Anaesthetics at Karapitiya Teaching Hospital
Experiences and Benefits
I spent my four-week elective in Galle, a bustling coastal city in the southern province of Sri Lanka. I joined the faculty of medicine at the University of Ruhuna, and was posted at Karapitiya Teaching Hospital, a large public facility with over 1500 beds; which provides free emergency, medical, surgical and outpatient based care to people from the surrounding area. The city itself is a hub of tourism, situated along the main coastal rail line and host to many colourful markets, grand temples and shaded beachfront areas. As well as a large Dutch coastal fort – a bold reminder of Sri Lanka’s colonial past. The area surrounding the hospital, however, was well away from the sightseeing hotspots. Picturesque in its own way, with pockets of greenery suggestive of the wilder terrain just north, punctuated by the noise and chaos of busy roads.
To further explore my current interests, I chose to undertake my elective in anaesthetics, which also included some time spent with the intensive care team. This meant that I spent most of my time in theatres, shadowing the anaesthetists during routine and emergency surgical lists, with one or two days a week dedicated to attending ICU ward rounds. The theatres were well-equipped, clean and air-conditioned. In stark contrast to the rest of the hospital, which had open-air wards and stray dogs roaming the corridors – a far cry from my placement experiences at home, but a gentle reminder of the challenging environment in which healthcare is delivered.
Surgical lists were incredibly well staffed, often with three anaesthetic doctors per patient, meaning that I had ample opportunities to ask questions and gain a deeper understanding of the anaesthetic plan for each patient. I had the opportunity to spend a day observing in the neurosurgery theatre, something I had not witnessed before. The theatre was full of staff, and I stood with several other students, observing and receiving teaching from the neurosurgery consultant. The first procedure was transsphenoidal sinus surgery to remove a mass around the pituitary gland. This required careful consideration from the anaesthetic team, as the head positioning and surgical area could possibly interfere with the ability to maintain a secure airway, and as such the setup was meticulous.
Unfortunately, the surgery was blighted by several power cuts, each lasting up to 5 minutes. Observing students offered their phone torches to continue illuminating the surgical site, and things carried on largely uninterrupted. It was impressive to see how adaptable the team were, overcoming technical issues in an attempt to achieve a good outcome for the patient. Ultimately, the surgery was a success, with the team discovering what they thought to be a benign mucocele.
Overall this experience was valuable and helped me better understand the delivery of healthcare in a relatively resource-poor nation, specifically through the lens of anaesthetics and surgery. I had the opportunity to practice skills I have learned in medical school, such as cannulation and basic airway maintenance – with frequent advice given by the anaesthetic team. Sri Lanka also proved to be an excellent location to enjoy downtime after placement. Highlights included seeing an international cricket match, surfing at the local beach in the evenings and discovering new and interesting places to eat. My bursary from the Hospital Saturday Fund was invaluable to facilitating this experience and I greatly appreciate their help.
