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A mission to save little brains & spines
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- Dr Nirukshan Jayaweera undertakes a gargantuan task amidst a lack of facilities and instruments
By Kumudini Hettiarachchi
There is a common healing thread, giving new life and hope, bonding Chathura Chamoth Hewawasm (8) from Uswetakeiyawa, Dilitha Hettiarachchi (13) from Baddegama and Arkam Mohamed (10) from Weligama.
These are just three of more than 1,000 children from humble families across the country who have undergone complex brain and spinal surgery in 2022-2023, testament that the state health sector works seamlessly for the poorest of the poor even amidst numerous challenges.
Neurosurgeon along with his dedicated team at LRH handles sensitive brain and spine surgeries of children
The ‘doer’ with the wonder hands is Consultant Neurosurgeon Dr Nirukshan Jayaweera on a quest to overcome obstacles because of his special interest in Paediatric Neurosurgery with training in this niche specialty in the United Kingdom (UK).
Based at the premier Lady Ridgeway Hospital (LRH) for Children, Colombo, this one and only Neurosurgeon who along with his dedicated team handles sensitive brain and spine surgeries of children, is like a nomad. He is battling bureaucratic red tape and also going with the begging bowl to collect funds to buy state-of-the-art instruments.
While the dearth of neurosurgical and ICU facilities at the LRH is reining-in and restricting his full capability, he is very appreciative of the immense support he garners from LRH Director Dr G Wijesuriya and LRH staff.
Chathura
Arkam
It was in 2014 as a Registrar that Dr Jayaweera had seen the surgical feats that could be performed on children’s tender brains and spines under Consultant Neurosurgeon Dr Sunil Perera. Even though his overseas postgraduate training in the UK was in adult neurosurgery, Dr Jayaweera had done an extensive attachment at the prestigious Great Ormond Street Hospital for Children, London, on this love of his life.
On his return, he had been sent to Batticaloa in 2016 where the facilities were minimal, allowing only the drilling of holes in the skull and taking out blood clots. From there, after serving some time at the Karapitiya Teaching Hospital, he had come to the LRH.
Seeing the sorry state of children in the grip of neurosurgical issues, Dr Jayaweera’s mission had begun – looking for facilities and also begging for instruments.
Dr Jayaweera takes the Sunday Timesinto the realm of a child’s brain and spine to reveal the conditions which could affect them.
Dilitha
The congenital abnormalities, varying from mild to severe, include brain tumours; Chiari malformations (when a portion of the brain — the cerebellar tonsils — protrudes through the bottom opening of the skull into the upper spine); arachnoid cysts (a common brain cyst); encephaloceles (a neural tube defect where the brain and spine are exposed to the outside instead of being covered by the skull and skin); spina bifida (a common neural tube defect due to a deficit of folic acid in the mother before conception); and a tethered spinal cord (when the spinal cord is attached to the tissue commonly at the base of the spine – if not untethered, there can be lasting damage to the child’s spinal nerves).
It was at the height of the COVID-19 pandemic in the latter part of 2020, that Dr Jayaweera gave a project proposal on how to include the children who needed neurosurgery without leaving them to an uncertain fate.
With post-surgery infection being a high risk, he had appealed for Operating Theatre facilities in the Orthopaedic Theatre Complex that was being put up. It was here that he began small emergency surgeries such as inserting a shunt to drain the fluid build-up in brain cavities (hydrocephalus) at the end of 2021.
However, for complex surgeries, thanks to the open invitation of the late Consultant Neurosurgeon Dr Jagath Rathugamage, he had found a niche at the National Hospital of Sri Lanka (NHSL).
Dr Nirukshan Jayaweera
So now, Dr Jayaweera transfers the children who need surgery to the NHSL, performs the operations there, keeps them in the ICU there under very willing staff and then transfers them back to LRH once the critical period is over.
One such child is Chathura whose home in Uswetakeiyawa we visit on Wednesday. As his mother Shanika tells his tale of near-death and how Dr Jayaweera and his team saved him miraculously, the boy is quick to point out the errors of wrong ward numbers his mother is telling us. (Read Chathura’s story in the PLUS)
Dr G Wijesuriya
The tale of healing we also hear from Dilitha’s father, Mahesh who is a dozer driver, and Arkam’s father Zameer who has a small aluminium business.
Shanika is full of praise for the multi-disciplinary team at LRH still looking after Chathura and the NHSL’s ICU nurses who would cover the boy with their overalls when he indicated that he was cold even under the blankets.
High tribute and blessings are showered on Dr Jayaweera when she echoes the other parents: “Mae lokey dekka deviyo. Api babata jeevithey dunnata, eh jeevithey rekala dunne mae deviyo. (A god we have seen in this world. Even though we gave life to our child, it was protected by this god!).”
| You can help save children’s brainsA strong appeal goes out from the LRH neuro-team to help them save the brains and spines of little ones by contributing your mite. On call 24/7, with long days and longer nights and no vacation in sight, Dr Nirukshan Jayaweera’s heart-wrenching plea is that children’s brain surgery cannot wait. It is an emergency. Citing two cases where the children died awaiting neurosurgery, he adds: “Help me get the instruments and improve the facilities.” Contributions may be sent to Account Holder: Friends of Lady Ridgeway Hospital for Children (FLRHC), Account Number: 8364019, Name of Bank: Bank of Ceylon, Super Grade Branch, Borella. The Swift Code is: BCEYLKLX. Please mention the ‘purpose’ on the bank slip as: “To purchase neurosurgical equipment”. Please also email a scanned copy of the bank slip to: directorlrh@yahoo.comor hand over a copy to the Director’s Office on the 9th floor of the LRH. For more information, please contact the Planning Medical Officer, Dr Savithrie Dharmaratne on Mobile: 0714441705. The instruments even though “costly” Dr. Jayaweera desperately needs are: Operating Neuro-microscope (around Rs. 200 million); Neuro-navigation System (around Rs 300m); Neuro-endoscope (around Rs 75m) & Neuro-drill System (around Rs 100m).
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| Brain bypass surgeryRare bypass surgery on the brain – this is what Dr Nirukshan Jayaweera has done without fanfare or publicity.Performing such bypasses on children suffering from Moyamoya Disease in which the carotid artery in the skull was blocked, his healing hands had connected an artery from the outside of the skull to an artery inside, bypassing the block. It has been done through a craniotomy, where a part of the skull is removed temporarily to expose the brain and perform the procedure. Dr Jayaweera is also adept at correcting craniofacial anomalies, deformities that affect a child’s head and facial bones. |
The state health sector works seamlessly for the poorest of the poor even amidst numerous challenges. Pix by M A Pushpa Kumara
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