20 July, 2017

While There’s Life, There’s Hope

By Emil van der Poorten

Emil van der Poorten

Having been castigated for being a prophet of doom and gloom insofar as the future of the Resplendent Isle is concerned, being subjected to recurring abuse accompanying the allegation that I am simply a “disgruntled victim of the great Hector Kobbekaduwa’s Land reform” etc. etc., it gives me a bit of satisfaction to document a ray of hope in the murk that is Sri Lanka today.

As someone who underwent the travails resulting from a Specialist’s “outsourcing” of what was allegedly a “less-than-surgical procedure” in a premier teaching hospital, no less, it gladdened my heart to hear that the milk of human kindness has not dried up in every medical institution in this country.

To cut to the chase, I had, drawn to my attention, the case of someone who had  displayed the early symptoms of the current scourge of Sri Lanka – dengue fever. Consultation with a specialist physician resulted in warding at the Infectious Diseases Hospital (IDH) on the outskirts of Colombo.

This appears to be a more than pleasant surprise after the charnel house that passes for a Teaching Hospital and those who conduct its affairs in the hill capital.

Initial admission was into a ward packed to the rafters (almost literally!) with other dengue sufferers and resulted in periodic bed-sharing episodes. This sacrifice in comfort and privacy was unavoidable in the hospital’s effort to deal with a crisis situation with totally inadequate resources.

The cleanliness of the ward left little to be desired, the toilets and bathrooms were clean and the showers had water pressure that would have been the envy of most Colombo homes!

I’d like to believe that, even in a system that is so critically under-funded and where our so-called leaders don’t hesitate, at the drop of a hat, to take off for places such as Singapore and the United States at the first suspicion of serious illness, there are still some medical practitioners to whom the Hippocratic Oath is more important than money in the bank or the next world cruise funded by some multi-national drug giant.

As someone who was at death’s door for nearly a week thanks to the botching of what was supposed to be a “simple non-surgical procedure,” thanks to medical “outsourcing” and who on several mornings woke up in a bath of urine, thanks to the fact that the staff ignored requests to leave a urinal within reach of one whose thoracic cavity housed a stainless steel “heart repair kit” which wouldn’t brook anything resembling a twist of the upper body, it certainly gladdened this heart to see what appears to be a light at the end of the tunnel of death and despondency that is Sri Lankan medical treatment today.

I have gone to great lengths to document my own experience because it is in such direct contrast to what seem to be the conditions prevailing at the Infectious Diseases Hospital, operating under the additional stress of this country being in the throes of an unprecedented outbreak of a mosquito-borne disease the treatment of which is still very much in the exploratory/development phase.

The foregoing is meant to be but an acknowledgement of the fact that all is not lost in terms of humane conduct by skilled professionals, working under the most trying of conditions in this country. Conditions at the I.D.H. are not perfect.  However, the contrast between similar institutions and this one should be patently obvious.

What else can be done to publicize and capitalize on this seemingly exceptional situation? Public acknowledgement such as this little piece needs to be replicated whenever one comes across medical practitioners and the administrators of medical institutions who are driven by concern for those in their care rather than how much each patient is capable of contributing to his/her bank account.  There have to be stories out there similar to this and those aware of them need to place these acts of decency and concern for one’s fellows on the record. We must keep the flame of human kindness burning.

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    ” Milk of kindness has not DRIED….” Yes and hope is there, because we still have LIFE. Did you hear of the “Amazing” surgery that was performed at the Galle, Karapitiya Teaching hospital. A man who makes a living by “tree climbing” fell off a tree from the height of about thirty five feet and hitting a fence, a stick (giliceedia) of five feet in length pierced through his thigh. He was transported to this teaching hospital in Galle from Angunakolapelessa with the stick hooked on to the leg. A team of doctors headed by Dr.Udesiri, immediately went into action and after hours of performing a laborious surgery removed the stick and saved this 55 year old man who made a living by tree climbing. That “Milk of Kindness” coupled with “talent” and “expertise” of that team of medical personnel saved that man. This man from the village of Usweva in Angunakolapelessa would never have even heard of Singapore; but he named Edirige Surath is among us and said “Thank You” without being called upon to pay “millions”. So we have HOPE.

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      What of the God Doctor Gamage?

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    Thanks; Emil. you ve described it so beautiful. Not just in health sector, rural poverty in across the country had been forgotten by Rajapakshe biased media. The message sendt out to the world was as if it came out from LONDON. Reports prove over 40% live under poverty not even having 2 dollars of incomme per day. Can you imagine ? I wonder why they the politicians waste the funds for purchase of super luxury vehicles ( 300 to 400 Millions each) while 5- 6 million worth vehicle can do the same job in a country with carpeted roads today. If I wanted, I could afford a vehicle worth 5 fold more than the current one. It is the attitude of people. I think the kind of huges wastages can easily be curtailed.
    I am not living in the country but in Europe. My vehicle is not even 5 millions (50 lacks in rupees). I question why lankens allow their law makers to waste the tax payers funds this way ? If law makers could curtail the costs in 40 fold, the sums could better have been used for the upliftment of the poor. Thanks to SIRASA gammada, now we know there are lot more in the country who are not even accessed to proper clean water which is the cheapest food item of the people.

