By Rathindra Kuruwita

Despite the easy availability of the 1990 ambulance service, most people who have met with an accident are brought to the hospital by personal vehicles, Dr. Sajith Ranathunga General Surgeon at the National Hospital of Sri Lanka, said.

“Out of those vehicles, most are three-wheelers. When an accident happens, most people don’t know what kind of hospital they should be taken to. Staff in the 1990 ambulances know, but the average man on the street does not. We must educate Sri Lankans and create a system where everyone knows where to take a person who has met with an accident, based on the nature of the injury.”

Dr. Ranathunga said that the 1990 ambulance service has done a lot to minimize fatalities. He added that Sri Lanka has several types of hospitals, and hospitals like the Colombo National Hospital are tertiary care hospitals. The next rung of hospitals are district general hospitals, and they, too, have surgeons and emergency care departments.

“Then there are the base hospitals. These hospitals, too, have surgeons who take care of emergency situations. There are also hospitals that only have a general practitioner, and they take steps to transfer patients that need emergency care to a hospital with better facilities,” he said.

Meanwhile, Dr. Kirthi Abayajeewa, Consultant Surgeon at the Colombo National Hospital said Sri Lankan hospitals receive about seven cases of serious accidents that result in death. About 10 times more people become differently abled due to accidents. About 10 times that number of people suffer from minor injuries that do not require hospital visits.

These are high numbers, and we have been in this high range for many years. “There was a drop in accidents during COVID. But it has returned to the usual high rates following the lifting of lockdowns,” he said.

As a country develops, the number of people who die or get permanently injured reduces. However, in a country like Sri Lanka, fatalities that occur during accidents are higher than in a developed country, he mentioned.

Dr. Abayajeewa said that when it comes to motor accidents, ignoring road rules, the quality of roads, and vehicles, are the main reasons why most accidents occur and why there are higher fatalities. He said that recently they held a convention on accidents to share their knowledge among all stakeholders.

“We need to establish a trauma network covering all hospitals. This might cost a lot but is essential as we go forward.”

Dr. Gayan Ekanayake, Plastic Surgeon at the Colombo National Hospital, said the use of data and the application of data science in the management of injuries are low. “Everything depends on data. We need to immediately start collecting, analysing and using data to make key decisions on accident prevention as well as the management of accidents.”

Dr. Ekanayake said road accidents caused by violating road rules, injuries caused by those who are depressed, burn wounds, and violence that occurs due to domestic disputes, can be reduced with a change in attitude.

“I especially see interpersonal violence as a serious burden to the healthcare system. For example, a lot of people come in with injuries caused by sword attacks, and we have to do several surgeries that take over 12 hours. These are resource-intensive operations. The most striking feature is that most of these sword attacks have been done, emulating what people see in films. Resorting to violence has become normalized. We need to change our attitudes,” he said.

Domestic violence is also a serious problem. About 10 years ago, there were campaigns to deter domestic violence, and these programmes must continue because people tend to forget, he said. “The other problem is road accidents. Some people become speed demons once they get behind the wheel. They completely forget the risks involved in excessive speeding and violating traffic laws,” he added.