23 November, 2017

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Horrors Of Ward 30 At Teaching Hospital Kandy 

By Lasantha Pethiyagoda

Prof Lasantha Pethiyagoda

Prof Lasantha Pethiyagoda

I would like to outline the horrors of ward 30 at the “Teaching” hospital at Kandy, Sri Lanka, where I was an inpatient from 8th to 12th July.

A cardinal principle in a hospital is that it should not cause harm to a patient, especially through neglect. It was shocking to observe invasive procedures ranging from insertion of a cannula, catheter for drainage to intravenous medication are conducted almost casually and often aggressively with scant regard for patient health or comfort.

Most patients are quite weak on arrival, and therefore susceptible to infection, often with antibiotic resistant germs that grow in areas that are never properly cleaned.

In the apparent absence of publicly available data on rates of in-house infection, and a lack of standardised methodology or proper surveillance, patients seem to be severely compromised and at the mercy of their “destiny” when in hospital.

A considerable percentage of patients were observed to be wheezing and coughing, bringing up phlegm which is invariably emptied into open containers kept by their bedside. The stench itself is nauseating as beds are arranged less than a metre apart, most beds with frayed mattresses and paint peeled frames themselves being about a metre wide.

Patients always hold on to other patients’ bed rails to proceed to and from the abhorrently disgusting squat toilets which have gaping cracks and holes with highly visible faecal matter sloshing with water. The walls of toilets have layers of deposits in different shades of brown that are never dislodged by cleaners hosing them down.

The beds, walls, furniture or other fixtures are never wiped down with a detergent or disinfectant. Only floors are washed with buckets of water once a week, and merely swept on other days, with dust resettling on beds, patient food receptacles and clothes.

The cracked cement floor is pockmarked with holes and indents, obviously harbouring multitudes of pathogens. No microbiology staff were sighted taking swabs of cultures. No infection control audit could possibly be conducted. Large open garbage bins near the wash basins and latrines are overturned by scavenging dogs that seem to have unhindered access.

Hence, putrefying food remnants, discarded dressings, vomit bags and fruit peels are strewn on the wet floors, where leaking taps, blocked and overflowing wash basins spill to the floor. No colour-coded waste containers are evident. It seems as if bodily fluids, festering dressings and used medical supplies are all disposed in one lot.

Mice regularly scoot across the aisles with no apparent inhibitions. Antibiotics seem to be administered almost normatively, regardless of consequences to individuals’ condition or immune capabilities. Ventilation to reduce airborne infections consist of one or two fans operated at random from a loose and caving fabric ceiling with multiple layers of darkened dust and cobwebs that seem to have been untouched for years.

Patients are routinely transferred from beds to other beds or positions under other patients’ beds in grossly overcrowded conditions with some patients sitting on visitor stools while they wait for a chance to lie down. The whole operation of the ward seems to undermine the basic respect that any human being is owed as citizens by the state.

Those responsible for perpetuation of this despicable state should be forced to endure these conditions first-hand so that otherwise wasted public funds can be utilised more compassionately and considerately.

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Latest comments

  • 24
    7

    But we have the Mattala Airport, carpeted roads, super highways, night motor races, trips abroad to canvass for the Commonwealth Games, Victory Parades etc.

    Aren’t these enough?

    These are the “visible” development that Rajapakse supporters brag about.

    The undeveloped state of the nation are hidden and confined to things like hospitals, medical services, universities, rural schools, CKD prone North Central Province, and such like.

    We have some of the dumbest of the dumb posted out as ambassadors, appointed as chairmen of corporations, promoted as heads of departments and vice chancellors of universities.

    And now we are clamoring for more. So let us all “Bring Back Mahinda” and appoint him “Prime Minister”. And don’t forget the prince in waiting, Namal. He’ll have to take over when the old man retires! So let’s make him the Leader of the House.

    Mahinda Maha Rajaneni ta Jayawewa!!!

    • 3
      4

      Current President was the Minister of Health for long years. What was he doing for many years under the “corrupt” regime?

