Features
Lady Ridgeway Hospital: A haven for sick children in Sri Lanka
125 YEAR BIRTH ANNIVERSARY:
By Dr. B. J. C. Perera
Specialist Consultant Paediatrician
I wrote an article in The Island newspaper, under the aforesaid title, 12 years ago, on Monday 09th June 2008. I have retained that title but content of this article is different. It’s worth looking at this hospital from a more current perspective particularly since the Lady Ridgeway Hospital for Children (LRH) is celebrating its 125-year jubilee in October 2020.
The LRH had very humble beginnings. At the outset, 125 years ago, it was constructed from public donations; rupees 46,000/- to be exact, as a small 50 bedded hospital. Lo and behold, today, this magnificent edifice, with over 1,000 beds, is the largest children’s hospital in the world, I repeat, in the whole world. It has stood the test of time as the final port of call and a veritable haven for sick children of our homeland. It is the National Referral Centre for this entire nation. The hospital functions sans any and every mundane consideration such as ethnicity, caste, creed and wealth of children who are brought there. This glorious medical facility is one that is solely devoted to sick children. If there is anything fanciful that is needed to be done in Sri Lanka for a sick child, it could be done in this hospital. It now caters to every type of malady that affects children. You name any specialty for the care of a sick child; it is available here. Everything is provided entirely free-of-charge and it is the crowning glory and the feather in the cap of the paediatric component of our Free National Health Service, the pride of Sri Lanka.
To date, I have been a doctor for exactly 50 years and a Specialist Consultant Paediatrician for 42 years. Out of that long period of half a century of service to the nation, I have spent 16 years in the hospitals of Kandy, Badulla, Ratnapura, Kurunegala and Kalubowila. Compared to that, and in contrast, I have worked in the Lady Ridgeway Hospital, in different capacities, for a total of 17 years. My service at LRH culminated with my retirement from the Ministry of Health in 2007. In lighter vein, I have been properly ‘themparadufied’ in our health sector, both public and private. I have most definitely, seen it all.
Those really were the days, around half a century ago, when during my medical student apprenticeship and internship, I saw how Mother Nature used to take the lives of our children with all kinds of infectious diseases. The wards at LRH were full with cases of meningitis, pneumonia, whooping cough, diphtheria, polio, diarrhoea, dysentery, cholera, measles, tetanus, tuberculosis, chicken pox, hepatitis, amoebiasis and even rabies. In fact, this is a list of just only a few of them. Add to it, the ravages of under-nutrition leading to marasmus and kwashiorkor, extensive vitamin and micronutrient deficiencies and major uncorrectible congenital heart abnormalities, and what did we have? A hospital bursting at its seams with sick children. It was practically a place that spelt out the real meaning of human susceptibility to disease and even mortality. During certain times it was indeed a bit of a hell on earth. The deaths were totalling up to some very significant numbers. By today’s standards, they had very few things they could do for intractable heart failure, liver failure and kidney failure. All types of paediatric malignancies and cancers were practically untreatable. The doctors and Specialist Consultants, as well as all other grades of staff of yore fought as hard as ever, tooth and nail, to save all those severely ill children who were brought to the LRH. However, most unfortunately and ever so very often, to no avail whatsoever. The dice was dreadfully loaded against those unfortunate children, as well as against the healthcare workers who had to look after them. In those halcyon days, each ward had a Consultant, a Senior House Officer and just two interns; a totally inadequate number of medical personnel to cater to the intense daily needs. Work was absolutely horrendous. It was not unusual to see many dead bodies of ill-fated children being wheeled out of the wards regularly, day in and day out. It was such a distressing and depressing landscape. There was hardly any light at the end of the tunnel. Yet for all that, the staff fought on bravely and relentlessly to save the precious lives of little children. To their eternal credit, they managed to save quite a few of the very seriously ill ones too.
