The Easter Sunday bombings that took place a month ago have left us reeling in shock. Almost 200 people have lost their lives. At least another 300 more are injured. Tragedies like these leave heavy wounds. Both physical and mentally. Modern medical technologies have helped us prolong our lives and heal many wounds. But does it have solutions that can heal the wounds from tragedies like this? More importantly, are these solutions affordable?
Identifying income levels
The deadly Easter Sunday bombings occured in 3 areas. They are Colombo, Negombo, and Batticaloa. Can those injured by this tragedy afford the necessary treatment? To answer this question we first need to identify the income levels of these areas. Hence we took a look at the data from the latest Household Income and Expenditure Survey. Granted, it’s from 2016 but that’s the state of open data with the Sri Lankan government.
If we take a look at the average monthly household income, Colombo averages around LKR 84,917. Batticaloa in comparison is only around LKR 37,130. Further, Negombo, located in the Gampaha district comes in at around LKR 32,396. So now that we have formed a baseline on the incomes of these areas, we can next look at some of the challenges that these people would face.
Loss of Limbs
Among the deadliest injuries, victims of bombings suffer from is the loss of limbs. Depending on the severity of the explosion, the limb can either heal or require amputation. The latter is disastrous. In an instant, this would shatter a life. Simple acts like climbing a staircase or even going to the washroom, which was once natural would now become complex.
This is where prosthetics come into play. They can help the victims regain a sense of normalcy. However, prosthetics are expensive. For example, a prosthetic leg can cost anywhere from $5,000-$50,000. In Sri Lanka, however, the Meththa Foundation offers prosthetic limbs from around LKR 7,500 for a below elbow prosthetic arm and goes all the way up to LKR 32,000 for an above the knee artificial limb.
However, these prosthetics offer minimal functionality. If you’re looking at advanced functionality, then the price immediately skyrockets. Furthermore, each prosthetic limb must custom fit every patient. In addition, once the prosthesis is complete, the patient will also have to undergo physical therapy for weeks, perhaps even months. Additionally, prosthesis is also not a long term thing. Prosthetics require a change every three to five years.
In recent times, we’ve seen 3D printing as an alternative method to creating prosthetics. This is because the production method is considerably cheaper than traditional machining. Back in 2016, we saw Nissanga Warnapura – CEO of 3D Concept Studio talk about how he and his team created a 3D printed prosthetic hand for a child whose hand was “too small to operate on” by most doctors in the country.
Robotic limbs are also becoming a go-to choice for amputees. These give amputees the ability to carry out functional tasks as they normally would. The only difference is that the artificial limb is mechanical and can to an extent simulate the operation of a limb. The University of Moratuwa, for example, developed a robotic prosthetic arm in June 2016. This was primarily for war victims but the same can be applied here as well.
However, 3D printing can be expensive with even the smallest prints costing in the thousands. Robotics is also still at the research stage. That means they too are years away from being accessible to everyone. That leaves us with traditional prosthetics.
Such artificial limbs (above the knee) costs LKR 32,000. If the victim is taking part in any sporting activity and wishes to continue after a prosthesis, that can cost anywhere between LKR 45,000-50,000. Based on the data we have, we can see that already that’s a months salary gone. So while we do have different prosthetics available, they aren’t exactly affordable.
Shrapnel is a slow but dangerous killer
Another dangerous outcome of a bombing is shrapnel. This can be in the form of steel or lead balls. It’s using these tiny pieces of metal, that explosives kill with the force of the explosion sending these tiny pieces of metal flying everywhere at high speeds. It can also be caused by the splintering of glass and other materials that explode in the vicinity of an explosion.
Either way, shrapnel is dangerous. It can pierce human skin and injure vital organs. In the case of the Easter Sunday Bombings, a victim in Negombo had shrapnel in her face. Sadly, the removal of shrapnel is not easy. You can’t just dig around inside a person with a pair of tweezers. It all depends on how much shrapnel a victim has in their body, where it is, and the size of the shrapnel.
In some cases, surgeons may actually recommend to leave the shrapnel in and take it out after a period of around 3-6 months. But in the event, immediate surgery is necessary, it again depends on where the shrapnel is and the size of it. To better understand this, we spoke with Ahamed Thawwab Mohideen, who is a practicing surgeon at the Base Hospital in Mahiyanganaya.