      What did he do after more than 7 months in power now, as the President. Surely, one does not need a lot of time to remove spittoons, garbage and old dressings. Now even the streets of Colombo that were clean, a while ago, have piles of garbage.

      Most probably Yahapalanaya” thrives with garbage.

  • 24
    4

    Dear Prof.

    Without funding these are the predicable results in a third world hospital. Where is the funding? Hidden in Swiss ban accounts and buried in Mattala and the Hambantota Harbour, those black holes which swallowed billions of Rupees. Let’s hope at least some of the stolen loot will be returned to Sri Lanka to fund schools, hospitals and universities.

    • 4
      4

      Who are managing the hospitals ? At least who are
      responsible for patients ? Why is that doctors
      and nurses work stoppages only focus on their
      personal demands and not of the conditions of their
      work places, the hospitals ? They spend major part
      of their lives in hospitals , they are the health
      professionals of the country and they don’t care
      about the condition of their work place ? Why can’t
      they just refuse to work under unhealthy
      conditions? They can make a huge contribution to
      the entire health sector. Almost in every national
      hospital there are at least two doctors who saw
      the conditions of NHS in the UK. Then why their
      experiences not fully practiced and shared with the
      patients ? Kalubowila is also the same I heard.

  • 18
    0

    No one has any illusions about the quality of care in government hospitals which are, with the rare exception, for the hoi polloi, but Prof. Pethiyagoda’s expose is truly shocking, should be investigated IMMEDIATELY and remedial measures taken WITHOUT DELAY!

    If this is what a person of his eminence is subjected to in circumstances where it’s an accepted fact that “knowing someone in the system” provides far better care than the average, only God can help someone who doesn’t.

    Ministers of this government who appear only too ready to leap to the defence of their “reputations” need to respond IMMEDIATELY to Prof. Pethiyagoda’s accusations, doing so on Colombo Telegraph.

  • 14
    0

    How good it will be if all concerned contributors of CT – amare, native, sumane, julampitiya, native, non native rw his friend dj and the venerable Izeth H will take some time off their boringly repetitive political wisdom and support the author of this article by highlighting the thousands of similar horrors in this country and see whether they can make these the issues to fight over during this election campaign!

  • 14
    8

    Have you born in the West or Siri Lanka? What you say here was in SL all the time.. You didn’t know??? Medical staff do not respect salaries they get, hence no respect to patients, do not care about patients… Attendants and doctors both get bribes. Not that common with Doctors, but attendants won’t do anything unless we give them money for Kasippu bottle. . Have you spoken to a doctor there, how disrespectful are they? They talk to you like medical science is something very very special and only they know and we are just dumb asses. no respect. This is one of outcome of so called greatest Sinhalese Buddhists culture.. no respect or care at least as a fellow human….

  • 6
    1

    Dear Peththa,

    Please remember that you are in your homeland Sri Lanka and not your adopted homeland Australia. Politicians have time and time again raped our country’s economy, society and culture and there seems to be no escape in the forseeable future and I don’t think we will ever attain the desired standards in our healthcare system. So, please bear it with all of us and may you get better services once you return to Aussie Land. Kumar (a collegue of your at the CHS in 1980)

  • 14
    1

    Dear Prof

    Someone of your background (a university teacher in Australia) would have sought treatment in a private hospital if he fell ill while in Sri Lanka. Maybe you didn’t have medical insurance and didn’t want to pay the exorbitant fees charged by private hospitals. So you sought treatment in a government hospital. Fair enough. But unfortunately you had to endure a most horrific experience which you articulate so well. It’s heart breaking to think it is in these hell holes that the low income and poor people, who constitute the majority of our population, have to seek treatment when they are sick. They have no choice. Only positive outcome of your experience is that you have exposed very powerfully the appalling conditions prevailing in government hospitals and the suffering of ordinary people on a daily basis as a result. You have done a great service on behalf of the most vulnerable in our society. The doctors, nurses and other staff in these facilities don’t have to be Mother Theresas. At least they should do their duties for which they are paid. Hope the media in Sri Lanka would follow up on this. Actually the media should have brought this tragedy to light already. Instead they are preoccupied with attention whores such as the political scumbags and mediocre celebrities. The Sri Lankan media stinks more than our hospitals.

