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From VOA Iranawila to state-of-the-art COVID-19 Management Centre
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Medical Administrator Dr. Dimuth Ponweera flanked by some of his staff
A while ago, those travelling along the Chilaw-Puttalam Road at dawn would see what they thought were “red eyes” glinting and glimmering in the distance.
It was the Voice of America radio station at Iranawila leased by the Sri Lankan government to the United States of America set on around 500 acres with a network of roads, drainage canals, fences and modern office buildings as well as service connections to public utilities and onsite self-generated power.
Handed back to the Sri Lankan government in 2017, Iranawila which was in disuse has now metamorphosed into a state-of-the-art COVID-19 Management Centre for the Puttalam district which opened its doors on April 7.
It is from Medical Administrator Dr. Dimuth Ponweera transferred from east to west, from the Eravur Base Hospital, that we hear the minute details of ‘Operation Iranawila’. He was not new to the area, having been the Medical Superintendent of the Marawila Hospital for five years and also Acting Deputy Regional Director of Health Services (RDHS) for Puttalam for a brief period.
The state-of-the-art Iranawila COVID-19 Centre
“Iranawila is the result of excellent supervision, coordination and teamwork,” says Dr. Ponweera before casting his eye to the recent past when Marawila became a hotspot for suspected COVID-19 patients with a large number of people returning from Italy.
Both micro and macro-level planning was done simultaneously, he points out, explaining that while construction was underway staff training was initiated on site by Consultant Microbiologist Dr. Thushara Senanayake with practical training taking place at the National Institute of Infectious Diseases, Angoda, and the Homagama Hospital.
Two potential sites, the Madurankuliya Education Centre and Iranawila were identified with the support of Puttalam’s Deputy Inspector General of Police (DIG), Nimal Perera on March 18, for quarantine/isolation and treatment of patients. This had followed a meeting held at the Marawila Base Hospital which was a newly-dedicated isolation centre, being told of the limitations of space and concerns over disease spread there by Consultant Physician Dr. Chandana Abeysinghe.
The spotlight had then fallen on the Iranawila complex as a long-term plan for outbreaks of this nature, with Health Ministry Directors Dr. Sudath Dharmaratne and Dr. Priyantha Atapattu visiting the premises along with a team from the RDHS office and the Marawila Hospital.
A report had been submitted by the RDHS, Dr. Dinusha Fernando, to the Director-General (DG) of Health Services, Dr. Anil Jasinghe, with President Gotabaya Rajapaksa approving the project by 6 p.m. the same day and the keys to the complex being handed over to the DG who acquired the premises under the powers vested in him by the Quarantine and Prevention of Disease Ordinance.
Action followed soon after, with the Iranawila keys being handed over on March 23 to the Puttalam RDHS, Dr. Fernando, by Dr. Dharmaratne, the Project Director who represented the ministry’s Directorate of Healthcare Quality and Safety.
Dr. Ponweera says that a novel thing was that support for the project was forthcoming without reservation from the area’s political leadership, administrators, police, army, religious leaders and supply providers. Many doctors too from the area and outside provided their expertise including Dr. Abeysinghe; Puttalam Hospital’s Consultant Community Physician Dr. Thushani Dabrera; and Kandy National Hospital’s Consultant Microbiologist Dr. Mahen Kothalawala.
He pays tribute to the many donors who had also come forward to support this national cause and include Sri Ram Construction; Lalan Eco Latex Mattress; Independence Holdings (Pvt.) Ltd, Colombo; INSEE Cement; Orel Corporation; Lanka Tiles & Royal Ceramics Lanka; Weehena Farm; Hybrid Vehicle Services, Marawila; Asiri Group of Hospitals; and lawyer Lalantha Ranasinghe.
At the first Steering Committee meeting held at the Madampe office of the RDHS, a deadline had been set for the completion of the Iranawila project on April 7, with the Engineering Directorate of the army taking on the onerous task of seeing to all the constructional aspects.
Now the 40-bed Iranawila COVID-19 Management Centre opened on schedule on April 7 with a staff of 40 (medical, nursing and other) is fully functional.
| Why this Management Centre is unique The centre is planned in such a way to ensure maximum safety for the healthcare staff while being based on international infection disease management principles, Dr. Dimuth Ponweera tells the Sunday Times, detailing how both administrative (work practice) controls and environmental controls are in place. The administrative controls include: Management measures that reduce the risk of direct exposure of staff to patients; a safety control and patient communication room with intercom facilities, CCTV and patient monitoring system; a robot worth Rs. 1.2 million donated by Atlas Axilla (Pvt.) Ltd., to minimize staff exposure to patients when handing out medicines and food; and staff-patient communication conducted with the help of a video conference facility with a monitoring system worth Rs. 1.1 million incorporated in the robot by CISCO systems, Millennium IT ESP and CISCOM Technologies. The environmental controls include: · Physical and mechanical measures taken to reduce infection transmission; all patient entry/exit points, staff entry point to wards and doffing room cubicles protected with a double-door system (when one door is opened the other door closes) to ensure safety. · Well planned and designed zoning which include Zone 1/Green Zone A – staff rest rooms and dining; Zone 1/Green Zone B – Staff working area including control room (Green Zone A and B separated by an inbuilt corridor); Zone 2/Yellow Zone – Staff area is separated from patient area; Zone 3/Red Zone – Patient area which consists of four wards (one female and three male wards) with a total of 40 beds. Going into specifics, Dr. Ponweera says that the building uses the existing central air-conditioning system based on ventilation and pressure management principles of airborne infectious diseases management. This is by the creation of a positive to negative pressure gradient from the staff zone to the patient zone (Green Zone to Red Zone). With regard to ventilation, he points out that the physical separation between the Yellow and Green Zones makes sure that no air movement is possible between these zones. Even in the case of a breach in the physical barrier, the air movement would be from the Green Zone to the Yellow Zone, not the other way round because the pressure is positive in the Green Zone. “The air flow is designed in such a way that clean air first enters the Yellow Zone and then goes to the Red Zone, after which it is cleaned with HEPA (high-efficiency particulate air) filters, minimizing the risk of having infected air in the Yellow Zone. Negative air pressure is maintained in the Red Zone to ensure that no air moves from this zone to the Yellow or Green Zones,” explains Dr. Ponweera. He says a heartfelt thank-you to Madhawa, Anuruddha and Omega of Chartered Architects [Independence Holdings (Pvt) Ltd.], for their advice; the input of Dr. Mahen Kothalawala; Dr. Supun Perera who designed the architecture at no cost; and well-wisher Chandana Fonseka who personally journeyed to the Hambantota Hospital to bring back the high pressure stabilization machine. | |