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Lady Ridgeway Hospital: A haven for sick children in Sri Lanka

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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.



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Features

Investigative Journalism?

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I usually end up totally exhausted when I finish reading the local newspapers from the Pearl. There are so many burning questions and so much is written about them but there are no conclusions and definitely no answers. For example, we seem to have three burning issues right now and this is not in order of importance.

We have a lengthy report that has been published on the Easter Sunday carnage. Everybody knows what I am talking about. However, no one, be it an editor, a paid journalist or a single one of the many amateurs who write to the papers, has reached a conclusion or even expressed an opinion as to who was responsible. At least not a believable one! Surely there are energetic and committed young people in the field of journalism today who, if asked, or directed properly will go out and find a source that would give them at least a credible hypothesis? Or do conclusions exist and has no one the courage to publish them?

At least interview the authors or should I use the word perpetrators of that report. If they refuse to be interviewed ask them why and publish an item every day asking them why! Once you get a hold of them, cross-examine them, trap them into admissions and have no mercy. It is usually geriatrics who write these reports in the Pearl and surely a bright young journalist can catch them out with a smart question or two, or at least show us that they tried? The future of the country depends on it!

We have allegations of contaminated coconut oil been imported. These are very serious allegations and could lead to much harm to the general populace. Do you really believe that no one can find out who the importers are and what brands they sell their products under? In this the Pearl, where everyone has a price, you mean to say that if a keen young journalist was given the correct ammunition (and I don’t mean 45 calibres) and sent out on a specific message, he or she couldn’t get the information required?

We are told that a massive amount of money has been printed over the last few months. There is only speculation as to the sums involved and even more speculation as to what this means to the people of the Pearl. Surely, there are records, probably guarded by extremely lowly paid government servants. I am not condoning bribery but there is nothing left to condone, is there? There are peons in government ministries who will gladly slip you the details if you are committed enough and if you are sent there to get it by a boss who will stand by you and refuse to disclose his sources.

I put it to you, dear readers, that we do not have enough professional, committed and adequately funded news organisations in the country. We can straightaway discount the government-owned joints. We can also largely discount those being run by magnates for personal gain and on personal agendas. As far as the Internet goes, we can forget about those that specialise in speculative and sensationalist untruths, what are we left with O denizens of the Pearl? Are there enough sources of news that you would consider willing to investigate a matter and risk of life and limb and expose the culprits for the greater good of society? Can they be counted even on the fingers of one hand?

In this era when we have useless political leaders, when law and order are non-existent when the police force is a joke, it is time the fourth estate stepped up to the mark! I am sure we have the personnel; it is the commitment from the top and by this, I mean funding and the willingness to risk life and limb, that we lack. Governments over the last few decades have done their best to intimidate the press and systematically destroy any news outlet that tried to buck the usual sycophantic behaviour that is expected from them by those holding absolute power.

Do you think Richard Nixon would ever have been impeached if not for the Watergate reporting? Donald Trump partially owes his defeat to the unrelenting campaign carried out against him by the “fake news” outlets that he tried to denigrate. Trump took on too much. The fourth estate of America is too strong and too powerful to destroy in a head-to-head battle and even the most powerful man in the world, lost. Let’s not go into the merits and demerits of the victor as this is open to debate.

Now, do we have anything like that in the Pearl? Surely, with 20 million-plus “literate” people, we should? We should have over 70 years of independence built up the Fourth Estate to be proud of. One that would, if it stood strong and didn’t waver and collapse under pressure from the rulers, have ensured a better situation for our land. Here is Aotearoa with just five million people, we have journalists who keep holding the government to account. They are well-funded by newspapers and TV networks with audiences that are only a fraction of what is available in the Pearl. Some of the matters they highlight often bring a smirk of derision to my face for such matters wouldn’t even warrant one single line of newsprint, should they happen in the Pearl.

Talking of intimidation from the rulers, most of us are familiar with the nationalisation of the press, the murder and torture of journalists, the burning of presses to insidious laws been passed to curtail the activities of Journalism. These things have happened in other countries, too, but the people and press have been stronger, and they have prevailed. We are at a watershed, an absolutely crucial time. It is now that our last few credible news sources should lift their game. Give us carefully researched and accurate reports with specific conclusions, not generalisations. Refuse to disclose your sources as is your right, especially now that the myopic eye of the UNHCR is turned in our direction.

All other ways and means of saving our beloved motherland, be it government, religion, sources of law and order and even civil society leadership seems to have lapsed into the realm of theory and rhetoric. Our last chance lies with the Fourth Esate and all it stands for. I call for, nay BEG for, a favourable reaction from those decision-makers in that field, who have enough credibility left in society, DON’T LET US DOWN NOW!

