Embarking on a new career in physiotherapy in the UK

by Padmani Mendis

Excerpted from Memories that linger…….My journey in the world of disability

(Continued from last week)

I was going to be a doctor. Instead, I became a physiotherapist. It has been 66 years now since that decision was made, and never a regret. Just relief together with joy that I had made the correct choice. I believe that, had I studied medicine, I may well have emigrated to settle down in some land far away from that of my birth.

My mother had always wanted a doctor in the family. She had tried with each of her children in turn until there was only one left, and she appeared to have succeeded at last. I was kind of agreeable with the thought. The first step in gaining entrance to medical college at that time was that one should obtain at least five credit passes in the Senior School Certificate or SSC Examination. Having got those, the next step for me was success in the Higher School Certificate, HSC, or University Entrance Examination.

We had just entered the Sixth Form or Year One of the HSC. One day all the sixth formers in both the science and arts streams were asked to come together. We were to be addressed by a lady who worked as a physiotherapist at the General Hospital, Colombo. She was from England and had been sent to work there by the World Health Organisation or WHO. This lady introduced herself to us as Elizabeth McDowell. She told us about the work she did at the General Hospital.

And then she showed us a short film about how she did what she did. This film showed people who could not do so after strokes being taught to walk; those who had been paralysed by polio doing exercises and making their muscles strong; they could now put these parts of their body to daily use and be independent; those who had pain in the necks and backs being relieved of it through the use of lamps and machines. Some had their necks or trunks stretched out to give “traction” which would relieve their pain. Those who had asthma and phlegm in their chests and other breathing problems were placed in various positions and tapped on their chests; with this the phlegm would be loosened, they would cough it out more easily and be able to breathe in comfort.

All this and more Elizabeth showed us. Then she invited any of us who would like to know more about her work to come to see her at the General Hospital and learn more about it. The purpose was to encourage at least some of us to see a future in this new profession and join the course of study that was to be made available at the General Hospital. This was a profession that was formally new to Ceylon. There were a few young Ceylonese who had been sent by the Government on Colombo Plan Scholarships to study and return qualified as physiotherapists. Some had been sent to England and Scotland and others to Australia and New Zealand. Although all of them had to come back when studies were over, many of them emigrated later to the UK and some to Canada. Later, even to the United States.

In these countries, the work of physiotherapists was better recognised and compensated in relation to their value, and their futures were more promising. For many decades after that, even as Sri Lanka continued to produce her own physiotherapists, this exodus continued. But patients now knew about physiotherapy and asked for it. The country was continuously in short supply until the market in those countries had been filled. The Ministry of Health was then required to increase cadres and make physiotherapy more accessible to patients who were in need of it.

Physiotherapy education was started by the Ministry of Health as a two-year course of study. It is now available as graduate courses in several universities. Masters and PhD studies are also now available.The morning that we visited Elizabeth at the General Hospital we were a group of nine, young and adventurous, and Deepthi was with us. With the smell of ammonia in the hospital she fell into a faint. Deepthi went on to Medical College and then as Dr. Attygalle, ended up as an eminent Anaesthesiologist. We still tease her about her faint on her first visit to a hospital.

Destiny

That visit with Elizabeth provided for me my first encounter with disability. Even though I had been a passive observer during the encounter, it had impacted my life forever. For that is when, in my subconscious, I had seen my future in this profession. I can still see that visit in my mind’s eye. I knew I no longer wanted to be a doctor. I would be a physiotherapist.

This decision however I kept to myself, knowing I should share it with my mother only when the right time for it came. I was not sure then that I would have the opportunity to avail myself of that course of study. So I went on to prepare for the HSC Examination that would enable my entrance to Medical College, more or less forgetting for the time being, the interest in physiotherapy that was created in me that special morning.

Then something strange happened to me in the second year of Form Six. I crashed in my studies. While I had gained a distinction and credits in science subjects at the SSC Examination, the marks I got not eighteen months later for term examinations were now like 10%, 18% and even below 10%. No one knew what had happened. If it happens to a young teenager now, no doubt the advice of a medical professional would be sought and a diagnosis would have been made.

