CWC Serving the Community

CWC we visited is situated in the middle of a community who is of average education level. Most of the mothers were of very young age (both i talked to were 19-21) Their main income is through business, and that doesn't adequately cover for medication from a pvt hospitals all the time.

In this setting, the mid wife plays a significant role in their health maintenance.

The couple me and my friend talked to, has been recognized by the midwife after marriage, counseled on having a baby, directed to maternal clinic in the first few weeks of pregnancy, and has been followed up until child birth.

And now she helps in the vaccination process too.

Everything is provided free of charge, compared to a single consultation fee >Rs.1500 in the pvt sector. Aren't we lucky to be born Sri Lankan?

She has been able to win the parents' trust and so that all advices given are accurately followed, making the Midwife's work much easier. The families living in that area are very familiar with the Midwife, they even call her by her name.  

Maintaining Sri Lanka's health state would have merely been impossible w'out the concept of 'midwife'. This sure has more effect in rural areas where health care facilities are minimal.

Thank you for your time spent reading my blog :)

Name of student: Sachintha Satharasinghe

Date of Visit:        29.8.2012

Post number:       3

Water Treatment Plant & Sewage System....

Sanduni Dhanoddya Samarajeewa

28 August  2012

Post – 3

On  28^th August 2012 we were supposed to visit Water Treatment Plant & Sewage System at Raddoluwa. The scope of the visit is to get an idea about the process of water purification prior to distribution.

The programme was commenced with brief introduction of the water treatment plant. The narrator explained that it was established during 1987 with the aim of supplying water to the housing scheme. At present it supplies 4500m² of water to following locations.

1.  2481 house in the scheme 
2.  2500 houses out of the scheme
3.  Wijaya Kumarathunga memorial hospital
4.  Police station and Army Base Seeduwa
5.  Katunayaka industrial zone

  Then we stepped out to witness the water treatment plant. Initially water is pumped to the plant from Dandugan Oya. After that the narrator briefed the activities taking place after pumping.

Aeration: during this process water is turn around in the air to mix with O_2.For this, Cascade method, Disk and Mechanical methods are used.

                                               

During this they add "Alam" (AlSO₄) -  It positively charged and combined with negatively charged mud particles and forms mud floccules. Then add Ca(OH)₂  - It corrects pH value  to 7. 0.

Sedimentation: during this process mud and other particles are separated. 

  
Filtering: Raddoluwa plant has 2 units of rapid sand constant head filters. It filtered the water by sand filters.

Storage:  Mud free and filtered water comes to two large tanks which has the capacity of 2000m² each. Storage tanks are covered by granite chips to avoid direct sun light.

Chlorination:  Water disinfected by Chlorine (Cl₂) in the storage tanks.

Distribution:  after all these proceedings water pumps to towers and then it is distributed to houses.

Then the narrator begins with the details of water sewage plant. She told, in the sewage plant basically waste water coming from houses is cleaned.  Initially the sewage collects in to pits called gully. Then it drains in to main man hole and it drains in to sewage well. Then it is pumped via aluminum bars by three pumps. Then it’s go to a aerator and supply O₂ for bacterial activity. Then during the sedimentation the degrading process occur.

                During the chlorination, dried material pumped in to drying lagoon to dry under sun light and the important thing is they distribute it free as fertilizer. Now the disinfected water is ready to release in to the river.

These proceedings are seems to be very easy when somebody go through this. But it is not that…..

Shyama Udeshika

27.08.2012

post 3

              Rehabilitation Hospital-Ragama

Ragama rehabilitation centre is the largest hospital in Sri Lanka which provides rehabilitation care. Patients are referred from hospitals after acute care or appropriate referral from a hospital OPD or a GP. Any doctor who has gone through the patient can write referral to the consultants. But direct transfers are not accepted. Also vegetative patients and patients without care givers are not accepted.At present there are 2 consultants,12 medical officers with other staff.

