Even those photos give only a weak picture of what has really happened on that December day, when the Sri Lankans celebrated there monthly Poya festival and families were shopping on the markets: Within seconds a Tsunami killed 39.000 people!
Six weeks later Lions Clubs of the Hannover Region organized a charity event , a concert performed by the well known German singer ANGELIKA MILSTER, the first aid contribution achieved was about 40.000 €. Another 40.000 € came from SOLVAY GmbH, collected among management and employees.
We ran into various problems when we tried to find the “right” project. And it was a call from the nearby Lions Club of Hikkaduwa who helped bridging the search for a sustainable project for young and helpless Tsunami victims: Help building a Paediatric Intensive Care Unit within the large Karapitiya Teaching Hospital in Galle, in the Southwest of the country. The sponsors nominated Prof. Wolf Dieter Gogoll and Hartmuth Schulz as project managers. And together they formulated the Realisation Strategy.
At first everything was a about the building. Medical technology, equipment, personnel, and cost of operation should be part of the Sri Lankan Government. On August 27, 2006, the laying of the foundation stone could be celebrated.
Third from left Mr. Nissanka Epaliyana the local coordinator, delegated from the Lions Club of Hikkaduwa. The second from right – Dr. Pushpa Punchihewa, initiator of the project, and Director of KTH Children Wards.
Day and night – even during heavy monsoon rain – construction went forward.
The building was ready to be handed over to the KTH. The head surgeon of KTH, Dr. Kumara, lightened the oil lamps as part of the Buddhist ceremony.
But there was disappointing news waiting for the German delegation: The City of Galle and the Government declared unable to keep their promises to taking care for the equipment cost apart from the cost for staffing and operations. So they asked the Lions for further funding: Construction of the upper floor and delivery of the state-of-the-art medical technology to equip the PICU. Would the sponsors be able to take this big new additional burden? To make a long story short – they said “Yes, we make it!”
Now what? How much would it cost? The PICU architecture, basically done by Lion Prof. Dr. Christen from Hannover “Kinderklinik Auf der Bult “, came to the horror amount of 300.000€ - training expenses excluded. But the almost incredible succeeded: The Lions mobilised all efforts, SOLVAY joined in again, and eventually the money once collected by Council and citizens of the City of Hannover as aid for Tsunami victims was sufficient for the start.
The first two beds had been installed meanwhile, equipped with dummies and basic equipment installed. It became obvious that strategically spoken it should be worked for quite some time with two beds only, to concentrate on recruitment of suitable staff and grow to four beds only when necessary. competence was available. Nurses and doctors were hired – consultants for paediatrics and nurses with experiences in paediatrics.
On Sri Lankan side it was Dr. Pushpa Punchihewa, head of KTH’s 2 paediatric and the neo-natal wards, who was appointed accountable for the project. With Lion Nissanka Epaliyana, delegated from Lions Club Hikkaduwa a further co-project-management-person came into the game. All procurement and payment affairs should be running through him, resulting in 100% investment!
Still in October 2007 – Dr. Kathrin Seidemann, leading consultant for paediatric intensive car and Hannah Toensfeuerborn, head nurse for paediatric care, both from Hannover Medical School (…read more about Hannover Medical School)travelled to Galle. As the first two beds had been installed meanwhile, targeted training on the job was possible. Their audit results, kept in a detailed trip report, were basic for all further plans. So it was decided to let them work totally on their own for the next 6 months, and that training would have to play the key role for the time to come.
And then the first group of two doctors and two nurses came for a three weeks training stage to Hannover; among them the future head of the PICU Dr. Upeksha Liyanage. Later they told that they never ever would have thought being able to transfer what they had acquired. But they did it!
Dr. Chinthika, Susima, Dr. Upeksha, and Damayanthi for learning at MHH
Unbelievable with which success stories they were able to surprise everybody of their Hannoveranian peers already in December of the same year:
Now another 18 months practice, practice, practice followed – also with try and error. The team tried to achieve expertise in intensive treatment.
When in April 2010 a team of four paediatric intensive medicine professionals from MHH travelled to Galle an era of comprehensive learning as fixed in a fostership-agreement between the two PICU’s in Galle and Hannover started. The experienced team as mentioned before travelled more than once to Galle even using their private vacation times; Dr. Upeksha Liyanage, meanwhile appointed PICU head, came for a longer training sequence to Hannover. The German team found fabulous working results of the PICU team – so that the basis was more or less settled.