At that time it seemed to have been alright, was not talked about, and somehow we coped with the situation. At home my mother did not show me that she was unduly worried. At school, it appeared that teachers had taken it as a matter of course – I had done badly in my examinations. Mrs. Amirtharanee Ratnasingham, our class teacher in Form Six Two and I had an easy relationship of mutual affection. My sister Nalini and she had been classmates and good friends. Beyond her intellect and knowledge, her personality made her an exceptional teacher. I had tremendous respect for her. I felt that she was always protective of me, always there for me.

Coming straight from the Principal’s office one morning at the end of the second-term, she called me aside. She said to me with great tact something like, “Padmini you have not done too well in your exams. Maybe you need to study a little more so you will be ready for the University Entrance next year. Why don’t you wait another year with us and do the exam next year? Would you like to do that?” That was good news to me because I too felt I did not know enough to sit that exam. It was, in fact, a relief. I replied that yes of course I would stay. But I had a sneaking feeling that I may not.

Before the end of that term, I had told my mother that I would not be continuing my studies at Ladies’. She was, of course not just sorry that she would not have a doctor in the family; more than that she worried about my future and what I would do now. But I reassured her that I would do something useful. I guess she knew her daughter and had trust in me.

When Miss Simon was told about my plans, she would have none of it. “No,” she said to me sternly in her office. “You are not going to stay at home. At the beginning of next year, you will come back and help Mrs. Ratnasingham in the Lab.”

Which I was happy to do. It gave me time to share my decision with my mother. I was called the Lab Assistant and was paid a salary, or allowance, of one hundred and thirty-five rupees. A princely sum to a young girl just out of school. When I showed surprise that I should receive such a large amount, I was told that this was my entitlement, having the qualification of SSC after my name.

My mother had by this time bought a house at Clifford Road, Kollupitiya, so that the younger of my two sisters, now 28, could have her own home and look after the three younger brothers and me. My mother continued to live at Kalubowila with Uncle Lyn. But her heart was with us and every morning she would come to Clifford Road and return to Kalubowila in the evening.

Most of my friends were all still students, waiting to start at the university or medical college. And here I was, financially independent. At the end of every month I would give fifty rupees to my sister as my share of house expenses. She would take no more. A monthly visit with my mother and sister to Ranjana Stores on Bankshall Street in Pettah was a part of the calendar. Here they would every month help me choose a saree made of exquisite “Katau” voile to add to my working wardrobe, now growing at a steady pace.

These beautiful Indian sarees at that time cost around twenty rupees each. Occasionally my mother would buy me a soft Kashmiri silk with a matching blouse piece for three times that amount. Other minor incidentals and the remainder was savings. I was given no choice but to put that into a Post Office Savings Book. There was a small post office not far from us at Kollupitiya. It is this that has grown to what it is now.

Sharing my Secret

These were happy times working with Mrs. Ratnasingham, getting both chemistry and physics labs ready for lessons and experiments and afterwards making sure that the students would leave the rooms clean and tidy. Getting the flowers and leaves and any other material Miss Lakshmi de Mel required for her botany lessons. And seeing to it that the rats, cockroaches and other odious animals and insects Mrs. Arulampalam wished to have for her Zoology classes were available on time. When alone with Mrs. R, she would often say to me, “Padminee, what are you going to do. You must do something.”

Which got me thinking that it was time I had a chat with my mother. I told her I would like to become a physiotherapist with the why and a possible how. Most of my brothers had gone abroad for various studies and so had my sister Nalini’s husband Leslie. She had of course gone with him. I felt it was a kind of family tradition that I should follow. If my mother agreed, I would find an affordable way. She agreed and I did.

