The Singapore-Malaysia Tzu Chi medical relief team has organized a three-day free clinic in Ratnapura, Sri Lanka from August 27 to 29, 2009. This is also the first time that the Tzu Chi Singapore and Malaysia chapter participated in medical outreach in rural Sri Lanka province. It was estimated that about 1,500 people will benefit from this outreach.

Crowd of patients waiting in line outside the hospital. Some of them live nearby while others have traveled far, hoping to seek treatment by Tzu Chi medical team.

The local reverend conducted a mass praying session for the free clinic during the opening ceremony.

A canvas set up in the middle act as a wall to separate two temporary operating rooms. Even though the surgeons have to work under such conditions, their medical service is never compromised.

Nursing students from a local nursing school serve as translators to bridge communication between the medical personnel and the patients.

Some of the ophthalmic equipments were shipped from Singapore, hoping to provide the best medical care to patients suffering from eye diseases.

Medical personnel conducting careful examination of a patient's eyes.

To prevent Janaka’s leg swelling from worsening, the doctor suggested applying bandage to it and invited Janaka to try it out on the spot.

General Practioner Dr Edwin Lim listens carefully to the patient in order to make the correct diagnosis and treatment that will help the patient.

Famous for its gems and Ceylon tea, Ratnapura is situated in the mountainous region of Sabaragamuwa Province in central Sri Lanka. In one of its provinces, Kahawatta, three quarters of the people here are Tamil, mostly hard labourers living in rural villages near gem mines or tea plantations. The Singapore-Malaysia Tzu Chi medical relief team has organized a free clinic here from August 27 to 29, 2009.

On the early morning of August 27, Tzu Chi volunteers departed from the hotel and headed towards the Kahawatta Base Hospital, where the free clinic will be held. Upon their arrival, they found a crowd of patients already waiting at the hospital. After a brief discussion, the medical outreach team decided to bring forward the free clinic, which was originally scheduled to commence in the afternoon.

Trekking the mountains

Ratnapura, also known as the “City of Gems”, is situated in the mountainous region of central Sri Lanka and has a population of 1.1 million people. 300,000 of them live in one of its provinces, Kahawatta. The place is famous for its gem stones and Ceylon tea. In the early days, people have followed the footsteps of gem mines and tea plantation owners and migrated from north Sri Lanka to here. Gradually they settled down and their descendants form the population of Kahawatta as it is known today. Due to such unique historical background, three quarters of the people here are Tamil, which is more than the national average of 18%. The Tamil people here mostly work as hard labourers and live in rural villages, near gem mines or tea plantations.

The venue of the free clinic is at the biggest Base Hospital in Kahawatta. In the century old hospital, there are general practice, gynaecology, pediatrics, psychiatry, dentistry wards and an emergency unit. However, the hospital lacks a surgical ward. Should a patient require surgery, he or she would have to be transferred to the Ratnapura General Hospital, which is an hour's journey away. Most of the poor families here could not even afford the 50 rupee traveling fare (about 50 cents USD). Helplessly, they have to suffer in pain as their diseases are often left untreated.

As this is the first time Kahawatta is receiving an overseas medical team, the local officials were very concerned about the outreach program. The officials have not only provided their utmost cooperation and help, they have also held a grand opening ceremony on the first day. There were Sri Lankan children in their traditional costumes dancing, praying and giving thanks before leading all the guests into the hall.

During the ceremony, the guests lighted up candles, which symbolize light and hope, followed by a praying session led by the local reverend. Quite a number of Sri Lankan government officials, including the Mayor of Ratnapura and Sabaragamuwa’s Provincial Director of Health Services were also present to give their thanks to Tzu Chi.

Mr Kapila Kannangaraa, the Provincial Health Director, said in his speech, “Tzu Chi is a very good organization. I have never heard of Tzu Chi until the 2004 tsunami disaster. After witnessing the relief mission brought by Tzu Chi, I am very impressed with your team spirit and working efficiency. Your organizational skill and selfless contribution are remarkable. As a Buddhist myself, I'm proud of you all.”

A dream no more

Sri Lankans are friendly and gentle people who always have a ready smile on their face. Some of them live nearby the hospital, while some have traveled from far to seek treatment at the free clinic.

18 years ago, newly married and expecting her first baby, Chandra had accidentally fell down and overturned a kerosene lamp on a table, dousing herself with the combustible liquid which severely burnt her body, neck, chest and arms. Unable to receive immediate medical attention back then, the burn scars had been with her since; the muscle around her neck had shriveled and contracted, and she could no longer turn her heads around freely.

Unable to face her sudden change in appearance, Chandra's husband left her. The younger brother of her husband, Selvam, took pity on Chandra and married her. Together, they have three children now. Even though Selvam has continued to bring Chandra to the hospital to seek treatment, no government hospital was able to provide the surgical care required. The expensive medical bills that will undoubtedly come with seeking treatment with private hospitals have deterred them from doing so. Chandra, ashamed by her own appearance, would often cover her scars with long-sleeved clothes, and gradually became reclusive. Tears are a constant companion whenever she is reminded of her ordeal. To be able to turn her head freely has become an unreachable dream to her.