 

 

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Features

The world sees ugly side of our beauty pageants

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Yes, it’s still the talk-of-the-town…not only here, but the world over – the fracas that took place at a recently held beauty pageant, in Colombo.

It’s not surprising that the local beauty scene has hit a new low because, in the past, there have been many unpleasant happenings taking place at these so-called beauty pageants.

On several occasions I have, in my articles, mentioned that the state, or some responsible authority, should step in and monitor these events – lay down rules and guidelines, and make sure that everything is above board.

My suggestions, obviously, have fallen on deaf ears, and this is the end result – our beauty pageants have become the laughing stock the world over; talk show hosts are creating scenes, connected with the recent incidents, to amuse their audience.

Australians had the opportunity of enjoying this scenario, so did folks in Canada – via talk show hosts, discussing our issue, and bringing a lot of fun, and laughter, into their discussions!

Many believe that some of these pageants are put together, by individuals…solely to project their image, or to make money, or to have fun with the participants.

And, there are also pageants, I’m told, where the winner is picked in advance…for various reasons, and the finals are just a camouflage. Yes, and rigging, too, takes place.

I was witnessed to one such incident where I was invited to be a judge for the Talent section of a beauty contest.

There were three judges, including me, and while we were engrossed in what we were assigned to do, I suddenly realised that one of the contestants was known to me…as a good dancer.

But, here’s the catch! Her number didn’t tally with the name on the scoresheet, given to the judges.

When I brought this to the notice of the organiser, her sheepish reply was that these contestants would have switched numbers in the dressing room.

Come on, they are no babes!

On another occasion, an organiser collected money from the mother of a contestant, promising to send her daughter for the finals, in the Philippines.

It never happened and she had lots of excuses not to return the money, until a police entry was made.

Still another episode occurred, at one of these so-called pageants, where the organiser promised to make a certain contestant the winner…for obvious reasons.

The judges smelt something fishy and made certain that their scoresheets were not tampered with, and their choice was crowned the winner.

The contestant, who was promised the crown, went onto a frenzy, with the organiser being manhandled.

I’m also told there are organisers who promise contestants the crown if they could part with a very high fee (Rs.500,000 and above!), and also pay for their air ticket.

Some even ask would-be contestants to check out sponsors, on behalf of the organisers. One wonders what that would entail!

Right now, in spite of the pandemic, that is crippling the whole world, we are going ahead with beauty pageants…for whose benefit!

Are the organisers adhering to the Covid-19 health guidelines? No way. Every rule is disregarded.

The recently-held contest saw the contestants, on the move, for workshops, etc., with no face masks, and no social distancing.

They were even seen in an open double-decker bus, checking out the city of Colombo…with NO FACE MASKS.

Perhaps, the instructions given by Police Spokesman DIG Ajith Rohana, and Army Commander, General Shavendra Silva, mean nothing to the organisers of these beauty pageants…in this pandemic setting.

My sincere advice to those who are keen to participate in such events is to check, and double check. Or else, you will end up being deceived…wasting your money, time, and energy.

For the record, when it comes to international beauty pageants for women, Miss World, Miss Universe, Miss Earth and Miss International are the four titles which reign supreme.

In pageantry, these competitions are referred to as the ‘Big Four.’

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Better use of vanity projects; Cass apologises, and New Year graciousness

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A wise one, with the interests of the country at heart, calling himself ‘A Member of the Silent Majority’, wrote in The Island of Friday, April 9, offering an excellent solution for the better and genuine use of the Mattala Mahinda Rajapaksa International Airport which was built at a stupendous cost to both the Treasury, and wildlife abundant in the area, to satisfy an ego and sycophants’ cries of Hail to the King. Even sans Covid and lockdowns and shut downs of airports, the Mattala Airport was a white elephant, endangering and displacing the black elephants, roaming along their familiar corridors; receiving such few airplanes. Thus, as the writer Cass mentions says, convert the airport to a super hotel with excellent and sure-fire access to wildlife watching, like referred to hotels in Kenya and elsewhere. Yes, it will definitely be a bigger money earner than an airport waiting for a plane to land. Expensive equipment going rusty could be transferred to smaller airports being developed all over the island. There was such a hue and cry when storerooms, within the deserted airport, were used for paddy storage, but not even a whimper of concerted protest when the vanity projects were being built. We also heard that on the rare occasions a plane was to land/take off, peacocks in the area were shot at to prevent them flying into the planes. Aney, what a sin, just to have a name on a nameboard! Use the Suriyawewa Cricket Stadium too for a better purpose and less costly to water and maintain green in near desert climate conditions. What about a residential training institute for youth, perhaps in small industries? If the king-sized ego demands the name be present, OK, leave it. What’s in a name?