Then, over many a decade, especially over the last few of them, the tide gradually turned. Successful vaccination almost totally removed some of the deaths and disabilities caused by a plethora of nasty infections. Many medical advances provided ways and means of dealing with former killer diseases. Improvements in heart surgery made it possible to treat at least a majority of congenital heart defects. When I finally reached the out-and-out hub of Paediatrics, which LRH was, in 1995, as a Specialist Consultant in charge of a unit, just about 25 years after my own internship at LRH, the scenery and settings had changed so much and well beyond belief that it was almost unrecognisable. In my ward I even had the absolute luxury of the services of a Senior Registrar, one who just needed two further years of training abroad before becoming a Consultant, four Postgraduate Registrars waiting to sit for the Final MD in Paediatrics Examination and four intern house physicians. The academic level of all those individuals who cared for my patients was absolutely top-class. They were right up-to-date in the sphere of scholarly paediatrics. They were all very fine and dedicated young doctors who would never ever allow a child to die without a steadfast and committed fight.
The advances in surgery were almost unbelievable. To top it all, around the time that I finally reached LRH as a Specialist Consultant, we had the services of several very fine Paediatric Surgeons whose handiwork in the Operating Theatres were almost too good to be true. Some of the recoveries from incredible surgical tragedies were really like those from the pages of volume of fiction. They were the work of gifted artists who wielded the scalpel with telling effect. One little anecdote that comes to mind is the surgical prowess of one particular general surgeon in lung operations. He was, and still is, quite a maestro at it. In those days that I was in charge of a unit, because of my personal interest in childhood respiratory disorders, we used to get quite a number of children with major lung problems which sometimes needed expert surgery. The usual practice was to send them off to the Colombo General Hospital Thoracic Unit for surgery. Lung surgery in children is a very tricky business. Things could go wrong at the drop of a hat. I somehow got to know that this particular young surgeon at LRH was so very good at it and I used to plead with him to get the surgery done at LRH itself. I used to say “Aney, please, please, PLEASE.., do it for me as a personal favour”. The very fine man that he was, and still is for that matter, he never ever refused. He has surgically taken off lobes of lungs and even the whole lung sometimes of my ill patients. True to life, those children recovered without any problems in about a week to 10 days. We never had even a single death after extensive lung surgery. They went home to a normal fruitful life and an entirely normal life-span. Just for the record, one could remove a major portion of the two lungs and still be able to lead a normal life with even a well-functioning half a lung. When I used to thank the surgeon profusely for doing it for me, he used to just smile and even feel a bit embarrassed.
It was all in a day’s work for him but for us, it was an absolute life-saver for our patients. In fact, that surgeon is still in active service at LRH. That is the quality of the Paediatric Surgeons that we have even today, with no exceptions whatsoever. Their commitment is truly wonderful. They will not let an unfortunate child suffer unnecessarily. They will fight on with every available means, daytime as well as well into the middle of the night, to save the lives of children to whom they had practically committed their professional lives. I have seen with my own eyes, these surgical colleagues leaving their families and their own little children at home to come to LRH in the middle of the night to perform life-saving surgical operations on our little patients.
Now, fast forward to 2020!!!! After my retirement in 2007, I now work only in the Private Sector and there are several instances where I have had to send patients to LRH for further investigation and treatment. One particular little tale comes to mind rather forcefully. A frantic mother of one of my regular patients telephoned me around mid-day, just about a couple of weeks ago because her little pre-schooler had taken an overdose of some medicines. My immediate advice over the phone was “please do not take the child anywhere other than to LRH. Do not go to any other place but rush him to LRH. Do not even bring him to me. I am just asking you to take the child to the very best place in the whole island”. They rushed him there and the staff attended to him pronto. He had what we call a stomach-wash performed on him, then they instilled some activated charcoal into the stomach, did some baseline blood tests and kept him in the ward. He did not turn even a hair and recovered within a couple of days. Incidentally, I think the mother threw my name around a bit and when the Consultant of the ward got to know, he had said “I trained under Dr BJC and we have done exactly what he would have done in the circumstances”. He was one of my Postgraduate Registrars and it was extremely nice of him to say those things. Of course, the mother and the relatives of the child were ever so pleased.