    • 1
      20

      Ahem … when did Mr. Pethiyagoda receive his doctorate to address himself as Professor? Being a lecturer at a university does not make one a Professor.

    • 0
      0

      The only difference between public and private hospitals in Sri Lanka is that in private hospitals patients can have their own rooms and dont have to witness the illnesses of other patients a metre away. I have been admitted to three of the top private hospitals in Colombo over the past six years and the level of cleanliness is no different from that described by this writer. Nurses clearing their throats and spitting in the handbasins, a/c ducts clogged with grime and food with absolutely no nutritional value. The attitudes of all staff from cleaners to doctors is appalling with no work ethic and certainly no signs that they care. They are downright lazy. What to do about this culture? Build new hospitals instead of useless airports, build new universities instead of concrete phallic towers and man them with teachers and staff from countries that do care.

  • 11
    14

    We have to admit it. If Gota was in charge of Government hospitals they would be clean and efficent.

    • 6
      3

      Taraki

      be careful – u do not need a dictator or a military man to improve things.
      we do not have to pay that kind of price

      Decent doctors can do much.

      Prof mark amarasinghe ran a very neat ward in kandy hospital – i do not know what happened to that ward after his time.

    • 2
      3

      taraki

      “We have to admit it. If Gota was in charge of Government hospitals they would be clean and efficent.”

      Here is a myth “Mussolini really get the trains running on time” that is being exploded by a journalist, read the excerpt and enjoy lies:

      Making Italy work: Did Mussolini really get the trains running on time?

      But did Mussolini really do it? Did Il Duce, in his 20 years of absolute power, really manage to make the railway service meet its timetable? The answer is no.

      Like almost all the supposed achievements of Fascism, the timely trains are a myth, nurtured and propagated by a leader with a journalist’s flair for symbolism, verbal trickery and illusion.

      In 1936 the American journalist George Seldes complained that when his fellow-countrymen returned home from holidays in Italy they seemed to cry in unison: ‘Great is the Duce; the trains now run on time]’ And no matter how often they were told about Fascist oppression, injustice and cruelty, they always said the same thing: ‘But the trains run on time.’

      ‘It is true,’ wrote Seldes, ‘that the majority of big expresses, those carrying eye-witnessing tourists, are usually put through to time, but on the smaller lines rail and road-bed conditions frequently cause delays.’

      And there is no shortage of witnesses to testify that even the tourist trains were often late. A Belgian foreign minister wrote: ‘The time is no more when Italian trains run to time. We always were kept waiting for more than a quarter of an hour at the level-crossings because the trains were never there at the times they should have been passing.’ The British journalist Elizabeth Wiskemann, likewise, dismissed ‘the myth about the punctual trains’. ‘I travelled in a number that were late,’ she wrote.

      The notion that the trains were running on time was none the less vigorously put about by the Fascist propaganda machine. ‘Official press agents and official philosophers . . . explained to the world that the running of trains was the symbol of the restoration of law and order,’ wrote Seldes. It helped that foreign correspondents in Rome were very carefully controlled and that the reporting of all railway accidents or delays was banned.

      Il Duce himself never missed an opportunity to be associated with great public works, and railways were among his favourites. Whenever a big rail bridge, or a station or a new line was opened, he was there to take the credit. In 1934, with a triumphant fanfare, he opened the direct Florence-Bologna line which included ‘the world’s longest double-track tunnel’. He failed to point out that the project had been initiated by another government, long before he took power.

      Typically, he fell victim to his own propaganda. Mussolini’s biographer, Denis Mack Smith, points out that Italy usually imported its coal by sea, but after the Second World War broke out this was no longer possible and it had to come overland. The Duce’s railway system, however, was not up to the job.

