There are about 1,500 families living in the district of Kesbewa in Colombo, Sri Lanka. Although there are roads and alleys cutting across the entire district, traffic is quite inconvenient. Villagers in search of medical treatment have to travel two to three kilometers to reach the main road via a three-wheeled “tuk-tuk” before following up with a bus journey; sometimes they would need to alight and transfer to one or two different buses before arriving at their destination. For people with limited mobility, it is an arduous and difficult journey.
On August 16, 2014, Tzu Chi Colombo office held the first free clinic at Nanasa Community Centre in Kesbewa. A team of volunteers from Singapore had arrived earlier on 9 August, to help with planning and preparation work. On 12 August, Sri Lanka Tzu Chi volunteers brought brooms, mops, plumbing and cleaning tools, and carried out a thorough cleaning of the community centre so that patients could receive treatment in a clean environment.
The volunteers also erected tents in front of the Bodhi tree located just outside the doors of the community centre for registration and waiting purposes. Some neighbouring residents took the initiative to clear away the weeds around the tent area.
The local Tzu Chi volunteers had been looking forward to the event. From helping to apply for a temporary practising license for Singapore doctors, to arranging for different modes of transportation as well as cleaning up the venue, they carried out their duties and responsibilities very well, such that when the main Singapore team of 46 members arrived on 15 August, they only needed to do some simple planning and arrange the layout before starting work the very next day. Clinic services provided included dental and medical care, and Traditional Chinese Medicine, as well as eye-testing and distribution of free spectacles.
Planning for Patient-Centred Care
"We, as representatives of Master Cheng Yen, should try to imagine that if the Master were here, which angle would our Master consider in order to care for the community folks here? Although the available floor space is limited, we should plan for the event and venue with the community folks as the centre of our focus, so that the work flow will be smooth and the folks will feel comfortable,” exhorted team leader Dr Fong Poh Him, at a briefing session with the TIMA members and volunteers.
It was the first time that the community centre was used as a venue for a free clinic and the team wanted to ensure that there was adequate supply of water throughout the whole day. There was only one water pipe in the community centre, therefore there was an urgent need to connect water pipes to the dental department in order for there to be enough water pressure to provide for dental restorative services, as well as for cleaning the dental instruments right after treatment. Power outages are common in Sri Lanka, so a generator was rented to ensure a stable supply of electricity.
The community centre occupies two storeys, with the first floor being taken up for dental services. The dental team and volunteers took nearly three hours to set up two portable dental chairs as well as extraction stations, together with proper equipment layout, and a trial run was carried out successfully.
Meanwhile, other volunteers took the opportunity to practise verbalising simple dental terms using the local language, in the hope that they would be able to communicate better with the local patients.
The TCM section was located on the second floor of the community centre. Initially, no fans were available there and the ventilation was inadequate, but Tzu Chi volunteers soon managed to set up fans to ventilate the place.
"Hello, fellow villagers and friends, we are from the Buddhist Tzu Chi Foundation. You are welcome to visit our free clinic tomorrow at the community center, where professional doctors from Singapore will serve you with care!" Taking advantage of the timing in the evening when residents typically return home, local volunteer Rananjaya made the announcement riding in a three-wheeled tuk-tuk, covering a stretch of about 15 kilometres in the community to advertise the free clinic services for the following day.
Humane Doctors, Heartwarming Care
"My leg hurts. A visit to the hospital means a journey with bus changes plus walking, which takes up more than an hour. Today, I only need to walk for ten minutes to see the doctor!" Polio victim Sriyanthi beamed, holding on to her crutches.
Two young TIMA doctors, Kee Kok Wai and Li Si Yi, both first timers in the Sri Lanka free clinic, tended to Sriyanthi. After checking through her medical records and X-rays, the doctors found that the length of her crutches were too short for her height, causing her to walk with a tilt. The long-term imbalance in her posture caused Sriyanthi to develop shoulder pain, numbness in her hand, as well as knee pain.
The two physicians did a demonstration on the spot, showing Sriyanthi how to rotate her thigh to strengthen her muscles in order to decrease the wear and tear on her knee joint which was causing her pain. Noticing her bare feet, the doctors advised her to put on shoes whenever she went out, in order to reduce potential cuts and abrasions, as well as to provide better support for her legs. The caring doctors also referred her case to Sri Lankan volunteers, who would assist her in getting a new set of crutches more suited to her height.
Sriyanthi took out a Tzu Chi bamboo coin bank with a smile on her face and passed it to a Tzu Chi volunteer, saying, "I got this coin bank from Tzu Chi at the free clinic last year. The pair of glasses I received from you has helped me see clearly when sewing." She so cherished her new glasses that she was only willing to wear them whenever she sewed, for fear of losing them.
