Nawaloka incident not anticipated-Duminda's family

While questions have been raised about the health condition of MP Duminda Silva, his family released a set of photographs to the media yesterday which they asserted had been taken after he was admitted to the Sri Jayawardanepura Hospital and later at Mount Elizabeth Hospital in Singapore and Nawalaoka Hospital in Colombo.

In a statement to the media, the family, explaining the events that followed Duminda Silva’s discharge from Nawaloka Hospital on April 28, said that they had not been anticipated by the family and the situation had rapidly spiraled out of control.

“What was intended to be a simple low key exit from the hospital turned out to be the highlight of the year due to the sheer exuberance of his supporters and the unprecedented media coverage he continues to draw. We too were perturbed by the sequence of event's which posed definite risks to his condition, further having seen the clips, the doctors at mount Elizabeth hospital have informed us of their serious concerns about exposure of this nature and the risks it poses to his recovery process,” the statement said.
 

The full statement issued by Duminda Silva’s family

It is unfortunate that many are misinterpreting this incident purely based on superficial facts without, publishing well researched articles which will provide the readers with an unbiased report of the actual situation, the sequence of events and its intricacies. One has to also question also the logic behind generalizing based on one isolated event.

We would like to reiterate that what transpired on the 28th of April 2013 was not anticipated by the entire family and the situation rapidly spiraled out of control. The fact that Duminda's face eluded the public's eye for the last one and a half years stands as a testament, to the extreme care and caution we had taken to protect him from situations which may have subjected him to any pressure whatsoever. What was intended to be a simple low key exit from the hospital turned out to be the highlight of the year due to the sheer exuberance of his supporters and the unprecedented media coverage he continues to draw. We too were perturbed by the sequence of event's which posed definite risks to his condition, further having seen the clips , the doctors at mount Elizabeth hospital have informed us of their serious concerns about exposure of this nature and the risks it poses to his recovery process.

Any right thinking individual will concede to the fact that, we have at all times acted with dignified restraint and have never tried  abuse or influence the judicial process by publicly challenging and commenting as resorted by others, stooping down to disgracefully publicizing flippant, deceitful and self-contradictory statements. In their eyes justice seems to be in operation only when a judgment goes in their favour, and further goes on to repeatedly make degrading statements regarding the Judiciary and the judicial process. It is our belief that they may be under a false notion that they can twist the arm of the legal framework with their antics.

It's also pertinent to state here at least in this late hour that, this incident evokes such negative reactions, due to the incessant barrage of negative publicity Duminda has had to contend with throughout his political career, due to the baseless accusations which were supported and fueled his political opponents at the time, which they used to gain political mileage.

Let's not forget the fact that although Duminda is not the most popular among the elitist society of Colombo, he still remains a larger than life figure in the hearts and minds of the people he tirelessly and magnanimously served.  His heart is set at serving the "have not's " of our society, in contrast to others who rarely walk the talk , and are pre occupied with currying favour with the elitist strata  of this country.  It’s unfortunate but the reality is that the poor  he serves have but little voice , and can only show their support and reverence by congregating in numbers. This is what transpired on the 28th.

Although we knew that there may be people who would flock to get a glimpse of him, we simply could not predict the number nor the way they would react on the day.  I don’t think we have to mention that Duminda draws immense crowds whereever he goes.

We must say without reservation that our main intension from the very first day subsequent to the incident in October, has been concentrated on and have revolved around his recovery and don't see the need to get embattled in a war of words with anybody. When the time is ripe our legal experts will present to courts the evidence which will prove to the courts and the general public his absolute innocence.  

It is ludicrous to assume that Duminda’s doctors and Lawyers blatantly misrepresented facts to the courts.  Firstly what was stated to the courts was the fact that Duminda is still in a stage of recovery and will be thought to be so until he is able to get involved in his daily activities and normalcy without any eventualities for a considerable period of time, devoid of medication. The doctors nor the Lawyers are omniscient, to accurately predict how he would react to certain situations or if those situation will evoke negative responses. Therefore like in all medically sensitive situations they stress on extreme care and caution to prevent or greatly reduce any manifestation of ill effects. His foreign panel of neurosurgeons and post care therapist strongly advised he should not be subject to any sort of stressful situation due to the unpredictability associated with the recovery of a brain injury and trauma of epic proportions.  

Further it’s plain to comprehend that private hospitals are better geared to handle recoveries of this nature and due to the adherence to best practices tend to be more hygienic than the prison hospital. However in general as hospitals have heightened levels of bacteria and infections, it was best that he returned to a home environment. These were the concerns brought before the honourable judge who understood his complications and kindly conceited to granting bail.

