Beyond the call of duty | Sunday Observer

Beyond the call of duty

Pic:Roshan Pitipana
Pic:Roshan Pitipana

Oblivious to the harsh realities of life around them, three sisters aged ten and below make believe they are princesses in a dreamland. Their playhouse is a hospital bed and their playthings are toys supplied by relatives as well as the medical staff at Ward 79.

Only if they were a little older, just enough to understand, they will tell that their beloved mother was suddenly called to eternal rest by God Almighty, to whoever will be brave enough to ask them. The three siblings are among the youngest victims of Easter Sunday’s suicide attacks supposedly masterminded by Islamic State terrorists. Of course they are not the worst affected, for there are others who lost both parents in the senseless attack. The girls have been spared their father to teach them as they grow the meaning of love …in a world full of hatred. And they have a caring circle of aunties and uncles, a nurse on duty says.

Victims of the Katuwapitiya Church attack, the three girls though minors were being treated at the National Hospital of Sri Lanka (NHSL). That Sunday, the medical staff disregarded all protocols to take in the patients and treat them as soon as possible to minimise the number of deaths. The girls were among the critically injured who got transferred from Negombo to the NHSL. The eldest of the three is still being treated for a head injury while the other two have recovered enough to go home.

“At the moment we have only 17 inpatients out of the 267 brought here after the serial blasts,” NHSL coordinator Pushpa Ramyani de Zoysa told the on Saturday. Of them, only four are still in the Intensive Care Unit (ICU). The NHSL counted 59 deaths, of them 50 were declared dead on admission.

The victims from the Kochcikade church and the three hotels – Shangri-La Colombo, Cinnamon Grand and Kingsbury were rushed to the NHSL. In addition, the most critical patients from the Katuwapitiya blast from several hospitals in Negombo and the suburbs were transferred there. All hospitals, especially the NHSL has been praised for the contribution it made to save lives in the aftermath of the serial blasts that killed 253 and injured and maimed another 500.

Casualties

“It was the first time after over a decade we faced a disaster of this magnitude,” Deputy Director General-NHSL Dr. Kumara Wickramasinghe said. Within a span of few hours seven suicide blasts were recorded in the Western and Eastern provinces. In 1996, over 1,400 victims were rushed in after LTTE terrorists carried out a suicide attack on the Central Bank in Colombo.

The NHSL maintains a disaster preparedness plan.”We update it and have mock drills every 3-6 month. We were ready and even on a Sunday morning we managed the situation well,” the Deputy Director General said.

According to the emergency response plan, once the telephone exchange receives a message from the police or the disaster management centre, key people get informed immediately to call in necessary human resources.

“We got the first message around 8.45 a.m. about the Kochchikade church blast. Almost simultaneously the casualties started arriving,” he said.

The staff identified the casualties, there was no time to know their names so a tag was put on. “We had a ‘emergency triage’ in place to identify - the dead, critically injured, the not severely injured but needed urgent care and minor cases.”

The triage helped to assign priorities, and transfer each patient to the appropriate place for treatment. The attack had given them a chance to make it fool proof and identify shortcomings.

One of the shortcomings identified was the arrival of onlookers to the accident service wards, the hospital did not have a plan to keep them off.

The critically injured were channelled to the resuscitating room. “ On an ordinary day there will be only one team on duty to assess patients but that day we had three to receive the injured and wheel them in fast to the necessary units , a lost second meant a lost life in a situation like that,” Dr.Wickramasinghe said. Many were bleeding profusely and were in need of blood transfusions.

He thanked the donors who flocked in huge numbers by Sunday noon to donate blood at the Central Blood Bank. “We had more than we needed within hours and had to issue public notices to stop more donors from coming.”

The heavily injured were directed to the surgical theatres. The NHSL had 10 surgical theatres functioning that day, normally only about half of them will be in operation. Orthopedic and Neorotrauma theatres were also opened in addition to the emergency theatres. ICU beds which are an issue on any given day were freed to face this tragedy not just from the accident service but the neurotrauma and general surgical wards as well. The NHSL was offered support by nearby state hospitals by keeping their ICUs ready for any overflow of patients. However, the need to transfer the patients out for ICU care did not arise.

The Deputy Director said the transfer of critically injured to the hospital in ambulances contributed to lower the number of deaths after admission. Initially, when the news of the disaster reached the NHSL, the hospital ambulances were dispatched to the disaster sites. Later, many patients were brought in the free ambulance service as well.

During the 1996 Central Bank and the 1997 Hotel Galadari terror attacks by the LTTE, patients were transferred in three wheelers and private vehicles. Over 90 people died in the Central Bank blast.

Ambulances at the Castle Street, Lady Ridgeway Children’s Hospital and the Colombo South Teaching Hospital were put on standby to respond to the disaster. “We told them to be ready to take in patients not so severely injured if we had an issue, at the time we did not know how many would be brought in and when the flow will stop. The situation was very uncertain. The police could not tell us when it will stop. “

Team effort

He said the entire staff must be given whatever praise the hospital is being accorded. “It was a team effort, consultants, doctors, nurses, supporting staff and paramedical staff worked day and night during the first few days…they went way beyond their expected duty.”

The hospital also learnt that when it comes to a large influx of patients, there would be an issue with linen and other consumables in the accident service and that was an area which was overlooked.

However, the hospital, a 3,250 bed facility managed to call in supplies from other in house units. Individuals and organisations too came in with donations, as some of the victims were in need of clothes and basic supplies.

Some patients who were in a stable condition were transferred to Lady Ridgeway Children’s hospital and to the Colombo South Hospital.

“When I look back, of course, there were shortcomings overall, but people’s lives were saved as they were brought in within a short time and they received treatment soon.”

Of the 21 injured foreign nationals brought to hospital plus 11 bodies, everything had been cleared by late last week. The Deputy Director General said the hospital had no foreign nationals warded as of Saturday.

A lady doctor who was with the emergency teams recalled how she broke down on seeing a severely affected child being brought in but later suppressed her emotions to perform the duty at hand.

Demons were let loose on that fateful Sunday morning but as it turned out Angels rose to the occasion to take charge and relieve the suffering of the innocent.

 

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