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Quadriplegic doctor aspires to walk again

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Dr. Dinesh Palipana Queensland’s Australian of the Year 2021

By Sajitha Prematunge

Dr. Dinesh Palipana does not have the full command of his fingers and his usual offer of a handshake took the form of an awkwardly extended fist. President Mahinda Rajapaksa, like a good sport, fist bumped the quadriplegic doctor, gangster-like, an act of empathy Palipana appreciates to this day. Such are the trials and tribulations Sri Lankan-born Australian doctor, lawyer and disability advocate, Dinesh Palipana is faced with, on a daily basis. But such technicalities didn’t prevent him from recently being named Queensland’s Australian of the Year 2021.

The quadriplegic doctor, the first of its kind in Queensland, and the second in Australia, is currently a lecturer at the School of Medicine, Griffith University; Adjunct Research Fellow at Menzies Health Institute Queensland and Senior House Officer (Emergency Department) at Gold Coast University Hospital. “Eleven years ago I was lying on an intensive care bed, I couldn’t move my arms and legs, I couldn’t eat or breathe. My life was falling apart all around me. But to be here after all that trauma seams surreal. But I am grateful for life, for my community, friends and family that supported me,” said Dr. Palipana.

He is a founding member of Doctors with Disabilities Australia, an advocacy group for physicians with disabilities and the ambassador for Physical Disability Australia. Palipana is a member of the scientific advisory committee of Perry Cross Spinal Research Foundation. In 2019 Palipana was awarded the Medal of the Order of Australia for his service to medicine; Junior Doctor of the Year at the Gold Coast University Hospital; Henry Viscardi Achievement Award, a global award in recognition for his work in disability advocacy; and ‘Change Making’ in National Awards for Disability Leadership. All these accolades and achievements would have been impossible without the love and support of his mother, Chithrani Palipana. “My mother taught me what love, strength, commitment and perseverance are.”

 

Tragedy

Born in 1984, Palipana and his family migrated to Australia in 1994, when he was 10. Not only physical disability, Palipana knows only too well how debilitating mental health disorders are as well. He battled with depression, anxiety and panic disorder while studying law. “It took some time. I had to readjust my life and thinking. Finding my purpose really helped.” He realized that law was not his calling. He commenced his Doctor of Medicine at the Griffith University in 2008. When he was 25 and half way through his medical degree, he lost control of his car while driving home on a wet night. The car aquaplaned and rolled. When it finally stopped, he realized that he could not move or feel his legs. Palipana was far enough in his medical education to self diagnose it as a spinal cord injury. It left him quadriplegic.

He lost all sensory and motor function below his chest due to the injury. “I can’t move my fingers,” said Palipana. He has had to make a lot of adjustments to life. “Initially, going from a normal life to being paralysed, was very challenging.” Palipana pointed out that even day-to-day activities can be difficult with impaired movement. Despite a life-changing disability, Palipana decided to go back to medical school. Against all odds he graduated in 2016, with quite a few awards, as the first quadriplegic medical graduate in the state of Queensland, the second in Australia. He also completed a medical clerkship at Harvard Medical School.

Prof Harry McConnell of Griffith University was instrumental in getting Dinesh back on his feet, no pun intended. “He is a passionate believer in inclusivity and has always fought for the rights of those with different abilities. He did a lot of work to facilitate me coming back to medical school. He also helped me a lot with getting my life back together.” Palipana was inspired by Dr Harry Eeman, Australia’s first doctor with tetraplegia, who sustained a severe form of Guillain-Barré syndrome (GBS), a rare neurological disorder that left him paralysed, halfway through medical school. “Dr. Eeman spent time with me to figure out solutions to some of the physical challenges. His experience really laid the foundation for my journey.”

 

Medical school

Palipana adapted new methods to train as a quadriplegic doctor, in partnership with Griffith University and the Gold Coast University Hospital. Quadriplegia can turn everyday activities into obstacles, but he learned his way around them. “Before coming back to medical school I spent a lot of time finding solutions to challenges. I had a great team helping me.” And with persistence, he learned how to hold a stethoscope making use of the natural grip of his fingers. He learned how to examine patients. “I even learned how to insert a cannula with some assistance.”