There were many other patients whom I had sent to LRH over several years and I have always asked them how it was at LRH when they came to me again. Every single time the mothers have said “It was a bit inconvenient for us but the child got star-class treatment and that really is what matters” or something basically to that effect. It has always warmed the cockles of my heart to hear such complimentary statements. My heart and soul have always been with LRH and anything unsavoury and disparaging said about that hospital would really hurt me to the core. We did care so much for the little children admitted under us and it is so good to see that those who have come after us do care as much, and are dedicated to the cause of providing the very best possible care for the patients as well.
Well, the Lady Ridgeway Hospital for Children, the mother of all hospitals in our resplendent isle, is 125 years old. If walls could talk, the walls of LRH would have all kinds of stories to tell. She would say how she had seen the worst of many diseases that affected children and also how things have changed over a century and a quarter of her existence. She would have a perpetual smile on her face in view of the progress achieved in caring for sick children, especially over the last few decades.
The lady needs to be feted and acclaimed on her 125th Birth Anniversary. The administrative staff, the doctors and all other grades of workers of LRH have planned a fitting celebration for her on the 01st of October 2020. In a glittering ceremony due to be graced by Prime Minister Mahinda Rajapaksa and Minister of Health of Sri Lanka Pavithra Wanniarachchi MP; they will acknowledge the priceless role played by LRH towards the healthcare of Sri Lankan Children. The ceremony will include the laying of the foundation stone for a new nine-storey building, opening of the new bone marrow transplant unit, opening of the new Operation Theatre Complex, official issuing of the hospital logo, formal release of the hospital song written by Dr. Rathnasri Wijesinghe with music compiled by Dr. Rohana Weerasinghe, and the commissioning of the new website for the hospital. These latest developments would help to make an excellent place for sick children, even a little bit of a better place for them.
All these would be a fitting and splendid accolade to an illustrious medical facility that is absolutely like no other. May she go from strength to strength and continue to be a dazzling beacon of excellence in healthcare for our children in this Pearl of the Indian Ocean.
Viva Lady Ridgeway Hospital, please do take a bow on your 125-year Birth Anniversary. It is the very least you so richly deserve, for the commitment that you have shown for the sick children of our beautiful Motherland. You are indeed a majestic haven of excellence for them.
Author
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There’s an ill more dangerous and pervasive than the Coronavirus that’s currently sweeping Sri Lanka. That is the fear to express one’s convictions. Across the public sector of the country in particular many persons holding high office are stringently regulating and controlling the voices of their consciences and this bodes ill for all and the country.
The corrupting impact of fear was discussed in this column a couple of weeks ago when dealing with the military coup in Myanmar. It stands to the enduring credit of ousted Myanmarese Head of Government Aung San Suu Kyi that she, perhaps for the first time in the history of modern political thought, singled out fear, and not power, as the principal cause of corruption within the individual; powerful or otherwise.
To be sure, power corrupts but the corrupting impact of fear is graver and more devastating. For instance, the fear in a person holding ministerial office or in a senior public sector official, that he would lose position and power as a result of speaking out his convictions and sincere beliefs on matters of the first importance, would lead to a country’s ills going unaddressed and uncorrected.
Besides, the individual concerned would be devaluing himself in the eyes of all irrevocably and revealing himself to be a person who would be willing to compromise his moral integrity for petty worldly gain or a ‘mess of pottage’. This happens all the while in Lankan public life. Some of those who have wielded and are wielding immense power in Sri Lanka leave very much to be desired from these standards.
It could be said that fear has prevented Sri Lanka from growing in every vital respect over the decades and has earned for itself the notoriety of being a directionless country.
All these ills and more are contained in the current controversy in Sri Lanka over the disposal of the bodies of Covid victims, for example. The Sri Lankan polity has no choice but to abide by scientific advice on this question. Since authorities of the standing of even the WHO have declared that the burial of the bodies of those dying of Covid could not prove to be injurious to the wider public, the Sri Lankan health authorities could go ahead and sanction the burying of the bodies concerned. What’s preventing the local authorities from taking this course since they claim to be on the side of science? Who or what are they fearing? This is the issue that’s crying out to be probed and answered.
