My chest throbbed with immense pain while watching the movie” Ira handa yata,” Under the sun and moon. This movie reflected the 30 years of war that ruined the lives of millions in this country, and I felt it deeply as I was a victim of it since I was born and until I finished my medical degree. The tears of the living dead and the cries of the innocent had been reflected sharply throughout the film as I witnessed most of it myself during the time I served in an immediate post war area. The theme it carried not only bears a clear history of the war but also the humanity and its relativity towards the nation.
It takes a lot of courage and kindness to look at one another with
love and compassion even when one has lost almost everything he owned.
“It’s so good that it all ended doctor” every single person I met, told
me, that their lives are so much better, the children are safe and
they’ve returned “home”.
It was not all sunny and bright! Every day I come across hundreds of
people who come to us with all their illnesses. Billions of fears, tears
and pains seem to flock beneath their smiles. Even though they greet us
with a smile sometimes, I have come to an understanding that it’s not
easy holding all that down. Most people I meet seem to have tiredness in
their faces; we can’t expect cheerful grins from them as they have lost
their happiness on the road to salvation.
(pseudonym) was a 42 year old admitted with very low hemoglobin. Apart
from her medical conditions it was her eighth pregnancy, in which she
carried a high risk for postpartum problems. Risk of heavy blood loss,
still birth and gestational diabetes are high in elderly, multiparous
women (women who have given birth to more than one child)
“Your hemoglobin is very low and considering your age, risks are high you know.” I tried to explain her situation.
“Even though I had seven children, I lost six of them doctor Amma,” she said. Amma is a word of respect in this language.
Her older boys were taken by the terrorists to be trained as child
soldiers and she lost two children during the tsunami that hit the
coastal areas. Tears dropped down her cheeks and I was struggling to
“I have only one child, who’s 16 and wanting to go abroad to his
relatives. Is it wrong for me to have more children doctor?” she asked.
Ramya (pseudonym) was about 26 weeks pregnant when she was diagnosed
with gestational diabetes (high blood sugars during pregnancy). We
started her on soluble insulin as her blood sugar levels were rising up
on each visit for blood sugar series. As her condition was manageable
with the insulin I had to explain her on injecting it herself and the
care of insulin .
“You should store this in a refrigerator…”
“Doctor, we don’t have a refrigerator. Do I have to stay here? ” she interrupted me.
This is a common question we always come across as most of the villages don’t even have electricity.
There were four other kids and she was pregnant with the fifth. She
had most of the factors that indicated that it is a high risk pregnancy.
Her condition will be severe if she’s unable to use medications at
home. They’ve returned to their villages recently to their roofless
homes with shelled walls. The rural hospital seems to be far away from
her home and keeping her here was also a challenge as she had 3 months
Asking them to come to a closer residential area for this matter
was a joke as they never understood that life risks are greater than a
piece of land they owned. They barely have homes and survive on Kuli
weda (menial labor) which pays about 200 to 300 Rupees a day. It’s not
enough at all for a family of six. After so much of debate and a talk
with her husband, he agreed to paddle every morning and evening to the
hospital nearest to them for the insulin and we taught the method of
storing it in a clay pot buried underneath a cool spot in their garden
Every day we come across these kinds of problems and we seem to be
the listeners and bearers of their pain. Hospital is the sacred place
for them to resolve all their issues and sometimes family matters too.
They expect us to resolve all their problems but all what we can do
is merely help them with unrealistic solutions such as inform about them
to the welfare society of the hospital, social workers or a helpful
Coming for clinics seems the only chance for them to dress up and
travel. They come there with the best clothing they have, not to mention
that they love silver and gold. Most of them are dressed in sarees
bathed in gold or silver dust. At the end of the physical examination
rounds we transform into shiny golden statues by all the dust from their
sarees and salvars.
On their long run for survival many lost their homes and were taken
as a human shield by the terrorists till the final battle from town to
town. So, almost all of them with chronic diseases had lost their clinic
books or diagnosed cards from past along with their homes, valuables
and family members. Yes family members too!
Whenever we ask them what happened and why couldn’t they secure those
cards or books, a river of tears fall out with the war wounded history.
Lives of these people have torn, twisted and blasted sometimes but
regained as I write this note now, that’s the change we see at present
in this end of the country.
War had hit them really hard. Almost all seemed to bear a scar or a
wound from the past. A shell, a bullet or a bomb blast written all over
it. It was so painful at start but we overcame the pain as this was a
Communication was the key of our profession as we had to ask
everything to understand the illnesses. When I was posted there I had no
fluency of Tamil language in which 98 percent of this community spoke.
It was the time that I regretted the most for not having any interest
to learn the other language. I had to, somehow learn it and become a pro
to survive and serve here. My Transformation into a Tamil language pro
within weeks was a surprise to all and how I overcame that challenge is