When asked how inclusive Australian professional culture is, in terms of employment opportunities for the differently-abled, as opposed to a country like Sri Lanka, Palipana admitted that it initially proved difficult to secure an internship in medicine in Australia. Despite two years in clinical training as a medical student at the Gold Coast University Hospital, Palipana had trouble securing an internship. In 2016, he was the only Queensland medical graduate without an employment offer. “I worked really hard in medical school and got good grades. It was very frustrating that non of those things mattered.”

Palipana admitted that medicine is not the most inclusive profession, but said it has improved much in the past five years. Although he explored the possibility of pursuing a medical degree in a Sri Lankan University, Palipana said that most university administrations were reluctant to accommodate him, “Except for Kelaniya University. Other universities have a long way to go in terms of inclusivity.” As a quadriplegic doctor working in Australian, Palipana said that shortcomings of accessibility are not restricted to Sri Lanka. “Accessibility needs a lot of work globally.”

His perseverance paid off. He was eventually employed by the Gold Coast University Hospital as Queensland’s first quadriplegic intern. His disability makes him no less capable as a doctor compared to an able-bodies person. Gold Coast Health, Emergency Medicine Director, Associate Professor David Green, speaking to the Today Show Australia, vouched for Palipana’s ability to pull his weight, albeit on a wheelchair. “In a big, busy emergency with a lot of staff, his value is enormous…After a while you just forget about his disability,” said Green on the Today Show. Dinesh said that the team spirit gets him through. “Besides, there are plenty of patients, I can examine, who do not require me to perform any procedure.”

When asked whether his disability has made him more empathetic towards his patients and whether the accident and subsequent hospitalization made him more able to relate to his patients, Palipana said he remembers what it felt like to be a patient. “It can be disempowering and terrifying. Anchoring myself in my own experiences helps me to remember what it’s like being a patient.” On the other hand Dinesh said that he has never had a patient react negatively to him. “Every single patient has been amazing. I am privileged to be a part of their journey towards recovery.”

Cutting-edge rehabilitation techniques for spinal cord injuries has a major research appeal for Palipana, who is determined to walk again. As Griffith University’s Biospine Project co-lead, Palipana explained that thought-controlled rehabilitation involves translating thought patterns into movement. “For example, if someone’s thinking of walking, we can translate that thought to movement by electrically stimulating the leg.” Promising results suggest that it can re-programme the spinal cord to restore some function in people with paralysis. “Therapies such as thought-controlled rehabilitation, drug therapy and digital twins have separately shown to restore some function in people with chronic paralysis. It is our hope that people like me will be able to stand on their own power again.” His ultimate goal is to come up with a therapy for spinal cord injury.

 

Advocacy

After recuperating at hospital for eight months, Palipana came back to Sri Lanka, where he spent another year, recovering in the company of family and friends. While in Sri Lanka he raised awareness and funds for spinal cord injury victims. In fact, his disability was a catalyst to his advocacy for training medical students with disabilities in Australia. “I’m lucky to be in a position to advocate for people with different abilities,” said Palipana.

Palipana obtained his law degree from the Queensland University of Technology in 2007 and was admitted as a lawyer in 2020. His background in law gave new impetus for his advocacy work on inclusivity in medical profession and education in Australia. “Law is a great tool that can be used to do a lot of good. It allows us to navigate legal and social structures.” His advocacy work with the Australian Medical Association has paved the way for national policies on inclusivity in medical education and employment. He used his story to demonstrate how the community can work with disability, to overturn a set of guidelines issued by the Medical Deans of Australia and New Zealand in 2015, vesting Australian medical schools with the power to exclude students with a range of disabilities. “Another major obstacle faced by students with disabilities was the attitudes of education establishments such as universities and academics.” Palipana said that Griffith University was an exception.