Considering the need for absolute truthfulness and honesty on the part of all relevant persons and quarters in matters such as these, the latter have no choice but to resign from their positions if they are prevented from following the dictates of their consciences. If they are firmly convinced that burials could bring no harm, they are obliged to take up the position that burials should be allowed.
If any ‘higher authority’ is preventing them from allowing burials, our ministers and officials are conscience-bound to renounce their positions in protest, rather than behave compromisingly and engage in ‘double think’ and ‘double talk’. By adopting the latter course they are helping none but keeping the country in a state of chronic uncertainty, which is a handy recipe for social instabiliy and division.
In the Sri Lankan context, the failure on the part of the quarters that matter to follow scientific advice on the burials question could result in the aggravation of Islamophobia, or hatred of the practitioners of Islam, in the country. Sri Lanka could do without this latter phobia and hatred on account of its implications for national stability and development. The 30 year war against separatist forces was all about the prevention by military means of ‘nation-breaking’. The disastrous results for Sri Lanka from this war are continuing to weigh it down and are part of the international offensive against Sri Lanka in the UNHCR.
However, Islamophobia is an almost world wide phenomenon. It was greatly strengthened during Donald Trump’s presidential tenure in the US. While in office Trump resorted to the divisive ruling strategy of quite a few populist authoritarian rulers of the South. Essentially, the manoeuvre is to divide and rule by pandering to the racial prejudices of majority communities.
It has happened continually in Sri Lanka. In the initial post-independence years and for several decades after, it was a case of some populist politicians of the South whipping-up anti-Tamil sentiments. Some Tamil politicians did likewise in respect of the majority community. No doubt, both such quarters have done Sri Lanka immeasurable harm. By failing to follow scientific advice on the burial question and by not doing what is right, Sri Lanka’s current authorities are opening themselves to the charge that they are pandering to religious extremists among the majority community.
The murderous, destructive course of action adopted by some extremist sections among Muslim communities world wide, including of course Sri Lanka, has not earned the condemnation it deserves from moderate Muslims who make-up the preponderant majority in the Muslim community. It is up to moderate opinion in the latter collectivity to come out more strongly and persuasively against religious extremists in their midst. It will prove to have a cementing and unifying impact among communities.
It is not sufficiently appreciated by governments in the global South in particular that by voicing for religious and racial unity and by working consistently towards it, they would be strengthening democratic development, which is an essential condition for a country’s growth in all senses.
A ‘divided house’ is doomed to fall; this is the lesson of history. ‘National security’ cannot be had without human security and peaceful living among communities is central to the latter. There cannot be any ‘double talk’ or ‘politically correct’ opinions on this question. Truth and falsehood are the only valid categories of thought and speech.
Those in authority everywhere claiming to be democratic need to adopt a scientific outlook on this issue as well. Studies conducted on plural societies in South Asia, for example, reveal that the promotion of friendly, cordial ties among communities invariably brings about healing among estranged groups and produces social peace. This is the truth that is waiting to be acted upon.
Author
By Sanjeewa Jayaweera
It was on 3rd January 1972 that our family arrived in Karachi from Moscow. Our departure from Moscow had been delayed for a few weeks due to the military confrontation between Pakistan and India. It ended on 16th December 1971. After that, international flights were not permitted for some time.
The contrast between Moscow and Karachi was unbelievable. First and foremost, Moscow’s temperature was near minus 40 degrees centigrade, while in Karachi, it was sunny and a warm 28 degrees centigrade. However, what struck us most was the extreme warmth with which the airport authorities greeted our family. As my father was a diplomat, we were quickly ushered to the airport’s VIP Lounge. We were in transit on our way to Rawalpindi, the airport serving the capital of Islamabad.
We quickly realized that the word “we are from Sri Lanka” opened all doors just as saying “open sesame” gained entry to Aladdin’s cave! The broad smile, extreme courtesy, and genuine warmth we received from the Pakistani people were unbelievable.