Impressions from those days: Typical training sequences
Start early in the morning…
Demonstration with dummy Practicing with dummy
Visitation – and case discussion And then - practicing
Afternoon lectures – audience even from the outside
Soon after everyone in the Southwest of the country knew that the German doctors did also treat most serious cases, sometimes even at night times or when the electricity was interrupted – as one can see on the photograph.
From a distant little village little Vihansa was hospitalised with a severe septic shock – almost not alive anymore. All went well – she survived.
End 2010 – PICU professionally equipped with 4 beds.
Thomas’ programm in November: Lecturing and demonstrating
It was Claudia’s first visit - Hannah demonstrating the defibrillator
Waiting for Kathrin’s lectures
As you may see on Youtube – her lectures were somtimes very specialhttp://www.youtube.com/watch?v=oiytZKAazi0&feature=channel&list=UL
Even smaller issues needed transfer: If you like, have a look on the translated helping hands poster of the WHO into Sinhala language:
January 2011: A German delegation of the PICU Charity Group went to Galle in order to meet important Sri Lankan stakeholders for accelerated support of the project: Barbara und Prof. Wolf Dieter Gogoll und Hartmuth Schulz..
Meeting Hon. Maithripala Sirisena, the Sri Lankan Minister of Health.
The Minister of Health wants us to develop the PICU to become t h e lighthouse example for similar plants all over the country.
The Lions District 111 NH decided to take PICU Galle as third International Sponsorship Project and started a further call for support all over the District NH 111. And the Lions Service Day on May 14, 2011, run on Hannover’s World Expo Plaza, was dedicated to the common project.
Dr. Sasse, Head of PICU/MHH, Dr.Robin-Winn, Prof.Gogoll, Lions District NH 111 Governor Klein, Hannover Region President Jagau, Arora, Zada (from left)
The German singer and artist Angelika Milster visited the Lions Clubs Hannover-Eilenriede. With her benefice concert in February 2005 everything started; the first 40.000 € had been collected – the PICU starting capital. Professor Gogoll told her about the outcomes and the Lions Club’s President Ditmar Hartmann (left) and Bernd Weste, the concert initiator expressed their thanks with a nice bouquet of flowers.
In July 2011 we lost the most senior person fort he fostership with PICU Galle.
Which good news…as promised in February by the Minister – a Paediatric Intensivist was recruited and joined the PICU team, Dr. Manjula Hewageeganage. Dr. Upeksha eventually got professional assistance. Dr. Manjula gained his specialisation in Australia, were he also worked for several years. Now he lives in Galle with his wife and two children. As far as we know he is the first consultant in Sri Lanka holding this specialisation diploma. Here amidst doctors and nurses.
And also in September 2011: Medical technology could be extended by three machines
There were two important events:
Firstly - a further training session by the MHH: Dr. Kathrin Seidemann, Dr. Thomas Jack, and the two nurses Hannah Tönsfeuerborn, and Claudia Heinemann went down to Galle for a further education and training sequence. Kathrin’s resumed …”we have to repeat continuously what’s necessary for paediatric intensive care…constant dripping wears away the stone…”
And secondly - The Rhön-Klinik, a private hospital in the city of Hildesheim, some km south of Hannover moved into a new building, giving the Förderverein PICU the unique opportunity to gather all what might be good for the further equipment of PICU and for the Intermediate Care Unit on first floor.
Meanwhile all collected money had been spent. Nothing left for further beds. And it came clear that without reasonable Intermediate Care Unit (IMC), i.e. a ward ready to host most serious cases right after intensive treatment which require round the clock supervision and care, the goal to getting a comprehensive paediatric intensive care would not be accomplished. After preparatory works – the calculation was about another 130.000 € - there would be enough space for an IMC on the upper floor.
And now a new search for donators and supporters began. Very many contributed… and end of 2013 most of it was covered. But if you think of the missing - two to three beds and the cost for training and development – there is still some distance to walk.
Fundraising activities of the PICU Förderverein went on – quite successfully! One of such steps – more immaterial – was the project work of 6 students from Hannover University of Applied Sciences. As part of their Bachelor of Science studies they had to work on a practical case out of “Marketing in Social Networks”.
And they took “fundraising for PICU” as an issue. On www.betterplace.org , keyword „PICU“ and with a nice little video on Youtube http://www.youtube.com/watch?v=XgWtqKsz3gw you may have a look into their results.
