DISASTER MANAGEMENT AT TEACHING
HOSPITAL BATTICALOA DURING THE EASTER SUNDAY ATTACK
21st of April 2019 was an
unfortunate day for all Sri Lankans and Batticaloa once again received the mass
casualties following a brutal terrorist attack.
During the 30 year war which ended in 2009 such events were very common. 2004 Tsunami was another tragedy which bought
mass casualties. Although we rehearsed several times at the Emergency
Department in the recent past, the real emergency of a mass casualty broke in
yesterday ( 21/ 04/2019 )
The explosion at the Zion church
happened around 8.50 am. Since this place is less than a kilometer away from
the Hospital, Dead bodies and injured patients were bought immediately. The
time for the preparation at the Accident and Emergency was very minimal. It
took some time for us to realize that it is a bomb blast. Initial stories were
Gas explosions or Transformer explosion because the first admission came with a
burn.
The triage at the A and E was led
by Dr.T.R.Nimalaranjan (Consultant Surgeon) who was on call along with the two
Consultant Anaestetists namely Dr.S.Mathanalagan and Dr.Yogananth. Although it
was a Sunday following a long weekend holiday the hospital authorities were
able to brought enough doctors, nurses and other health staff within an hour.
When I arrived at the A and E , I was surprised to see that each patient is
attended by at least one doctor and two nurses.
There were a total of 69
admissions. Majority was having penetrating shrapnel injuries and some had
flash burn in addition. 04 patients died in the R room due to inevitable
injuries to head, chest and abdomen in spite of resuscitation. Out of this
four, three were children which was very heartbreaking. Another 26 dead bodies
were also bought but they were triaged out. All 03 operating theatres at the A
and E, the ENT theatre and a routine theatre
were opened immediately for operating (5 tables). 02 Emergency
Laparotomies, One Thoracotomy, Few Neck explorations, Fasciotomies, and many
compound fracture cleaning were some of the immediate procedures we did. One
child needed a clavicle division to ligate a laceration on subclavian vein. Two
patients were transferred to TH Kandy and TH Anuradhapura for Neurosurgical
care. Two children had evisceration of eyes due to penetrating injuries.
Existing patients in the Intensive
Care Units were transferred out to ICUs at DGH Ampara to clear Emergency beds.
Dr.V.Jeevathas (Consultant ENT surgeon), Dr.N.Jayaratne (Consultant Orthopaedic
surgeon), Dr.A.Madushanka(Consultant OMF surgeon), Dr.W.Wijayasiriwardana
(Consultant eye surgeon) and Dr.R.Ramesh
(Consultant Physician) did their maximum to safeguard the lives of this
unfortunate. I was surprised to see Dr.Salakianathan, who is a Senior
Consultant Surgeon at United Kingdom and a member of the CSSL came in to do a
Neck exploration.
I should not forget the services by
Dr.Anton Swarnan (Senior Registrar, NHSL ) , Surgical Registrars
Dr.Harikrishanth, Dr.Kokulan, Dr.Kovoor, Dr.Pakeerathan, Dr.Arulprasanth,
Dr.Sivakaran and Dr.Kalaventhan. Some of them are not working at the TH
Batticaloa but were on holiday with their families and quickly responded to the
emergency call. Dr.Kalaranjini, Director TH Batticaloa coordinated all the
activities with no time for preparation.
Although it’s an unfortunate event
and should never happen in this country again, it gives a feedback for our
performances. The importance of continuous updates on ATLS and NTMC courses for
all surgeons in this country became very obvious on this day.
Thank you
Dr.S.Branavan
Consultant General Surgeon
Council Member ( Eastern Chapter)
Minutes before the blast: Smiling children are pictured at Sunday school service where 14 youngsters died in attack that killed 28 people
Zion Church’s pastor Father Thiru Kumaran, pictured left on a
podium, was preparing for the Sunday service when he met the man who he
believes was the suicide bomber. After he asked when the Easter mass
would start, the pastor said he invited ‘Omar’ into his church. Around
half of the victims were said to have been children – some of whom are
thought to be pictured here, top right and bottom right. They were
caught in the suicide blast as they left Sunday school and played in the
grounds of the church, inset. Brave worshippers are said to have
confronted a man ‘acting suspiciously’ outside.
