come into contact with floodwater; Throw away cut vegetables, leafy greens, herbs, and fruits exposed to muddy water; Wash all utensils, plates, and surfaces using boiled water and soap; and Store dry rations in waterproof or tightly sealed containers.
If receiving cooked meals from community kitchens, consume them while still hot and avoid storing leftovers.
Maintain strict personal hygiene
During floods, pathogens spread rapidly. Key measures include: Frequent handwashing with soap; Cutting and cleaning fingernails thoroughly; and Using clean latrines or designated temporary sanitation facilities.
Good hygiene remains one of the most effective tools for preventing infection.
Warning signs that require immediate medical evaluation
Seek urgent medical attention if any individual exposed to floodwater develops: Fever, Muscle pain, Red eyes, Dark or yellowish urine, Severe headache, Vomiting or diarrhoea, and Extreme fatigue.
These symptoms may indicate leptospirosis, dengue, hepatitis, or other serious infections. Early diagnosis dramatically improves outcomes.
After floodwaters recede – Essential actions for the recovery phase
Clean and disinfect your home thoroughly
Begin by removing mud, silt, and debris.
Then: Disinfect floors and surfaces using household bleach at recommended concentrations; Wash and sun-dry clothing and bedding, as damp fabric supports rapid microbial growth; and Repair damaged latrines promptly to prevent environmental contamination and diarrhoeal outbreaks.
Prevent dengue
Flooding creates numerous stagnant-water pockets suitable for mosquito breeding. This significantly elevates the risk of dengue outbreaks.
Protect your household by: Eliminating all water-filled containers (cans, pots, tyres, gutters); Cleaning roof gutters regularly; Storing water only in properly closed containers; Using mosquito repellents, coils, and bed nets; and Wearing long-sleeved clothing at dawn and dusk.
A single neglected container can put an entire community at risk.
Waste management
Floods generate large quantities of debris, garbage, and animal waste.
To reduce health hazards: Collect waste in secure bags and keep it away from children; Avoid burning plastic or rubber; and Notify the authorities about blocked drains or malfunctioning sewer systems.
A clean environment supports safer community recovery.
Prevent electrocution
After floods: Do not touch submerged or wet electrical appliances; Wait for a qualified electrician to inspect your home; and Keep children away from electrical poles and exposed wires.
Post-flood electrocution incidents are common but preventable.
Mental health and psychosocial well-being
Floods generate significant emotional stress. Common reactions include: Shock, Fear, Anxiety, Sleep disturbances, Sadness over losses, and Worry about future disasters.
Protecting mental health is essential for holistic recovery.
Promoting psychological well-being
Talk and share: Discuss experiences with family, friends, and neighbours. Reassure children: Provide clear, calm explanations. Stay connected: Social bonds foster resilience. Rest appropriately: Avoid physical overexertion during clean-up activities. Limit distressing news exposure: Reduce media overload. Seek help: Contact the 1926 voice helpline or the 0755551926 WhatsApp service.
When to seek professional care
Consult a healthcare provider if you or a family member experiences: Persistent sadness or hopelessness; Panic attacks or severe anxiety; Prolonged insomnia; Irritability or anger; and Difficulty performing daily tasks.
Community strength – The foundation of recovery
Sri Lankans have a long-standing tradition of resilience, solidarity, and compassion. Disasters test these strengths but also create opportunities for collective healing.
Ways to contribute: Assist elderly neighbours with home clean-up; Share boiled water and food with those without supplies; Participate in community dengue-control initiatives; Support children and pregnant females with unique needs; and Adhere to public health guidance and encourage others.
Every act of cooperation accelerates communal recovery.
GMOA in the frontline – Strengthening health services for flood-affected populations
In the aftermath of Ditwah, the Government Medical Officers’ Association (GMOA) has served as a pillar of the national health response. With hospitals and primary care facilities in the hardest-hit Districts overwhelmed, GMOA members extended their working hours to maintain uninterrupted emergency services.
Operating in close coordination with the Health Ministry’s Disaster Management Unit, the GMOA rapidly deployed medical teams to severely affected regions. Clinics were established in evacuation centres sheltering thousands of displaced individuals. These facilities enabled the early detection and timely management of leptospirosis, dengue, diarrhoeal diseases, and other flood-associated conditions. GMOA teams also prioritised continuity of care for patients with non-communicable diseases who had lost access to routine medications or clinic services. Through the support of generous donors and members across the island, the GMOA continues to provide essential medicines and supplies to flood-affected families.
In addition to clinical operations, GMOA doctors have played a significant role in public education. Through media communications, social media outreach, and collaboration with local health authorities, they have guided communities on water safety, hygiene, infection prevention, and early health-seeking behaviour.
To support the public further, the GMOA operates a dedicated hotline — 0774506602 — to address the health-related concerns of affected individuals.
Together, we can rise above the floodwaters and build a healthier tomorrow.
The writer is a Medical Officer at the National Blood Transfusion Service
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The views and opinions expressed in this column are those of the author, and do not necessarily reflect those of this publication