Ward 8 in Sri Jayawardenapura Hospital – a symbol of humanity and hope
With the dawning of the New Year it became clear to me that my first task in this New Year, 1999, must be to capture my most outstanding memory of the old year, 1998, for the sake of those who may value a symbol of humanity and hope to lighten the increasingly darkening horizons of the present day. It might also serve to encourage these who valiantly try to emulate the highest standards of excellence in their profession or vocation, despite rapidly falling standards of many others around them.
I spent about 3 weeks in April 1998 in Ward 8 of Sri Jayawardenapura Hospital, Kotte. I was operated for umbilical hernia, which is not a major operation, but due to complications caused by flu and a cough caught in the ward (not a nice thing to happen to one who has had a cut of 9 stitches down his stomach!), swelling of the prostrate gland, catheterization, and recurrence of haemorrhoids (which I thought I had long since overcome by meditation!), I had to face a fair amount of pain, had quite an anxious time and was in need of good medical attention. This I received in very good measure and I would like to record some of the details of this story and of the Ward 8 as a whole, especially some examples of the human touch which make such a difference to those in pain and anxiety.
I wanted to write this as soon as I left hospital but due to pressure of work was unable to do so. I would have given up the idea but then I came across three articles in the newspapers within about a month, in which the writers related nasty and tragic occurrences and conditions experienced by them in hospitals. The first article was entitled "National Hospital or Belsen Camp?" (The Island - 25.10.98). It speaks of "gross negligence on the part of the doctors and the supporting medical staff of the National Hospital" "This is a classic example of wilful neglect by the doctors in the O. P. D. and that ward". The second article had the heading "The Angoda Inferno" (The Island - 01.11.98). It details over-crowding (annual average of 10,000 patients), lacking a proper water-supply, blaring noises in the vicinity and inadequate living - quarters of para-medical. The third article had the heading "The Cancer at Ragama Hospital" (The Island - 27.11.98). Four deaths after surgery led to much controversy, the indications being that there was misadventure. The last of these cases to die after operation was a woman who had a Caesarean operation. Both mother and the infant died. There was a terrible aftermath: "To add insult to injury, her body which was lying on the bare floor of the mortuary left hospital sans the left ear which had been eaten by rats that frequented the mortuary. The Director of the Hospital confirmed the story of the earless body". This is a really awful record. However, it must also be mentioned that the writers of the articles tried hard to be fair. The first writer wrote "Let me hasten to add that not all doctors are morons like those who were in Ward 47 A that day. There are thousands that are dedicated to their profession and are most sympathetic and humane in the treatment of the sick in their care". The second writer mentioned a Committee that was valiantly trying to improve matters. The third writer mentioned the effort of the local Pradeshiya Sabha to improve matters.
So much has been written and said about the faults and weaknesses of hospitals and those working in them that I felt I must put down on paper my story of Ward 8 in Sri Jayawardenapura Hospital, which shows another side of things. It demonstrates the resilience of people in general, the determination to preserve their humanity in the face of the deterioration and dehumanizing of the social system, the steadfast attempt of so many medical personnel to maintain the highest standards of excellence, despite falling standards all around them, the surfacing time and again of natural feelings of compassion and service for those in pain and need.
Now one of the things one looks for most in a hospital is cleanliness, and especially in the toilets. In this respect the highest possible standards were maintained and the toilets were kept spotlessly clean. Here, one must also mention that it was a non-paying ward, with only a nominal payment, which, however, was not levied from the clergy. Obviously, many persons deserve credit for this high standard, for in all these matters it is collective work that counts. But I feel I just must record what I saw as an extra-ordinary example of one person. And though I have decided to keep names out of this article I feel I must mention her name. She was Iranganie. It was Sinhala and Tamil New Year’s Day, April 14th. Two cleaners who normally shared the clearing of the 48 - bed Ward had gone off on holiday. The replacement, who must have come from some reserve force, was Iranganie. She set to work with brush and pynol. There was something about the way she set about the work that drew me to watch her intently, though without letting her know it. She was so utterly thorough and quick, non - stop, reaching out to the furthest corners, not missing an inch or the smallest scrap of paper or any other particles. There was, of course, no one supervising her but she did a perfect job and she seemed so cheerful right throughout.) Am sure she would have done the same with the toilets, though I was not able to watch that. Quite marvellous! May be the humblest link in the chain but how important! Actually, there are so many people like her who do their own little task so well but go un-noticed and are thus under-valued! But there are always some people who spoil things. There were may be one or two patients who always insisted on washing their plates with all the left-over food particles into the normal sinks, though there were special receptacles and special sinks and flushes for that purpose. The notices put up were faded and so were disregarded. As a result one sink had gone out of order for the whole period I was there and other sinks also were affected from time to time. Evidently, there was no prompt and effective repair services. This is a weakness that could be remedied. Also perhaps patients should watch each other and, when necessary, advise and correct each other!