2012 The Year of Reconstruction
Starting signal for the next bigger reconstruction came on November 20, 2012: Key focus was the so-called Intermediate Care IMC – to become mostly located on first floor of the building. “Intermediate care” means – patients still too weak for transfer into the general paediatric wards or not yet ready for home leaves, who needed further 24 hours care, should have their places over there. Up to now life saving intensive care beds were often over occupied, even for longer periods, with intermediate care patients; with other words beds capacities were blocked.
Therefore extensive revision for the complex in total was needed. In particular since the KTH administration offered another 4 m of space from the neighbouring building. A Hannoveranian architect specialised in PICU design and planning honorarily dug into the matter and came up with a plan as you may see in the two pictures.
The future ground floor should basically host the intensive care facilities, the future scope with seven technically equipped beds, three isolation rooms with strictly separated water and sewage management, sterilisation and washing facilities, certain staff rooms and the entrance area.
On first floor a ceiling had to be put in, all energy supply, oxygen, compressed air and vacuum for the seven beds, air cooling, staff rooms, washing room for the patients, etc., etc. And most importantly – both stories had to be connected by an elevator for beds transportation.
Eventually on June 10, 2013, the inauguration could be celebrated framed by a solemn Buddhist ceremony and under the presence of those involved in the reconstruction, the PICU staff, former patients and their parents, KTH leadership team and many celebrities, as the Parliament Deputy Speaker, the local Member of Parliament, the German Ambassador and the Embassy Secretary, the once initiator, Dr. Punchihewa, now in Lady Ridgeway Hospital in Colombo, of course the Lions, headed by the local project coordinator Lion Nissanka Epaliyana, and of course the press. Speakers reminded the start from zero after the Tsunami disaster and the impressive results now achieved, and promised their ongoing support for the wellbeing and the further development of the unit.
And to put it in a nutshell: The reconstruction result is great for the number one intensive care unit in the country. Please, have a look on the first few photographs – they are not yet perfect, better ones will follow. But already those pictures showing the expectant crowd or the listening audience might get you an impression about this important day.
Some minor finishing will be necessary and one major one – we don’t have the budget for the elevator.
End of February the two directors of the PICU Charity Group, Prof. Wolf Dieter Gogoll und Hartmuth Schulz travelled to Galle, in order to meet the most influencing persons for PICU’s well being and to discuss with PICU management the strategy fort he year(s) to come.
Highlights of the more than successful trip:
All seven beds of the intensive care ground floor now occupied with seriously ill patients.
The Intermediate Care Station on first floor ready - but operations could only start when new nurses and doctors will be delegated by the Government.
The Minister of Health, Hon. Maithripala Sirisena, whom the two already met for the second time, repeated his vision to develop PICU as a lighthouse project for intensive care units for other regions of Sri Lanka. The pictured Letter of Award was handed over.
The project received special recognition when the Sri Lankan President, H.E. Rajapakse, received the stakeholders, and asked for a comprehensive description of the PICU story.
Saved children and their parents came into PICU to see their „uncles“ from Germany. And they honoured them with flowers, music, and performances. A wonderful thank-you-party for all faithful and loyal PICU sponsors over so many years.
And not to forget…
· During the visit it became possible to install the first tele-medicine connection between the two PICU’s in Galle and Hannover. From now on, on each Thursday at 14:30 local time the two teams will exchange important issues, discuss complicated cases, will have e-learning sequences, etc.
· The foundation of a Sri Lankan PICU Charity Group was prepared. The Deputy Ambassador of the German Embassy in Colombo, Mrs. Einig, promised to win the Sri Lankan Women Entrepreneurs Association as members.
May – December 2014
Just a glance concerning fundraising during said months….
Tea – Activity: Mr. Wijesinghe, owner of a midsize tea plantation located in the Baddegama Mountains, donated us 20 kg of his tea, as gift for our sponsors. And right after, through mediation of the German Embassy in Colombo, Sri-Lankan’s largest tea trader Dilmah gave us another 50 kg. Leo Club Gutingi from Göttingen supported us by distributing the tea on occasion of the annual Lions District NH111 conference to quite a number of Lions Clubs. And the senior golfers of Hannover GC and quite a huge number of individual sponsors were also happy getting this wonderful fresh tea, and made it easier for them to continue supporting the PICU Charity Group. Of course – we are continuously looking forward to finding further tea plantation owners in Sri Lanka. Eventually it is for the best of many children of their home country. Not to forget…the Sri Lankan Embassy in Berlin organized the delivery. Hot Thanks!
