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Stoma Therapy Unit at Kalubowila: A boon for patients
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STH Director Dr. Sagari Kiriwandeniya registering the first patient at the newly-opened Stoma Therapy Unit
By Kumudini Hettiarachchi
Dr. Amal Priyantha
No tamashas, the launch was simple—an awareness programme for health staff on the first floor and then the opening of the unit on the ground floor of the Colombo South Teaching Hospital (CSTH), Kalubowila, with the lighting of a different kind of lamp recently.
A boon for numerous patients who grapple with a problem in silence…it was the opening of the Stoma Therapy Unit, scarce among tertiary care hospitals (available only at the Kandy National Hospital and the Kurunegala Teaching Hospital) around the country.
Dr. Ushanth Dalpatadu
A 23-year-old student from Tanamalwila and a 54-year-old engineer from Angoda—who have with appreciation accessed the invaluable services and support of both doctors and nurses in this sphere at the CSTH—were also very much a part of the celebration of achieving a major milestone, the establishment of this unit.
For, the engineer had been compelled to have a stoma after a kidney operation, and the student after an accident that resulted in him having surgery. Without proper management and care, they had faced numerous issues, unable to attend to their work and feeling embarrassed to talk about their problem, until they were directed to the CSTH.
Now Room No. 9 on the ground floor—used alternatively with the plastic surgery unit—of the CSTH’s administrative building is where the full gamut of stoma management will take place.
A heartening note was that while the Stoma Therapy Unit will be headed by the current Consultant Gastrointestinal Surgeon (GI), Dr. Ushanth Dalpatadu, the earlier Consultant GI Surgeon, Dr. Amal Priyantha, who laid the groundwork for these services at the CSTH, was also present. Many were the words of tribute also paid to the dynamic CSTH Director, Dr. Sagari Kiriwandeniya.
What is a stoma, is clearly explained by Nursing Officer Inoshi Kumari when she says that it is a surgically-created opening from an area “inside” the body to the “outside” to divert the flow of secretions, faeces or urine.
Stoma is the Greek word for ‘mouth’ or ‘opening’, she says, creating the image of a spout or rosebud, pink and moist, like the inside of the mouth. Even though it looks raw, there is no pain, as no nerve endings are involved.
Dr. Amal Priyantha and Dr. Ushanth Dalpatadu open the unit, with Dr. Sagari Kiriwandeniya and staff looking on
On the crucial role played by nurses, Nurse Inoshi says that it was in 2012 that the Health Ministry and the Faculty of Medicine, University of Colombo, conducted the first Certificate Course in Stoma Therapy for nurses to enhance knowledge and skills. In 2015, the first batch of 40 nurses studied for the Diploma in Enterostomal Therapy, conducted by the Health Ministry in association with the Stoma Therapy Association, followed in 2018 by a second batch of 35.
Happy that there is an Enterostomal Therapy Nurses’ Association in Sri Lanka now, she says that these nurses are spread over 50 hospitals and more than 10 clinics, while there are also more than 10 resource persons across the country.
“Stomal therapists educate patients, their relatives and carers in pre- and post-operative care,” she adds.
Dr. Dalpatadu talks of the stoma types—Gastrostomy (an opening into the stomach from the abdominal wall, made surgically for the introduction of food); Colostomy (an opening in the colon or large intestine through the abdomen) and ileostomy (an opening in the ileum, the last section of the small intestine).
Stoma nurses, including Nursing Officer Inoshi Kumari (left), lighting the ‘different’ oil lamp. Pix by M.A. Pushpa Kumara
A gastrostomy is for a feeding device, explains Dr. Dalpatadu, pointing out that a colostomy is created with a loop of the large intestine to send out solid waste, and an ileostomy is created with the end of the small intestine to put out liquid and small particles of undigested food waste.
Referring to the advantages of having a Stoma Therapy Unit, he adds that they include stoma assessment and post-operative follow-up, counselling, complication detection, referral and management, advice on nutrition, patient/family education, supply of stoma appliances (bags, dressings and equipment) and long-reach stoma care.
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