      ‘Only two of the nine railroads through the Alps had been provided with double tracks and their capacity was estimated as equal to little more than a quarter of Italy’s peacetime needs,’ writes Mack Smith.

      ‘As the trains running on time had become one of the accepted myths of Fascism, and as Mussolini had never charged anyone with the task of planning communications in the event of war, the matter had gone by default.’

      http://www.independent.co.uk/voices/
      rear-window-making-italy-work-did-mussolini
      -really-get-the-trains-running-on-time-1367688.html

      • 5
        0

        Rip van Winkle, Native V, yes you are right. For Gota the price would be too high. Any government since 1948 could have sorted out this mess but they could not be bothered. I expect our new one to be no different.

        • 1
          1

          taraki

          Did Goat really get the trains running on time?

          We know his white van fleet was operated with ruthless efficiency.

  • 13
    0

    Dear Prof,

    I have also observed the same in ward no. 25 in Kalubowila teaching hospital. Of course the cleanliness is much better in Kaluwila hospital, however the treatment received by the in-patients from the doctors, nurses and the attendants is the worst I have seen. In fact, the patients are treated like sub humans, just like the Nazis treated the Jews in concentration camps.

    The main issue is that the attitude by nurses and doctors towards the patients. These poor souls are treated like stray dogs purely because they can not afford to pay in the private hospitals.My father in law was admitted to this ward. However he wanted to be discharged and stay at home so that he can die with some respect and peace.

  • 5
    1

    Good of you to have taken the trouble to make this exposure, Lasantha. Why not send it to the newspapers like Island. They are sure tp publish it in the public interest

  • 4
    6

    Taraki, Gota & his cronies were in charge of these facilities for the last 10 yrs but nothing was done. So why do you think things would change now?

    • 6
      1

      SIRISENA was the Health Minister.

      • 4
        3

        Good one! Sirisena’s governance has not improved since his days as the Health Minister!!! Everything is ‘jaramara’ as usual!

  • 8
    0

    What the good professor is pointing out are the gross deficiencies in the infrastructure, and the failings in their maintenance. These are dependent on funding by the government. The present President WAS the Health Minister of the previous government, and was as successful in that role as he is as President. The ministers had the reputation of laying foundation stones for future hospitals merely for the photo opportunity without actually funding the projects.

    He has not criticized the doctors, nurses and other personnel except to say he observed cannulae being inserted within sight of other patients, a procedure that is seen commonly undertaken on the roadside after accidents in any country by paramedics. However, there is no getting away from the fact that free medical services provided to the general public in Sri Lanka have deteriorated immeasurably over the years.

  • 3
    0

    Dear Prof,

    I appreciate your thoughts about Sri Lankan Hospitals. But I don’t know why others take politics in to this. These hospitals were like this when Maithree was Mininster of health. These were in the same condition when UNP ruled our country. So who ever rule the country, the people who use the public property should also be thoughtful about cleanliness.
    There are incharge nurse matrons and doctors in a ward. They should be vigilant of these.
    Anyway we can’t expect the same standard as in a developed country, where they always use disposable things whenever possible.
    I have seen many people just wipe their hands on walls, they spit on the floor, we should train our people to keep our own place clean. I understand that they are patients, but we see patients in developed countries are so careful about cleanliness even if they are I’ll.
    I think there is no relation ship with tidiness and poverty, we should start from the schools to train kids not to litter every where, keep things in Oder, be clean and tidy.
    We have good morals I think compared to other nations but same time we lack certain things. We should try find solution for ourselves without putting all the blame on politicians. I am pretty sure all who accuse politians would do the same if they become politicians. We should start from inside, from family. That’s the massage should go to public.
    If not all will blame the politicians, but nothing will be changed, only the ruling party.