„Singing Bet“ on Lions Service Day: The dm-drugstore in Langenhagen city betted against the PICU Charity Group that they would not be able to get 100 people on a Saturday morning in front of their local shop singing the old German folk and kinderlied in favour of the Sri Lankan children. If they would make it the owner promised to spend 2.000,- Euro. The bet was perfectly organisized by Lions Club Langenhagen – and of course the bet was won! The Club doubled the sum – what an outcome… In parallel the tea sponsoring resulted into further effects.
Numerous individual sponsors supported the PICU project permanently and over years with great donations. Many of them with PICU from the first moment on; be it as sponsors for travel expenses for trainees and teachers in connection with the learning sequences in Sri Lanka or Germany or together with the procurement of another 50 litres of steril lium for hand disinfection. Very important – even the very small amounts totalled at a great amount.
Milestone birthdays were also used as fundrainings to support PICU Charity Group and its targets.
Donations of goods had an important weight during the last months. Examples: Hannover Medical School, Paracelsus-Klinik, Medical Supply Centre MVZ Langenhagen together with their assicated offices donated so many medical equipment and consumptive goods that a huge 40‘ sea- container could be filled and brought over to Sri Lanka. Assembly and collection of the goods the Autohaus Gessner & Jakobi made a VW bus available, and the owner of a huge storage in Letter-Süd took care for sufficient storage until delivery of the goods to Hamburg. Continental and Eu-retec, Conti‘s affiliate in Sri Lanka, took over the transport costs.
Time! Team members from Hannover Medical School invested significant parts of their annual holidays: Once again and repeatedly! Not to speak about the amount of time our local partner, Lion Nissanka Epaliyana, put in as he was and is the one who is always there if something does not work as it should – even through to looking to the wellbeing of visitors from Germany.
Elevator ready for use – eventually!
What is worth waiting for! The bed elevator connecting ground floor level, the intensive care area, with the Intermediate Care on first floor can be used. The THK administration installed an inspection ladder for the maintenance of the driving machine. A curious alongside story: The THK craftsmen did not dare climbing up; so the leading consultant from Hannover Medical school got up and showed them the how! The elevator was sponsored by the H&D Urban Foundation. Another hot thank-you!
And there is another story which illustrates the problems and stumbling block which you have to tacle or avoid on your way to PICU autonomy: THK promised to install a roof on top of the elevator building, in order to protect motor and shaft against rain – think of the monsoons… But when the MHH team came in on January 2016 there was no roof at all…but first corrosion could be detected already.
In order to have a brief impression of what has been donated and shipped to Sri Lanka and by whom, please, have a look into an excerpt from the packing list of the 40‘ container, reaching Colombo in August 2014. The goods were stored over more than 2 ½ months until the container was filled and the Sri Lankan Ministry of Health released us from import fees, as for instance import duties, import vat and harbour fees.
Sponsored medical equipment from Drs. Angela Eger, Elina Hummel, Peer Kistenbrügge, Paracelsus Prvt. Hospital, Katrin Fronhoff, Hannover Medical School, Dep. for Paediatrics
Mobile Sonograph w./Universal Sensor-Head / Anasthetic Apparatus“Fluotec”/ Heated small metal cabinet / Toilet chair for immobile children / 6 Infant beds w. trolley / 4 Hospital toddler beds / Isotherm heating lamp / Heating bed for infants Babytherm 4200 (Draeger) / System-trolley for hygienic clearing / 55 Mattress for toddler hospital bed / 3 Trolley with stainless steel baskets.
Sponsored Medical Consumables from Hannover Medical School, Dept. for Paediatrics, Paracelsus Klinik, Langenhagen
Syringes / Infusion line for blood products / Infusion line/ Band aid / Sterile wound dressing / Bandage / Denta swab for mouthcare / Sterile equipment for inserting central lines/ Examination gloves / Duvet covers / Pillow cases / Baby clothes (onesies, jackets)
From October 6 to 10, 2014, the team of Hannover Medical School travelled for another training sequence to Galle. Partially a new MHH team:
Since PD Dr. Kathrin Seidemann due to family reasons moved to Southern Germany, Leading Consultant Dr. Thomas Jack took over, supported by young Dr. Joke Buring. And from the first moment on part of the team and somehow something like a soul of the project the nurse Hannah Tönsfeuerborn. New as part of the team, a very senior person, Karl-Heinz Ross, who, after more than 30 years with Hannover PICU and there in charge of medical technology and hygiene-management, felt too young to retire: Kalle, as he is called by everybody, now member of the German Senior Experts Organization, went over with them for a 4 weeks period, accompanied by his wife. And his professional expertise was exactly that what was needed in the PICU and its present state of development.