High risk Negombo facing shortage of vital staff

By Kumudini Hettiarachchi

With a massive dengue disaster engulfing the country, there is disillusionment in health circles that no Medical Officers (MOs) have been designated for dengue at the Negombo District General Hospital in the post-intern vacancies advertised by the Health Ministry on Friday.

Even though a Dengue High Dependency Unit (HDU) is to be set up shortly in a renovated old, disused ward at the Negombo Hospital, with the Ministry providing funds amounting to Rs. 38 million for the repairs and the equipment, a request for 10 designated Dengue MOs to work there seems to have been ignored, the Sunday Times understands.

The Dengue HDU coming up at the Negombo Hospital

The ‘Post-intern List’ put online by the health authorities on Friday, calls for applications from doctors who have completed their internship to fill the vacancies for MOs in State hospitals around the country.
The vacancies are decided by the health authorities from requests made by hospitals through the relevant Regional Director of Health Services (RDHS). Then a high-level Health Ministry official would sit down with a representative of the Government Medical Officers’ Association (GMOA) to work out the requirements, a source said.

The Sunday Times learns that in view of the Dengue HDU at the Negombo Hospital likely to be opened in about a month, the hospital had requested 10 designated Dengue MOs to man it. However, the list put out on Friday by the Ministry has no such allocation and many health experts were disheartened about the issue, as dengue seems to be the ‘plague’ in Sri Lanka now, with hospitals being inundated and wards overflowing with patients.

“During the last six months of the year, 12,165 suspected dengue cases and 65 deaths have been reported to the Epidemiology Unit from all over the island,” according to the unit’s official website, updated on Friday, June 15.

Around 50.66% of dengue cases were reported from the Western Province, the Unit said. The decision to set up the Dengue HDU at Negombo was taken because consistently Negombo has had the highest number of dengue patients when compared to any city or place in the country and is a major contributory factor for the high numbers in the Western Province, it is learnt.

When Dengue Specialist, Consultant Paediatrician Dr. LakKumar Fernando who set up a Dengue HDU at Gampaha moved to Negombo, the setting seemed ideal for a town with high numbers of dengue patients to get a model HDU not only to be replicated across the country but also as a training centre for young doctors.

The Sunday Times learns that within the first three months of this year alone the Negombo Paediatric Ward has managed 157 children with the dangerous Dengue Haemorrhagic Fever, in addition to large numbers with Dengue Fever.

The Dengue HDU is a dire need here, many health sources said. The proposed 20-bed Negombo Dengue HDU with 10 beds for adults and 10 for children will see both physicians and paediatricians working in tandem.

The management of dengue in both children and adults is more or less the same and the idea is to train juniors on the correct guidelines, said Dr. Fernando when contacted by the Sunday Times. Commending his physician-colleagues for managing large numbers of dengue patients very well, he said that with their unstinting cooperation and dedicated work, the Negombo HDU could be made into a model.

But with only six MOs being assigned to the Negombo Hospital, who will have to be divided among the needs of the other consultants and units and no designated Dengue MOs, the Dengue HDU will be a non-starter even before it begins, sources pointed out.

“When looking after seriously-ill dengue patients who have got into the critical phase of leaking in a 20-bed HDU, there will be a need for at least 10 designated MOs,” another source pointed out. Dr. Fernando confirmed that it would not be possible to run a Dengue HDU successfully without adequate staff.

Has the Health Ministry lost interest in this vital project, was the concern in health circles. If so, it would indicate the tragedy that is the dengue situation in Sri Lanka, a retired health administrator lamented.

Health Ministry assures action

We will look into what has happened, a high-level Health Ministry source assured, conceding that designated MOs would be needed to make Negombo’s HDU not only a model but also a centre of excellence with regard to dengue training.

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