1. Bishan Rajapakse
MBChB, Otago, NZ
Emergency Medicine Advanced Trainee (ACEM),
PhD candidate (ANU),
Global Health Drinks –22nd March 2012
Dr Bishan Rajapakse - Research and International Emergency Medicine
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2. http://bishansworld.posterous.com/anu-research-fest-2010-going-beyond-the-endpo
Dr Bishan Rajapakse - Research and International Emergency Medicine

3. • Who am I and why I took the path of
“research” and international EM
• Research findings and experiences
• How to “Take the plunge”?
SURPRISE ENDING!!!
#globalhealthdrinks
Dr Bishan Rajapakse - Research and International Emergency Medicine

4. Dr Bishan Rajapakse - Research and International Emergency Medicine

5. • Prevalent in
developing world
– 200,000 deaths /
year worldwide
• 15-30% mortality
See slide share for full
presentation on OP Rx
http://www.slideshare.net/
bishanrajapakse
Dr Bishan Rajapakse - Research and International Emergency Medicine

6. Resuscitation Study
2006 2008 2010
AChE Research
Dr Bishan Rajapakse - Research and International Emergency Medicine

7. • file://localhost/Users/bishan/Movies/
Beyond the Endpoints (hi res).dv
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Dr Bishan Rajapakse - Research and International Emergency Medicine

8. “Imagination is more
important than knowledge”
“Anyone who has never
made a mistake has
never done anything new” Albert Einstein
Dr Bishan Rajapakse - Research and International Emergency Medicine

9. Bishan Rajapakse, Andrew Dawson
Dr Bishan Rajapakse - Research and International Emergency Medicine

10. • Difficult to access
education
– Can’t come to
central locations
• Consultant
educators are
limited
Dr Bishan Rajapakse - Research and International Emergency Medicine

11. Dr Bishan Rajapakse - Research and International Emergency Medicine

12. • 25 Question MCQ (45mins)
• Scenarios Assessments (10mins)
• Personal feedback given at follow up sessions
Dr Bishan Rajapakse - Research and International Emergency Medicine

13. Pre Post 6 week 3 months post
Training post
Calls for help 45% 53% 76% 74%
Initial Airway 22% 88% 60% 67%
Opening
Initial 40% 83% 68% 81%
breathing
Check
Correct 8% 79% 82% 88%
compression
ratio
Dr Bishan Rajapakse - Research and International Emergency Medicine

14. • Greater chance of policy
change
• Integration of networks
– Sustainability
– Builds capacity for local action!
• Career development
Dr Bishan Rajapakse - Research and International Emergency Medicine

15. Dr Bishan Rajapakse - Research and International Emergency Medicine

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18. 18
Dr Bishan Rajapakse - Research and International Emergency Medicine

19. • Emergency medicine
a developing
specialty
• Ambulance and
Paramedic training
19
Dr Bishan Rajapakse - Research and International Emergency Medicine

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21. 21
Dr Bishan Rajapakse - Research and International Emergency Medicine

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23. 23
Dr Bishan Rajapakse - Research and International Emergency Medicine

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26. • Dangers
– Roads
– Animals
– Civil instability
• Isolation, alienation
and depression
• loss of clinical skills
Dr Bishan Rajapakse - Research and International Emergency Medicine

27. • Academic work is
hard, and can be
tedious!
• Financial loss
• Often have to write
a Thesis
• Takes time!
– May lengthen a
specialist training
considerably
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Dr Bishan Rajapakse - Research and International Emergency Medicine

28. The journey of a thousand miles
begins with one step. Lao Tzu
Dr Bishan Rajapakse - Research and International Emergency Medicine

29. Back to 2005…..
Dr Bishan Rajapakse - Research and International Emergency Medicine

30. • Social Work/
Community
service
• Fun, Travel,
Adventure
• Finding
“roots”
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Dr Bishan Rajapakse - Research and International Emergency Medicine

31. “Always follow your ‘heart’
and your own dreams as
life is too short to follow
someone else’s dreams”
Dr Bishan Rajapakse - Research and International Emergency Medicine

32. • Step 1 – Dare to dream
• Step 2 – Be aware of your fears
• Step 3 – Write down both
• Step 4 – Keep fears at bay, let the
heart say what it must, then trust!
• Find your mentors : Forums, People,
friends, Books & Movies
Dr Bishan Rajapakse - Research and International Emergency Medicine

33. • Don’t compare yourself with
others!
• BE inspired
• Inspire others
Dr Bishan Rajapakse - Research and International Emergency Medicine

34. • Amazing
Experience
• Eye opening
• Pro's and Con's
• Similar
Opportunities
exist! 34
Dr Bishan Rajapakse - Research and International Emergency Medicine

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36. Dr Bishan Rajapakse - Research and International Emergency Medicine

37. Discussion:
…..Time for your thoughts!
Dr Bishan Rajapakse - Research and International Emergency Medicine

38. • http://www.facebook.com/groups/
international.em
• http://lifeinthefastlane.com/2011/06/
alternative-emergency-medicine-training/
• http://www.slideshare.net/bishanrajapakse
• http://bishansworld.posterous.com/
• http://about.me/bishan.rajapakse
• Twitter: @trainthetrainer
• Email: bishan.rajapakse@gmail.com
Dr Bishan Rajapakse - Research and International Emergency Medicine

39. • Please provide me with feedback on this
talk (2min survey) so that I can learn and
improve!
– If you attended the “Global Health Drinks” on
23/3/12
• http://www.surveymonkey.com/s/BCHNWJY
– If you just viewed this talk on slideshare
• http://www.surveymonkey.com/s/BJVCVCV
Dr Bishan Rajapakse - Research and International Emergency Medicine

40. Going “beyond” the Endpoints!
Beyond the endpoints are the bits that are not seen,
The thoughts and emotions that lie behind the PhD’s sheen,
And whilst they will not appear in the final binding,
They are the reminders of how the road was so very winding.
Research is more about the journey than its destination,
It is to respect the ‘process’ as well as the final creation,
And the process lies within the changes we experience in “ourself”,
Which sometimes speaks more than that book up on the shelf.
My story is long, but I’ll try and keep it short,
It won’t be like some kind of scientific report!
For this is about a journey of mind and soul,
How this process has helped me feel whole.
I collected data in the depths of Sri Lanka,
Amongst my own first culture,
Where beautiful rivers flow, and green paddy fields grow,
With coconut trees that surround, where wild elephants can easily be found.

41. I collected data in the depths of Sri Lanka,
Amongst my own first culture,
Where beautiful rivers flow, and green paddy fields grow,
With coconut trees that surround, where wild elephants can easily be found.
I studied suicidal poisoning and its medical cure,
In villagers who drank pesticides when they felt desperate and insecure.
Some would say it was a cry for help,
Either way, they did not do well.
We tried to understand how to ease the terrible prognosis,
By studying a portable machine that could help in treatment and diagnosis,
But whilst collecting this data, an additional vision was to develop,
Another study - “training doctors in resuscitation”- was soon to envelope.
Whilst in Sri Lanka my mind expanded more than I would have believed,
Working with different cultures and systems into which I’d soon be weaved.
And with this I began to see my thesis as more than a mere ‘cog in a wheel’,
For perhaps, it may bring about change in the world, in a way that is real.
Bishan Rajapakse,
23.3.10