When the volunteers poured the contents of the coin bank into the big container at the waiting area, the hard coins made loud rattling sounds and Sriyanthi’s smile stretched radiantly across her dark-complexioned face. She requested for the return of the now-empty can so that she could continue to save up and help others in need.
Travelling a Long Way to Seek Medical Advice
Other than villagers who lived nearby, among those who came to attend the free clinic was someone who had heard about the fine quality of medical care provided by TIMA members. 35-year-old Venerable Wimalatissa lives 300 kilometres away from the venue of the free clinic. He took a long ride which commenced at 4pm in the afternoon on the previous day. After twelve hours, he arrived at his layman brother’s home, about 80 kilometers from the community centre, and it was his brother who accompanied him to the free clinic.
Three years ago, Venerable Wimalatissa was diagnosed with a rare disease known as congenital cerebral arteriovenous malformation. His condition was quite serious, with frequent seizures and high blood pressure, and he had to rely on drugs to keep his condition under control. A Sri Lankan neurologist advised him to undergo surgery for vascular closure to prevent further deterioration of his condition, but the surgery would cost up to one million rupees (equivalent to SGD9,600). Hence, Venerable Wimalatissa wished to seek advice from the Singapore TIMA doctors.
Dr Fong Poh Him attended to the Venerable and carefully read the medical report he brought. He carefully analyzed and explained the pros and cons of surgery. With the Venerable’s consent, Dr Fong took pictures of the medical report using his smartphone and relayed the information to his daughter in Singapore, also a doctor, and requested her to seek expert advice from neurologists in Singapore. While waiting, Dr Fong discovered that Venerable Wimalatissa’s eyesight has also been affected, so he conducted some cataract tests and referred him to optometrist Shirley Chua for the appropriate eye tests and prescription of spectacles. The Venerable was full of gratitude for the care and aid he received.
75-year-old Wimalawathi came specifically to collect her spectacles that day. She had used her old pair of glasses for four years, and this new pair of spectacles restored clear vision back to her. Now old and unable to work, she lived a simple life, relying on her savings. Before she went home, she hugged the volunteers and profusely gave them her blessings.
"Seeing the joy expressed by fellow village folks when they put on their new spectacles, and upon thinking of how these spectacles will help them in reading books and watching TV, I feel very happy for them," said Sri Lankan volunteer Jerome Kingston.
The community free clinic benefited 659 people. A total of 159 people received free spectacles, and 23 people were tested for new glasses which they will receive in the near future. After a day of service, the team of volunteers quickly and efficiently dismantled the setup, cleaned up the place, and put away the equipment, ensuring that the site was returned to its original state of quiet and order.
Medical Relief for the Sick and Disabled
Since 2011, on every full moon day (Poya Day), Colombo Tzu Chi volunteers have been providing various services to residents in the Victoria Home for the Disabled, including haircuts, manicures, laundry, bathing, feeding, and keeping the residents company by chatting with them like family members.
In May 2014, a Tzu Chi Singapore team came to the Home for a visit, and discovered a severe shortage of medical and dental services there. Although the Home had nurses on rotating shifts, there was no regular medical care, and dental services were especially lacking.
Therefore, after holding the Kesbewa community free clinic on 16 August, the Singapore medical volunteers went to the Victoria Home for the Disabled, providing GP, dental, TCM, and optometry services to the residents.
The Victoria Home has a history dating back 126 years; the building is old and dilapidated and there is limited space available. In order to accommodate the free clinic, residents of one ward had to be moved out to the corridors to make space for the dental and GP clinic.
Most of the residents have mobility problems; some of them have both intellectual as well as physical disabilities, and have to be perpetually confined to their beds. Some have normal mental capacities, but were either paraplegic or totally paralysed, relying on wheelchairs to move about. The medical team divided themselves into two separate groups, one providing services in a fixed location for residents who were mobile as well as for the employees and their families, while the other brought their armamentarium of instruments with them into the wards, providing services to the bedridden patients.
Internal medicine physicians Dr Kee Kok Wai and Lee Si Yi were led by the head nurse to the innermost parts of the Victoria Home, where most of the patients could not speak and had to have their daily necessities taken care of by others. The physicians bent down to greet and examine the residents, gathering from their observations made from eye contact as well as inspection, that many of them had small physical wounds or skin diseases that escaped the attention of others. Several residents had low blood sugar, but they just endured their condition because they had no way to communicate or express their needs. The physicians then instructed the hospital's medical staff to make adjustments to their medication needs and requirements in accordance with their differing conditions.
