By Nihal D. Amerasekera
There has never been an age that did not applaud the past and lament the present. (Anon)
In the 1960’s the GHC must have been one of the largest hospitals in the world for its sheer patient numbers. It served a growing population of the city and its suburbs and also the whole country as a hospital for tertiary referral of complex problems. It had many entrances and exits and to these portals converged hordes of patients’ relatives and wellwishers from near and far. Such a place was a magnet for soothsayers , magicians, quacks and salesmen. Like the doctors, lawyers and funeral directors they lived on the misery of these unfortunate people. There was often a weariness at the weaknesses of our health service and at a world that did not care. As a medical student I have often watched this awesome spectacle as it unfolded around the GHC.
Those were the days of trams, rickshaws and quickshaws. Punchi Borella is a small junction but an important crossroad. To the south is Borella, to the north Maradana, to the west The General Hospital and the Aswattuwa with the old colonial name, Lipton Circus; and to the east the Welikada Prison. At the centre of the junction is the Bo Tree never short of devotees. The road to Maradana was narrow and lined with rows of tenements. There was a small hotel at the junction that served those delicious thosai and sodhi on a banana leaf with a "stretched" cup of tea to wash it down. The sodhi was rather dodgy as I recall with bits of previous day’s dhal, last week’s vegetables and last year’s tomatoes. But the taste was heavenly. The man who served the vegetables wore no shirt and dripped sweat into the bowl. I can still hear him shout "Cup Tea". Sadly this eating house is no more as I searched for the taste of the 60’s. It may have been a blessing in disguise as my stomach may not have withstood the assault.
Donald’s Studio was just a stone’s throw away beyond which was Ananda College, Wicks Bookshop, Moulanas, Maradana Railway Station and Buhari’s - the best place for ‘Gothamba Roti.’
During the week large numbers gather at the Punchi Borella Junction. Many hundreds who flocked to the General Hospital Colombo from all over the country as patients or patients’ relatives found a haven here. There aren’t many Sri Lankans who don’t like oils. Our village folk love smelly oils to apply on the head for headaches and catarrh. These are never in short supply and many vendors sang their praises. Its potency is directly proportional to its pungent smell. They look like engine oil and perhaps this has some healing effects too unbeknown to the big oil companies. After all petroleum is a by-product of sea creatures buried many million years ago. Whether it is constipation or asthma, there is an oil to make you better. Copious amounts of the stuff is applied on the patients in hospital and the stains are often seen in the pillow cases and bed clothes.
The precious oils
Crowds gathered to hear the Medicine man with a crisp voice advertising his ‘kokatath thailay’. As its name implies it is the oil for all occasions and ailments. A few drops of this precious liquid will cure anything from piles to nervous diseases and from epilepsy to gas in the belly. It is particularly effective for aches and pains (APR or athey-paye-ruthawa) a common symptom of the elderly. The sale is brisk and he moves on after a couple of hours of non stop advertising to save more lives elsewhere.
There was also a man who specialised in toothaches. He knows he has hit upon a common complaint and a positive money spinner. The medicine is in a small bottle which contains a few drops of fluid. He explains that only a single drop is needed in the tooth cavity and hey presto! the pain vanishes. A sucker is born every minute and he makes a quick buck to getaway before being found out that it was just coloured water from the Kelani.
I was a medical student then. My mentors were the consultant staff at the hospital. Mostly they were a dedicated bunch. Even with the best will in the world they were not in a position to provide the finest service to every patient in their care due to the massive patient numbers. The result was an inevitable neglect of some. It is unfortunate that foolish and ill-informed criticisms of a personal nature are made against the consultants diverting the attention from the real problems of a health service bulging at the seams and a government unable to provide the money and the direction. I can personally vouch for the passionate commitment of many of my teachers. To ‘muddy the waters’ further there were touts at the GHC gates asking the patient’s relatives to visit the homes of these clinicians if better treatment is required. I do not believe this information was doled out free of charge and perhaps resulted in some improved care for those who took their advice.
Alternative to medicine!
Some desperate relatives go to the palmists and astrologers who have a brisk trade in this cauldron of despair. For them disease is caused by mal-aligned stars. Eager to know what’s in store for them and their patients they listen intently to their patter which is often well rehearsed. It’s mostly doom and gloom to sell their talisman to ride over their misfortune. People are asked to wear them for 3 to 6 months until the alignment of the stars change. At least when the doctors can’t help they have the talisman to give them some hope.