Any matter, financial or economic, with benefit to country buttressing it – refer to Dr Harsha de Silva and Eran Wickremaratne. Likewise, anything pertaining to fauna, flora and preservation of natural habitats ask Devani Jayathilake. Cassandra would give two years of her life (she does not have 10 left, she suspects) to know what the answers of the three wise and sincere ones mentioned would be to the proposal to convert the Mattala Airport, oops sorry – Mattala Mahinda Rajapaksa International Airport – to a 7 star hotel for wildlife watching and then tourists proceeding to Yala and other places that were touted to be reached easier if planes brimful of tourists, landed in Mattala. Pipe dream even sans Covid-19.

The thought of the millions, nay billions, our country was indebted to China to construct these vanity projects aka white elephants of the Rajapaksa fiefdom sends Cass’s blood racing in her contracting veins. And now another hair-brained scheme is being exposed, not new but re-exposed: that of the stupendous amount sent direct from the Central Bank with no nod, as reported, from the then Cabinet or Parliament, to an American-resident con-man to improve our appearance on the world stage or at least American stage. My word!! Cosmetics of creams and colours and such like can improve the face of an already beautiful woman. But a country that was once beautiful, glorified, accepted internationally and then politician-spoilt, cannot be redeemed by PR work, however expensively. Nivard Cabraal was the then Govenor of the CB. Of course, as every Banda, Singho and their women say, nothing will come of this. Powerful political sweeping under the carpet in the presence of cardboard administrators and sycophantic hosanna singers, makes the matter disappear and not merely hides it. Unless of course there are enough intrepid outers-of-truths and persistent protestors, brave and national minded enough to continuously tease the matter like a cat its caught rat. Ranjan is locked away in hard labour for four solid years, losing his Parliamentary seat for misusing the gift of his gab, while convicted murderers of the right colour attend Parliament, escorted and all.

Cass apologises

To the reigning Mrs World, Mrs Caroline Jurie, for crowning, uncrowning and recrowning of the winner of the recent Mrs Sri Lanka contest. Caroline Jurie took this stride because the winning contestant was four years on the way to being a divorcee, which status forbids a woman from attempting to wear the crown of Mrs…. (country) with a view to becoming Mrs World. This title and honour is bestowed on a woman who promotes, holds sacred the institution of marriage and is a married woman. Cass castigated Caroline Jurie without knowing then the fact that Jurie had protested about this candidate being considered due to her impending divorce; and allowed to contest. She said she withdrew from the panel of judges since her point was not taken by the others. WHY is the Q. Easy to answer. The new beauty queen of shaky married status was a loud speaker in favour of Presidential Candidate Gotabaya R in Polonnaruwa (captured on social media) and probably spoke on stages for SLPP Parliamentary candidates. So of course she was slated to win; vision impaired over rules and future probabilities, She has her height – one advantage. Beauty can always be dexterously rubbed and painted in. But honesty is important and cannot be cloned or grafted in.

Cass now definitely faults the new Mrs Sri Lanka. She should not have contested, having her papers sent in for divorce and not retracted. What happens when she wins the divorce (or her husband wins it, however the divorce was first mooted). Another local contest? And if the divorce was still pending and she went overseas at great expense and won THE crown or a lesser one. To be returned forthwith when she has to remove the present gold band from her third finger, which probably she has already removed but hastily wore for the contest and when preparing for it? This is why Cass avows that many young women particularly, are so very selfish and forward and uppity and even dishonest now. In Cass’ time and even a decade or two later, a girl would never do what this new beauty has done, flipped aside a core rule and necessity of the contest, just to win by honest means or foul. Way the country’s going, my friend.

Post – Aluth Avurudhu

Cassandra is stuffed gill-high with kavun, aluwa and crunchy kokis, preceded by kiributh and lunumiris. She is fending for herself because a dip in Covid numbers and having had the jab, her domestic wished to enjoy a family new year having missed the last one, locked down as we were. Cass made her own kiributh – tasting somewhat like it should, but the sweets were all gifted her. So, also the offers of help, sleep-ins at others’ homes and solicitous frequent inquiries of ‘how are you?’ Kind and gracious relatives and friends, acquaintances too are thanked; and the most appreciated being neighbouring kitchen helps and care givers. Three-wheeler drivers who spin Cass around on errands too make enquiries. And thus her thoughts when resuming work at the nekath time and word processing this article. Sri Lankans are such good people: kind, caring, willing to share and genuine. And then specters themselves on this very sunny landscape: the dishonest, selfish, revengeful and disgraceful. Shrug them off, clear the mental picture and pronounce thank goodness for goodness around.

May all of us (decent people) have a very good year to follow today –Subha Aluth Avuruddhak!

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