New hospital short-staffed COVID priority cripples Polonnaruwa Kidney Hospital

A front view of the hospital

Reportedly, the functioning of this new hospital has been delayed due to the scarcity of qualified consultants, doctors, surgeons, supplementary doctors, nurses, laboratory officers and minor staff members

Beijing Institute of Architectural Design in China has designed the hospital with a blend of Sri Lankan and Chinese heritage

Those who were earmarked for employment through President Rajapaksa’s 100,000 appointment programme could not be absorbed into the hospital cadre due to opposition from the trade unions

President Gotabaya Rajapaksa and former President Maithripala Sirisena inaugurated the China – Sri Lanka Friendship National Hospital of Nephrology on May 11. Kidney patients heaved a sigh of relief with the hope that treatments and transplantations for kidney patients would begin soon. It has been more than one month since the hospital was inaugurated, but treating patients is yet to begin. Giving hopes to kidney patients Polonnaruwa General Hospital Director Dr. M. K. Sampath Indika Kumara commenced operations at the hospital following a Pirith chanting (religious ritual) ceremony on July 26 with the participation of 100 persons including doctors, nurses, minor staff members, administration officers of the kidney wards and the Dialysis Unit serving the Polonnaruwa General Hospital. 

Reportedly, the functioning of this new hospital has been delayed due to the scarcity of qualified consultants, doctors, surgeons, supplementary doctors, nurses, laboratory officers and minor staff members. According to internal sources the hospital will soon be opened to public after qualified consultants and nurses are recruited from China. A spokesperson of the hospital said that if the required number of staff members for the hospital- which is 1400- had already been planned beforehand, this issue would not have arisen. The task of appointing staff members was in the hands of the Health Ministry, the spokesman added.

“This hospital has many high-tech machines and training should be given on handling them. There are already 15 doctors and 30 nurses who have received accommodation facilities. Its operations should begin in 2-3 weeks”

- Former President Maithripala Sirisena

The National Hospital of Nephrology was constructed in Polonnaruwa district following a donation by the Chinese Government as per a request made by then President Maithripala Sirisena to Chinese President Xijing Pin. This was during Sirisena’s visit to China in 2015. 

The main attraction of the hospital is that the medical and other equipment used here have been made using modern technology.

12 billion rupees have been spent to construct this hospital. The foundation for this medical facility was laid on 06.12.2017. Work on the project began on 31.07.2018. Even though the construction of the hospital was to be completed on 30.07.2020, work remained incomplete on 31.12.2020. The delay was due to the Covid-19 pandemic. However the hospital was finally opened in May 2021. 

A view of the spacious hospitial premises

Beijing Institute of Architectural Design in China has designed the hospital with a blend of Sri Lankan and Chinese heritage.   

The Health Ministry was in charge of the project and Polonnaruwa General Hospital Director Dr. Sampath acted as the Project Manager. Its administration came under the Polonnaruwa Hospital until it was to function as a separate hospital. Dr. Sampath was vested with the task of ensuring that the construction of the hospital would be completed without a delay. The spokesperson said that the doctor had done his duty well, but the hospital could not function as the Health Ministry overlooked the task of appointing its staff. When the Daily Mirror contacted state medical professionals like Dr. S.H Munasinghe, Dr Asela Gunawardene and S Sridharana to inquire  whether the short-staffed condition at the Polonnaruwa Hospital would affect the functions at the Kidney Hospital they were not available for comment. However, a Health Ministry source commenting on the issue said that at present the total focus was on using all staff to treat COVID patients hence the shortcomings at the Kidney Hospital. 

The hospital kitchen

The hospital consists of all facilities including state-of-the-art equipment, medical equipment and wards with a capacity of 200 beds. There is also a dialysis unit consisting of 100 blood dialysis machines. It includes a clinic for external patients and kidney patients suffering with other diseases, a modern laboratory and a research and development centre. The hospital also provides services including radiology and CT scanning. It has five state-of-the-art theatres to transplant kidneys, 20 ICU beds, an auditorium with 200 seats, a parking area with a capacity to park 300 vehicles and accommodation facilities for staff of the administration division, consultants, doctors, paramedical doctors, supplementary doctors, nurses and minor staff.

The spokesperson said that the inauguration of the hospital was delayed as the staff members of the Polonnaruwa Hospital were busily engaged in their duties related to dealing with the COVID-19 challenges. “The hospital staff was assigned with duties in quarantine centres in Welikanda, Punani, Gallella, Punani Brandix and Kandakadu which are under the authority of the Polonnaruwa General Hospital. As the centres are currently less occupied, the staff members would be assigned with duties at the kidney hospital,” the spokesman said. 

One of the wards

Dialysis tests earlier conducted at the Polonnaruwa Hospital began at the new hospital commencing on July 26. It would take two to three weeks to commence transplantations and surgeries. The staff at the Polonnaruwa Hospital is inadequate to maintain its function because the same staff has to maintain another hospital, according to the spokesman. The staff at Polonnaruwa Hospital is limited, but they have begun operations at the kidney hospital due to their dedication. The kidney hospital will come under the purview of the administration of the Polonnaruwa Hospital until 2022. It will begin its operations as a separate hospital from then on wards. But to begin functioning in such a manner it would take longer as the hospital lacks adequate staff. 

Consultants alone are not sufficient for the function of a kidney hospital. The hospital also requires all types of doctors including radiologists, physicians and surgeons. If these specific doctors are employed, every department of the hospital would have begun operations under the administration of Polonnaruwa General Hospital. 

