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 Post subject: Memoirs of a surgeon at Base Hospital, Polonnaruwa
 Post Posted: Fri Oct 07, 2005 3:42 am 
Memoirs of a Surgeon at Base Hospital, Polonnaruwa

By Dr. Gamini Goonetileke, 2001

There are few hard data. I am drawing on my background of 19 years of service as a surgeon in this country, 12 of which was spent in one-man stations in small Base Hospitals in rural and semi-urban areas.

On my return to the country from the UK after the Fellowship I was appointed to Base Hospital, Polonnaruwa, as acting surgeon. I proceeded reluctantly to this hospital where the DMO was my friend and colleague. This was a small hospital with 200 beds. There were 3 consultants in the hospital at that time. Initial accommodation for me was provided in an old dilapidated hospital building. A bed was supplied from the hospital ward. A mosquito net was also provided, to prevent me from getting Malaria which was rampant in Polonnaruwa at that time. Food was a problem as I did not know how to cook, therefore had to be obtained from a nearby household. Being the only surgeon, I was treated with much respect and held in high esteem probably second only to King Parakramabahu the great. This boosted my ego tremendously. Therefore I decided to continue my stay in spite of the difficulties. This was the only hospital with surgical facilities in the entire Polonnaruwa District serving a population of 300,000 people, most of whom were farmers and Mahaveli settlers. It was an important hospital in view of the Mahaveli project. Later on it assumed greater importance as a center for treating the war wounded, both military and civilian.

The facilities were less than basic for a surgeon to work with. During the first three months there were no house officers or an anaesthetist. However, I performed surgery anaesthetising the patients myself; using local, regional, spinal and sometimes even general anaesthesia. The junior doctors including an anaesthetist who arrived later on a WHO funded project were from Burma. They were provided for much better than the local consultants and also enjoyed a higher salary. Foreign qualified Sri Lankan interns were appointed much later. During the entire period of my stay in Polonnaruwa I did not set my eyes on a Consultant Anaesthetist, a Radiologist, a Histopathologist or even a Microbiologist. Laboratotry facilities were primitive and the only tests that could be done were wbc/dc, Hb% and urine FR. A small blood bank was run by a nurse. The Xray machine was old and only plain X’rays were available and those too of poor quality. The operating theatre was short of equipment and on my trips to Colombo I was in the habit of visiting the EME to pick up equipment which I transported myself to Polonnaruwa. On one occasion when I visited another division to collect stationery, an officer there asked me whether I was the pharmacist of Base Hospital, Polonnaruwa. He was surprised that the surgeon was doing the lowly work of the hospital pharmacist. But work had to go on.

As the only surgeon in this hospital I was expected to provide a day and night service. The only time off was when I left the station once in 3 months. The workload was heavy, wards were crowded with many patients on the floor or sitting on benches provided. The diagnosis of disease in most cases was clinical. Surgical operations were performed daily. There were no peers to discuss problems or to obtain advise when needed. The work was interesting and covered nearly all aspects of surgery. Fifty percent of the work consisted of trauma and emergency care. Patients were usually admitted late because of poor transport facilities and sometimes were in a moribund state. There were a wide variety of surgical cases as I will illustrate now. In spite of the difficulties I was able to perform 15,000 operations. The staff was very co-operative. Several aspects of my work in Polonnaruwa have been presented at scientific sessions both locally and abroad. This has helped me to advance in my surgical career. The immense gratitude of the people kept me contended for 6 1/2 years. This was an experience of a life time. I am saying all this to impress my younger surgical colleagues of the wealth of experience that could be gathered by working in an outstation Base Hospital.

Do not wait for the best job to start work and remember The lessons you learn best in surgery are your own. Nothing is more fixed in your mind than your own experiences. The experience of others help, but, my dear friends there is no substitute for your own.

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