12th October 1997

Ranaviru Sevana: seven years on...

In need of a greater public support

By Tharuka Dissanaike

This week Rana Viru Sevana celebrates its Seventh Anniversary. For the past week various events were organised by the Army's Rehabilitation Directorate to commemorate this occasion, including religious worship and a seminar for the disabled soldiers and will culminate in a grand musical show, performed by, of course, the talented band at Ranaviru Sevana (RVS).

A lot of work has been done in the past few years, transforming the jungled hilly property to the well- equipped rehabilitation centre it is today. The RVS now produce its own artificial limbs for war amputees from the forces. It is equipped with a hydrotherapy unit and other advanced rehabilitation therapy units. Vocational training is given to the soldiers to equip them for a civilian life.

Regimental Centres in Ambepussa, Anuradhapura, Ampara serve those soldiers who have been through the programmes and sent to their respective regiments. Some rehabilitated soldiers are leading living in houses donated to them by the Army Seva Wanitha. The Ranaviru Apparel Project opened at Yakkala employs 350 disabled soldiers in a garment factory catering to the export market.

But RVS is not without its problems. Lack of space at their present location at Ragama is a serious constraint. Added to this is a shortage of water supply. Seven years ago, when Rana Viru Sevana was first built, the Army never anticipated that there would be so many soldiers who would become disabled through war, said Brigadier Dudley Perera, Director of Army Rehabilitation.

Estimates point out that there are around 10,000 disabled soldiers in the country, counting amputees as well. A majority would have suffered amputation of limbs. Many also have suffered permanent disability, which means that they cannot continue in the ranks and further, they need training to be independent and carry out their daily routines on their own.

"About half this number are rehabilitated and have either gone back to their civilian life or rejoined the Army," Brigadier Perera said.

But daily, as the war rages on, more casualties are wheeled in and the waiting list for rehabilitation has grown. In the Military Hospitals at Army Head Quarters and Panagoda soldiers who have been treated medically for their injuries await dispatch to Rana Viru Sevana. But the space constraint holds them back. For already RVS is over crowded. While 80 beds are available in three wards, there are 118 soldiers there at present.

Awaiting rehabilitation, the condition of these injured soldiers, especially those paralyzed and bed ridden worries and their young bodies waste away for the lack of exercise and therapy.

While on the other hand, it appears that the number of rehabilitated soldiers moving out of RVS to their homes or regiments is few and far between. Too few, in fact to make considerable impact on the over crowded situation.

"This is indeed a major problem that we are facing," Brigadier Perera said. Community based rehabilitation for these soldiers is a long term process, he said. "It can't be done over night."

With funds being drained off for the immediate needs of war, financial difficulties are strongly felt. The many ambitious projects planned out by the Army Rehabilitation Directorate are hampered for the lack of available money.

When injured soldiers are brought in from the battle front, they are initially treated for shock and injury at the Military Hospitals. There the extent of damage is classified and those with 60 percent disability, including paralysis, blindness, loss of two limbs, deafness, memory loss are sent to RVS for long term rehabilitation, which is geared to gradually equip them with the strength to do daily work, such as, brushing teeth, washing, going to the toilet, eating and manoeuvring a wheel chair or walking with the aid of crutches.

The place is manned by a 300 member staff, but yet the numbers are inadequate to cope with the work. Captain Wettimuny, a doctor working at RVS said that the wards are in need of additional nursing staff to care for the many bed-ridden patients.

Soldiers undergoing rehabilitation here, although happy with the therapy complained of over-crowding. Some days, they said water is supplied only for a limited time.

Major Wickremasinghe, Officer Commanding (Administration) at RVS said that one of the most serious problems faced by the RVS is water. Water is supplied through a single tube well. Although they want to sink a new well, "it will cost 4-6 lakhs and money is a constraint," Major Wickremasinghe said.

While additional trained nurses and therapists are needed, there is no room to accommodate them. The lack of proper storage makes it difficult to keep extra mattresses, wheel chairs and crutches. Also Mjr. Wickremasinghe said that many organisations make ad hoc donations of items that cannot be used in this country.

"We get used wheel chairs and walking aids from European countries which just cannot be used here," he explained.

The RVS has asked for more land to put up additional buildings. Land from the Government Rehabilitation Hospital is earmarked for the expansion project. But the handing over of the land has not been finalised yet, and the Army is in want of funds to do the construction.

