REPORT OF IMPRESSIONS GATHERED DURING MINISTRY OF HEALTH SPONSORED VISIT TO DH PADIVIYA AND GH VAVUNIYA

BY PROFESSOR A.H. SHERIFFDEEN, ACCOMPANIED BY DR. JAYALAL

All in all the doctors, nurses and minor staff together with the paramedical staff are doing a heroic dedicated service. They work almost 20 hours per day with the arrival of every new batch of patients which is once every 2 to 3 days! It is almost a miracle that the health of this staff has been able to withstand the trauma both physical and mental. The stories that the patients come out with are unbelievably tragic and will no doubt affect the health of the patients and staff treating them in the long term. They need to be protected.

Doctors interviewed: Dr. Bhavani Pasupathiraja, Medical Superintendent who appears confident and in total control of the difficult situation and appeared to command the respect of all grades of staff; Dr.Purupananda, MO Anaesthesia who was familiar with almost every patient in the ICU and wards, working well above the call of duty; Dr. Akhilan Registrar, Surgery who was confident and looked capable.

Conclusions: Sending extra staff is a priority. Whilst the logistics of this are being worked out, it is important that at least the equipment and consumables requested are sent as soon as possible so that the doctors working under trying conditions are made aware that the Ministry is listening to them and trying to help.

STAFF

Surgeons with SHOs work round the clock dealing with emergencies and infected wounds, resulting from delayed access to treatment. The delay is caused by the difficulty faced by patient in getting to a medical facility from the site of injury. Infected compound fractures are the rule rather than the exception.Extra MOs for Wards urgently needed especially since WHO and Pradesha Sabha  funded temporary Wards are coming up.

Anaesthetist  SRs support the surgical team admirably. They could do with extra medical officers in OT and more in the Wards.

Permanent orthopaedic Surgeon urgently required. External fixators required for the compound fractures.

EQUIPMENT & CONSUMABLES

• OT: Sutures 3/0 and 5/ Proline needed. Also needed are bone wax, Gelfoam and artery forceps of all sizes. Elastoplast and Micropore plasters needed in OT and Wards.
• ICU: Requires a Paediatric ventilator and 2 Monitors. Total Parenteral Nutrition (TPN) solutions are not available.
• Extra supplies of inotropes: adrenaline,dopamine, dobutamine needed.
• 3 way urinary catheters required especially for patients with haematuria.
• Path Lab: no facilities for Histopathology and Microbiology. The latter is urgently needed in view of the large number of infected wounds.
• Consumables: consumption of antiobiotics and analgesics very high needing urgent replenishment of stocks.
• Cefuroxime (intravenous) is not available and urgently needed.
• Other frequently use antiobiotics are Co amoxyclav, Ciprofloxacin, Metronidazole, Cloxacillin and oral Norfloxacin
• Children’s Ward requirements: Children’s clothes, basic washable toys, educational material.
• Nebulizer
• Consultant Physician needs the following: 4 adult and 1 paediatric nebulizers
• Calcium resornium sachets for management of over 100 patients in chronic renal failure. Initially 1000 sachets.
• Azithromycin 250 mg tabletsx 200
• Tramadol tablets 50 mg x1000
• Antibiotics and analgesics are consumed rapidly since over 90% wounds are infected

General: Packets containing the following will help: Plastic Mug/cup, Plastic plate, soap, sarong/sari/children’s clothes, male/female. Numbers are difficult to predict. An INGO supplies such packets on arrival. There are over 2000 patients in the Wards with another 500 to 600 accompanying persons/family/children in the Hospital.