When Selvam and Chandra first heard of the Tzu Chi free clinic, they were very excited and have traveled to Kahawatta in February. However, the postponement of the mission due to civil war in Sri Lanka has disappointed them greatly and the couple was afraid of getting their hopes high again.

On August 28, the excited couple departed at four o'clock in the morning for a 4-hour journey that will take them to the Kahawatta Base Hospital. On the same afternoon, Chandra was sent into the operating room, where plastic surgeon Dr Fong Poh Him personally operates on her. One hour later, Chandra was already out from the operating room and appeared in good condition despite her bandage. “She will be able to turn her head freely from now on!” Dr Fong announced.

Upon hearing the good news, relief and happiness swept over Chandra and Selvam. Touched by the thought that she will be able to move like normal people, with a weak body still recovering from the anaesthesia, Chandra knelt down in front of Dr Fong prostrating to him. Chandra's sudden act of gratitude also moved the volunteers who were present.

The first patient

The first patient in the surgical ward was 41-year-old Janaka. Led by Colombo volunteer Asitha, Janaka has reached the hospital early in the morning. Janaka lives with his wife in Galle, which is at the southwestern coastal region of Sri Lanka. They had two sons who are both afflicted with multiple congenital disabilities. The eldest son passed away when he was eight due to severe health problems. The younger son, who is four this year, looks emaciated. The little boy has stiff limbs and does not seem to exhibit any other sign of consciousness apart from eating and drinking. He was wholly dependent on his mother's care.

The ruthless tsunami in 2004 had destroyed Janaka's house. With the help of Asitha, the house was rebuilt, but God seems to be testing his faith.

Two years later, Janaka discovered that his right leg was getting swollen day by day and he started to experience difficulty in walking. Not long afterwards, his left leg seems to be afflicted with the same disease and he was unable to stand up on both legs for long, thus ruling out any labour job for him. Under Asitha's recommendations, Janaka's family became one of Tzu Chi's beneficiary recipients.

Janaka has come to the free clinic with high hopes. Dr Fong Poh Him diagnosed his condition as a result of an infectious disease caused by parasitic worms. The infection had blocked his lymph nodes, resulting in accumulation of fluids and swelling. However, the surgery to remove the worms was unable to be performed on site as there was no microscope.

Seeing that his condition is still not too serious, Dr Fong prescribed wrapping Janaka's legs with bandage to prevent further swelling. Dr Fong even demonstrated on the spot how to apply the bandage and invited Janaka to try out on his own.

After the consultation, Janaka felt immense relief and decided to take part in the relief distribution day organized by Tzu Chi Hambantota early next month. The local volunteers will continue to provide care to Janaka and his family, and supply him with bandage and other necessities.

Together as one

Rain or shine, it has not stopped crowds of people from seeking medical help during the three days of medical relief. Determined to help as many people as they could, the medical team and the Tzu Chi volunteers worked together as one.

On the first evening, the general practice ward was swarmed with patients, and the pharmacists were having a hard time keeping up. Already done for the day, the surgeons and dentists willingly helped out in dispensing medicines to the waiting patients, so that the patients may go home and rest early.

On the third and last day, there was a heavy downpour where the volunteers had to direct the patients who were waiting in line to the hall on the third floor of the hospital. Despite the difference in language, a friendly smile and a little sign language has helped ease their communication barrier.

At the clinic site, there was a group of nurses in uniform who help to register the patients, provide care to them, and most importantly serve as translators to bridge the communication between the medical personnel and the patients. These nurses are from a local nursing school. Their teacher, Kumari, also came volunteered as translator. Kumari felt that the service is a very meaningful opportunity as her students can benefit by learning from the Tzu Chi medical association personnel.

After three days of working together, the nursing students have built rapport with the Tzu Chi volunteers. They were even able to perform Tzu Chi’s sign language songs to calm the patients.

On the last day, the local officials specially organized a closing ceremony for the free clinic. In his speech, Mr Kapila, once again expressed his admiration for the determination shown by the medical relief team “who came despite numerous obstacles and difficulties”. The medical relief team's efficiency and the medical personnel working together as a team have also left a deep impression on him. Lastly, he hoped that Tzu Chi volunteers will continue to provide help and care for the local community.

The three-day medical mission has benefited a total of 2808 patients, which has far exceeded its initial estimate. This also shows that the local community is indeed in dire need of medical relief. Under the kind invitation of Brother David Liu, CEO of the Tzu Chi Singapore and Malacca, Mr Kapila and the director of Kahawatta Base Hospital, Dr P. I. Tissa Perera will attend the Tzu Chi International Medical Association annual convention in Taiwan in late September to know more about the organization.

The journey of great love does not end here. United by great love, the seed of kindness has spread from Hambantota, Colombo, and ultimately to Ratnapura. May this force be able to unite more people, so that we can reach out to thousands of other destitute Sri Lankans.