This was all to do with Mrs Sirima Bandaranaike’s decision to allow Pakistani aircraft to land in Colombo to refuel on the way to Dhaka in East Pakistan during the military confrontation between Pakistan and India. It was a brave decision by Mrs Bandaranaike (Mrs B), and the successive governments and Sri Lanka people are still enjoying the fruits of it. Pakistan has been a steadfast and loyal supporter of our country. They have come to our assistance time and again in times of great need when many have turned their back on us. They have indeed been an “all-weather” friend of our country.
Getting back to 1972, I was an early beneficiary of Pakistani people’s love for Sri Lankans. I failed the entrance exam to gain entry to the only English medium school in Islamabad! However, when I met the Principal, along with my father, he said, “Sanjeewa, although you failed the entrance exam, I will this time make an exception as Sri Lankans are our dear friends.” After that, the joke around the family dinner table was that I owed my education in Pakistan to Mrs B!
At school, my brother and I were extended a warm welcome and always greeted “our good friends from Sri Lanka.” I felt when playing cricket for our college; our runs were cheered more loudly than of others.
One particular incident that I remember well was when the Embassy received a telex from the Foreign inistry. It requested that our High Commissioner seek an immediate meeting with the Prime Minister of Pakistan, Mr Zulifikar Ali Bhutto (ZB), and convey a message from Mrs B. The message requested that an urgent shipment of rice be dispatched to Sri Lanka as there would be an imminent rice shortage. As the Ambassador was not in the station, the responsibility devolved on my father.
It usually takes about a week or more to get an audience with the Prime Minister (PM) of a foreign country due to their busy schedule. However, given the urgency, my father spoke to the Foreign Ministry’s Permanent Sectary, who fortunately was our neighbour and sought an urgent appointment. My father received a call from the PM’s secretary around 10 P.M asking him to come over to the PM’s residence. My father met ZB around midnight. ZB was about to retire to bed and, as such, was in his pyjamas and gown enjoying a cigar! He had greeted my father and had asked, “Mr Jayaweera, what can we do for great friend Madam Bandaranaike?. My father conveyed the message from Colombo and quietly mentioned that there would be riots in the country if there is no rice!
ZB had immediately got the Food Commissioner of Pakistan on the line and said, “I want a shipload of rice to be in Colombo within the next 72 hours!” The Food Commissioner reverted within a few minutes, saying that nothing was available and the last export shipment had left the port only a few hours ago to another country. ZB had instructed to turn the ship around and send it to Colombo. This despite protests from the Food Commissioner about terms and conditions of the Letter of Credit prohibiting non-delivery. Sri Lanka got its delivery of rice!
The next was the visit of Mrs B to Pakistan. On arrival in Rawalpindi airport, she was given a hero’s welcome, which Pakistan had previously only offered to President Gaddafi of Libya, who financially backed Pakistan with his oil money. That day, I missed school and accompanied my parents to the airport. On our way, we witnessed thousands of people had gathered by the roadside to welcome Mrs B.
When we walked to the airport’s tarmac, thousands of people were standing in temporary stands waving Sri Lanka and Pakistan flags and chanting “Sri Lanka Pakistan Zindabad.” The noise emanating from the crowd was as loud and passionate as the cheering that the Pakistani cricket team received during a test match. It was electric!
I believe she was only the second head of state given the privilege of addressing both assemblies of Parliament. The other being Gaddafi. There was genuine affection from Mrs B amongst the people of Pakistan.
I always remember the indefatigable efforts of Mr Abdul Haffez Kardar, a cabinet minister and the President of the Pakistan Cricket Board. From around 1973 onwards, he passionately championed Sri Lanka’s cause to be admitted as a full member of the International Cricket Council (ICC) and granted test status. Every year, he would propose at the ICC’s annual meeting, but England and Australia’s veto kept us out until 1981.