"It is indeed a very sad thing to see the generally dirty environment, the poor facilities, as well as seeing patients who are paralysed or epileptic, and how they are unable to take control of their own lives," said Dr Kee Kok Wai. He was very grateful that he could, through an interpreter, help to prescribe medications suitable for the residents, and he was especially thankful that the Colombo volunteers could provide some laughter and a flicker of hope for the residents through their monthly visits.
Serving with Joy and Gratitude
"Do not worry, this tooth is already very loose, it can be gently and easily removed.” Dentist Eugene Tang patiently comforted a patient before extracting his tooth. It was the first time that the Home had had any form of dental services provided at patients’ bedsides. Some residents had never seen a dentist before, so they could not help but feel tense.
To ease their tension, Dr Tang hummed music and sang an Indian song, even dancing to the tune of the music. The accompanying dental team also echoed his efforts and danced along. Upon sensing the happy mood, the residents rejoiced with the team.
“I can see that some residents are still very young, and they have stayed at the Home since they were teenagers and will likely continue to remain there for the next few decades. Then there are those who are already eighty or ninety years old who, living within the confines of the four walls in their wards, can hardly distinguish the days or years. Seeing them in this state, it made me realise how we must cherish our own blessed life, and to cherish everything and everyone that we have now,” shared Dr Tang, moved by what he had witnessed.
In the temporary dental clinic that was set up, Dr David Lim Guang Xu had his right hand bandaged because of an injury, but he was still wearing protective eye gear complete with headlights and going about his professional duties.
Concentrating on the check-ups for residents and employees, he was undeterred by his injury that was sustained two weeks ago. In a previous Sri Lanka mission with Tzu Chi, he had missed out on serving the local residents. This time, he would not let his injury stop him from seizing the opportunity to serve the locals.
"Although I am right-handed and the injury means that I cannot do cleaning nor extractions with my right hand, I can still do checkups and help with health education with my left hand. This reduces the burden on the other dentists, so that the overall treatment process can be carried out smoothly," a smiling Dr. David Lim said as his eyes shone with the joy of being able to help others.
53-year-old Padma suffers from disability in both legs and is wheelchair bound. Despite that, she is very self-reliant and goes about performing her own daily laundry as well as drying her clothes, and this has caused long-term injury to both her arms in recent months.
After being attended to by the GPs, Padma was referred to the TCM department. TCM practitioner Lim Lee Fong examined her carefully and suggested acupuncture to her. Padma did not show any fear, and after the acupuncture treatment, Lee Fong even gave her a massage, and then asked her to lift up her arm. She broke out in laughter, because the pain that had troubled her for six months had disappeared. “Thank you so much, I can now carry on with my daily laundry and can dry my clothes again!” Padma said happily.
The TCM practitioners were surprised at the residents’ high level of acceptance for acupuncture. Every resident who received the treatment beamed happily, appearing very upbeat; they did not seem to be afraid of the needles.
"I am very grateful to have the opportunity to participate in this medical mission. I have always wanted to help others, and after joining Tzu Chi, my wishes have gradually been fulfilled," said TCM physician Cindy Tang Feng Mei.
Among the Tzu Chi volunteers, there were eight entrepreneurs who were assigned to bathe the residents. They also massaged the residents and gave them candies, caring for them as though they were their own family.
"When I was shaving his beard, I saw his eyes glistening with tears and at that moment I……" Lim Guo Quan's voice choked and tears welled up in his eyes. "I was trying hard to hold back my tears…… Usually I only need three to five minutes to finish shaving, but today I had to take a full 30 minutes to do that and with sweat flowing down my back, too!" shared an emotional Lim, who is a busy executive in a multinational establishment.
Moved by the Spirit of Great Love
The free clinic ended at three in the afternoon, after serving over 200 residents. Tzu Chi volunteers also celebrated the birthday of Victoria Home’s 84-year-old superintendent, Mr Thawarap Peruma. For the past 24 years, he had been a faithful guardian of the Home.
"You all did a remarkable job today! Thank you all for your services. I hope you can come back again!" said the elderly superintendent.
This overseas medical mission by Singapore TIMA members was made possible by the support of Sri Lanka Ministry of Health as well as local doctors. A military hospital Oral and Maxillofacial Surgery Consultant, Dr. Mashantha Muthumala, undertook the responsibility of covering and supervising the team during the mission.
During Dr. Muthumala’s visit to the mission sites, he witnessed the mutual co-operation of Tzu Chi volunteers from both countries in bringing medical care with great love to the local community, and was deeply touched. "You brought with you not only medical treatment, but also the world's most heartwarming love and care, and it is something well worth learning for us." He wished to encourage more local medical personnel to collaborate with Singapore TIMA members, and also expressed that he would continue to give full support to future Tzu Chi free clinics.