Brighton and Sussex Medical School 2012

Medical, Sri Lanka Kandy

There were a number of reasons I chose Sri Lanka. Firstly, I had never travelled to Southern Asia so that part of the world was on my to do list. Its proximity to India also meant I could stop off and see the sights on my way back to the UK. Secondly, I wanted to go somewhere where there weren’t any language difficulties.

Although I was after an adventure in a completely different part of the world I wanted to work in an environment where I was able to learn. Generally speaking, the doctors I met whilst on placement spoke excellent English and were happy to translate if necessary. Finally, I wanted to go somewhere where I could enjoy myself. I had heard from friends who had travelled there that there were some fantastic places to visit in Sri Lanka - they weren’t lying. As well as stunning beaches and scenery there were also fantastic opportunities to be immersed in culture. The weather was also an obvious bonus and there were plenty of opportunities to top up the tan.

I was based at the busy General Hospital where some departments seemed to be almost of Western standards and others clearly lacked the staff and resources to provide adequate care for vast numbers of patients; many of whom would had travelled for hours to get there. 

The paediatric surgery department had exceeded my expectations. It was very well equipped and the staff were fantastic.

I started on the General Medicine department where ward rounds would begin at around 8am. Wearing a white coat and the lack of air conditioning made the rounds almost unbearable until I was able to acclimatise to the conditions. This was much to the delight of the Sri Lankan medical students who thought it was hilarious that I had to carry a bottle of water around with me and regularly wipe the sweat that was pouring from my forehead. Huge numbers of patients would be seen by a team of doctors and swarm of students. Some patients were lucky if they got 5 seconds of the consultant’s time. On a busy morning it wasn’t uncommon to have all the beds filled, patients lying under each bed, and the family waiting room being filled with new patients either sat on plastic chairs on the concrete floor. It was fascinating to see conditions that would rarely, if ever, be seen in the UK.

The General Medicine department was not the kind of standard I thought it would be prior to my trip. Perhaps this was down to my naivety. Being a core part of the hospital I expected the facilities to be amongst the best. I was surprised to find that this wasn’t the case. The wards were small, crowded and not especially hygienic. The wards were still an exciting place to learn about conditions I had only read about in text books before. Snakebites were common as was tuberculosis and rheumatism. It was interesting to see x-ray films since I had only really ever viewed digital copies in the UK. I had a lot of respect for the doctors who had to work with far less technology than I had been used to seeing. A CT scan was quite a big deal so patients couldn’t just be sent down to the department like they are in the UK. Instead the team had to decide if the scan was really necessary and whether the information they gained from it would be worth the relatively high cost of the investigation.

I spent the second half of my placement with the Paediatric Surgery team. The department was very modern in comparison to others I had seen and there were no other students so I was something of a novelty to the members of staff. Despite the early starts I was keen to change in to scrubs and get into the air-conditioned theatres. There were plenty of opportunities to assist in a number of different operations. One particularly interesting case I saw was the removal of a large nephroblastoma from an 8 year-old boy who also required his spleen and tail of pancreas to be removed due to compilations. I especially enjoyed spending time in the clinics I as felt it was an excellent way to get experience in examining patients.

The paediatric surgery department had exceeded my expectations. It was very well equipped and the staff were fantastic. One of the main differences I noticed with UK hospitals is the length of time patients would be kept in. Here it would be common to send a child home after a simple operation such as a circumcision. In Sri Lanka it was routine to keep this kind of patient in for a week! This seemed an excessive waste of resources and a huge burden on the family but one of the consultants explained to me that it was absolutely necessary. If he had discharged the patient he would not have been able to guarantee that he would have seen him again for a follow up in the clinic even if the mother had been urged to bring him back. This was down to a combination of travel time and differing attitudes towards medical conditions.

Away from my placement the accommodation was fantastic. I stayed in the large Work the World house with a number of other students who were all keen on having a good time when not at work. We would often wander in to the town to explore and go travelling together on the weekends. Although it was a bit of an effort to make it to the coast the beaches were certainly worth it. I made many friends whilst away; several of whom I have kept in touch with since returning to the UK. 

If I said my time in Sri Lanka was interesting that would be an understatement. I felt it was a fantastic opportunity to view healthcare in a resource-poor setting and also a great travel destination. I would thoroughly recommend it to other students looking for an elective placement and an interesting cultural challenge.  Where I went on my weekends: -

1. Arugam Bay

If you can get a group of other students together I would recommend hiring a driver to take you down to Arugam Bay. Although it is a long way from Kandy it is worth the mission. It is home to a fantastic beach that is famed for its waves and surfing. There are some nice places to stay and eat as well as one or two bars that get lively in the evening.

2. The Hill Country

Don’t forget that there are sights to be seen on your door step in Kandy. There are some spectacular waterfalls not too far away and some beautiful tea plantations that you can visit. I would recommend taking a tour of one of the tea factories and then heading to Nuwara Eliya aka “Little England”. This small town will remind you of Sri Lanka’s former links with the UK – remember to pack some warm clothes as it can get very cold that high up in the hills! If you enjoy walking and like the outdoors you can visit Horton Plains and the famous “World’s End” site.

3. Colombo

Although Colombo is not famous for being a beautiful city it certainly worth a visit. There are several tourist attractions including one or two museums and perhaps the only casinos and nightclubs you will find on the island. A good night out! Try and watch some cricket if you get the chance – Sri Lankans are crazy for it!

4. Galle and Unawatuna

My favourite weekend! Galle, a former Dutch city, is home to a famous fort which is stunning to walk around. Unawatuna meanwhile is just a short trip away and has a breath-taking beach which makes the journey worthwhile.

5. Sigiriya

Although quite pricy for a Sri Lankan tourist destination it is definitely worth a visit. The site is the remains of an ancient fortress and palace on the surface of a huge rock. The view from the top is amazing but there are lots of steps to climb up! 

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