Then I must mention the nurses. There was a good standard of skill and care. But here again I would like to mention one particular example that was extra-ordinary. Veritably, a characteristically Sri Lankan version of Florence Nightingale! May be she was not a charismatic or forceful personality as such, as Florence Nightingale must have been, but she had an unfailing gentleness and patience in everything she said and did. She was fairly small- made and somewhat dark - skinned, with a lovely smile which was the same for all she attended on so skilfully, so modest, soft - spoken and self-effacing, she would be surprised and, may be, embarrassed at being singled - out for special commendation! I did not get to know her name, otherwise I would have mentioned that too!
The male nurses and attendants also were good, on the whole, though they could not always respond to the many calls on their services. At night, especially, there seemed to be a shortage of attendants. Sometimes, patients had to respond to the call of fellow - patients and this, to some extent, made up for what was lacking.
With much regret, I must mention one unfortunate episode. There was a young man brought in one night with acute suspected appendicitis. He was given some temporary relief until, may be, there was definite diagnosis and the operation could be done. Late the next evening he was in acute pain and calling out. A doctor was called in, prescribed some treatment and left. But it was dinner - time for the nurses and they trooped into an adjoining room for dinner without attending to the patient. The young man was in agony and was desperately calling out loud and long! But the nurses were oblivious to all this, evidently enjoying their dinner. All the others in the ward were helpless, mentally sharing in the young man’s agony. At last, after over half an hour, the nurses calmly emerged, in a minute did the needful, as the doctor had prescribed, and the young man’s agony was eased. This, we felt, was real callousness, plain and simple!
Then I come to the Surgeon - in - Charge. He was the Kingpin! Everyone looked up to him with awe, admiration and even veneration. Obviously, he set the tone of the whole place. There was a prominently displayed prayer or slogan, as it were, in the office - of the Ward: " Lord grant me the serenity to accept the things I cannot change; the courage to change the things I can; and the wisdom to know the difference." That was real depth, I thought. He was a man of few words, with a quiet sense of humour. Actually, I knew he had played rugger for Royal College. I myself had played cricket for Royal many years before his time and he would have known it. I thought we would at some stage discuss sport! But it was not to be ! He treated me exactly like any other patient, possibly with even more reserve. He could be quite brusque at times. May be he was somewhat in awe of me as I was of him! Anyway, I had complete confidence in his skill and care. At times, because of my age, my condition gave some cause for anxiety, there were some complications, and I suffered quite an amount of pain, but ultimately, with some skilful remedial treatment, I came through alright.
Here, I must specially mention the anaesthetist. As I was wheeled into the operating - theatre and placed on the operating - table, she asked me: "Would you like me to say a prayer?" Now I happen to be a clergyman and it is not often that a lay person asks to pray for a clergymen! So I said: "Yes, please do". Then she repeated some verses from the 91st psalm, starting with one of the loveliest verses in the book of psalms:
"He who lives in the shelter of the Most High,
Who lodges under the shadow of the Almighty,
Says of the Lord, ‘He is my refuge and fortress,
my God in whom I put my trust"I followed it intently and at the end said: "Amen. Thank you" Evidently I was quite calm. Actually, I had been given a sleeping tablet in the ward and must have been more or less unconscious when she spoke to me, but I came out of unconsciousness just enough to respond in faith to the prayer. So I was in the best possible disposition to respond to the operation and the consequent healing process.
Next, I must refer to the team of six house -officers—three women and three men. The senior one, who was the head, was a pretty petite woman but quite tough and obviously found no difficulty in establishing her authority over the three men who were all tall well - built steppers! Honestly. Believe it or not, the whole team, without exception, could not be bettered for sheer charm, polish, competence, hard work and efficiency! They were, obviously, closely following their role model, the surgeon-in-charge! Several of them attended on me personally during my stay in the ward and I appreciated their skill and advice. I have taken down all their names and will always remember them, though it is not necessary to reveal them here!
And there were about eight medical students, male and female, who were having ward - training. Their role-model was the team of house - officers and it is amazing how infectious - charm, polish, competence, hard work and efficiency - is! They were given long, informal and intimate lecture - discussions in the ward by two or three of the house - officers and did rounds in the ward with them. Then, on their own, they would examine the patients at great length, taking copious notes. I loved watching them doing this with utter seriousness and utmost courtesy! It was all done in a very human and humble way. I felt really proud of our young Lanka! The patients went through the process with patient indulgence! I myself looked forward to a real long examination but, unfortunately, I was dealt with quite cursorily! May be they were somewhat scared of me ! I had a chat with them before I left. I told them how much I appreciated their gently, serious, humble and human approach to the ordinary people. I said: "I hope you will always retain these qualities! Sri Lanka needs them very much!".
