You’d never guess Sri Lanka has lived through 20 years of brutal civil war. Strolling along the Galle Face promenade in Colombo, you’d never sense the horror of the 2019 Easter attacks at the Kingsbury Hotel. Driving through its winding rural roads, past bustling shops, street vendors, and children walking to and from school, you’d never suspect the debilitating economic crisis that has gripped the country in recent years (and from which it is only just emerging).
To the naked eye, Sri Lanka is vibrant, thriving, and defiantly beautiful. It has opened its doors to the world and stepped up to its challenges. Remarkably, it is meeting them head-on.
So, in 2024, when the WHO asked the RCN International Academy to provide technical advice on the role of Public Health Nursing Officers (PHNOs), our insight into the country’s efforts to care for its growing elderly population, the burden of non-communicable diseases (NCD), and the need for strengthened health promotion was admittedly limited. What quickly became clear, however, was that Sri Lanka had placed nurses at the centre of its primary care reform. They had realised the obvious: nurses were the answer. And I know they knocked on the right door.
From that first Teams meeting to developing a pilot programme, consulting with WHO and the Ministry of Health, forming a faculty team, designing a workshop, booking a flight, and simply getting on with it, about two months passed. It has taken me longer to organise a weekend away in the UK.
Over the past year, we have educated roughly 300 PHNOs in palliative and elderly care, dementia, health promotion, mapping and referrals, documentation, and nutrition. We’ve helped build a strong Sri Lankan faculty and a small team of medics who, judging by their enthusiasm, have developed a fresh appreciation for the power of nursing. Together, we’ve shaped a proposal for a two-year programme to equip specialist primary care nurses to deliver precisely what reform demands: lead primary care centres, map community health, manage NCDs, guide patients to the right pathways, promote health, and keep communities safe.
When we last left Sri Lanka on 1st November, the weather was warm and heavy with the first hints of monsoon season. We had just finished six days of teaching 120 postgraduate PHNOs and met with the steering team about essential curriculum changes to support professional development. The plan was simple: return home, meet regularly, and secure continued funding from the World Bank and WHO.
On 27th November, we finalised the draft programme proposal and sent it off for review. Then came a message from the course leader:
“All good so far, but bad weather.”
Monsoon season can be unforgiving. We saw last year how relentless rain blocks roads, floods fields, and makes life infinitely harder, especially for vulnerable communities in rural areas and urban slums.
But nothing had prepared Sri Lanka for
The PHNOs we met over the past year are now back in their primary medical care facilities, working under extreme conditions. Many are also deployed to displacement camps across the country, often working alone or with minimal support.
On Monday the 1st December, the nursing faculty and the Sri Lankan Nurses Association reached out to the RCN for technical guidance. Within hours, we established daily Zoom drop-in sessions that brought together local PHNOs, the Association’s president, faculty leads, UK and Myanmar experts in disaster and humanitarian response, and RCN members who stepped in to help.
During our latest call, several PHNOs connected live from their clinics. Behind them, the sounds of patients and the aftermath of storm damage filled the air. Their expressions brightened as they recognised familiar faces from across the world. They asked pressing questions: how to prioritise care when everything felt urgent, how to capture what they were witnessing, and how to be sure they were doing right by their patients. When the session ended, one message arrived on WhatsApp:
“It was wonderful to hear your voices. Because you are there, we dare to continue.”
This rapid and heartfelt mobilisation has been possible only because of the trust nurtured over the past year. What shines through this coordinated effort is the extraordinary resilience of Sri Lanka’s nurses - their courage, their dedication, and their solid commitment to care even in the most urgent of circumstances.
It is also a powerful reminder of what a genuine, long-term partnership can achieve: the ability to strengthen nursing not just locally, but across the globe, creating ripples of hope and healing that reach far beyond borders.
