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Karapitiya Teaching Hospital, the only tertiary care institution in the south, is allegedly suffering from heart trouble, with many patients needing urgent attention being turned away at the once-a-week clinic.

Take Wednesday, June 14, the cardiology clinic day. Many of the patients who had queued up from early morning and come long distances had been told in no uncertain terms that only 30 new patients would be seen by the cardiologist that day, The Sunday Times learnt.

When 10-year-old Chamila Ruwan Kumari, accompanied by her mother A. Banduwathie, arrived at the Karapitiya Hospital because the little girl had a papuwe gasmak (palpitations), the paediatrician had immediately directed her to the cardiology clinic.

The mother and child who had come from remote Urubokke off Deniyaya, spending about Rs. 500 and leaving home at the crack of dawn, had been turned away from the cardiology clinic with the excuse that the quota for the day was over and asked to come for an echocardiogram on June 20. What is the plight of Chamila, whose parents are eking out a living by doing odd-jobs, if she has to make many trips to Karapitiya?

Ironically, The Sunday Times understands that the only hospital to have a cath lab outside Colombo is Karapitiya, with the one at Kandy not functioning.

Chamila’s case is not an isolated one. S.W. Gunasekera, 57, a CTB labourer from Thihagoda in Matara who had severe chest pain on May 26 while at work was immediately rushed to the Karapitiya Hospital and was in the Intensive Care Unit. He was discharged on June 1 from hospital but directed to come on June 14 to the cardiology clinic. He too being considered an aluth ledek (new patient) was turned away with the same excuse – only 30 will be seen and he was not one of them.

A pain in the chest sent D. Nandawathie, 53, from Boossa to the Karapitiya OPD, where she was immediately ordered an ECG, followed by instructions to rush to the cardiology clinic. “Thundu deela ivarai,” she was told she says explaining that the clinic staff informed her that the numbers were over and she should come back the following week.

It was a similar problem for K.G. Sugathadasa, 55, from Hiyare in Akmeemana, who was told very clearly that his “ECG was honda ne” (ECG was not good) and sent to the cardiology clinic, only to be told that he needs to come the following week.

When The Sunday Times raised these concerns with both the Karapitiya Hospital Director Dr. Prasad Wijewickrema and Deputy Director Dr. Shelton Perera, the answer was that there was an issue with regard to the demarcation of positions between the two cardiologists based at Karapitiya, with the matter being taken up not only with the Public Services Commission and the Administrative Appeals Tribunal but also in the Court of Appeal.

“We have written to the Health Ministry seeking clarification on the matter,” said Dr. Perera, however, adding that the overcrowding at the cardiology clinic was due to the lack of a proper referral system in the country. “Some patients do not need to come to the clinic. Others can seek treatment at hospitals like Matara where there is a cardiologist,” he said.

When asked whether there was a waiting list for such tests as angiograms at the cath lab and also others such as echocardiograms, Dr. Perera checked and replied in the negative.

Lamented Dr. Wijewickrema, “As there is no proper referral system, most people by-pass other hospitals and seek attention at Karapitiya. So there is overcrowding and Karapitiya can’t cope with the work. In addition, we also have inadequate facilities in the cardiology unit. The bed strength is not enough and there is no space to develop the unit.”

However, The Sunday Times understands that there is no waiting list for tests because patients are turned away and told to come another day, causing much inconvenience to them. “When we are referred to the clinic, we are not examined by the cardiologist that day but given another date. Then when we come on that day, we are examined but given another day to either get an angio or an echo done, making it three visits to the hospital,” a patient who declined to be identified said. “Most patients who are very poor can’t afford to do this. It is a waste of time and money.”

The Karapitiya cardiology unit has one male ward and one female ward with a total of 16 beds and one cardiology intensive care unit with nine beds. The speculation at the hospital is that due to the problem between the two cardiologists, the consultant and the other whose job description is not clear yet (whether it is a ‘resident cardiologist’ post coming under the consultant or ‘supernumerary cardiologist’ post on par with the consultant) the facilities are under-utilized.

What is the much vaunted, free, state health sector offering poor patients like 10-year-old Chamila? There is another crucial question that Karapitiya Hospital should address immediately with regard to the heart patients who are turned away from this important tertiary care institution, where all facilities should be available, in the south.