So now I have come to the end of my little story. For me it was really memorable and I hope my readers will catch something of the excitement of it and what it means for Sri Lanka! I dedicate it to all those in the medical profession, at all levels, who strive to maintain high standards of excellence and above all, the human touch, in their work and service to suffering humankind, in the midst of much discouragement and despair.
A Grateful Patient
An open letter to the Chief Minister, WPC
Let me congratulate you, Chief Minister, not for any spectacular achievement gained by you or your political party at the recent Provincial Council elections, but because the position of Chief Minister WPC has been thrust upon you by the sheer generosity of the law that provides two bonus seats to the political party that has a slight edge over the next in line. But for that generosity of the law, you as everybody else fully well knows that the real position is 44-44-8. The Janatha Vimukthi Peramuna with its eight (8) seats in your Council has been described as the "Kingmaker" and that your position is totally dependent on them (JVP). Nothing is further from the truth. The eight JVP members alone cannot oust you from power unless they get the UNP membership also to vote against you. The UNP, however, led by a gentleman among gentlemen par excellence of the calibre of a personality like Karu Jayasuriya, will consider such a move only if you do not deliver the goods. And it is to that matter that I now wish to draw your attention.
Judging from what the man on the street says about you, from what you have stated on public platforms and over the print and electronic media, you appear to be a well-intentioned politician with justice and fair play to all uppermost in your mind. That is natural as an Attorney-at-law. But, Chief Minister, you are aware that even hell is paved with good intentions. Good intentions alone will not be good enough.
I would like to draw your attention to an advertisement that you had placed in the Yukthiya newspaper tabloid. Translated into English, it would run like this: "We have not wasted one copper coin of the Council’s money. Is that not enough?" (Yukthiya 4.4.99) Now, Chief Minister, voters elect politicians to a Council not to go and waste money. Their prime and most sacrosanet duty is precisely not to waste money. And then that rhetorical question "Is that not enough?" Takes the cake, the baker and the bakery. That simply is not enough.
And that brings me to the crux of the matter: What have you done during your four years as Chief Minister WPC during your previous incumbency? Several Municipal Councils came under your purview and supervision, the most important among them being the Colombo Municipal Council and the Dehiwala-Mt. Lavinia Municipal Council. Thanks to its former exemplary and efficient Mayor, Karu Jayasuriya, Colombo Municipal Council had achieved a rare degree of efficiency and excellence in its administration of affairs. But in contrast look at the utterly inefficient, third-rate manner the Dehiwala-Mt. Lavinia Municipal Council is conducting its affairs. Every single road and lane maintained by this Council is in a dreadfully shocking state of negligence and disrepair for the last two years or more, yes, during your previous tenure in office as Chief Minister. Just drive down any of these roads and lanes and have a look for yourself. If after such a drive the shock-absorbers of your official vehicle still remain in good order, please be so kind as to let me know the brand name of those shock-absorbers.
Although your Council may not be directly involved, and strictly not within your purview, is the widening of the Kawdana Attidiya road. The widening of this road commenced nearly three years ago and abandoned half-way, from the Kawdana Post-Offic and beyond. The residents living on either side of the road that is yet to be widened, have pulled down their parapet walls, demolished parts of their residences and may have been received compensation from the Government. But for some mysterious reason, the road widening has come to a complete standstill. Of course, you have every right to dismiss this matter as not coming within the purview of the WPC. But as Chief Minister, within whose area of administration this main road runs, the least that you could have done was to make inquiries from those responsible especially the amiable Minister of Transport and Highways himself who belongs to the same political party as yourself, why this kind of farce is foisted on the voters. There are some who have expressed the view that the widening has stopped owing to ethnic reasons. Perhaps you may know what that means. I don’t. Naturally all this has affected the Member of Parliament of the area and a powerful ruling party (Your own party) Cabinet Minister who failed to retain his seat electorate wise and even the adjoining seat was retained by the skin of his teeth. And as for you Chief Minister, while you received some 162,000 votes, your rival in the Opposition Karu Jayasuriya received almost double that number 250,000 odd votes. Why? I do not wish to embarrass you with an answer.
You see, Chief Minister, today’s voters are not just country bumpkins who can be taken for a ride, as is clearly manifest from the pattern of voting at the recently held elections to the five Provincial Councils. And I hope you have noted that every Cabinet Minister suspected of having a hand in highway robbery of votes thuggery and rigging at the notorious Wayamba Provincial Council ‘elections’ have lost their seats electoratewise to the UNP. You can fool some of the voters all the time, all the voters some of the time, but if you think you can fool all the voters all the time, then you are living in a fool’s paradise.