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    The doctors working in public hospitals in Sri Lanka have to work under trying conditions. A few years ago, I had to go to Peradeniya teaching hospital with some breathing difficulty. Though I went there with the knowledge and assistance of a relative who is a physician working in the same hospital, I was kept in the OPD for a couple of hours until an ECG was obtained and checked. I was asked to sit on the side of a hospital style bed. On the other side there was a person from a far away village. In the opposite bed,there was a university undergraduate with some tummy ailment. He had come prepared with a pillow,slippers,a towel,and toothpaste etc. around me were many women,elderly,men amounting to about 20-30 in the OPD. A nurse came and checked me after checking other women etc. I took my turn. Finally I was allowed to go home after the ECG results came. But the manner the staff have to manage patients from distant places each with unique stories is not easy. Thus you become a number not necessarily because of the attitudes of the doctors. They are doing a job. I didn’t and even couldn’t even imagine the situation in the toilets. I was there with the peasants and the rural folk. I thought to myself how much of trouble they took to come by public transport in the hope of getting treatment.Each of them had a card detailing the consultations with specialists and medications prescribed. I think the President and ministers should stay in a hospital for a few days to experience the pressures doctors and patients go through. Then go to Singapore and USA for a holiday,,

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      All these prove that the lanken health sector must be invested lot more than they have done sofar.
      Even in UK, the standards seem to be no comparable to that of Germany, Austria, france switzerland and several other EU states. The problem is UK too, belong to the category with free health. Germans pay lot more to their insurances, each and everyone must be entitled to National or PVT insurances. Those who would not have to face trials.
      The law in terms of HEALTH is held above anything else.
      I think, srilanka cant afford free medicine for the decades to come. People should slowly line up to get this.
      What bothers me is, there are problems not being able to manage proper systems for the doctors available in the country. Latter is what I heard lately from few of my friends. If you would go to Badula or any other hospitals, youw ill se the availablity of Doctors but most of them would not be under pressure as seen in Germany, UK, or any other places.
      Nurses are not well trained to do the job yet. They talk about high even today, proper trainings are far from the prevailing systems.
      German doctors for exmaple dont allow their nurses to collect the blood from the patients. They themsevles are the ones to finalize discharge letters. From dawns to dusks, medical doctors are under pressure as no other. May be the disadavantage of health insurance system. However, patients are kept above than the status of the docs. Every patient is given the right to choose their speicalists. No such channel doctors in German health systems. Specialists are plentily available.

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    The general attitude of the Health Dept: staff has changed for the better which is most heartening, and the dedication that they are working with, despite all the shortcomings that they have to put up with, (Thanks to the crooks who swindled this country) needs the highest commendation.

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    Good of EvdP to take time to salute the silent numbers that make life bearable. Yes, there are many who stay true to the Hippocratic Oath they took at graduation (unlike the appreciable few who swore the ‘Hypocrites Oath’.)

    It is right that as much as we expose the one, we should thankfully remember the other.

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    As my old man said, Land Reform was one of the most iniquitous laws passed hurriedly as a result of the JVP uprising. Some sort of reform was needed but not the way they did it. Luckily after EL became Agri Minister, some of us were able to buy back a few acres lost. But you had commented on my personal biased view on my grandfather, but I can tell you that my grandparents completely opposed it and were very upset. But my mom and my uncle Monty, the loveable socialists and MP at that time used to have heated angry arguments defending it. In case of my own Grandfather he worked hard to make his land productive in Dullewe off of Matale. He was man who had to build his wealth because of a wasteful useless Step Father after his own father died very early in his life. So I am not sure what you wrote on my biased personal commentary about a man who carried himself in public and private with equinamity, but I appreciate you writing under your own name. So I am returning the favor. JR got back a lot of his lost land and that helped others and their Trinity College friendship and network helped my father and few to buy back some of the land that was seized. More later,,Father’s day and my daughter is yelling at me to go to the movies. Cheers old chap.

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      Interesting disagreement, particularly since it seems to have broken the mold of irrelevant abuse that often greets what I write!
      Would like to be in personal contact with you and, if you wish to do so, you can find an email address that will enable contact on the internet.

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    The writer has been very kind in his praise of the few acts of mercy still heard about, in the matter of public health in Sri Lanka. It is quite true that doctors in hospitals work under trying conditions in saving lives and healing the sick and wounded. I can name a handful of them myself.

    However, the tragedy is rooted elsewhere. There is a culture of selfishness, opportunism and exploitation in society that has been exacerbated by the prematurely introduced free market system in the late 1970’s.

    Successive governments have had the problem of keeping the doctors who were trained free of charge, in the country to return their obligation in the service of the poor, whose money, in the form of taxes on consumer goods, goes towards funding free education.

    In that endeavour, private practice has been facilitated. This is largely unregulated, in that there are no limits on how many patients one can see in an evening for fees ranging from about Rs 1000-Rs 3000 per consultation. So, many are the practitioners who submit to the vice of greed, and see 50-60 patients in a matter of 4-5 hours. Private hospital charges are another sore point again. Most patients can ill-afford these prices, yet have no alternative, given the scenarios described by the writer.

    I have outlined in explicitly vivid detail, my own horrific experiences at Ward 30, Kandy Teaching Hospital in 2015, in an article on 27th July in Colombo Telegraph. I believe these conditions still prevail in many hospitals.

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      Lasantha Pethiyagoda:
      I would appreciate a copy of the article you had published on July 27th 2015 because I intend writing a series of columns on my own unbelievable experience in that hospital.

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