Palipana is also vocal about disability rights in the times of COVID-19. “The COVID-19 pandemic highlighted some of the inequities that differently-abled people face. Everything from healthcare access to employment has been an issue,” said Palipana. When health resources are scarce, some would argue that they are better utilized on those with a higher chance of survival. When governments of the developed world are forced to consider how to ration ventilators between people with disabilities and those without, how has COVID-19 affected those with disabilities?

If one with lungs as compromised as those of Palipana’s, were to contract COVID-19, the prognosis would indeed be bleak. Palipana explained that people with disabilities, depending on the disability, can be at high risk of increased complications due to COVID-19. “Many disabilities affect lung function. My lungs for example, don’t function as well, because of the spinal cord injury. It’s 30 percent of what it should be. If I were to get COVID-19 or even the flu, the chances of an adverse outcome is relatively high. Similarly, people with multiple sclerosis and stroke victims are susceptible,” pointed out Palipana. That should not justify sidelining people with disabilities. Palipana maintained that it is all the more reason to safeguard such vulnerable groups. “Through different forums and organisations, I am fortunate to be able to make a contribution in this important area.”

His message to people with debilitating disabilities and illnesses, who may be contemplating giving up on life is, “As a good friend once said, life is about ups and downs. Whenever there is an up, just know that there will be a down. Things can get challenging, but anyone can overcome them and live their dream, if they have the will. If I can become a doctor and lawyer others can too. Just find your passion and chase it.”

Going from being unable to breathe without the aid of a respirator, to advocating for disabled people and developing medical aid, real life success stories such as that of Robin Cavendish, never cease to inspire. Dinesh Palipana who proved his mettle by doggedly pursuing a career in medicine, while advocating for disability rights is, without a doubt, of that same calibre and hopefully will inspire multitudes more to achieve similarly extraordinary aspirations.



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Features

Strong on vocals

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The group Mirage is very much alive, and kicking, as one would say!

Their lineup did undergo a few changes and now they have decided to present themselves as an all male group – operating without a female vocalist.

At the helm is Donald Pieries (drums and vocals), Trevin Joseph (percussion and vocals), Dilipa Deshan (bass and vocals), Toosha Rajarathna (keyboards and vocals), and Sudam Nanayakkara (lead guitar and vocals).

The plus factor, where the new lineup is concerned, is that all five members sing.

However, leader Donald did mention that if it’s a function, where a female vocalist is required, they would then feature a guest performer.

Mirage is a very experience outfit and they now do the Friday night scene at the Irish Pub, in Colombo, as well as private gigs.

 

 

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Dichotomy of an urban-suburban New Year

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Ushered in by the ‘coo-ee’ of the Koel and the swaying of Erabadu bunches, the Sinhala and Tamil New Year will dawn in the wee hours of April 14. With houses to clean, preparation of sweetmeats and last-minute shopping, times are hectic…. and the streets congested.

It is believed that New Year traditions predated the advent of Buddhism in the 3rd century BC. But Buddhism resulted in a re-interpretation of the existing New Year activities in a Buddhist light. Hinduism has co-existed with Buddhism over millennia and no serious contradiction in New Year rituals are observed among Buddhists and Hindus.

The local New Year is a complex mix of Indigenous, Astrological, Hindu, and Buddhist traditions. Hindu literature provides the New Year with its mythological backdrop. The Prince of Peace called Indradeva is said to descend upon the earth to ensure peace and happiness, in a white carriage wearing on his head a white floral crown seven cubits high. He first plunges, into a sea of milk, breaking earth’s gravity.

The timing of the Sinhala New Year coincides with the New Year celebrations of many traditional calendars of South and Southeast Asia. Astrologically, the New Year begins when the sun moves from the House of Pisces (Meena Rashiya) to the House of Aries (Mesha Rashiya) in the celestial sphere.

