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Healing the patriotic wounds : Quick to care
A band of dedicated men and women, the Army Medical Corps minister to war wounded often under difficult circumstances.
While the over 100,000 strong Sri Lanka Army fights for the country, a small band of dedicated men and women among them, the Army Medical Corps, battle to save the lives of their comrades injured in the war. Beside the fighting soldiers on the battle field, and at their bedsides in the hospitals, the personnel of the Army Medical Corps devote their time and energy to treating the injuries and uplifting the morale of the wounded soldiers.
"Our duty is to provide medical treatment as well as first aid from the time of the injury on the field through the period in the hospital, right until the wounds are healed," said Colonel S.D.C. De Silva, Director of Medical Services in the Sri Lanka Army. A MBBS graduate of the Colombo Medical Faculty, Col. Silva has specialised in Ear, Nose and Throat surgery. He is the Commanding Officer of the Sri Lanka Army Medical Corps, constituted by doctors, nurses, paramedics and nursing assistants. The military hospitals at Colombo, Palaly, Diyatalawa, Panagoda, each with a Commanding Officer also come under his direction.
In addition to the Regular Medical Corps, there is a Volunteer Medical Corps with volunteer medical personnel mobilised from government medical service and private practice. The two medical corps Regular and Volunteer, form the Medical Services Regiment, commanded by Major General Thurairaja, the Medical Services Advisor.
The personnel of the Regular Medical Corps serve in the military hospitals as well as in the various medical aid posts at the army camps and on the battle front. "Our men are at the battle front with the fighting soldiers and treating them," Col. Silva said. During the last three months, two soldiers of the Medical Corps were killed at the front while about six others were injured. "If we don't go to the field with the soldiers, there are no medical facilities for them," Col. Silva said. "I am proud to say that we are able to save many lives by timely treatment. If treatment is not given at the correct time on the field, it could be too late and many lives would be lost." Col. Silva commented that when the infantry soldiers see the Medical Corps beside them, it is a morale booster for them. They know that if they are injured help is at hand.
The Army Medical Service has the necessary facilities for their work on the battle field. Modern, well equipped ambulances, solar powered refrigerators, stocks of blood, saline and drugs are available on the field when military operations are carried out.
"Our doctors are very experienced in field surgery," Col. Silva said. "Amputations often have to be done on the field in order to save the lives of the soldiers." He explained that when a military operation is in progress, field hospitals are established at strategic points. Tents or abandoned buildings serve as operating theatres. Emergency surgery including amputations are often performed in these makeshift field hospitals.
Explaining further, Col. Silva said that Palaly Hospital has a 24 hour cover and is staffed with a full medical team. The operating theatre functions throughout the day and night. "We cannot forget the civil doctors and surgeons who assist us voluntarily by taking turns at Palaly," Col. Silva said. "They are a great help to us since we are really short of doctors. There are about twenty doctors in the regular Army Medical Corps and they have to do the work of 200, during an on-going military operation." Col. Silva recalled the night of the Paranthan attack, when he left for Palaly at 11 p.m. with a team of five doctors and twenty five other medical staff. By midnight, they were at Palaly. Around 200-300 casualties needed treatment that night. A continuous service has to be provided in such instances.
"In war areas, medical teams have gone very close to the battle front," said Col. Amerasinghe, Consultant Anaesthetist of the Army Medical Corps. He too, often serves at the front when a military operation is on. "We are able to save a large number of soldiers," Col. Amerasinghe said. "They are given treatment very fast at the Advanced Dressing Stations (ADS) that are set up. Emergency surgery is carried out and blood transfusions are given at these stations. Even closer, Regimental Aid Posts manned by male nurses are set up as close as one could get to the front. So when an infantry soldier goes to the front, he knows that medical attention is available. The death rate would be much higher if these medical facilities were not available so close to the front."
The only Consultant Anaesthetist in the Medical Corps, Col. Amerasinghe has trained about ten House Officers in anaesthesia. During a military operation, several medical teams, made up of a surgeon, anaesthetist, another medical officer and male nursing staff are sent to the front. Female nurses only serve at the hospitals.
