By Hema Senanayake –                              

Hema Senanayake

The news was everywhere. It was on TVs and in all national newspapers. I was truly thrilled as a citizen about the marvelous job that our doctors have done. I am not sure how many of them are GMOA members. Whatever the case is, I was curious whether the leaders of our nation might have had the same feeling like me. I wanted to know it firsthand. So, I went to the website of our President Maithripala Sirisena. I did not find any single congratulatory message sent to the team of doctors and their supporting staff who performed, perhaps the most difficult surgery. But I found the following:

President congratulates Sri Lanka Cricket Team

and the following too,

President congratulates Sri Lankan Cricket Team leaving for 20-20 Word Cup

Both above messages were to congratulate our cricketers. Thereafter, I did not go to search the archives of Prime Minister’s news portal. However, I was waiting for this day on which our doctors might turn a new page of our medical history. It has happened now. A few months ago, one of the leading consultants of the team of doctors who performed this surgery met us at our home. It was a friendly family visit. But on that day he narrated a story for which I listened spellbound with occasional questions. For me, heart transplant is like a horror story in a movie.

The process usually begins with harvesting a heart from a patient whose brain was completely damaged or dead. That person is a dead person but live on life support system in a hospital. Then doctors would explain the patient’s situation to the immediate family and would make an unusually difficult request. Doctors would ask the family the heart of the patient. Literarily they say, give us his heart we will fix it to another patient who is in need. True Dracula story, if medical science and ethics do not involve. If they agree to donate the heart, doctors will begin two processes almost at the same time. First, they plan to harvest the heart in good quality and secondly, another team of doctors would open the chest cavity of the recipient for the transplant; in fact both processes begin almost at the same time. The reason is that according to the available technology a harvested heart cannot be kept in good quality for more than three hours. It has to be fixed on to the recipient patient immediately.

As he continued to explain, his enthusiasm was quite visible in his face. We were listening. He further explained that once he has been assigned to a team of doctors who harvest hearts when he was in London a long time ago. The chances are very rare that the donor patient and the recipient patient would be in the same hospital. Instead what is possible is that both patients would be located in two different hospitals with having significant distance in between two hospitals. Therefore bringing a harvested heart within three hours to the location of recipient patient is not possible if transportation facilities are not available. In the U.K. they have it. They use small planes for the purpose. It is quick and making no stops for traffic jams. Then his enthusiasm faded, at least I thought so. He lamented that it would take long time for Sri Lanka to have that kind of efficient transport system. This has hampered for having heart transplant procedures in Sri Lanka. There are quite a few donor patients and recipient patients appearing time to time. If they are located in two distance hospitals, doing a heart transplant is not possible because they cannot bring the harvested heart within three hours. Then he said the only possibility of doing a heart transplant in Sri Lanka is that both patients must be in the same hospital.

Luckily for the recipient of Kandy Teaching Hospital, the donor patient was admitted to the same hospital after a fatal motorcycle accident. The Kandy Teaching Hospital was unwittingly waiting for the miracle to happen. Finally, it has happened. The Daily News reported it as follows:

“Sri Lanka’s first ever heart transplant have been completed successfully at the Kandy Teaching Hospital according to hospital sources. The complex surgery was carried out by an expert team of three heart surgeons, a transplant surgeon, a cardiologist, Transplant Coordinators, Anaesthesiologists and other supportive staff.” (July 10, 2017)

It appears that even reporters were jubilant in reporting this news in their respective newspapers.  They sense the commitment of doctors who performed it. One doctor of the team told the media that they still could not properly sleep even after the three days of the surgery. No one told them to do the transplant neither they were paid money. Their commitment was so high; I guess only a highly professional team bounded by true ethics can do it. I have a feeling that most of the doctors in Sri Lanka are like this.

People must understand that this is a job that cannot be done by making it an essential service. Recently, once, Dr. Nevile Fernando, the chairman of SAITM, suggested that the medical profession must be made an essential service to prevent trade union actions of doctors. On the contrary, I think doctors must be free and be respected so the nation would benefit more and more. Doctors, even if they happen to strike, they do not do it for fun, they do it as an action of last resort when their voices are not heard yet they feel bad for having to strike. Now assume what reflects, if some of the doctors who performed the heart transplant happened to go on strike respecting to the decision made by their union the GMOA? Was it lack of commitment towards their patients? No. It shows the failure of the governance. Accordingly, it is not unusual that in such a government, the heads of the government might have missed to congratulate the team of doctors and the supporting staff that have performed the historic first-ever heart transplant in Sri Lanka.