At the workshop within RVS limbs are produced for amputees. At present the capacity of the workshop is around one limb a day. This too needs to be improved since the numbers of amputees are increasing. Plans to extend the workshop area are already under way. But the quality of the product too has to see improvement, as there are complaints of heaviness of the limb. "It is the type of rubber used to produce the foot," Mjr. Wickremasinghe said.

"We produce it from natural rubber, found locally."

Each limb costs Rs. 8000 to be produced here. The life-span of an artificial limb is around two years after which the soldier will have to look for a replacement.

Vocational Training is given to those who have been rehabilitated to a point. Handicraft, electrical work, clerical work, hotel management, accountancy are taught at RVS or specialised institutions which give the Army large discounts on their courses. But finding suitable employment for those so trained is not as easy.

"The army absorbs a majority of the disabled back into their ranks, as staff officers, clerks, maintenance crew," Brig. Perera said.

But yet these appointments are made as and when they are available. Although much has been done, there appears to be no regular policy evolved within the army to provide employment for their disabled troops. Some have settled down to self-employment with the training given to them.

"These disabled people need more recognition from society," Brig. Perera said. He said that the private sector could be more active in providing employment to disabled persons. Tri Star Apparel have already recruited some soldiers with disability to work in their factories.

RVS plans to train soldiers in computer operating and photo development. To this end they request public support in providing the computers and equipment.

But as said earlier, the most serious problem at RVS, is the lack of soldiers moving out after rehabilitation. A number of factors prevent rehabilitated soldiers from taking their due place in society, thus allowing room for new patients. Many are discharged and sent to their homes only to find them returning again with complaints that their homes are not equipped to receive them.

In their villages, these soldiers face problems with toilets, access through pathways not suited for wheel chairs. Some families are so rural and poor that they cannot accommodate their disabled member. "Some are kept inside the house, without proper care or help to move around." Brig Perera said.

J. Tillekeratne was one of the first soldiers to undergo rehabilitation at RVS. Paralyzed below the neck with a bullet wound, he can now manage his daily functions independently. Living with his wife in a donated house in Udupila, Tillekeratne still spends at least three weeks every month at RVS for his therapy and treatment.

Here again the rehabilitation process appears to have come to the crossroads. While the aim of RVS, as Brig. Perera explained is to equip the soldiers and reintroduce them to society. When it comes to the latter a stumbling block has been formed. For most soldiers RVS provided them with facilities and care that their homes cannot compare. Therefore they shy away from moving out. Some soldiers have been at RVS for the last seven years. Secondly their communities and families are ill equipped to care for them. To encourage soldiers to move out, more awareness needs to be imparted to their communities and the families need to be educated on caring for the disabled.

Existing health and social service infrastructure in villages could be used for this purpose, instead of straining the Army's overburdened bureaucracy. There should be a long term vision and policy on the part of the government and the Army for these disabled soldiers.

The Rehabilitation Directorate on its part, to solve this problem, is considering building a Home for Disabled Soldiers at Bolagala. But once more the lack of funds has proved a barrier. The Army has also not been able to provide the soldiers with new homes for resettlement, in the recent past. "The army cannot provide everything," Mjr. Wickremasinghe said. He invited private donors to help disabled soldiers in need of housing.

Now with an entire Ministry devoted to the task of rehabilitating a nation still ravaged by war, the difficulties faced in the process of community based rehabilitation should be looked into carefully. Meaningful solutions should be adapted to the conditions at villages. Post rehabilitation care would be most successful if the rehabilitated soldier could return to his family and community. The necessity of the hour, obviously is to encourage soldiers, who have been through the sophisticated rehabilitation procedure at RVS, to move out into the community so that their injured colleagues could also enjoy the benefits of Rana Viru Sevana.

10 soldiers, upper arm amputees received modern, bionic arms from India recently. These soldiers made the trip to Chandigar in two batches to have the myo-electronic arms attached. The arms are electronically controlled by brain impulses and the fingers are more mobile than in a normal artificial upper limb.

We met several soldiers who have returned from India with the new arms. They were quite thrilled with the improved hand movement and demonstrated to us the many uses of the limb, by playing billiards, sweeping the floor and drinking water from a bottle held by the artificial limb. The new limbs have certainly made a difference in the lives of these disabled soldiers.

45 more are awaiting the trip to India for the myo-electronic limbs. The National Defence Fund has financed this project, each limb costing Rs. 32,000. In India a three week stay is required for measurements, fitting and post-therapy on using the limb.

Continue to Plus page 5 -Keragala: a new life for Army families

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