In Search of a Way

I first looked for scholarships that I could apply for. Off went a letter to the German Embassy telling them of my interest and asking whether they would consider giving me a scholarship to study physiotherapy in Germany. They said that they had given out all their scholarships that year in 1958. However, they advised me to learn German so that they could consider me for the next year. That was rather too long to wait, but I started German language lessons. Just in case I could not find a faster route.

We had at school a teacher of English called Erin Muller. It was obvious to us that she was related to the well-known Orthopaedic Surgeon Gerry Muller. I had heard that Mr. Muller had his own clinic where he employed a physiotherapist from England. I told Miss Muller that I would like to meet her to find out about opportunities in the UK. She gladly arranged for this. I was given the address of the Chartered Society of Physiotherapy or CSP, headquartered in London.

The CSP was responsible for all physiotherapy education in the UK. My next letter therefore went to the CSP taking care to inform them of our financial constraints. Back came the reply that there were three hospitals in the UK to which I could apply. Costs of study would be within my mother’s budget. So, I sent letters of application to all three. Post was then carried by ship. It turned out later that all three would offer me a place. I grabbed the offer made in the first letter that reached me. I had got a place to study physiotherapy at the Royal Orthopaedic Hospital or ROH in Birmingham.

The Course of Study in Physiotherapy in the UK was in length then three years and three months. All costs had to be paid for, including the course and related fees and all costs of accommodation had to be met. This we could absolutely not afford. But the three hospitals recommended in the letter offered a way out. They were all Orthopaedic Hospitals. They offered a combined course whereby a student who first followed a two-year course in Orthopaedic Nursing with them, could then avail of free tuition in physiotherapy as well as have accommodation provided for during the period of the physiotherapy course. Here it was. My mother was hesitant, pointing out to me what I was letting myself in for. But she was no barrier, And never had been throughout my life.

My letter of acceptance had to be accompanied by a letter of recommendation from my school principal. Now how was I to get this?

Miss Simon and I had never been very close. As part of her daily routine, she would go to the hostel every day to have lunch with the boarders. I would accost her on her way there at noon-time.

And so I did, making my request. That she was at the same time shocked, amazed and happy for me is an understatement. Yet filled with pride that quiet me had gone far beyond her expectations, she admonished me for, “leaving everything until the last minute”. I went to her office that afternoon and her letter was in my hands. The next morning that letter attached to mine was on the high seas on its way to inform the ROH, Birmingham that they would soon have a student from Ceylon.

Preparation for my Mother

Meanwhile, there were lots of things to be done. Most important to my mother was to find out as much as she could about this Orthopaedic Nursing and Physiotherapy course that her daughter was determined to go to England for. She had to be sure even now that she was doing the right thing in letting me go.

When Mr. Muller had earlier heard of my interest in physiotherapy he had been delighted. He had invited me to come to his clinic and be with his physiotherapist while she worked whenever it suited me and her. I had been doing that regularly. So my mother had an opportunity to speak with her.

Then an appointment was made with no delay with the Officer-in-Charge of the British Council in Colombo. When he heard about our plans, he was angry with my mother. He used words like, “do you realise what your daughter will have to do as a nurse in England? Do you know that she will have to go down on her hands and knees and scrub the floors? Are you going to let your daughter do these things?” Which had my mother in tears. But I had read enough about nursing in England to know that this was not true. I was as determined as ever that I would go. I had to go to England to study. I tried to persuade my mother that he was misleading us. Why he did that I knew not.

But my mother would go no further without ascertaining the truth of what the British Council Officer had told her. So she next made an appointment to meet Ceylon’s other well-known Orthopaedic Surgeon at the time, Dr. Francis Silva. Dr. Silva was a relative of my father’s, but my mother made this a formal occasion, seeing him in his surgery.

When he heard of what I wished to do and what the Officer had said, he first dismissed that person’s stories out of hand. Then he filled my mother with reassurance. She was actually “Pansy Akka” to him. He told her what a useful profession this was in England. He told her Ceylon needed many more young girls like me to who were willing to do what I was planning to do. My mother was almost satisfied – maybe I would be alright.

(To be continued)