Health and health services on plantations in Sri Lanka

Sri Lanka is an example of a country which has achieved impressiveimprovements in health status since Independence despite itslow income per head. However, the improvement has been uneven,with plantations consistently lagging behind. Most of the estateworkers in Sri Lanka are Indian Tamils who have traditionallybeen economically disadvantaged and politically isolated, apattern which began under the colonial pattern of recruitmentand management Poverty, overcrowding, poor water and sanitationand health services were all reflected in the low health statusof estate workers and their families. However, since nationalizationin 1975, there has been considerable investment on estates and,with the introduction of a uniform health policy designed tomeet the needs of estate workers, the health status of workersand their families has dramatically improved. Interventionshave included components on housing, water supply and sanitationas well as health and child care and have been planned withthe involvement of the workers. The components which have broughtabout the improvements were specificially designed to meet theneeds of plantation workers and developed within a structurequite different from that which applies in rural peasant areas.It is possible that a separate structure responsive to the specialproblems on estates is needed if Health for All is to be a realityin plantations.