'REHABILITATION' is the process of restoring normal function of life after a disease or trauma.They provide medical rehabilitation to                                                                            

• spinal injury patients after acute management due to road traffic accident, fallen from tree, tuberculosis, cancer and transverse myelitis.
• congenital abnormalities such as cerebral palsy
• any rhumatological disorders like athritis
• rehabilitation of amputee.                                                                                             

  There are departments of                                                                                                          

• Physiotherapy
• Occupational therapy
• Work shops of making prosthesis and orthosis
• SLSPO- Sri Lanka School of Prosthetics and Orthotics
• Vocational rehabilitation centre

                                                                                                                                                        During Physiotherapy they are trained to maintain balance, posture, and skills for wheel chair. Here they given excises to reduce the contractures and to increase the range of movement of joint.As well as strengthening excises for functioning muscles.                                                                                                              

Occupational therapy  is to improve hand function and fine motor activity by strengthening hand muscles. Aims of this is to achieve domestic, vocational, and social independence, to increase quality of life.They are trained how to use aids and adaptations (products designed for the patient according to the disability.

                                                 

                                                                                               

                                                                                                 

                                                          

                                          

Wheel chair work shop supplies wheel chairs according to the width, height, physical abilities, environment and occupation of the patient.

                                                    

Sri Lanka School for Prosthetics and Orthotics is the trainig centre for prosthetics and orthotics. Students are taught to make and fit prosthesis (artificial limbs) and orthosis (braces) to international standards. The course consist of two year practical and academic trainig with one year clinical practice.

                     

Aim of Vocational Rehabilitation is to make disable persons are more productive. Here they are trained to sewing,computing, and handy crafts.

Water sewage and treatment plant in Raddolugama

Please include : Janitha Prasadini Sirimanna /3

       We visited to water treatment  plant and sewage system  in  Raddolugama .We reached their around 8.45am.First they gave brief introduction about   water treatment  plant.

                                It commenced in 1987 to supply drinking water to the housing scheme of over 2000 houses.Now they supplies water to

                                        2481 house in scheme

                                        2500 houses out of scheme

                                        Wijaya kumarathunga memorial hospital

                                         Police station and armybase Seeduwa

                                        Katunayaka industrial zone

      Then we went to see treatment plant.Plant contain 2 treatment units and sewage treatment system.By treatment units water of Dandugan oya  clean to drink. Treatment process is first pump water from river.Then clean water by

                                    Aeartion

                                    Sedimentation

                                    Filtering

     Then water chlorinatin done and distribute water to houses.Water checked in once in to weeks in regional lab to check quality of water.

                        Then we visited to sewage treatment unit.It  treat and disinfect  kitchen water and sewage before release in to water.It is done by

                                    Collection

                                    Large particle separation

                                    Aeration

                                    Sedimentation

                                   Chlornation and release

Meghawarna Rajapaksha
   2012/08/29
 Post no 03
                                        Unforgettable Journey...... !!!!
                                                              Unbelievable Service....!!!!

 Today was a much expected day for me.. My mind was filled with such curiosity to seek what's going on there..??? Who works in there.. What do they do.. Why do they do.. How do they do.. Who helps them,guide them..!!!
                                Well... Today is the day of reckoning.. the day of answers.. Yup... the unquenchable waiting atlast has reached its destination...We are going to colombo friend in need organization.. Atlast .. A dream come true..
                                                 I heard my friends who went there before talking about this.. Since then i was so eager to visit there..To see it from my own eyes..millions of grattitudes for the community medicine department for arranging this clerkship programme...No words to express the thanking.. We were just like frogs in a well only hugging books all around us..not knowing what really is out there.. Didnt know much about how the community health is secured... But WOW..!!!! Clerkship made up our eyes.. What an opportunity it gave us.. I would definitely say.. The best ever clinical appointment for me.. The places we went.. The procedures we saw..Truly amazing..How many places & personel devoted for the sake of the safety of community health.. simply unbelievable...!!!!
                                                                                    CFIN is situated near Gangarama temple.. It is the oldest charitable organization in the country established in 1831.. which is now morethan 180 years old..Its main function is manufacturing artificial limbs for amputees..They produce prosthesis which is an artificial device extention that replaces a missing body part... &  Orthosis which is an orthopedic device that supports or corrects the function of a limb ...
                                                    Right after we went inside a person came with a nice smile & welcome us.. He gave us details of the organisation.. what they produce.. & also he showed us various types of artificial limbs in according to their evolvement... also he told us how they get the refferals for this organization...
                       1.direct - walk in basis
                       2.MO hospital
                       3.Referal through Grama Niladhari - via social services officer AGA office-                                                    social serviceMinistry - approves funding..
                       4.NGO's
                                                                      Then we were taken to their factory sites... we saw how the artificial limbs are made step by step.. i have to mention it is not that simple.. it is not that easy.. They produce such a variety of prosthesis & orthosis... All for the benifit for those who were just capable as us but thought themselves not to be capable as normal anymore due to the loss of parts of their body... This organization gives them hope.. gives them ability.. gives them their happiness for the maximum level as possible.. gives them self confidence again..
                                  Prosthetics ....Lower limb
                                            1. Hip disarticulation prosthesis
                                            2. Trans femoral prosthesis - above knee amputation
                                            3. Through knee prosthesis
                                            4. Ankle disarticulation prosthesis
                                            5. Mid foot prosthesis
                                   Upper limb...
                                            1. Through shoulder artificial hand
                                            2. Above elbow  artificial hand
                                            3. Below elbow artificial hand
                                         