The New Year marks the end of the harvest season and spring. Consequently, for farming communities, the traditional New Year doubles as a harvest as well. It also coincides with one of two instances when the sun is directly above Sri Lanka. The month of Bak, which coincides with April, according to the Gregorian calendar, represents prosperity. Astrologers decide the modern day rituals based on auspicious times, which coincides with the transit of the Sun between ‘House of Pisces’ and ‘House of Aries’.

Consequently, the ending of the old year, and the beginning of the new year occur several hours apart, during the time of transit. This period is considered Nonegathe, which roughly translates to ‘neutral period’ or a period in which there are no auspicious times. During the Nonegathe, traditionally, people are encouraged to engage themselves in meritorious and religious activities, refraining from material pursuits. This year the Nonegathe begin at 8.09 pm on Tuesday, April 13, and continues till 8.57 am on 14. New Year dawns at the halfway point of the transit, ushered in bythe sound of fire crackers, to the woe of many a dog and cat of the neighbourhood. Cracker related accidents are a common occurrence during new year celebrations. Environmental and safety concerns aside, lighting crackers remain an integral part of the celebrations throughout Sri Lanka.

This year the Sinhala and Tamil New Year dawns on Wednesday, April 14, at 2.33 am. But ‘spring cleaning’ starts days before the dawn of the new year. Before the new year the floor of houses are washed clean, polished, walls are lime-washed or painted, drapes are washed, dried and rehang. The well of the house is drained either manually or using an electric water pump and would not be used until such time the water is drawn for first transaction. Sweetmeats are prepared, often at homes, although commercialization of the new year has encouraged most urbanites to buy such food items. Shopping is a big part of the new year. Crowds throng to clothing retailers by the thousands. Relatives, specially the kids, are bought clothes as presents.

Bathing for the old year takes place before the dawn of the new year. This year this particular auspicious time falls on April 12, to bathe in the essence of wood apple leaves. Abiding by the relevant auspicious times the hearth and an oil lamp are lit and pot of milk is set to boil upon the hearth. Milk rice, the first meal of the year, is prepared separate. Entering into the first business transaction and partaking of the first meal are also observed according to the given auspicious times. This year, the auspicious time for preparing of meals, milk rice and sweets using mung beans, falls on Wednesday, April 14 at 6.17 am, and is to be carried out dressed in light green, while facing east. Commencement of work, transactions and consumption of the first meal falls on Wednesday, April 14 at 7.41 am, to be observed while wearing light green and facing east.

The first transaction was traditionally done with the well. The woman of the house would draw water from the well and in exchange drop a few pieces of charcoal, flowers, coins, salt and dried chillies into the well, in certain regions a handful of paddy or rice is also thrown in for good measure. But this ritual is also dying out as few urban homes have wells within their premises. This is not a mere ritual and was traditionally carried out with the purification properties of charcoal in mind. The first water is preferably collected into an airtight container, and kept till the dawn of the next new year. It is believed that if the water in the container does not go down it would be a prosperous year. The rituals vary slightly based on the region. However, the essence of the celebrations remains the same.

Anointing of oil is another major ritual of the New Year celebrations. It falls on Saturday, April 17 at 7.16 am, and is done wearing blue, facing south, with nuga leaves placed on the head and Karada leaves at the feet. Oil is to be applied mixed with extracts of Nuga leaves. The auspicious time for setting out for professional occupations falls on Monday, April 19 at 6.39 am, while dressed in white, by consuming a meal of milk rice mixed with ghee, while facing South.

Traditionally, women played Raban during this time, but such practices are slowly being weaned out by urbanization and commercialisation of the New Year. Neighbours are visited with platters of sweetmeats, bananas, Kevum (oil cake) and Kokis (a crispy sweetmeat) usually delivered by children. The dichotomy of the urban and village life is obvious here too, where in the suburbs and the village outdoor celebrations are preferred and the city opts for more private parties.