Col. Amerasinghe said that the well equipped operating theatre now established at Elephant Pass is an added advantage. During a military operation or attack, patients needing emergency treatment are transferred to Palaly or Elephant Pass depending on the proximity of the military operation. Life saving surgery is undertaken at the closest theatre. Those who can be transferred to Colombo, or Anuradhapura and Polonnaruwa where there are special army wards, are airlifted to these hospitals. Patients with minor injuries are evacuated as fast as possible. "We have a good evacuation system," Col. Amerasinghe said, "We have to clear the way for tomorrow's casualties."
The demands on the Army Medical Services was clearly seen at the Army Hospital in Colombo. There were over 500 patients for the 436 beds available. The rest are accommodated on mattresses. "We have around a hundred floor patients at any time," said Col. Munasinghe, a Consultant Radiologist who is the Commanding Officer of the Hospital. According to Col. Munasinghe, the soldiers prefer to be treated at the Army Hospital even if they have to sleep on a mattress.
Soldiers in the Surgical Ward
Col. Munasinghe said that the Army Hospital is equipped with many facilities although there are limitations of space and staff. "The hospital has a very good Orthopaedic unit with two Orthopaedic Surgeons as well as a good surgical unit manned by two general surgeons," he elaborated. "There are also two physicians and a V.O.G. The Radiology Department is recognised for post graduate training. Pathology and X Ray departments are also good. Clinics are conducted in sub specialities such as Neurology, Cardiology, Dermatology as well as for Eye problems by government consultants. The Medical Corps also has several dental officers."
Col. Munasinghe said that the shortage of doctors particularly in the regular service is a great drawback. Every two years, ten doctors are seconded for service from the Health Ministry. However, only the regular army doctors are sent to the front line. "We have done many amputations on the field in order to save lives," said Col. Munasinghe who often serves on the battle front. "Sometimes blood vessels are ligated and the patients are sent to the nearest hospital. Fortunately, we now have some enthusiastic young doctors who serve in the front line."
At Anuradhapura, a young medical officer, Captain Nishanthi Pakshaweera is in charge of the Medical Reception Station (MRS). She has two pre interns and an Assistant Medical Practitioner to assist her. Soldiers from places such as Elephant Pass, Vavuniya, Mannar, Medawachchiya, Wilpattu and Chettikulam come all the way to Anuradhapura for treatment when the AMPs in these stations are unable to tackle the problems.
The Medical Station has a small ward with 13 beds for fever patients. About 150 patients attend the O.P.D. for treatment daily. A well equipped Physiotherapy Department with two Physiotherapists handles the rehabilitation of war casualties. About 40-50 patients from nearby army camps are treated daily at this department.
Capt. Pakshaweera who has served at Anurdhapura for an year, recalls the period after the Riviresa Operation. "Around 300 injured soldiers had to be treated," she said. A team also came out from Colombo to assist. According to Capt. Pakshaweera, of the Riviresa casualties who were sent, only one patient with very severe chest and abdominal wounds succumbed to his injuries. All the others survived. "They do a very efficient job on the field, so the majority of patients survive," she said.
Polonnaruwa Hospital also has a special ward for the Army. Similar Medical Reception Stations function at army camps at Trincomalee, Maduru Oya, Amparai and Mannar.
"At the Forward Defence Lines, we have well equipped Medical Aid Posts manned by male nurses," said General Thurairaja, Regimental Commander of the Medical Services Regiment and Advisor to the Army Medical Services. "Over 350 of these have been established covering all the remote areas. In the jungle areas, they stock ARV vaccines, anti-snake bite venom and so on. The medical corps men live with the fighting soldiers and look after their health."
General Thurairaja said that every army doctor is trained in Anaesthesia. There are also field medical officers who can amputate limbs when the need arises. After emergency treatment, the patients are flown to Palaly Hospital or direct to Colombo.
The Medical Corps of the Sri Lanka Army is composed of a handful of dedicated doctors and a comparatively small group of other medical personnel, totalling about 1,300. It is remarkable how much is being done by this small group together with the volunteer civil doctors who ably assist them. Keeping a large fighting army healthy is indeed a tremendous task.
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