Teaching & Learning

How Nursing in Sri Lanka Changed My View of the NHS

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Brooke French is a Mental Health Nursing student at the University of Lincoln. She travelled to Sri Lanka to undertake her nursing elective, learning the differences between a low-resource healthcare system and the NHS.

I chose to undertake my elective in Kandy, Sri Lanka as it was somewhere I’d never been before. Being a large city right in the centre of the country, there was plenty to do in my free time.

I’d heard a lot about Sri Lanka from other students at my university, so I knew it was a country I wanted to see for myself. Entering into an unfamiliar mental health setting, the information they provided was crucial. Many practices and treatments were extremely different to the UK. But more on that later.

Work the World’s team in Sri Lanka (the organisation who planned my placement) were brilliant. They were always present, offering support and guidance with everything from our hospital placements to travel plans. We went out on a city orientation on our first morning. We learned where and how to exchange money, where to buy local SIM cards for our phones, and where to find the best bargain souvenirs!

On our second day, a car picked us up from the shared house we were staying in and took us to our placement hospital. We underwent an introduction with the Chief Nursing Officer who then took us on a full hospital induction. At the main hospital entrance, we saw patients being rushed into A&E. Some were laid on the floor in corridors, and there were hundreds in OPD queues. It was a scene I’ll never forget. Unlike the UK, outpatients weren’t given a specific appointment time; they were only given a date. This meant patients often waited hours to be seen. It reminded me to be grateful for the systems we have in place in the UK.

As I was only in Sri Lanka for a limited amount of time (a month seemed like a lot, but it really wasn’t) I wanted to spend time working in as many departments as possible. I ended up spending time in the mental health unit, OBG and PBU/NICU. I even spent time in theatre, watching C-sections and other gynaecological procedures. In the labour room I saw babies being delivered and monitored and learnt a lot about neonatal development. The nature of cases in the hospital’s mental health department was similar to that of the UK. But, due to a lack of resources, there were noticeable differences in practise. Patients of all ages stayed on the same ward, for example. Sri Lanka had no community mental health services. Once discharged, there was a lack of support for patients. This often meant that they had to leave their families to care for them. One day, I went to visit patients at home with two of the ward nurses. We met people in some of the most deprived parts of Sri Lanka, administering depot injections as we went. It was surreal.

We took full advantage of our free time as there were plenty of places to visit and plenty of things to do in Sri Lanka. Highlights included visiting The Temple of the Tooth, seeing elephants, and going white water rafting to name a few. We travelled to the Cultural Triangle, went to Dambulla, saw the Golden Buddha, hired bikes to explore ancient temples and ruins, and went on a safari to see wild elephants. We climbed Sigiriya, saw tea plantations, visited Nuwara Eliya and Ella, climbed Little Adam’s Peak, visited Pigeon Island, went snorkelling, relaxed on the paradise beaches at Trincomalee…

I was initially unsure about doing an overseas elective, but I ended up having an unforgettable, once-in-a-lifetime experience.




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