Special Services

01. Patient Rehabilitation Services

Physical Rehabilitation Center, Digana

Due to lack of facilities and trained staff, the rehabilitation of physically disabled patients does not get adequate attention in the general health services. Most acute cases are managed in surgical and medical wards in general hospitals after which the patients may get discharged without any attention being paid to rehabilitation. Usually they end up as bed ridden or wheel chair dependant disabled citizens and are a burden to their family and society.  
According to the 1999 statistics of Teaching Hospital Kandy, for the 1st six month of 1999, 1100 patients who needed medium and long term rehabilitation were discharged without a proper rehabilitation plan.

In 2001 with government and other well-wishers’ donations, the Department of Health Services Central Province decided to develop a rehabilitation hospital in the underutilized rural hospital at Digana (about 15 km away from Kandy town).
Due to the constraint in financial and human resources it was proposed that the rehabilitation project be carried out in a phased manner.

1st phase    - 25 beds    - 2001 June
2nd phase    - 50 beds     - 2007 April

The two phases have been completed and services are successfully being delivered.
The total investment for the infrastructure development in the second phase was about 52 million rupees.

The available services are:

• Inward facilities: (There are 30 beds for male patients, 20 beds for female patients and 10 beds allocated for pediatric patients. All residential facilities are provided for these patients.)
• Medical Management - There are four Medical Officers in residence and a Senior Registrar from Kandy General Hospital visits the patients on a routine basis.
• Physiotherapy
• Occupational Therapy
• Vocational Training
• Supply of disable appliances free of charge
• Counseling services by professional counselors
• Training of relatives in the care of the disabled
• Staff training
• Follow up after discharge

Apart from the rehabilitation service the unit also provides medical, dental clinic services, Emergency treatment services and OPD services.

Community Resettlement

Community resettlement is a crucial factor in the rehabilitation of the disabled and is yet to be addressed even at National level. A community resettlement program is underway at Digana Rehabilitation Hospital and up to now 52 resettlement activities have been carried out.

02. Mental Health Services

Mental health services provided in the Central Province has improved gradually over the years and has been identified as model for mental health care. The services include a network of mental health clinics, management of acute patients, medium stay and long stay rehabilitation units and community mental health services. This programme is supported by the Psychiatry Department of the Peradeniya University, Psychiatry unit Teaching Hospital Kandy. The Mental Health Resource Centre was established in Katugastota to strengthen the planning, coordination and implementation of the mental health programme in the Central Province. ‘Nivahana society” a NGO actively supports the mental health programme in the programme.

Currently there are 2 tertiary care hospitals (TH kandy, TH Peradeniya) and three secondary care hospitals (DGH Matale, DGH Nawalapitiya and DGH Nuwara Eliya) with consultant psychiatrists of which 3 of the hospitals have in ward facilities. There are X hospitals with Medical Officers of Mental Health providing care while XX hospitals conduct mental well being clinics through trained MO or as out reach clinics.

There are four hospital providing medium stay facilities for patients. They are Sisila Deltota, DH Leliamabe, DH Muwandeniya and DH maldeniya. Long stay units are planned to be established in DH Walapane and DH Muruthalawa.

03. Dental Services

Preventive and Curative Dental Services

As the incidence of dental caries and periodontal disease is on the rise, the delivery of Dental care services is considered a primary health care activity.

The incidence of oral cancer is the highest among all malignancies in Sri Lanka. A high incidence of other oral diseases such as cleft palate and lip, odontogenic tumors, and other oral lesions is also recorded. Moreover, the demand for specialized dental treatment and fixtures (e.g. Dentures, braces etc and other orthodontic treatment) is on the increase. However at the moment patients who need these services are compelled to seek them from the few major dental hospitals in which these facilities are available.

In the Central Province, as well as in other parts of the country, dental services are provided both in the public and private sectors. The public sector provides not only curative but also preventive oral healthcare delivered by dental surgeons and dental therapists. Dental services in the public sector are provided through the Hospital Dental Clinics, School Dental Clinics, Community Dental Clinics and Adolescent Dental Clinics. The former delivers mainly curative services while the latter three provide preventive oral health services.

There is a Regional Dental Surgeon for each district and he/she participates in the planning and monitoring of dental services in his/her area and this has helped to establish an effective system to share information and to improve the delivery of dental care services.

Mobile Dental Services

The Mobile Dental Unit was established in 2002 to provide satisfactory curative & preventive dental care for the people living in rural and suburban areas where accessibility to dental treatment is minimal.

The areas recognized as very difficult areas due to difficult geographical terrain, poor infrastructure facilities and low socioeconomic and education levels have led to high incidence of dental caries and periodontal disease. The Provincial Department of Health identified these factors and currently have established three mobile dental units, one for each district to ensure dental services are brought closer to these populations who have no access to regular dental care.

The mobile dental services consist of a vehicle with fixed and portable dental chairs, essential dental instruments & material. The team consists of 4 personnel: one dental surgeon, a driver, driver’s assistant and one minor staff.  Services are provided on weekdays and Saturdays. The services are also provided on Sunday and public holidays, if requested by organizations, institution and societies etc.

The main services provided include education & motivation on oral hygiene, restoration of deciduous and permanent teeth, extraction, treatment for periodontal disease, dento-alveolar   abscess,   screening for pre-malignant lesions , diagnosis of oral  carcinomas and proper referral  for  tertiary care.