The tsunami in the Indian Ocean, in December 2004, seriously affected health care in Sri Lanka by damage to  hospitals, loss of records and displacement which exposed the affected population to increased risk from outbreaks of infectious disease. In order to ensure effectiveness of the rehabilitation measures and to help prevent outbreaks, the collection and transmission of health information from the periphery became a top priority of WHO.

Monitoring population health as it presents to healthcare services is called disease surveillance. If it covers all diseases, it is multi disease surveillance (MDS). In 2005, the Sri Lanka country office of WHO established computerised MDS systems in a number of large hospitals in tsunami-affected areas. In 2006, part of the project in the government hospitals of Batticaloa District of the Eastern Province was taken over by the Austrian/Swiss Red Cross at the request of the Epidemiology Department of the Health Ministry, the Provincial Health Services and the directors of the hospitals. The Austrian/Swiss Red Cross Consortium was the main sponsor, with additional funds coming from the Austrian newspaper the Kurier and Siemens Austria.

The project was managed by Lunar Technologies, starting in July 2006 and running to the end of 2007. With the help of computer hardware and software, it was designed to provide an electronic record of diagnostic information on all patients treated in the hospitals. The main objective was to improve the notification of communicable diseases using e-mail. In each hospital, a computer network was set up with a server connected to workstations. The Medical Officers of Health offices also received a computer connected to the Internet via telephone.

Lunar Technologies re-wrote the MDS program that had been produced by WHO with the help of the computing department of the Eastern University, using the Caché database ( We worked in close consultation with Health Ministry staff especially the Epidemiology Department, the RDHS of Batticaloa District and the directors of the Batticaloa Teaching Hospital and the District and Rural hospitals. The project was supported technically by the WHO country office in Colombo.

Alongside computer hardware and software, training was one of the largest parts of the project. All the hospital staff responsible for data input were trained in basic computer use followed by intensive training on the job. Basic training was carried out in the computer laboratory of the Eastern University; hands-on training was done in the hospitals. After 12 months support, the hospitals were able to manage the systems by their own staff.