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Not forgetting the mentally handicapped in these times of COVID
The hospital in hilly Udagama, Atabage, eight kilometres from Gampola
The Consultant is examining a patient who is wracked by a fit of coughing, when the Sunday Times calls him on Thursday morning. This is nothing new in these terrible times of COVID-19, with a rapid spread of the virus.
What is new though is that the doctor seeing the patient is not a Physician but a Psychiatrist. A Physician has also seen the patient to manage his COVID-19 symptoms.
This was the scene at the very first National COVID-19 Positive Hospital for Psychiatric Patients set up in hilly Udagama, Atabage, eight kilometres from Gampola.
“There was an urgent need for a special and separate hospital to treat people with mental illness who were also affected by COVID-19,” says the President of the Sri Lanka College of Psychiatrists, Dr. Gihan Abeywardena.
And so, about 5-6 months ago, the Sri Lanka College of Psychiatrists began negotiations and the hunt for a site, with the ready support of the Health Ministry. These efforts have borne fruit – the 17-room hospital came into being on July 26, with the doors being opened wide for its first patients that Friday, July 30.
The very first patient is a 15-year-old boy from Ratnapura, while four more are also receiving treatment here, including a 68-year-old man. The ‘catchment’ area of the hospital is the whole country and some of its inpatients are from as far away as Kantalai and Batticaloa.
The President of the Sri Lanka College of Psychiatrists, Dr. Gihan Abeywardena opens the first National COVID-19 Positive Hospital for Psychiatric Patients by cutting the ribbon as Consultant Community Physician Dr. Suranga Fernando attached to the office of the Provincial Director of Health Services; the Peradeniya University’s Psychiatry Department Head Dr. Dewasmika Ariyasinghe and Chair Professor of Psychiatry Prof. Thilini Rajapakse; and the Atabage Hospital’s Medical Officer-in-Charge Dr. Chintha Wijeratne look on.
Dr. Abeywardena says that anyone who is mentally ill or drug-dependent including heroin-dependent or alcohol-dependent and is affected by COVID-19 can find a place at this special hospital. Many heroin-dependent people with COVID-19 are turned away from other hospitals as health staff is under the misconception that they are aggressive and difficult to manage.
Set amidst a remote green-carpeted tea estate, away from the hustle and bustle of urban life, each room in the hospital has a bed, locker, facilities including for the administration of oxygen, CCTV and a microphone through which the patient may communicate with the monitoring station of the health staff, while a few rooms are also equipped with video screens which allow the patients to see the monitoring station and vice versa.
Explaining the logistics, Dr. Abeywardena says that the medical part of the treatment of each patient is handled by a Visiting Physician from the Kandy National Hospital or the Gampola Base Hospital once-a-week on a roster basis.
Eleven Consultant Psychiatrists from the Kandy National Hospital, the Peradeniya Teaching Hospital, the Nawalapitiya and Matale District General Hospitals and the Gampola Base Hospital take turns to see the patients, doing ward rounds every single day, a privilege that COVID-19 patients in some other hospitals may not have.
Six nurses sans mental health training have been loaned from the Gampola Hospital for three months and are receiving on-the-job training and four healthcare assistants have also been assigned temporarily, once again for three months, from the Kandy and Peradeniya Hospitals.
Amidst these staffing challenges, another issue is that under government regulations no COVID-19 hospital can operate without army and police personnel guarding it. This has posed accommodation issues with these personnel being compelled to lodge in the rooms meant for patients, says Dr. Abeywardena, adding that this is preventing the hospital from operating at full capacity.
An initiative of the Sri Lanka College of Psychiatrists and the Health Ministry soon after the second wave hit Sri Lanka, Dr. Abeywardena pays tribute to the Deputy Director-General of Non-Communicable Diseases (NCDs), Dr. Champika Wickramasinghe who has been a “pillar of strength”; the Central Province’s Provincial Director of Health Services, Dr. Nihal Weerasuriya; the Kandy district’s Regional Director of Health Services, Dr. Senaka Thalagala for support in getting the infrastructure in place and recruiting the staff; and the Atabage Hospital’s Medical Officer-in-Charge, Dr. Chintha Wijeratne whose immense assistance made it a reality.
Sri Lankans living in Perth, Australia, had donated funds to buy a refrigerator, washing machine, furniture and TV sets and recreation games for patients.
With Rs. 15 million from the Health Ministry, two huge wards of the long abandoned Divisional Hospital has now metamorphosed into the National COVID-19 Positive Hospital for Psychiatric Patients.