Producing some of the best teas in the world we are a nation of tea drinkers. As is often said ‘anytime is tea time’. There were several vendors selling plain tea at the gates. They carried a copper water container with a gas burner with small glasses arranged tastefully around the copper boiler. I have never seen them wash the glasses and my recent knowledge of microbiology prevented me from being a customer. The delicious pink iced drink called sherbert (saruvath) with its floating seeds is a thirst quencher par excellence and is everyone’s favourite drink for a hot afternoon. Those pink bottles proudly displayed round the pushcart was a positive crowd puller. To this day I do not know from where they get those seeds and the water for the sherbert. Perhaps I should have trusted my beginners luck.
There was a man selling banians. He was a rather elusive person - now you see him, now you don’t. Banians were a part of a patient’s costume in hospital and often in great demand. Hence he had a brisk sale and the price was low. Once I overheard a customer complain to him that the banian had only a front and no back. The vendor said "What do you expect for that price?"
At Punchi Borella the trainee barbers gather, under the spreading Bo tree, offering a free hair-cut to those who dare. You have to hold the mirror yourself to see their handiwork. The crows above are a menace to this open air Hair Dressing Salon the customers and the barbers being constantly bombarded with their excrement. Some said the crows provided the Brylcreem. The clicking of the scissors is their sign that action has begun. They haven’t yet mastered the use of the scissors and the scalpel and you would have done well to get out with your ears intact.
The Lipton Circus is not without its hazards. I vividly recall a elderly woman clutching her jaw in bewilderment. She had wanted to travel to Wellampitiya and joined the queue. Unfortunately she was in the wrong queue which was the one to the Dental Institute for tooth extractions. The 2 queues run parallel before diverging. Thankfully they removed the tooth, the whole tooth and nothing but the tooth. She was pleased a job long overdue got done but was too apprehensive to join the queue again.
There was a poet (kavi karaya) at every entrance to the hospital. They sang about the current topics - from the hazards of alcohol to political upheavals or a recent gruesome murder. When the poems didn’t rhyme he coughed and continued. He sold booklets of poetry or sheets of poems. Many listened to their tales and few bought the kavi kolas to take home to recite and mull over its contents. The Milk Bars had a brisk sale and many bought king coconuts, oranges and other fruits for their suffering kith and kin behind those iron gates.
My most haunting memory of the "gates" is the wailing of relatives after a death. I recall a typhoid epidemic which took a heavy toll. It is not a place for the faint hearted. After a while the wreath sellers and funeral directors converge on these unfortunate people. It is true they provide a service but it just reminds me of the vultures of the Serengeti plains in Africa. It was the poor villagers who came from far who suffered the most. I wish there was a safe place of rest for them to stay overnight. A government run information service for these simple rural folk would have been a great blessing. Perhaps the situation has improved since those distant days.
Having been abroad for nearly three decades on a recent visit I felt disorientated in the GHC. The well known landmarks had changed beyond recognition. Now there are road blocks and armed guards. The hospital is like a fortress. I was disorientated and disillusioned by the changes to the road names that made them lose its connections with the past. I will hang on to the memory of this impromptu theatre as it was 40 years ago for its sheer spectacle. I firmly believe it served a purpose keeping some worried minds entertained. Where there was despair they received hope. Many new private and public hospitals have now appeared and there is greater choice. The healthcare appears to be as good as in any developed country although available only at a cost. Hopefully it will filter down to the masses with time.
Health is wealth
A revolution has taken place in healthcare since the bad old days of the 60’s. In those days what happened within the walls of the hospital was shrouded in mystery. The illness, treatment and the likely outcome was never discussed with the patient or the relatives. Now there is more openness. The general public are more knowledgeable about health and disease as the advice is freely available on TV, internet and the news media. Fortunately the doctors too have moved with the times to embrace the change.
Some things never change
The doctors will never tell you so when they have no clue what’s wrong with you. The prescription will be written in ‘poor handwriting’ so that no patient can read it and the possible diagnosis scrolled in Latin like "erythema ab igne" giving the reader no hints. They will just blind you with science and keep the foot on the door for your next visit. Just in case you are booking a flight out , this practice is worldwide and you have no escape. As for the doctors, it’s only a matter of time before they too become patients and fall victim to the process they helped to propagate. In common with the rest of the subcontinent the bureaucracy, red tape nepotism and political meddling will take a lot longer to change.
Meanwhile keep healthy.
I wish to dedicate these memoirs to the physicians of the General Hospital Colombo 1962-67 who taught me medicine, its nuances and etiquette. Drs. W. Wijenaike, D. J. Attygalle, O. R. Medonza, Ernie Peirs, Thanabalasunderam and Professors R. P. Jayawardene and Rajasooriya. Their clinical and teaching skills cannot be surpassed. They gave of their best.
May they reach the ultimate goal of perfect peace.
(This article first appeared in the Sunday Island about a decade ago. It has since been modified by the author to suit the blog).