                 Orthotics... lower limb..
                                        1. Long leg caliper
                                        2. Short leg caliper
                                        3. Knee brace
                                        4. Aluminium back splint
               
                 Trunk orthotics...
                                        1.Scoliosis brace.
                                        2. Spinal brace
                                        3. Cervical collar for neck

                  Walking aid...
                                        1. Wheel chair
                                        2.Axillary crutches
                                        3. Walker
                                        4. Walking stick
                                                                             
                                                      The services this organization produces is far more extended than manufacturing artificial limbs.. They have simply devoted themselves for the disabled so that they can become as normal as possible.. What an service this is.. Truly unbelievable..!!!!
                                      1. Artificial limbs are manuactured.
                                      2. Stump conversion
                                      3. Physiotherapy + exercise + gait training
                                      4. Self employment grant
                                      5. Mobile bus limb fitting workshop
                                      6. Transient hostel facilities with provision of food
                                      7. Education for desabled children & elders
                                      8. Aidex annual sports meet.

M. B. P. De Costa

27/08/2012

3rd post

Ragama Rehabilitation Center

                Rehabilitation is a process that is targeted to achieve maximum possible independency in physical, mental and social functions in day to day life, following a disease or a trauma.

                Ragama rehabilitation center is the largest hospital which provides rehabilitation care in Sri Lanka, mainly for physical disabilities.

                Current staff of Ragama rehabilitation center contains,
                                           ·       Two consultants and twelve medical officers
                                           ·        Nursing staff of fifty

                                     ·         Minor staff

It has ten wards and around 250 beds. Ragama rehabilitation center is a tertiary care hospital, so there are no direct admissions to hospital. Ragama rehabilitation center functions under four main sections,

                                     ·         Orthopedic

                                     ·         Neurological

                                     ·         Pediatrics ( cerebral palsy)

                                     ·         Spinal cord injuries

 Each section has a separate physiotherapy and occupational therapy department. Each and every section of the hospital takes multidisciplinary approach towards all of its patients.

                                     ·         Physiotherapy – to prevent contractures

 Restore gross motor functions as much as possible

                                     ·         Skin care – Prevention of pressure sores

         §  Change position every two hourly

         §  Log rolling

         §  Air and water mattress

                                    ·         Other medical problems

         §  Bladder and bowel functioning

         §  Prevention of UTI

         §  Train for self-intermittent catheterization

                                    ·         Occupational therapy

         §  Mainly improve upper limb functions

         §  Dressing, washing and toileting

                                    ·         Vocational training

         §  Training in occupations those are compatible in carrying out with disabilities.

                                    ·         Speech therapy

                                    ·         Psychological support

         §  Family and social life

         §  Counseling

Parallel to above facilities, there are,

      §  Wheel chair workshop

      §  School of prosthetists  and orthosists

in Ragama rehabilitation center. In wheel chair workshop it manufactures free wheel chairs for hospital patients as they require. There are seven occupants and three of them were rehabilitated in the hospital.

 School of prosthetists  and orthosists not only trains prosthetists  and orthosists but also manufacture artificial limbs and other supporting devices to paitents.

Spinal cord injury rehabilitation section is the largest of such in Sri Lanka. After acute stages of the spinal injuries are managed in a hospital, patients are transferred here for long term institutional based rehabilitation. The goals are

         §  Maximum possible independency in self-care activities

   §  Washing

   §  Feeding

   §  Toileting

   §  Dressing

         §  Training in usage of wheel chairs and other supporting devices

        §  Prevention of other co morbidities

In nutshell, Ragama rehabilitation center provides an immense service to a group of human beings who are mistreated by nature and some other human beings.