Ragama: time and space cripple patients

By Udena .R . Attygalle

You recall a truck behind you and a sharp pain spreading though your whole body. Then your memory goes blank until you wake up at the Ragama Rheumatology and Rehabilitation Hospital .

That is only if this hospital has enough room for you and your condition serious. Else you won't make is it to Sri Lanka's only rehabilitation institution for the physically disabled.

With an in-ward capacity of only 190 beds, the hospital can hardly cope with this all important aspect of the health care set-up of the country.

The doctors headed by Dr. Lalith Wijeratne together with the nurses, physiotherapists, occupational therapists and minor staff will be your guides and helping hands during your stay at Ragama.

If your spine is shattered, your first few months will be restricted to bed. Depression, doubts about your abilities and frustration at all of a sudden losing your independence will probably set in .The first months will include inward physiotherapy until you get off the spinal shock.

With treatment taking effect in the following months you will start on the long road to recovery which will rarely be total .Six months of gym physiotherapy, the physical rehabilitation process will take you through a journey of "self rediscovery"

W .Laxman who had fallen from a mango tree as a schoolboy three years ago has for most of that time been an invalid. "But now with treatment I can do lots of things I had given up on," said a determined Laxman.

"But how they cope with the Herculean task of being in that no man's land between dependence and independence; when they go out into society is a total blank," said physio V. Sasiraj putting across the ultimate challenge for the patients.

Occupational therapy, commonly confused with Physiotherapy, is teaching the patient to live to the maximum with his disability. As Dr. Wijeratne put it "it's teaching a patient who has lost his right hand how to write with his left."

Various adaptive devices are made to fit the individual needs of the patients due to the ingenuity of the therapists.

We saw W. Stephen, a driver now without the use of the fingers of his right hand eating by himself ; using a spoon strapped to the palm of his hand . " I'm glad I can feed myself alone again," said a sanguine Stephen. We were also shown a modified well, constructed to teach patients how to use it safely. "This is basically teaching how to cope with life out there in society," said S. Jayaweera a therapist.

Lack of ward space sadly means that patients have to learn these skills quickly. The usual stay at Ragama is limited to around six months .

Follow up treatment is a very important aspect of the treatment for these injuries; unfortunately this, due to various restraints is the most neglected as well. Coming back to the hospital for checkups is unaffordable for most.

As Dr. Wijeratne said, "This also deprives the medical staff of important feedback." Do the techniques adopted really work?

The hospital social service officer collects funds to help in the social life of the patient. Architectural adjustments to buildings have to be made so that an independent wheelchair bound life is possible.

The social constraints involved are tremendous. Yet facilities to make life easy for the disabled is a must .

A special building code has already been passed to make public places like post offices, hospitals, and schools, wheelchair accessible and have facilities for the disabled. But public awareness and understanding remains the compelling need of the moment.

The hospital also urgently needs a new ambulance. The present one is in such bad condition that being transported in it is definitely not for spinal cord injury patients (or for any other patients).

The Ragama hospital needs to be expanded and upgraded; otherwise you can only pray "that accident" doesn't happen to you.

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