The spokesman added that the hospital has so far received the services of 14 doctors who have completed their training periods. But they are not trained to treat kidney patients because they received their appointments recently. They have been assigned to treat COVID-19 patients. They have been appointed to serve at this hospital as the number of patients in quarantine centres has decreased. Six pharmacists have been appointed to the hospital while the rest of the staff consists of staff members of the Polonnaruwa Hospital. The hospital was opened with the strength of this staff on July 26. Water samples were tested and the area was decontaminated while inspection activities were carried out at every nook and corner at the hospital. 

Trade unions oppose President’s employment drive
It will take at least 2-3 weeks to admit patients and operate every unit. The reason for this delay is the shortage of consultants in the country possessing knowledge about kidney disease and relevant practices. It is a national problem. Some hospitals have additional doctors specialising on kidney disease and they are unwilling to work in areas such as Polonnaruwa. Trade union decisions also add to these problems. Those who take up appointments request for transfers after completing 2-4 years in service. The hospital, despite offering such facilities, will be of no use if basic requirements cannot be fulfilled. Those who were earmarked for employment through President Rajapaksa’s 100,000 appointment programme could not be absorbed into the hospital cadre due to opposition from the trade unions. A hospital needs a lot of minor staff members, but trade unions opposed these appointments too.

The administrative authorities should appoint a staff prior to building a hospital and trade unions should not be accused. We have discussed about the causes of kidney disease and treatments and it is wrong to accuse us of the drawbacks in administration

-Government Medical Officers’ Association Secretary 
Dr. Shenal Fernando

Inscriptions on medical equipment at the hospital are in Chinese. Such softwares are being changed now so that they can  be used in a Sri Lankan environment. The hospital kitchen is equipped with modern accessories. To train minor staff members on how to use other equipment there is a group comprising Chinese workers- comprising three software engineers and several others- to train locals on using medical equipment,” the spokesman added. 
Dr. Sampath said that kidney patients were admitted from July 26 on wards and the Dialysis Unit had commenced operations. “Commencing operations at a hospital is not an easy task and it should be done in a systematic manner. Assigning staff members of the Polonnaruwa Hospital to serve at the Kidney Hospital will have no effect on its operations. The doctors already assigned are talented and experienced in treating kidney diseases. Therefore its operations could be carried out successfully. The most difficult task is to commence operations. After that the issues arising would be solved,” he added.

Former President Sirisena who initiated the establishing of this hospital said that when setting up a new hospital every area including the minor requirements should be focused on. “This hospital has many high-tech machines and training should be given on handling them. There are already 15 doctors and 30 nurses who have received accommodation facilities. Its operations should begin in 2-3 weeks.” Sirisena added.

Commenting on the unwillingness of the excessive doctors in Colombo to serve in Polonnaruwa and the presence of doctors without a proper training on kidney disease, Sirisena said that the team of consultants in Polonnaruwa General Hospital would be assigned to the kidney hospital. “As a limited number of patients are admitted due to COVID-19 there is no issue. The rest of the staff and supplementary doctors are being appointed. The hospital will start fully  functioning within a year,” he added.

Responding to allegations against the Health Ministry former Health Minister Pavithra Wanniarachchi’s media unit said that instructions had been given to the Secretary to the Ministry and the Director General of Health to appoint doctors, nurses and minor staff members to the kidney hospital; this was during a meeting held prior to the opening of the hospital.

The former health minister’s statement confirms that the Secretary had ignored her instructions to appoint staff members to the kidney hospital.

Attempts made to contact Health Ministry Secretary Dr. S. H. Munasinghe via phone and SMS proved futile.
Government Medical Officers’ Association Secretary Dr. Shenal Fernando said that there is a procedure to assign doctors to hospitals. He accused critics of having no knowledge of how this method functions. “Assigning doctors from a hospital to a newly built hospital can create problems. Post intern appointments could not be granted for a year as these doctors worked in hospitals specified for COVID-19 treatment. If they were given post intern appointments COVID-19 hospitals in the country would have to be shut. The Ministry did not grant these appointments, but is trying to grant appointment to the new hospitals. We have been requesting the Ministry to grant appointments even before the COVID-19 pandemic. But that did not materialise. Doctors who completed their internships and are expecting post intern appointments were assigned to COVID-19 hospitals due to the the need of the hour. Now they will be assigned to the kidney Hospital. That is not an insult to the hospital. Every vacancy will have to be filled with doctors available in the country. The ones available are serving everywhere in the country. The annual transfers of doctors were delayed due to the COVID-19 pandemic as the Public Service Commission was closed and we could not obtain its approval for such transfers.

Commencing operations at a hospital is not an easy task and it should be done in a systematic manner. Assigning staff members of the Polonnaruwa Hospital to serve at the Kidney Hospital will have no effect on its operations. The doctors already assigned are talented and experienced in treating kidney diseases. Therefore its operations could be carried out successfully. The most difficult task is to commence operations.

-Polonnaruwa General Hospital Director Dr. M. K. Sampath Indika Kumara

“We as the GMOA have never caused any delay to carry out the operations at the Kidney Hospital. The administrative authorities should appoint a staff prior to building a hospital and trade unions should not be accused. We have discussed about the causes of kidney disease and treatments and it is wrong to accuse us of the drawbacks in administration.” he added.  
Pix by Samantha Perera