Sahana Sewa Sathkaraya: A ‘Lionhearted’ effort that grants a lifeline to non-curable patients

The picture shows a group of nurses demonstrating the procedure to a caregiver at the National Hospital, Kandy

A team consisting of 06 nurses which is in charge of the palliative care unit

The nurse at the hospital advises a caregiver

The Lion’s Club building, situated in Kandy, where members of the medical staff are stationed at the ground floor awaiting a call to render their service 

• Nurses of the Palliative Care Unit will constantly have virtual connections with the patient’s family
• The objective of this service is to provide a comfortable life and facilitate the passage for a painless death for the patient
• This service has been provided to 1,875 patients who were admitted to the Kandy National Hospital

“Sahana Sewa Sathkaraya is a service initiated for patients admitted to the Kandy National Hospital with incurable conditions, such as cancer and kidney deficiencies. We admit patients to the Palliative Care Unit. This is a service provided free of charge,” explained T. M. Anura Rathnayake, In-Charge Nursing Officer, National Hospital, Kandy.
According to him, the patients are provided with all the equipment that are needed throughout their lifetime. Each patient is sent home with the equipment. A caregiver or family member who is tasked with taking care of the patient is advised thoroughly on the process to adhere when treating the patient. Meanwhile, the nurses of the Palliative Care Unit will constantly have virtual connections with the patient’s family. If needed a field nurse would visit the patient’s house for more treatment.
According to Rathnayake, the objective of this service is to provide a comfortable life and facilitate the passage for a painless death during the remaining years of the patient’s life. The main aim of implementing this service is to facilitate a home death. He added that patients of this nature are reluctant to stay in hospitals and prefer to spend their final moments at home.
Through this initiative, patients are sent home with all requirements provided. This service has been provided to 1,875 patients who were admitted to the Kandy National Hospital. Out of this number, 1,306 patients have passed away.
He added that the staff of the palliative care unit (for incurable diseases) would advise the closest family member of the patient in order to understand the latter’s condition. Moreover, the staff would guide the patient’s caregiver. They advise on the necessary procedures that should be implemented in the domestic environment in due course.
“There is a team of six nurses responsible for this process. Apart from them, 590 nurses are taking care of around 100 patients,” explained Rathnayake. These nurses are responsible for managing the patients throughout their lives.
Rathnayake said that there is a multidisciplinary team in the Palliative Care Unit. “Through this unit, counselors, physiotherapists, and pain management officers are provided to patients when necessary. The nursing team is well-experienced in helping patients face a painless death through effective pain management,” he explained.
A trained medical officer conducts a practice session for the caregivers and advises on the procedure that is necessary to adhere to when providing medical care to patients. This is a one-day training programme conducted to guide caregivers on the medical procedures to be followed at home.
This procedure provides special attention to the patient’s caregiver by medical officers. Nurses further instruct caregivers with additional details. More attention is given to patients who are being transferred for domestic care. This project was initiated in 2023.
The Lions’ Club building is being used for this purpose. Additionally, medical staff stationed at the ground floor of the Lions’ Club building in Kandy await instructions to execute this process.
The Palliative Care Unit also provides other necessities essential for patients. According to Rathnayake, equipment such as medical beds, air mattresses, oxygen tanks, wheelchairs, and other necessities is provided based on the patient’s specific condition. Furthermore, a bag of dry rations is given to families in need of financial help. Rathnayake added that cancer patients registered under the palliative care unit receive Rs. 3,000 monthly to meet their financial needs.
“All these facilities are provided by the society for palliative care.  At present, the association consists of 70 members who are willingly contribute to patient supplies,” explained Rathnayake. All necessary equipment is donated by the association to the unit.
The team of specialized nurses remaina continuously connected with caregivers through virtual platforms to provide necessary guidance in patient care. Caregivers are contacted monthly to obtain updates on the patient’s condition. The connections are executed through virtual platforms.
Further monitoring
Patients are further monitored through the RDHS (Regional Director of Health Services), rural hospitals, and public health nurses. If urgent professional medical support is required, a field nurse visits the patient’s home to address the situation.
He stated that while other hospitals have palliative care units, they are mainly focused on cancer patients. However, the Kandy National Hospital provides services to all types of palliative patients, including neurological, kidney, cancer, ENT, chest, cardiology, vascular, and other patients. Patients are recommended for palliative care by doctors and receive the required services through the unit.
Rathnayake further stated that after a palliative patient’s death, the family caregiver is brought to the center for counselling, aiming to restore mental stability. He recalled counselling a wife whose husband had passed away, as she was experiencing depression due to the loss of a long-term emotional bond.
Moreover, he mentioned that if the palliative patient has school-going children, the centre continues to support them by providing necessary supplies throughout their schooling years. “We have a list of 96 such students, and we provide the children with a scholarship fund. We receive Rs. 300,000 monthly from leading business groups in Kandy,” explained Rathnayake. In addition, Rs. 7,500 is provided to each A/L student to support education.
Rathnayake added that this unit undertakes funeral arrangements for families that face financial hardship. According to him, the Kandy National Hospital is able to vacate more medical beds for more critical patients by implementing the domestic treatment process.
As a result of the ‘comfortable home death’ concept, the nursing team of the palliative care unit has observed a visible increase in the number of patients passing away at home.
“The nurses in charge of the Palliative Care Unit have completed their postgraduate nursing degrees,” explained Rathnayake. He added that training programmes are conducted for nurses in rural hospitals, along with awareness programmes for counsellors and social service officers at the Lion’s building in Kandy. He stated that these programmes will be extended to village officers as well. “We are also planning to conduct awareness programmes for caregivers on procedures to be followed after the death of a palliative patient,” he said.
“We have established a palliative care unit at the Mahiyanganaya National Hospital. Similar units are partially available in other hospitals. However, the palliative care unit at Kandy National Hospital is outstanding, as we provide equal services to a wide range of patients,” said Rathnayake. He added that Maharagama Hospital has a unit specifically dedicated to cancer patients.
“We face challenges when transporting patients to their homes, as an ambulance is required,” explained Rathnayake. This service is currently limited to families facing financial difficulties. He also welcomed donations from external parties to support this initiative.

Those interested in contributing for this worthy cause can remit their contributions to Bank of Ceylon, Society for Palliative Care, National Hospital, Kandy.  The Savings Account number is 92973717, the Current Account number is 92976008 and the Scholarship Account Number is 94166967