University of Nottingham 2011

Medical, Sri Lanka Kandy

I originally arranged to undertake my elective in Bahrain. However, due to the protests in March 2011, I cancelled these plans two weeks before my elective was due to commence. I contacted my GP tutor to do an elective with him but he advised me that there was still time to arrange an elective abroad if I wanted to. I was directed to Work the World and within a week all arrangements for my elective had been made. This included getting confirmation of student status, obtaining a 2-month visa for Sri Lanka, and getting immunisations (Typhoid, DTP) flights and insurance organised.


I left the UK on the evening of April 1st. My flight was with Sri Lanka Airlines from Heathrow to Colombo. I arrived on April 2nd and stayed at a guest house in Negombo (a small beach town near Colombo) which is far more relaxed than the airport city. April 2nd was the date of the Cricket World Cup final in which Sri Lanka sadly lost to India. The atmosphere was really lively that evening, but there was an eerie silence when India won! I met the Work the World Programme Manager on April 3rd and spent the day swimming and acclimatising with him and two other students who arrived that morning (flights from the UK into Colombo tend to arrive first thing in the morning and Sri Lanka is 5 hours ahead of the UK so the first day is normally spent catching up on a bit of sleep in Negombo!) On April 4th we took the train to Kandy. It is a very beautiful 3-hour train journey. We arrived in Kandy and went to the house where we met the other housemates. I then went with Kavinda to town where I exchanged money at the Kandy City Centre and bought a cheap mobile phone and 500 Rupees credit. That evening I had the first of my weekly Singhalese lessons.


The house is in the hills in Paradise Park, Hanthana. It is a big house with large, shared bedrooms for men and women. The gardener ('Uncle') lives next door and is always up to greet you in the morning with a big smile. Champa, the housekeeper came to the house every day and always left it looking immaculate and Prasanga, the cook provided excellent food. I always looked forward to meals at the house (breakfast and dinner) and very Wednesday night at the house Prasanga prepared a barbecue which inevitably turned into a bit of a party! Although there are facilities to hand wash, there is no washing machine at the house so I got my clothes dry-cleaned quite cheaply at Mahaweli Reach in Kandy City Centre.
We all got along really well at the house. I saw Kavinda often, and he was great fun and taught us salsa dancing! We typically had to arrive at the hospital at 8am so caught a tuk-tuk into town at 7.30am every morning. The majority of the afternoon was free.


You will find that the hospital is very different from hospitals in the UK. The corridors are often lined with patients and wards are extremely overcrowded. Ward rounds and clinics are conducted in English. Ward rounds typically include many doctors and general advice would be similar to here: be punctual, ask questions, read up on cases you see. Dress code is to wear a white coat and dress smartly. Have your Work the World identification badge (Kavinda will provide this for you) visible and if you are doing a surgical attachment bring scrubs. I left my bag at the Postgraduate Medical Centre every morning and made friends with the librarian, Mr Sundar Raj. The library contains very few books and was very grateful for my donated BNF.

There are weekly lectures at 11.30am on most Wednesdays in the auditorium of the Postgraduate Medical Centre. I recommend going to them, I learnt a lot.

Both the consultants I worked with were very friendly and helpful. They took the time to discuss every patient they saw with me, both in the ward round and clinic. During my oncology placement I was surprised by how many cases of head and neck cancers I saw. This is mainly due to tobacco consumption and the chewing of betel, particularly in rural areas. Many patients presented late so I saw fairly advanced and destructive tumours. I also saw radiotherapy (brachytherapy and low-dose radiotherapy) sessions and spent some time with the radiology registrar in the imaging department going through CT scans.

My consultant got me quite involved particularly in the ward rounds and I had the opportunity to examine many patients and discuss them with him. He ran an epilepsy clinic and I became familiar with the clinical work-up and the diagnostic process.

I was also directed to a patient with a rare disease (vulvar Paget's disease) under the care of the consultant in gynaecological oncology. He asked me to take a history from and examine the patient at a later date under his supervision. I read up on the condition and gained a good history and the consultant asked me to write a paper on the case.


There is a lot to do in Kandy. It is a very historical and picturesque city and the lake is breathtaking. Kandy is most famous for The Temple of the Tooth, which contains a tooth of Buddha. It is a beautiful temple and in the evening there is a ceremony in which the casket containing the tooth is brought out. There is also a dance at the Kandy Arts Foundation at 5.30pm every day that is definitely worth seeing.

Kandy City Centre is good for shopping. There are many nice places to eat. I am a Muslim and eat halal and it was very easy to find restaurants serving halal food, of which the best was a place called The White House (near Kandy City Centre). Sri Lanka also contains many beautiful mosques. I went swimming regularly at the Queens Hotel in town and I advise having an Ayurvedic massage when you are there at the Hotel Suisse, it is a lovely experience.


There are several things to do outside Kandy in an afternoon. The Peredeniya Botanical Gardens are absolutely beautiful. It is very old (it was built in the late 1300s) and takes about two and a half hours to explore. I have been to Kew Gardens in London and to Kitchener Botanical Gardens in Aswan (Egypt) but Peredeniya Gardens outshined even those wonderful places.
I also advise going to one of the elephant reserves outside Kandy. I went to the one in Upali where I rode on an elephant and was hosed down by one in the river!
On the way to Pinduwala go to the tea factory where you can see tea being made; and to the Spice Garden, where you will learn more about herbs used in Ayurvedic medicine.
I also made it to Adam's Peak. It is about three hours' drive from Kandy and about 7000 feet above sea level. It is called Adam's Peak because when the Arab traders came to Sri Lanka they believed the footprints on the top of the mountain to be those of Adam. The Buddhists believe the footprints belonged to Buddha and called the peak Sri Pada. My housemates and I embarked on the trek at 1am and it took five hours to reach the top (5200 steps). We watched the beautiful sunrise from the Buddhist Temple at the peak. Incidentally the Arabs called Sri Lanka 'Serendib'; the word 'Serendipity' is taken from this after the British came across Sri Lanka by happy chance.

I also recommend going to Ella which is in the Hill Country where the major tea plantations are. There is a summit called Little Adam's Peak there, which I also climbed.
I have friends in Colombo and I spent a weekend with them. I saw Colombo Zoo, with a vast variety of wildlife including huge kinds of fish I never knew existed! My friends also took me to Kelaniya, a place where Buddha visited. There is a beautiful temple there.

We also went to Mount Lavinia beach, near Colombo, which has beautiful white sand and crystal clear waters. I also recommend going to Galle, an historic fort.
Make sure you visit the ancient (3000-year-old) city of Anuradhapura and see the old town and ancient temples. I went to Mihintale where Buddhist priests first started preaching the faith and Sigiriya (a palace built upon a rock) which was breathtaking.

To get from town to town, you can either go as a group in a taxi or alternatively you could use the very cheap and comfortable intercity buses (to go from Kandy to Colombo for instance the fare was the equivalent of £1.50) Trains are also very reliable.


Sri Lanka is a country with beautiful and varied geography and a great deal of history. The people were very friendly and I enjoyed every moment that I spent there. General tips are; decide on a tuktuk (a vehicle like a rickshaw) fare before you start a journey; drink bottled water; get a good guide book, such as The Rough Guide to Sri Lanka; be adventurous; grab every opportunity and have a great time!

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