  • 3
    0

    I don’t believe Lanka hospitals ( formerly Apollo ) is much better. For the high fees they charge the quality of service is abysmally low. The premises are mosquito infested–even in the day, especially the OPD and X ray areas. They are grossly overstaffed and I don’t mean doctors and nurses — lots of support staff, useless and incompetent men and women with an indifferent attitude channeling patients and manning the information counters. Visitors are shuffled around with little regard for their condition. Try getting a pathology report from their laboratory–it’s a nightmarish experience. I underwent an OPD surgery process and as soon as I was out of the OPD OT, I was walked to the OPD cashier to pay for my surgery. I was then given the operated tissue sample and asked to submit it to the pathology laboratory. After waiting in the long pathology queues to make payment I started to feel dizzy with pain as the effect of the anesthesia started to wear off. Then another queue to hand over the actual sample. By this point, I had spent almost 2 hours in the hospital post surgery and the effects of the anesthesia had totally worn off and I was in acute pain. This is heartless, why can’t they have a procedure to have the tissue samples directly sent for pathology testing rather than have the patient personally submit it–that too immediately after a surgical process. Callous and uncaring. It is my personal opinion that the quality of service was much better when it was managed by Apollo hospitals. The drastic overall difference is very visible.

    • 2
      0

      Very true. Expecting a surgical patient to transfer the pathology sample to the labs is beyond despicable. Lanka hospitals are unfortunately overstaffed (at non MBBS/MD level) with rude and incompetent “nurses”, far from clean and offer very poor service. One bright spot in this hospital is the set of admitting doctors and the house-officers; these are young MBBS doctors who are kind, knowledgeable and efficient.

  • 6
    0

    I say “amen” to your article experiencing the horrible conditions of a teaching hospital. I am a foreigner and a couple of years ago had to be in the intensive care unit of a private hospital. I have mixed feelings of my personal experience. There are doctors who could care less for you and more for the fees they get just visiting you. There are also the good ones who really are true to their doctors oath to heal. The same is true of the nurses. Imagine a doctor or nurse inserting a catheter without gloves. They did it to me. I was so scared of the bacteria infected toilets that I had a helper who helped me with my toilet needs. I was shocked how nurses would turn on the TV -loud at 9.pm to watch their favorite TV dramas in the local language or early morning listen to their religious chanting in an intensive care unit.There was nothing more that I wanted than to return to my hotel and back to my country. I did with several pleas to a doctor only to find that I came up with a severe urinary tract infection.I travelled back to my country and visited my physician who immediately diagnosed that I had a pretty bad urinary infection that would have spread into my blood system and could have been fatal.I agree – the whole medical structure needs a thorough investigation. This is one area the government must step in to clean up the rot that has infected the entire medical profession and institutions in the country. Reward the good doctors and nurses and terminate a careless doctors license to practice.Close down the dirty hospitalswhich in your case was Ward 30. There are so many ward 30’s.

    • 1
      0

      It is true
      I have seen everything as a doctor too
      But politicians are responsible for most of it..

  • 5
    0

    I am in full agreement that excuses about a lack of public funding has no credibility nor public sympathy when colossal amounts have been squandered on projects which have almost zero public utility, and as commentators correctly observe, merely pandered to tyrannical egos.

    A rather submerged fact in this state of affairs is that medical professionals seem to want the present status quo to be maintained, as many do private practice outside the public health system, and earn exponentially greater amounts than their austere government salaries.

    If the public sector facilities were world class or in line with WHO guidelines in basic care which is the right of every citizen, they would lose the lucrative private practices and consultations at private hospitals.

    Therefore, together with major shareholders of private facilities, the government practitioners benefit from keeping a healthy number of citizens perpetually dependent on the pharmaceutical, pathology laboratory, electronic diagnostic and surgical facilities turning over at a brisk pace.

    If one considers the numbers of sick people in Sri Lanka, they would be at an all-time high level in proportion to population growth, with record profits in the medical insurance industry and pharmaceutical industry, with a presumably major contribution from poor public health.

    The pathetic conditions in public hospitals helps to keep the private facilities running very profitably as they fleece the vulnerable with impunity. If conditions changed in favour of the people, the aforesaid business profits would surely fall, as a much larger section of the general population would stay with the public system.

    Think about it.

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