Bandaragama District Hospital is a small hospital with only 72 beds and staff strength of seven doctors and 20 nursing staff. Their services include obstetrics, dental, general medicine, and basic emergency treatment unit. Bed occupancy of the hospital wards is low as most of the severe cases are referred to the base hospitals in the district with better facilities. Nevertheless, the outpatient clinic consultation sees about 600 patients daily.
14 to 16 October 2011 marked Tzu Chi Singapore’s fifth large scale medical mission in Sri Lanka and the second time it was held in this district hospital. The free clinic services include minor surgery for lumps and bumps, hernias and cleft lip.
The surgical together with the logistic teams took great efforts in preparing the instruments, equipments and many necessities for the free clinic. Some of the general items such as couches, lamps, surgical gowns etc. were packed and stored in Tzu Chi Hambantota office (located in a rural town in southeastern coast of Sri Lanka) after the March free clinic, while surgical instruments and equipments such as forceps, surgical scissors, blade holders, tourniquet, ECG machine, and anesthetic drugs have to be brought from Singapore.
These instruments and equipments require regular maintenance check and fixing of any damages if necessary. Anesthetic drugs are kept in the refrigerator and checked to ensure that they have not passed their expiry dates.
As the surgical instruments are made of stainless steel, they need to be completely dried before storage so as to prevent rusting. Two to three months before the medical mission, the medical volunteers, mainly nurses, need to pack and send them for autoclaving. When the surgical packs were readied, they were brought over to the free clinic site by the advance team.
Such large scale of work and effort is almost impossible without a dedicated team of volunteers and staff. Sister Lisa Chong, who was in charge of the surgical team, was the key person to coordinate the process. She also mobilized her team of colleagues and technicians in Singapore to provide backend support to the surgical team although they were unable to participate in the free clinic personally.
When there’s a will, there’s a way
The surgical team this time consisted of eight doctors, two anesthetists and 17 nurses. Due to each of their shift commitment at work, forming such a big team proved to be rather challenging.
“The free clinic was initially planned to be conducted in August. It was then postponed because the dates clashed with the 2011 Tzu Chi Global Volunteers' Camp in Taiwan. Up till September, we were worried about not having enough medical personnel to form a team as many nurses who had applied for leave in August could not make it in October,” recalled Sister Lisa.
Fortunately in September there was a Tzu Chi International Medical Association (TIMA) annual conference in Taiwan. Sister Lisa took the opportunity to encourage doctors and nurses who participated in the conference to join the Sri Lanka medical mission and was much delighted when many nurses came to sign up with her upon their return to Singapore. “When there’s a will, there’s a way. When there's compassion, there's blessing,” Sister Lisa concluded the experience with much gratitude.
The act of putting together the medical doctors is usually done by senior TIMA member Dr Fong Poh Him. As the doctors are mostly from the private sector, they have greater time flexibility and therefore the process is less complicated.
In 2002, dermatologist Dr Tham-Wong Siew Nee heeded Dr Fong’s invitation and took part in the Tzu Chi free clinic in Batam Island, Indonesia.
Over the past ten years, Dr Wong has participated in over ten such medical missions with Tzu Chi. Recalling back from her maiden visit, she said, “It was very tough back then. There were no lights, but everyone tried hard and gave their best. The free clinic team is very well organized and efficient now.”
9-year-old Farha is one of Dr Wong's many patients at the free clinic. Some warts have grown on the little girl’s scalp and though there was no itch or pain, they caused her a strange sensation when she combed her long hair. Considering her appearance as a girl, Dr Wong gave her some analgesic to remove the warts without shaving much of her hair.
Warts are a common skin ailment, but in Sri Lanka the condition seems to be more serious which could be due to the local environment conditions. Dr Wong decided to thoroughly remove the warts to reduce the chance of recurrence on Farha.
With a heart of gratitude, the dermatologist said, “I am grateful to Master Cheng Yen for giving me the chance to render my services to the needy. Each time of contributing gives me joy and great satisfaction."
It was Dr Wong’s fourth time joining the medical mission to Sri Lanka, and she had brought along her oncologist daughter Tham Wei Ying. Wei Ying had volunteered with her mother at the Batam free clinic when she was still a medical student.
Both mother and daughter worked side by side to serve the patients. While Wei Ying was working on a surgery, her mother would assist her from the side and gave her some advice occasionally.
“I hope she sees for herself the contribution of the doctors, nurses, and volunteers in Tzu Chi and that she can learn from them and become a loving person that cares for others,” said Dr Wong. Her fervour and desire to provide community care and service is a good testament and mark of a good doctor and her commitment to serve has been nicely passed on to her daughter.
Bridging the relationship between patients and doctors
The trust of the villagers towards the Tzu Chi medical team has fostered a sincere patient-doctor relationship during the free clinic.
Anusshka is a 21-year-old born with a congenital cleft lip/palate and deformed limb. The shy and quiet youth was abandoned by his mother at a tender age and brought up by his aunt. Previous plastic surgery only recovered his facial creases as there were still cracks above his upper palate.
In view of his complex and serious deformities, Dr Fong Poh Him explained to Anusshka and his aunt that the reconstructive operation for his cleft palate will be complicated and that the end result may not turn out to be what he had hoped for. The process may endanger his life too.
Despite unable to render physical help to the young man, Dr Fong turned his focus to psychological support and advised Anusshka to make full use of what he has to learn a skill, and not to be too bothered by his appearance. Though Anusshka and his aunt felt disappointed at the outcome, Dr Fong’s warm encouragement and objective advice allow them to see their future direction well.
All for one, one for all
Back in Singapore, Dr Lewis Liew has his own surgery team but at the Sri Lanka free clinic, his team members were made up of medical volunteers coming from different hospitals and medical fields.
This was the second time the urologist and laparoscopic surgeon had joined a Tzu Chi medical mission and he was placed in charge of the hernia division. He first joined the medical mission to Sri Lanka in March this year and still remembered how he was amazed by how the volunteers have converted some bare and dirty wards and rooms into sparkling clean operating rooms for operation. Although the overall conditions of the operation rooms were not as good as hospitals in Singapore, the cleanliness and orderly standard were much better than what he had imagined.
As the free space was limited and the hygiene standard was poor, the advance team took two days to do thorough cleaning of the labour rooms and wards this time and made them into operating rooms for the minor surgeries and hernia operation.
“The makeshift operating theatres were lighted by normal light bulbs so the light is not bright enough and somewhat lengthened the operation time for each patient. The non-adjustable couches are also lower than the normal operating table and long period of bending can be quite strenuous, but it doesn't matter,” Dr Liew said with a willing smile.
In the past two years, Dr Liew would volunteer his service at the Tzu Chi Free Clinic at Redhill on his off days. This time, he took leave and put aside his clinic work to join the medical mission. He felt that the medical mission is meaningful and indicated that he would not want to miss any of it in future.
Local doctor Dr Muthumala, who participated in the September TIMA annual conference in Taiwan, also came to render his service to his countrymen in the free clinic. The dedication to ‘serve with a heart’ of the Singapore and Malaysia medical team left him deeply impressed and he felt that the medical humanity which the medical team brought along is an excellent learning model for the local medical staff.