 

 

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New Year games: Integral part of New Year Celebrations

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Food, games and rituals make a better part of New Year celebrations. One major perk of Avurudu is the festivals that are organised in each neighbourhood in its celebration. Observing all the rituals, like boiling milk, partaking of the first meal, anointing of oil, setting off to work, are, no doubt exciting, but much looked-forward-to is the local Avurudu Uthsawaya.

Avurudu Krida or New Year games are categorised as indoor and outdoor games. All indoor games are played on the floor and outdoor games played during the Avurudu Uthsava or New Year festival, with the whole neighbourhood taking part. Some of the indoor games are Pancha Dameema, Olinda Keliya and Cadju Dameema. Outdoor games include Kotta pora, Onchili pedeema, Raban geseema, Kana mutti bindeema, Placing the eye on the elephant, Coconut grating competition, Bun-eating competition, Lime-on-spoon race, Kamba adeema (Tug-o-War) and Lissana gaha nageema (climbing the greased pole). And what’s an Avurudhu Uthsava sans an Avurudu Kumari pageant, minus the usual drama that high profile beauty pageants of the day entail, of course.

A salient point of New Year games is that there are no age categories. Although there are games reserved for children such as blowing of balloons, races and soft drinks drinking contests, most other games are not age based.

Kotta pora aka pillow fights are not the kind the average teenagers fight out with their siblings, on plush beds. This is a serious game, wherein players have to balance themselves on a horizontal log in a seated position. With one hand tied behind their back and wielding the pillow with the other, players have to knock the opponent off balance. Whoever knocks the opponent off the log first, wins. The game is usually played over a muddy pit, so the loser goes home with a mud bath.

Climbing the greased pole is fun to watch, but cannot be fun to take part in. A flag is tied to the end of a timber pole-fixed to the ground and greased along the whole length. The objective of the players is to climb the pole, referred to as the ‘tree’, and bring down the flag. Retrieving the flag is never achieved on the first climb. It takes multiple climbers removing some of the grease at a time, so someone could finally retrieve the flag.

Who knew that scraping coconut could be made into an interesting game? During the Avurudu coconut scraping competition, women sit on coconut scraper stools and try to scrape a coconut as fast as possible. The one who finishes first wins. These maybe Avurudu games, but they are taken quite seriously. The grated coconut is inspected for clumps and those with ungrated clumps are disqualified.

Coconut palm weaving is another interesting contest that is exclusive to women. However men are by no means discouraged from entering such contests and, in fact, few men do. Participants are given equally measured coconut fronds and the one who finishes first wins.

Kana Mutti Bindima involves breaking one of many water filled clay pots hung overhead, using a long wooden beam. Placing the eye on the elephant is another game played while blindfolded. An elephant is drawn on a black or white board and the blindfolded person has to spot the eye of the elephant. Another competition involves feeding the partner yoghurt or curd while blindfolded.

The Banis-eating contest involves eating tea buns tied to a string. Contestants run to the buns with their hands tied behind their backs and have to eat buns hanging from a string, on their knees. The one who finishes his or her bun first, wins. Kamba adeema or Tug-o-War pits two teams against each other in a test of strength. Teams pull on opposite ends of a rope, with the goal being to bring the rope a certain distance in one direction against the force of the opposing team’s pull.

Participants of the lime-on-spoon race have to run a certain distance while balancing a lime on a spoon, with the handle in their mouths. The first person to cross the finish line without dropping the lime wins. The sack race and the three-legged race are equally fun to watch and to take part in. In the sack race, participants get into jute sacks and hop for the finish line. The first one over, wins. In the three-legged race one leg of each pair of participants are tied together and the duo must reach the finish line by synchronising their running, else they would trip over their own feet.

Pancha Dameema is an indoor game played in two groups, using five small shells, a coconut shell and a game board. Olinda is another indoor board game, normally played by two players. The board has nine holes, four beads each. The player who collects the most number of seeds win.

This is the verse sung while playing the game:

“Olinda thibenne koi koi dese,

Olinda thibenne bangali dese…

Genath hadanne koi koi dese,

Genath hadanne Sinhala dese…”

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