“The experience, lessons and the joys of healing”

“On the Nineteenth of September 1989, a bomb exploded in the town of Gampaha in the Western province of Sri Lanka at 9:40 AM. This story is published on my website on the 19^th of September 2021 at 9:40 AM, exactly thirty-two (32) years later to bring to the notice of those who read my stories the horrors that the people had to endure during that period and hoping that such acts will not occur in our country in the future”.

But, it occurred once again in April 2019!

A brief history of the unfolding events in Sri Lanka during 1987-1989

• The civil war in Sri Lanka started in the North-East in July 1983
• By April 1987, the Janatha Vimukthi Peramuna (JVP) was getting organised for an insurrection
• With the signing of the Indian initiated Peace –Accord the Indian Peacekeeping Force (IPKF) entered Sri Lanka and the Sri Lankan troops were confined to their barracks in the North- East and were spared the fighting with the Liberation Tigers of Tamil Ealam (LTTE)
• Following the invasion of Sri Lanka by Indian troops, the insurrection/revolt intensified
• It was however a low-intensity conflict compared to the North-East war.
•  The insurgents resorted to subversion, assassinations, raids on military, police, and civilian targets with much damage to public property and many unwanted deaths.
• The Government reacted through counter-insurgency measures
• It was during this period that the bomb explosion took place in Gampaha where the insurgents were very active.
• I was the only surgeon at the Gampaha Base Hospital and it was my duty to attend to the victims of the explosion. The details of this horrendous act have remained in my memory ever since with some of the victims becoming friends thereafter.

THE BOMB EXPLOSION

Date – 19^th September 1989

Time – 9.40 am

Place – Gampaha (Western Province, Sri Lanka)

Target – The Gampaha Police Station

The bomb was set to cause damage to the Police station, injure/kill policemen within and outside the station and cause fear and panic among the people during the morning rush hour; no doubt an act of terrorism

A thundering sound of the explosion

At 9.40 am on that fateful day I was in my ward at the Gampaha Hospital attending to my patients as usual. I heard a thundering sound coming from the direction of the town and I immediately recognized that it was a bomb explosion and alerted the staff to be ready to receive casualties. Having worked on the war front, I had heard the sound of many blasts at a distance and I was pretty sure this sound was due to an explosion. Yes, it was so, the explosion had occurred about 400 metres from the hospital.

An Eye witness account of the blast and the surrounding

The bomb that exploded had been placed in a small lorry parked outside the Police Station. The blast ripped through the perimeter wall of the station and the side of the building. However, no policemen were injured except that some were in shock. The bomb-laden vehicle was a wreck. It was a time bomb.

The Police station situated in the Gampaha town was at the junction of four roads, surrounded by many shops with the District Courts a stone’s throw away. The blast rocked the court premises nearby and the court proceedings came to an abrupt halt with the District Judge in a state of shock.

The people in the town in the morning rush hour were running Helter-Skelter to get away from the scene and the shops nearby put up their shutters in fear. No doubt there was pandemonium as no one had experienced such a situation before.

As shown in the map there were two vehicles at the junction close to the site of the explosion, a bullock cart and a vehicle, an Austin Cambridge. The carter died on the spot while the bull lay fallen with his eye protruding out following the sustained injury.

The unfortunate civilians

A total of twenty people were injured and this included the driver of the Austin Cambridge, his three (3) year old son and another fifteen year- (15) old boy who was in the car. The three-year-old boy had the habit of standing on the passenger seat and ‘hanging-on’ to his father who drove the vehicle on every occasion that they travelled and it was so that fateful day as well. The shutters were open, the blast wave ripped through the moving car. The car came to a halt and was a wreck. The driver fell unconscious with a wooden spike (shrapnel) going through the right side of the child’s head and sticking out like a horn, but he was conscious and crying out for his mother. The victims were rushed to the hospital in whatever vehicle was available without any first aid.  The aim of the people around was to get the injured to the hospital as soon as possible.

A surgical ward packed with people, patients, and others with a lone surgeon to the fore.

Although I alerted the ward staff to be ready to receive and treat casualties, we did not have time to prepare for the emergency. Within minutes, the ward was packed with patients, people from the town area, policemen, politicians, journalists, and more. Although my priority was to attend to the patients, in this scenario it was not possible as crowd control had to take precedence and had to be handed over to the policemen. In the meantime, some patients were hysterical and the others were crying out in fear that they would die.

