A legend in patient care — 150 years of illustrious service to the nation

National Hospital of Sri Lanka (General Hospital, Colombo)


National Hospital of Sri Lanka

By Dr. Joe Fernando,

Former Secretary, Ministry of Health


This year (2014) a grateful Sri Lankan nation salutes, this illustrious national institution and commemorates 150 years of dedicated service and recall the pivotal role it has played in the day to day life of the people of this country. Few institutions in Sri Lanka can boast of such a unique record, of service impacting on their life for 150 long lone years. Throughout this period the National Hospital of Sri Lanka has stood steadfastly in times of peace as well as in times of strife. It has withstood all the ravages that the country underwent on more than one occasion. Thus it is incumbent on every citizen to preserve, foster and develop this national institution for posterity. The British rulers who occupied the maritime provinces in the 19th century endeavoured to provide some form of health care to -the indigenous population, probably to protect their garrisons from pestilential diseases, and also through some degree of sympathy. With the above in view the Civil Medical Department was created in 1858 to cater to the needs of the indigenous population. This indeed was a land mark in the history of the medical services in this country. In keeping with the above the first hospital was established in Prince Street, Pettah. Pettah hospital had 100 beds. Soon the demand at the Pettah Hospital out stripped the facilities, and the outcome was the establishment of the General Hospital with 200 beds at the present site, in 1864.

Medical care during the time of the Sinhalese Kings

Medical care is not a new phenomenon to Sri Lanka. Ancient chronicles such as `Mahawansa’ where the history of its people is recorded, reveals that provision of health care services was considered a major responsibility of the state during the times of the Sinhalese kings. The concept was that the state whether represented by the King or the Prime Minister was duty bound to look after the health of the people. This developed as part of the Buddhist Ethos, which stress the duties of the rulers towards the ruled. The healthcare system that existed before the advent of the colonizing powers was entirely indigenous and included Ayurveda. During four centuries of colonial rule this system gradually lost its identity as an island wide network although the practice of indigenous medicine was kept alive by passing on the system from father to son.

The main seats of learning were the monasteries and temples, and naturally a considerable number of Buddhist monks were famous Ayurvedic Physicians. Furthermore, some of the kings were well known for healing the sick. Among the many kings who were famous for treating the sick was king Buddhadasa. Anuradhapura and Polonnaruwa were in succession capitals of Sri Lanka during the glorious periods of its civilization. The ruins of ancient cities clearly point to the existence of large hospitals constructed by the Sinhala kings for treating the sick. Ola leaf manuscripts contain descriptions of diseases and methods of treatment. Invasions by the South Indian kings as well as the Western powers heralded the decline of Ayurveda and other indigenous systems.

Medical care during the colonial era and the establishment of the NHSL

Successive invasions by the Portuguese, the Dutch and the British saw the gradual introduction of western medicine to this country. During the Portuguese and Dutch periods a few hospitals were built in the maritime provinces, chiefly in Mannar and Galle. However the Western system of medicine became established only during the British period. In the beginning the British were mainly concerned about the health of their garrisons. Nevertheless some degree of attention was paid to the health of the civilian population as well to ensure that the soldiers were spared from contacting pestilential diseases. A land mark in the western system of medicine was the creation of the Civil Medical Department in 1858. The British also created a ‘Native’ medical establishment, there by expanding the western system throughout the country. Even to this day some of the older hospitals in this country are referred to as civil hospitals. The main task of the native medical establishment was to serve the local population. In 1817 Dr. Charles Farell. Deputy Inspector General of Hospitals suggested to the governor that a general hospital be established for the poor. Accordingly in 1819 the first hospital was set up at Prince Street, Pettah which accommodated 100 beds. With western medicine increasing in popularity the demand increased resulting in outstripping the resources of the hospital. The outcome was the establishment of the present General Hospital Colombo (GHC) with 200 beds in 1864. It was located at Longden Place which was later named Kynsey Road in 1900, in recognition of the contribution made by Sir W. R. Kynsey. It is noteworthy that at that time Mutuwal was the residential area of Colombo, and the hospital was built at Longden Place so as to be in the countryside. By 1864 the hospital had 21 wards. The wards were connected by long corridors and the roofs were thatched. Some of the wards were named Seamen’s wards, Planters ward, Matapan Ward, Merchant Ward and Gnanasekaram Ward. There were also other wards — European surgical, accident, native surgical, native medical, female surgical, dysentery, diarrhoea, etc. A physician and a surgeon looked after the patients.

In 1870 under very fortuitous circumstances the Colombo Medical School commenced training of doctors. The first principal of the medical school was Dr. Loos. A fee of sterling 2 pounds was charged from the students at the beginning of each term. The declared objective of establishing a medical school was to impart to the-native youth of the country a practical, sound and safe knowledge of medicine and surgery. At the outset, the school commenced in a block of buildings of the General Hospital. In 1876 Mudliyar Samson Rajapaksha generously donated the land on which the present buildings stand. The buildings were put up by donations from Sir Charles Henry de Soysa and Muhandiram Samson Fernando. In 1880 the status of the medical school was elevated to that of a college. The General Medical Council of Great Britain recognized the licentiate LMS in Medicine & Surgery, granted by the College which was registrable in Great Britain. When the University of Ceylon was established in 1942 the diploma was converted to the degree MBBS.

In 1942 several developments which were favourable to the newly established hospital in general and the medical profession in particular took place. The Ceylon branch of the British Medical Association was established in 1887. De Soysa Lying in hospital was built and donated to the government by Sir Charles Henry De Sovsa. It was opened in 1879. Lady Havelock Hospital, later named Lady Ridgeway Hospital was opened in 1885. In 1900 the Bacteriological Institute (Pasteur Institute) now the MRI was opened. Again a donation by Sir Charles Henry de Soysa. The first head of the Bacteriological Institute was Dr. Sir Marcus Fernando. The aforesaid institutions were responsible in no small measure to the development of General Hospital as an excellent patient care institution and a teaching hospital. The Ceylonese doctors who succeeded the British medical personnel were very eminent personalities. The Principal Chief Medical Officer always had a very high regard for the local medical professionals, so much so that Sir West Ridgeway, Governer in his address to the Ceylon Medical College in 1903 remarked that ‘Ceylon’ is proud of its medical services and justly proud and it has been a great pleasure for me to be associated with the medical services of Ceylon, Ceylonese I hope it will remain.

To be continued tomorrow

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