Speaking to ReadMe, Ahamed shared, “A basic surgery to remove shrapnel that is located near any non-vital organs and veins can cost around LKR 10,000. That includes the cost of anesthesia, hospital and doctor fees as well as any medication.” However, if the shrapnel is lodged close to any vital veins or organs, the complexity and cost of the surgery increases
Thawwab explained that surgeries of this nature start off at around LKR 25,000 and continue to escalate from that point onwards. If surgery is not possible in Sri Lanka, then the patient might even have to be flown overseas for the surgery. This, in turn, means that the patient’s family would have to bear the cost of the flight, as well as the surgery.
Trauma plays havoc with one’s mind
The death of a loved one is not something that you can easily get over. That challenge is made particularly more difficult if they passed away due to a tragedy. Hence it can be a heavy toll on the mental health of the survivors. These invisible wounds are just as deadly as physical ones. One example of this is PTSD, the symptoms of which may not appear until months or even years later.
Sadly, technology has yet to give a definitive cure for conditions that hurt the mental health of a person. However, technology has made it easier for those affected to seek help. Both Government and Private hospitals also have visiting psychiatrists or counselors. With apps like eChannelling or Doc990, you can easily place an appointment to seek help. Additionally, thanks to social media many other initiatives like the Ohana Project are also more accessible.
But if we take into account the cost of professional treatment for the victims, we see that those in Colombo are more financially equipped to deal with these than those from Negombo or Batticaloa. For example, channeling a psychiatrist at a private hospital cost around LKR 2000-3000 via eChannelling.
Then you have the cost of the treatment itself which again comes in at around LKR 2,000 per prescription. Depending on how strong the treatment is, a patient might be asked to see the psychiatrist once or twice a week. Taking LKR 5,000 per visit as a baseline, that’s around LKR 10,000 per week and roughly LKR 40,000 per month.
Recovering from the Easter Sunday Bombings
As we saw with the Easter Sunday bombings, in many cases, those who lost their lives are breadwinners. Not only are the families of these people grieving, but they are also now financially unstable. This means that they have little or no income if their loved one was a victim of the tragedy. If the victim is an amputee, they might not be able to work until they can afford a prosthesis. Even then, they would need physical and mental support as well.
Recovering from a tragedy such as the Easter Sunday Bombings will require not only physical and mental support for the victims but financial support as well. As we spoke about, the cost of treatment, be it mental or physical is by no means cheap. This is especially seen in areas like Batticaloa. To its credit, the government has begun compensating the victims of this tragedy. Yet, the loss of breadwinners means these families would face an uphill battle.
Further, if we take a look at the numbers in terms of funds required, we can see that recovering from a disaster such as the Easter Sunday Bombings is by no means cheap. Prosthetics, for example, can cost all the way up to LKR. 45,000. Treatment for shock and PTSD can amount to around LKR 40,000 per month. Then there’s the cost of surgery for removal of shrapnel that starts off at around LKR 10,000 and increases massively depending on the complexity of the surgery.
Furthermore, the average income may be biased as a result of the wage gap between income classes. This also does not take into account losses incurred during the Easter Sunday attacks. In addition, the report taken from the Department of Census and Statistics is from 2016. Three years is enough for the data to be completely outdated, and we cannot assume an increase.
Recovery is by no means affordable
Considering all those factors, is treatment an affordable option for the regular citizens of Sri Lanka? No. The only people who may be able to afford it, the upper-income class, are also the people who probably have health insurance companies bearing some of their costs. The lower income class will be overlooked.
On a positive note, we have a lot of good people doing their best to bring everyone affected by the Easter Sunday Bombings back on their feet. No task is too small when it comes to this. However, while donations for immediate needs are easy to come by, long term effects like mental and physical therapy, and prosthetics, often may go without support.
Reaching out becomes more and more important in order to get some support for these long term problems. So can we rebuild? We can. It is up to us to work together and help each other. If you know anyone who was affected by this tragedy, we urge you to reach out and help them in any way possible, and also to reach out to any individuals or organizations if you are in need of assistance.