News

It is a Friday and the Kuliyapitiya Base Hospital, the largest under the purview of the North Western Provincial Council, is crowded with patients. Three surgeries are being performed in the so-called ‘operating theatre (OT) complex’ of this 590-bed hospital and the scene is disturbing.

Dr. Imbulpitiya

While the main OT doors are wide open to the outside environment, there are water-puddles at the base of these doors and parts of the walls are covered with fungus. The tiny side-room which doubles-up as the other OTs, with two beds there, has no ceiling lights essential for surgeries, while there is hardly any space for the surgeons and attending staff to move around.
Just outside the OTs are patients in their caps and gowns awaiting surgery, seated along an open corridor.

This is not the only malaise gripping the Kuliyapitiya Hospital which caters to a large number of men, women and children, it is learnt. As the hospital turns 100 next year (2014), there is no dearth of specialities for it has two each of Surgeons, Physicians, Gynaecologists & Obstetricians and Paediatricians. The sub-specialities are also available as there is an Ear, Nose & Throat (ENT) Surgeon, Eye Surgeon, Oral Maxillo-facial Surgeon, Anaesthetist, Dermatologist, Radiologist, Pathologist, Psychiatrist and Judicial Medical Officer, the Sunday Times understands.

In an important location, 46kms from the Kurunegala Hospital as well as the Chilaw Hospital, the Kuliyapitiya Hospital has been neglected for decades, says Consultant ENT Surgeon Dr. Nilantha Imbulpitiya who is the Government Medical Officers’ Association Branch Union President.

Dr. Imbulpitiya is puzzled over where the problem lies, but feels that this Type A Base Hospital is too big for the Provincial Council to handle, as it cannot fund it. Both Kurunegala and Chilaw Hospitals come under the central government’s Health Ministry.

Pointing out that the number of Consultants at the Kuliyapitiya Hospital has trebled over the last three years, he laments that the infrastructure, however, has not developed to facilitate their work. The OT is “very old”, the Sunday Times is told and it has only one “proper” operating bed. The renovations as far back as 1976, 37 years ago, were only to accommodate a Surgeon and a Gynaecologist & Obstetrician.

With the workload of the OT trebling and even with 30-35 ‘casualty’ and ‘routine’ surgeries being performed daily, there is a long waiting list for routine operations, points out Dr. Imbulpitiya, adding that sometimes patients have to grin and bear for about five months.

The casualty list includes road traffic accident and assault injuries, appendisectomies, wounds and emergency caesareans while the routine list includes laparotomies, thyroidectomies and mastectomies.

The OT cannot be sealed as the doors don’t close properly, so how can the Consultants ensure sterile conditions, he asks, explaining that the air-conditioning fails and dust and flies are everywhere. The central AC is not adequate and there is no proper lighting system.

Another life-and-death matter is when the electricity goes off but the back-up system takes as long as five minutes to come on. “We have to stop operations for five minutes and if the patient is on a ventilator, there has to be immediate manual intervention,” he says.

The other two so-called OT beds are in the corridor and there is the danger of infection, including from the sweat pouring down our faces into open wounds, says Dr. Imbulpitiya, painting a grim image. “The availability of only one proper OT table means that if a surgery is underway and an emergency caesarean case is rushed in, the make-shift bed has to become the OT table.”

The woes of the Surgeons are many, the Sunday Times learns. Citing the example of a routine thyroidectomy, he says it is a clean cut and patients don’t need antibiotics. But there have been instances when they have to prescribe antibiotics as the wounds have got infected.

If there is an infection, the Consultant who performed the surgery will be blamed and no one will look into the deplorable conditions under which he is working, he says. The surgeons’ changing room without any cubicles and no space for two people to fit in, is also pitiful.

The tragedy lies in the fact that in a five-storey ward-and-theatre-complex completed several years ago, the wards are occupied but the four OTs remain closed, except for eye surgeries. This is due to the lack of central AC, surgical instruments and equipment and vital anaesthesia machines with ventilators and also a dearth of nursing staff.

The plan for this building had not included central AC, the Sunday Times learns, which brings to the fore the obvious question as to who passed the design and why payments were made for such slipshod work.

There have also been complaints about the simple measures that should be in place at a hospital for waste disposal. The hospital has a white elephant of an incinerator atop the five-storey building and whenever there is incineration, unburned particles and ash float down to the Paediatric Ward, according to Dr. Imbulpitiya.

It would be laughable if it was not tragic that an incinerator which should be installed away from wards has been placed right on top of a five-storey complex, he says. The list of shortcomings gets longer. There stands another building constructed as storage space for drugs and medicines and to house the laboratory as well as the pharmacy. Instead, hordes of pigeons have taken over, with anyone going into the building if they survive the overpowering stench will be wracked by an asthma attack. “This building is under-utilised because no one took into account the threat posed by pigeons,” says Dr. Imbulpitiya.

Reiterating that there is a waste of skill, due to lack of facilities, equipment and space, he adds that the consensus at the Kuliyapitiya Hospital is that the central government’s Health Ministry should take it under its mandate and nurture and foster it to its full potential.

Medical Supdt. makes brief comment

Numerous calls by the Sunday Times to the Kuliyapitiya Hospital Medical Superintendent Dr. S. Arambegedera, were futile as he was busy.

The only comment he made was that the shortcomings of the new OT, which was a central AC would be rectified shortly. Such matters take time, he added.