All this, Mr. Chief Minister, has been said in a spirit of constructive criticism, because as a person, I still have my respect and regard for you. You have so often gone public in vowing that you will, under your administration as Chief Minister, make the Western Provincial Council an exemplary institution. The proof of the pudding is in the eating.
D. L. V. Chandraratna
The People’s Money
Your Defence Correspondent, writing in your newspaper on Sunday 16 May, states that President Kumaratunga has informed the Armed Services Commanders that she will not allow a supplementary estimate to their 1999 budgeted allocation. He quotes the President as stressing the need for fiscal discipline in every government department.
Not being one of the cognoscenti of either the defence establishment or the arms trade, I must assume that your Defence Correspondent has got this right. If so, this would represent yet another illustrative instance of the President’s selective application of precept and practice in governance.
Less than a month ago, at the beginning of only the second quarter of this financial year, her Foreign Minister went before Parliament to seek a supplementary allocation of Rs. 175.7 million, over and above the budgeted allocation of Rs. 1.9 billion plus which he had received at the commencement of this FY. He cited three reasons in support of his request: the need for extra staff, the need for some diplomatic property abroad, and the need to improve his information services. He received Parliament’s sanction, as expected. What was unexpected was the failure of the opposition to focus its attention on the core of the matter.
All three needs cited by the Minister could and should have been anticipated, projected, quantified and valued when presenting his annual estimate to the Treasury, at the end of last year. He did not identify any exceptional and unforeseen circumstances requiring an extra allocation for these purposes at this time. Sadly, the UNP’s spokesmen only alluded to the unconscionable disparity between the extravagance of the Minister’s supplementary request and the parsimony of the Government’s grant of relief to those devastated by the widespread floods at that time.
There are of course pointers in the public domain to possible other reasons for the Minister’s sudden need for more money. The independent English language print media had reported over the past weeks, such probably unanticipated charges against the exchequer as those arising from the diversion of long-haul carriers of the national airline across the Atlantic to ferry delegates attending an international meeting at a tourist resort in the Caribbean, the staging of a routine regional meeting at an expensive holiday resort here, special emissaries flying around the globe to canvas a Sri Lankan candidature for an elective international post, and so on.
Is one to conclude then that the moral of this tale is that fiscal profligacy is acceptable from the department of government (Foreign Affairs) which makes the least discernible contribution to the GNP, whilst others, including that (Defence) which makes the largest contribution to the protection of people and country, must exercise fiscal discipline?
Tudor Wijegooneratne
Colombo 8
An Appreciation
Percy SamaraweeraAn eventful life of a colourful personality ended on the 24th of March 1999. I had the privilege of being his classmate from 1945 to 1948 at St. John’s College, Panadura. I also had the privilege of being a member of the College first-eleven cricket squad together with him way back in 1947.
Percy was an all-round sportsman who excelled in cricket, football, hockey, athletics, boxing and swimming. I vividly recollect how he saved St. John’s from the ignominy of an innings defeat in our rival cricket match against Prince of Wales in 1947. Coming at the fall of the eighth wicket, he kept his wicket intact till the match ended on the last day, and during his stay at the wickets, he brilliantly dispatched three balls to the fine leg boundary in a single over. This enabled us to draw the match.
He was elected to Parliament in 1965 from Welimada defeating K. M. P. Rajaratna, leader of the Jatika Vimukthi Peramuna, who had represented that seat from 1956 and who was considered to be invincible. That defeat led to Rajaratna being sent to the political wilderness for ever.
The "Daily News", reporting the results of this election referred to Percy as the "Giant-Killer".
When we were students at St. John’s, little did we realize (including Percy himself) that Percy, the gay cavalier he was, would one day rise to the position of a national political leader. But his desire to serve his people was irresistible and he plunged into the mainstream of national politics, most of the time swimming against the current.
He came close to death on many an occasion in the course of his political activities, the closest being when he was critically injured following the bomb explosion at the Parliamentary Complex in 1987. He had his share of trials and tribulations as a politician, but he came out of them all with his determination strengthened to serve his people. The most striking feature of his life as a politician was that he never deceived or hoodwinked those who sought his help and sincerely and honestly helped them to the best of his ability.
The vast crowd that watched in silence as the flames enveloped his remains at the Badulla Stadium, bore more than ample testimony to his total and absolute dedication to the cause of the less privileged sections of the people.
May He Attain Nibbana.
Sena Jayawardena
Jawatte
Kalutara North