During his last visit to Sri Lanka, APSL President, Mr. Mervyn Silva, visited Anuradhapura Hospital on 25th August and met with Dr. Rajeewa Dassanayake, his medical colleagues and nursing staff.
The purpose of this visit was to:
- hand over a multifunctional patient monitoring machine bought with the funds raised during APSL 10th Anniversary event, which was gratefully received,
- learn more about the work going on with increasing numbers of patients with kidney disease, and
- find out how APSL may be of help in the future.
The hospital is faced with the serious situation of patients with kidney disease, presenting in ever increasing numbers. There are theories as to cause/s, but as yet no definite reasons have been found.It is possible that there are multifactual causes, rather than one main cause, making detection difficult. It appears that more females present in the early stages, and more males in the later stages of the disease.
A study has shown a 22% infection in Badulla, 18% in Polonnaruwa and 15% in Anuradhapura.
The epidemic appears to be more prevelant in low income families many with poor hygiene facilities and often social problems. The average household income among the dialysis patients was found to be Rs14,700 per month. Patients who are diagnosed to have reached advanced stages of kidney disease receive an allowance of Rs.500 per month from the government. The hospital has 4,000 registered patients and 4 satellite centres, staffed by junior doctors. The treatments carried out includes assessment in clinics, dialysis to clean the blood, and kidney transplants with follow up care. All treatment is free but the biggest cost to patients is in travelling to the hospital or clinics, which could be as much as half a households income.
The first floor at the CKD Unit is the hemo-dialysis ward, the second floor has separate male and female inpatient wards, and the fourth floor is the peritoneal dialysis ward ( through the stomach). The transplant unit can treat up to 1 patient every 2 weeks with kidneys coming mainly from family members, some from monks for altruistic reasons and some from deceased people.
According to Dr Rajeewa, one of the main problems for the hospital is facing is the low staffing levels. At the time of the visit, there were 6 doctors doing the work of an ideal number of 18, and therefore having to work extremely long hours, often doing a weeks work within one day! Also nursing staff numbers are low, ideally more trained nursing staff are needed. In spite of these difficulties, to their credit, amazing work is continually carried out, with only one complaint in 3 years!!!
Because of the large numbers of patients attending the clinic, often as high as 130 – 140 per session, a more effective management system is needed, where information and possibly educational input is clearly and effectively displayed, so the whole assessment area can operate more efficiently and smoothly and increase the level of patient care that all staff are working so hard to achieve.
The mulit functional monitoring machine donated during this visit was purchased with the funds raised at the APSL’s 10th anniversary dinner dance. They will enable the staff to monitor patients on the wards more accurately.
In addition to this monitoring machine, Dr Rajeewa and team have requested a syringe pump and an infusion pump to help them administer drugs more accurately to the transplant patients. They also asked for five digital blood pressure monitors that would help them measure patients’ blood pressure faster and more accurately. Being more portable devices they would also come in handy during the outreach screening programmes. Mr Silva promised to send these items through the next APSL representative to visit Sri Lanka. [Arrangements were being made to supply these items using the remaining funds at the time of writing this report.]
As with all hospitals, there is an ongoing battle with infection and much work needs to be done in trying to educate and change peoples attitudes towards standards of hygiene. However, during the visit, the hospital appeared very clean, all credit to the wonderfully hard working staff.
Mr. Silva thanked Dr. Rajeewa and staff for their warm welcome, for giving up their valuable time to show them around the hospital and for the detailed level of information which was shared.
10 Sept 2014