In my experience of treating such victims following an explosion, I had learnt that those who make the biggest noise have minor injuries, and their care although necessary is not urgent, while those with serious injury will be lying silently in a corner of the ward and if not recognized and treated urgently would die a silent death.

This is where the principle of TRIAGE had to be applied.

TRIAGE

• Although the numbers admitted to the hospital were not large, a triage situation arose as twenty patients were admitted within a short space of time to a hospital ward with limited facilities and staff.
• Triage is the process of sorting the wounded into categories of priority for treatment.
• The underlying principle “is to do the best for most”
• In this situation, being the most experienced officer on site I had to be the triage officer to take the decisions.

The experience that I had gathered at the Polonnaruwa hospital treating victims of war stood me in great stead once again. Experience certainly is a great teacher and, when combined with what has been learnt from books gives much confidence and is a great source of inspiration

Managing the injured

• That was my task with the limited resources available to me. The surgical team consisted of the consultant surgeon and two Intern House officers. That was the challenge too and I had no hesitation in accepting it, indeed the way forward
• The number of patients admitted amounted to twenty.
• Being the senior doctor on site I had to take the triage decisions to be executed by my junior staff together with the nurses
• As a small team, we visited each patient examining them to identify the seriously wounded.
• There were two who were seriously injured – father and son who were in the Austin Cambridge
• Father “N” was unconscious while the son “C” was semiconscious. What was more serious was that he had a head injury – a fracture of the skull with a piece of wood penetrating through and most probably damaging the brain, but without any neurological signs.
• There were no facilities for any special investigations.
• The majority had shrapnel wounds that required surgery, but not as an urgent measure. We decided to manage all the patients at this hospital.

The Two Priorities

Father “N” – was suffering from a concussion and required observation. He recovered completely over a period of a few days.

Son “C’ – the injury was more serious – compound fracture of the skull with penetration of the skull by a piece of wood and most probably going into the brain and required urgent surgery.

Child’s dream and the motivation

“C” had his education at a leading school in Colombo. Later on, coming to know exactly what had happened to him and how his life was saved, he too wanted to become a doctor and work under me one day. Unfortunately, his dream of becoming a doctor could not be realized, but he has proceeded to graduate in Information technology and has progressed extremely well in that field. After witnessing a “medical miracle” “C”s sister who was four years then was determined to be a doctor and has achieved her objective with the support of her parents.

Grateful parents

The parents are ever so grateful to me for the care I gave especially to their son in a small Base Hospital with limited resources leading to a good outcome enabling the child to proceed to higher education without any subsequent problems. They never expected such a complete and successful outcome. The friendship that they developed on that fateful day has lasted ever since.

The “icing on the cake”

“Restorative surgery” for the Austin Cambridge blown up in the bomb blast

The Austin Cambridge (UK) was of much sentimental value to ‘N’ as it had been purchased by his father in 1957. Therefore, he did not want to dispose of it for scrap metal but retained it in his garage for many years replacing part by part obtained from various motor car dealers in the country. After many years and much effort, the car has been brought back to shape and now needs only the final coat of paint. I am sure it will be of much historic value thanks to the efforts of ‘N’

“While reflecting on my surgical experiences spanning over three decades, I have realized the value of making use of every possible opportunity to acquire and enrich knowledge, accepting challenges, adapting to situations when working with limited resources, constant care and vigilance especially after surgery, establishing a rapport with the relatives of patients to build confidence and finally seeing a critically-ill patient recovering and coming back to normal life has given me much satisfaction which no money can buy” 

Acknowledgement

My grateful thanks to the family of ‘N’ for the long years of friendship with my family, for their concern towards us and also for providing the vital information regarding this incident and some of the photographs which I have used to enrich this story.

Dear Reader, If you haven’t read my earlier story, you can read by clicking this following link : “ST JOSEPH’S COLLEGE COLOMBO-10′

You also might be interested in watching some of our other photo gallery links are given here : ‘WAR FRONT – 1’ – ‘WAR FRONT – 2’ / ‘PHOTO GALLERY – PICTORIAL JOURNEY OF SURGERY’ / ‘MY LIFE’ / ‘SPORTS’