It comes without saying that the human brain and its functioning is one of the least explored organs in the human anatomy, and in Duminda's present situation no one can predict how he would react to extreme situations of mental or physical stress. The learned doctors in both countries have cautioned the family about irrecoverable damage it could inflict on his recovery, if he reacts negatively to stressful or physically exhausting situations. It’s based on these concerns that our lawyers presented their case before the judge, and not with any reason to mislead the courts or the general public. We have sought the advice of medical experts who are considered to be the best in the world in the field of neuroscience. Without an exception they have all cautioned about the above mentioned risks, so if anyone refutes this they should be more recognized and qualified than our panel of doctors who are experts in paediatric neurosurgery, neuro-oncology (brain and spinal cord tumours), stroke and stroke risk assessment, minimally invasive neurosurgery for spine conditions, chronic pain management , and functional restoration of patients. Dr Keith YC Goh is renowned for leading surgical teams in rarely performed surgeries to separate 3 sets of conjoined twins from Nepal, Iran and Korea in 2001 and 2003. He has been featured in major news media, newspapers and television (CNN, BBC, CNA, ITV).

Let’s not forget, that the two bullets which penetrated his skull ripped through his brain causing colossal damaged to both his brain and skull. Also the perpetrator who fired on him shot to kill and these are not shots which were fired in cross fire but were shot at point blank range with ample time to deliver both shots without the hindrance of cross fire.

His miraculous recovery was also aided by his immense determination and this same courage would have helped him on the 28th rise to the occasion , however the dangers and risks are still very much at large and real.

Hence we will continue to be optimistically cautious about his recovery process and take every effort to minimize exposing him to situations which may impart physical or mental stress on him.

Below are extracts from the panel of medical experts

Extracts from medical repot dated 16th July 2012

 Mr Silva was admitted to mount Elizabeth hospital on 2nd November 2011 after sustaining a penetrating head injury (gunshot injury) in Sri Lanka on the 8th of October 2011

He was initially treated in Sri Lanka - right hemicraniectomy   , wound debridement and removal of bullet fragments were done.

There are still remnant metal fragments in the deeper part of the right frontal lobe of the brain.

On admission to the hospital he was found to be conscious and responsive able to understand and follow instructions.

There was weakness of the left upper limb, especially the distal muscle affecting the hand and fingers  

He had a bullet entry point wound on the forehead and damage to the right side of the skull, (area of 42 cm in circumference)

Since admission to the mount Elizabeth hospital, Mr Silva received intensive neurological rehabilitation , ie : physiotherapy, occupational therapy and mind exercising therapy , under Dr. Ken Ung and the hospital team of therapists, He has achieved substantial improvement in all above parameters
On 19.05.2012 cranioplasty using a CT scan- customized pre fabricated implant , (osteo mesh scaffold with titanium rod) was performed to repair the right skull, hemicraniecotomy defect .

Subsequent to the operation, he developed left upper limb weakness.

CT brain scan showed significant fluid collection under the cranioplasty implant , which required another surgery

He subsequently recovered satisfactorily with gradual improvement in power of the left upper limb.

Mr. Silva is responding very positively and speedily after the cranioplasty surgery and has been advised to , refrain from air travel until he receives medical clearance

He is also advised to be within a hygienic and clean environment and refrain from stressful undertakings  

Extracts from medical repot dated 20th November 2012

Further to my medical report dated 16th July 2012, regarding the cranioplasty procedure performed on the 19th May 2012, using a CT scan- customized pre fabricated implant , (osteo mesh scaffold with titanium rod), research on the technique has shown that the growth of the skull bone into the scaffold should gradually take place over the next 1.5 - 2 years. It is very important that for the next few years he takes utmost care and is not exposed to risk of any impact or damage which will prove to be absolutely detrimental.

Extracts from medical repot dated 25th February 2013

He now intends to return to Sri Lanka with his parents in early March 2013, to attend matters which cannot be postponed.
I need to emphasize that his physical appearance is not an indication of the brain trauma he has suffered and absolute care must be taken for another 2 to 3 years

Although his recovery has been satisfactory, patients with such penetrating head injuries may have unpredictable changes in the condition. Any adverse factors, stress and the slightest impact will not only reverse the progress he has made but will also be life threatening.

He should not be exposed to unhygienic conditions as bacterial infections are easily possible and may affect the repaired skull defect, which has still not recovered fully. He should take his medication in a regular and timely manner.

The stress and trauma that he will undergo from air travel cannot be predicted and on arrival he should be transferred immediately to a fully equipped hospital and preferably be under the care of the doctor who attended him before in Sri Lanka.

Mr. Silva requires further medical examinations and evaluations mid-April. These frequent follow up medical visits will be necessary for the next few years.




Pictures, released by Duminda Silva’s family, of Mr, Silva undergoing treatment at the Mount Elizabeth Hospital in Singapore, on May 19, 2012.
October 18, 2011: Mount Elizabeth Hospital in Singapore


May 12, 2012: Mount Elizabeth Hospital in Singapore


May 19, 2012: Mount Elizabeth Hospital in Singapore