Step inside the National Health Emergency Operation Centre (HEOC) in Colombo and the first thing that catches the eye is a wall of glowing screens; streaming live news and weather updates from every corner of Sri Lanka. On ordinary days, the centre hums quietly, with staff methodically tracking the country’s health situation from behind their consoles.
But when disaster strikes – like floods and landslides triggered by Cyclone Ditwah in last November 2025, the atmosphere shifts instantly. The HEOC transforms into the heart of Sri Lanka’s health emergency response, coordinating life-saving decisions in real time.
That transformation does not begin at impact. In mid-November, as a low-pressure system developed along the south-east coast, the HEOC moved into a state of readiness. The centre began closely monitoring the system and coordinating in advance with key stakeholders within the health sector and beyond, ensuring that communication lines and response mechanisms were in place well before landfall.
When Cyclone Ditwah subsequently battered the country, bringing torrential rains, flash floods, and landslides, the HEOC formally activated its emergency procedures and protocols. Within hours, the HEOC team was coordinating with subnational HEOCs, district health offices, hospitals and disaster management authorities to support flood rescue operations, hospital evacuations, and the continuity of medical services during lifesaving search and rescue efforts.
/countries/sri-lanka/heoc-image-07-01-26.jpeg?sfvrsn=a50620f2_3 "HEOC Image 07-01-26")
WHO Representative visits the HEOC during the early days of Cyclone Ditwah response and is briefed by Dr K Wickramasinghe (Additional Secretary Medical Services), Dr Samiddhi Samarakoon (National Coordinator – Disaster Preparedness and Response Division) and their teams. (Image credits – WHO Sri Lanka/ Anjalee De Silva)
“The HEOC’s coordination was the backbone of our health response to Cyclone Ditwah,” said Dr Samiddhi Samarakoon, Coordinator of the Disaster Preparedness and Response Division at Ministry of Health. “By linking district health offices, hospitals, and emergency services in real time, the Centre ensured that resources reached the most vulnerable communities without delay.”
This coordination was especially critical as over 250 health facilities were themselves affected. Flooding, power outages, and disrupted access compromised service delivery in several areas. Through real-time information sharing, the HEOC assessed the functional capacity, supported hospital evacuations where necessary, and redirected patients, staff, and medical supplies to maintain uninterrupted essential health services. This coordinated approach ensured that care continued even as the system itself was under pressure.
The HEOC’s ability to respond effectively has been shaped by years of institutional strengthening. First established in 2004 in the aftermath of the Tsunami, the centre initially operating virtually to coordinate urgent health needs. In 2008, it was formally established in its current location within the Ministry of Health. Since then, WHO has consistently supported the centre, strengthening systems, upgrading equipment, and building the capacity of HEOC and surge staff.
This support extends beyond the national level. WHO was also instrumental in helping the DPRD set up a network of sub-national HEOCs across health districts. These centres form the backbone of ground level emergency management, providing real-time updates to the National HEOC. Since 2016, WHO has also supported the upgrading of the national HEOC in line with the 2015 guidance ‘Framework for a Public Health Emergency Operations Centre’ alongside simulation exercises, updated risk assessments, district response plans and operational guidelines and more recently information and communication technological upgrades for the HEOC.
“Strong coordination saves time, resources, and ultimately lives during emergencies,” said Dr Rajesh Pandav, WHO Representative to Sri Lanka. “The HEOC helps ensure that the right information reaches decision-makers when it matters most, and that different sectors work together effectively. This is why strengthening HEOCs is so critical.”
Over the years, the HEOC has coordinated responses to a wide range of emergencies including rebuilding efforts following the Tsunami, coordination of essential health services for the internally displaced persons in Cheddikulam post conflict in 2009, recurring floods and landslides, the aftermath of the Easter Sunday bombings in 2019, multiple dengue outbreaks, COVID-19 response, and most recently, the ongoing response to Cyclone Ditwah.
Today, the HEOC serves as a vital backbone for national-level decision-making during public health emergencies. Its personnel systematically collect, compile, and analyze health-related emergency data, presenting evidence-based insights to relevant authorities. This process is strengthened by real-time updates from sub-national HEOCs, ensuring that decisions are informed by timely, accurate, and ground-level information.
As Sri Lanka continues to strengthen its preparedness for future public health emergencies, the HEOC remains a symbol of resilience and foresight. It is not only a command centre but also a hub of collaboration, evidence-based decision-making, and trust.