Overcrowded wards, unhygienic
conditions, broken down medical apparatus are what greet patients
who flock to the Kurunegala Teaching Hospital
The Kurunegala Teaching hospital, a central referral centre and
an important provincial hospital is in a sickly state with patients
having to put up with poor hygiene standards and overcrowded wards.
An investigation by The Sunday Times revealed that the numbers in
the ward far exceeded the number of beds available, with patients
scrambling for space even along the corridors where dogs and cats
also fight for space.
were the conditions at the Premature Baby Room (PBR) and the Intensive
Care Unit (ICU) of the Paediatric ward. Contrary to accepted medical
practice, the PBR and the ICU appeared to be lacking in sterile
conditions. The PBR comprises a smallish partitioned room, with
three incubators and a few cots. Two incubators were left unused
in the corridor just outside, as there was no space inside the PBR.
and sterility are a must in a PBR. But the exhaust fan in the PBR
doesn't function and there is no air conditioning either. Thus,
the windows in the incubators are left open as the room temperature
reaches a higher level than the incubator temperature resulting
in the babies suffering from high fever. The whole purpose of using
incubators therefore is lost. The risk of increased humidity is
that the babies' nervous system could get affected and they could
get dehydrated. Owing to the lack of sterility, paediatricians at
the hospital, reportedly give strong antibiotics to avoid infections
and unnecessary deaths.
PBR is the ICU with the two units being divided by a narrow corridor.
Here too doors and windows are left open and it lacks the sterility
expected at any ICU in any hospital. People enter the ICU with their
shoes on and the tiled floor is cracked in places allowing the easy
settlement of germs and dirt.
The ICU is
a cramped rectangular room with four beds, which are shared by two
babies, and one ventilator. Monitors are positioned next to each
bed, but they cannot be viewed from the nursing centre, which is
located at one end of the room. Large rusty oxygen cylinders are
placed by the side of each bed instead of wall oxygen which is usually
used in ICUs. Adjoining the ICU is a smaller room where one finds
the drug cupboard and a drug trolley. The trolley leans against
a glossy wall stained with blood. Not far from the PBR and the ICU,
a corridor leads to a large, open drain.
Added to this
misery is the plight of mothers who have to feed their babies at
regular intervals but do not have a waiting room close to the PBR.
Mothers who have to express breast milk to feed their babies are
forced to use a narrow corridor with chairs. Especially during visiting
hours the lack of privacy makes it very uncomfortable for the mothers
who wait with mugs to express milk.
One young mother
who had given birth to twins and who had to come to the PBR every
three hours to feed her babies said she had to wait for almost an
hour before she got the privacy to quickly express some breast milk.
There were others who said they felt dizzy having to walk all the
way from the maternity ward to the PBR, especially those suffering
from high blood pressure.
The play area
section of the paediatric unit is also not very safe. In a not-so-large
enclosure, the only safe thing around were the two swings. The seesaw
was broken and the mat slide was not only broken but also rusted.
The maternity unit was another dismal sight. On the way to the wards
one finds pregnant mothers seated uncomfortably along the floor
of the corridors and others on benches in overcrowded wards.
handles more than 1000 deliveries each month. The maternity section
has two units in one big ward (ward 9) with 16 beds in each. When
The Sunday Times visited the hospital, the total occupancy was 40
in one unit and 63 in the other. During the lunch hour too, mothers
have their meals seated side by side along the corridors.
ward was no different. Patients were all over - in the corridor,
along the walk ways, on the beds and under the beds - just anywhere
and everywhere there was space. An unfloded cardboard box made the
mat for many of these old men and women lying on the floor. When
it rained, they had little choice but to huddle together inside
the already congested ward to avoid the spray from heavy rains.
sleeping all over, doctors complain they find it difficult to do
ward rounds or to attend to a patient in the night. The Kurunegala
hospital has four surgical theatres, for Orthopaedics, ENT, Dental
and Gynaecology and Obstetrics. All the theatres are in the same
unit. Two of these have been under repairs for the past one and
a half months. Therefore in place of five to six surgeries a day,
only two or three are performed.
theatre doors, which are expected to close spontaneously, are under
repair and surgeons complain that every time they go in and out,
they have to close the door themselves. Oxygen cylinders, cupboards
and broken equipment are seen lying around in the sterile area of
the theatre complex.
hospital is equipped with a generator, it has not been set up to
connect to the power supply immediately after a power cut. Doctors
claim that they have to sometimes stop surgery, until the generator
is switched on.
ward has two units. The female unit has 15 beds in each unit, but
on average the occupancy is about 50 in both. Everyday, 15 to 20
admissions are made. Wards 17 and 18 are for males and have a bed
strength of 30. However, the occupancy rate is 50 or 60 at any given
Two other wards
set aside for post operative care - Ward 15 for females and Ward
16 for males - are also overcrowded prompting doctors to discharge
patients well ahead of the actual date. In the psychiatric unit
there are 21 and 19 beds in the male and female wards respectively
giving a total of 40 beds. However, on average, there are 75 patients
in the unit.
machine (a screening machine) which had been purchased about ten
months back is reportedly lying idle. As a result several tests
are not done in the hospital forcing patients to pay high prices
in the private hospitals. Although the hospital has a cancer surgeon,
patients are referred to Colombo as the doctor has no ward or clinic
to conduct his work in.
doctors say although construction work seems to be a continuing
process at the hospital, the institution has little to show as development
over the years. A newly constructed room to wash gloves remains
closed, as the hospital has begun using disposable gloves. The hospital
also does not have an incinerator.
The lack of storage facilities appeared to be another problem with
boxes of drugs being left along corridors.
hospital's Director Dr. Ananda Gunasekera said overcrowding was
not unique to Kurunegala hospital as all hospitals in the country
faced the same problem. When questioned about the conditions of
the PBR and ICU units he said the hospital maintained sterility
standards and followed WHO recommendations.
He also said
there was no need for windows or doors to be kept shut or for the
ICU and PBR units to be airconditioned to be sterile. He also said
that a new PBR unit was being constructed and the present one would
soon be closed down.