I always felt that our Cricket Board made a mistake by not inviting Pakistan to play our inaugural test match. We should have appreciated Mr Kardar and Pakistan’s efforts. In 1974 the Pakistan board invited our team for a tour involving three test matches and a few first-class games. Most of those who played in our first test match was part of that tour, and no doubt gained significant exposure playing against a highly talented Pakistani team.
Several Pakistani greats were part of the Pakistan and India team that played a match soon after the Central Bank bomb in Colombo to prove that it was safe to play cricket in Colombo. It was a magnificent gesture by both Pakistan and India. Our greatest cricket triumph was in Pakistan when we won the World Cup in 1996. I am sure the players and those who watched the match on TV will remember the passionate support our team received that night from the Pakistani crowd. It was like playing at home!
I also recall reading about how the Pakistani government air freighted several Multi Barrell artillery guns and ammunition to Sri Lanka when the A rmy camp in Jaffna was under severe threat from the LTTE. This was even more important than the shipload of rice that ZB sent. This was crucial as most other countries refused to sell arms to our country during the war.
Time and again, Pakistan has steadfastly supported our country’s cause at the UNHCR. No doubt this year, too, their diplomats will work tirelessly to assist our country.
We extend a warm welcome to Mr Imran Khan, the Prime Minister of Pakistan. He is a truly inspirational individual who was undoubtedly an excellent cricketer. Since retirement from cricket, he has decided to get involved in politics, and after several years of patiently building up his support base, he won the last parliamentary elections. I hope that just as much as he galvanized Sri Lankan cricketers, his political journey would act as a catalyst for people like Kumar Sangakkara and Mahela Jayawardene to get involved in politics. Cricket has been called a “gentleman’s game.” Whilst politics is far from it!.
Author
Believe me, seeing certain videos, on social media, depicting action, on the dance floor, at some of these entertainment venues, got me wondering whether this Coronavirus pandemic is REAL!
To those having a good time, at these particular venues, and, I guess, the management, as well, what the world is experiencing now doesn’t seem to be their concerned.
Obviously, such irresponsible behaviour could create more problems for those who are battling to halt the spread of Covid-19, and the new viriant of Covid, in our part of the world.
The videos, on display, on social media, show certain venues, packed to capacity – with hardly anyone wearing a mask, and social distancing…only a dream..
How can one think of social distancing while gyrating, on a dance floor, that is over crowded!
If this trend continues, it wouldn’t be a surprise if Coronavirus makes its presence felt…at such venues.
And, then, what happens to the entertainment scene, and those involved in this field, especially the musicians? No work, whatsoever!
Lots of countries have closed nightclubs, and venues, where people gather, in order to curtail the spread of this deadly virus that has already claimed the lives of thousands.
Thailand did it and the country is still having lots of restrictions, where entertainment is concerned, and that is probably the reason why Thailand has been able to control the spread of the Coronavirus.
With a population of over 69 million, they have had (so far), a little over 25,000 cases, and 83 deaths, while we, with a population of around 21 million, have over 80,000 cases, and more than 450 deaths.
I’m not saying we should do away with entertainment – totally – but we need to follow a format, connected with the ‘new normal,’ where masks and social distancing are mandatory requirements at these venues. And, dancing, I believe, should be banned, at least temporarily, as one can’t maintain the required social distance, while on the dance floor, especially after drinks.
Police spokesman DIG Ajith Rohana keeps emphasising, on TV, radio, and in the newspapers, the need to adhere to the health regulations, now in force, and that those who fail to do so would be penalised.
He has also stated that plainclothes officers would move around to apprehend such offenders.
Perhaps, he should instruct his officers to pay surprise visits to some of these entertainment venues.
He would certainly have more than a bus load of offenders to be whisked off for PCR/Rapid Antigen tests!
I need to quote what Dr. H.T. Wickremasinghe said in his article, published in The Island of Tuesday, February 16th, 2021:
“…let me conclude, while emphasising the need to continue our general public health measures, such as wearing masks, social distancing, and avoiding crowded gatherings, to reduce the risk of contact with an infected person.
“There is no science to beat common sense.”
But…do some of our folks have this thing called COMMON SENSE!
