11th February 2001
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Battle has begun for shock-busting Doc

A Trauma Unit for war victims and others is the vision of the President of the College of Surgeons of Sri Lanka
By Ruhanie Perera
Trauma is what worries him and his dream of setting up a trauma unit will move a step closer to reality, with the new mantle that has fallen on Consultant Surgeon Dr. Gamini Goonetilleke.

"Trauma is the number one cause of hospitalisation in Sri Lanka and the third commonest which results in death. Yet we don't have a proper trauma unit," says Dr. Goonetilleke who has just been inducted as the 19th President of the College of Surgeons of Sri Lanka.

The youngest surgeon to have been honoured with this post, Dr. Goonetilleke's interest in trauma goes back to the time when he served at the Polonnaruwa Base Hospital. It was his first appointment as Consultant Surgeon. 

"I was the only surgeon for the whole district at the time (1982 - 1989) and came across many patients seeking treatment for trauma due to various reasons, the main one being agricultural accidents." 

The ethnic conflict, although an agonising burden for surgeons working in the conflict and border areas and a cruel fate for those living amidst it, served to widen Dr. Goonetilleke's experience. Being in charge of the special military ward he helped establish, Dr. Goonetilleke was called upon to treat injuries caused by automatic weapons, conventional and homemade explosive devices, including landmines, sea mines and anti-personnel mines. "Other than that, we have patients suffering from trauma due to traffic accidents, assaults, robberies and burn injuries. This is why we need specialised trauma care." 

The dream of establishing a trauma unit will be one step closer 

to reality when the special trauma course for junior doctors begins this month. 

Dr. Goonetilleke said that he had arranged for foreign funds for the unit, so all he needs now is the support of the local authorities.

Yet another concern of this eminent surgeon is the lack of health education for the public. 

Many patients seek treatment only after their diseases are very advanced. By then it's too late to do anything. Complications can be avoided if symptoms are recognised and not ignored (most often out of ignorance) by the patient. 

"The only way to make a positive impact on this subject is to get through to the public via the electronic and print media on the importance of, what I term, preventing surgical disease and early admission to hospital."

"Our society also needs more general surgeons," says Dr. Goonetilleke listing the last of his primary concerns. "There are some districts without a general surgeon and others with just one serving a population way above the ideal ratio of one surgeon per 50,000 people." His recommendations are to encourage more general surgeons to continue training and further their education. And finally encourage them to carry out their own research. 

Having won 10 medals for himself from medical associations for his research, he encourages his juniors to conduct similar research and present papers. "These are my three main concerns. Since 1982 I have conducted research into these subjects and have been planning and preparing to combat them. Now as President of the College of Surgeons while in active service, this is my chance. 

"I recognise the possible tasks from the impossible and so will concentrate on what I feel I can accomplish."

Other than the primary issues, Dr. Goonetilleke's ambitious 

'Plan of Action' for 2001 sets down basic recommendations that seek better funding for health services, the formulation of a national policy on health care services, better facilities in hospitals and better management of health services. He also highlights the need for cost recovery which requires that all patients make a subsidised payment and only those who can't afford are exempted. The money earned by cost recovery is to be utilized within the hospital to improve services. 

Clinical audit, endorsed by professionals all over the world as a means of improving patient care, reducing cost and eliminating waste and inefficiency has also been included in Dr. Goonetilleke's list of recommendations.

Dr. Goonetilleke who has served Sri Lanka for 19 years has seen many a change. 

But his first experience as surgeon in Polonnaruwa had the biggest impact on his life. 

"There I came across so many poor people who needed so much help, which is what inspired me to work for them. And in return you get so much of genuine gratitude; that is what makes all this worthwhile." 

Moving from Polonnaruwa to Gampaha, Dr Goonetilleke was finally posted to Sri Jayawardenepura General Hospital where he now serves as General Surgeon.

With many publications to his credit mostly dealing with trauma, missile injuries, blast injuries, injuries caused by anti-personnel mines, incisional hernia, benign strictures of the oesophagus and many more, it is Dr. Goonetilleke's hope to catalogue the research material collected over the years some day. "Some of the photographs I've taken of special cases aren't found in textbooks," he says and adds laughingly, "Maybe I'll write a book on them, maybe in retirement."

To Dr. Goonetilleke "surgery is a science, surgery is an art, surgery is a skill, surgery is a discipline, surgery is an instrument to serve society. Surgeons ought to be always humane and must continue to serve the cause of suffering mankind".

"I've always had big plans for the medical sector and in this position I feel that I can implement at least some of my plans. Above all I want to make people, in whatever walk of life they may be, care about life and learn the importance of it," stresses Dr. Goonetilleke who completes his term as President in December. 

By then he hopes to have put in maximum effort to uphold the standards of the College and serve the people of the country. 

It's obvious that Dr. Goonetilleke is a man committed to his work for "surgery is life itself. It keeps me going and I will keep on going". 

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