Features

Preventing the Preventable; Preserving healthcare services

Published

3 years ago

2023/09/25

Recent address by
Dr. Sarath Gamini De Silva
to the Galle Medical Association

It is indeed my privilege and pleasure to be given this opportunity to address the members of the Galle Medical Association (GMA). I am grateful to the President and the Council of the GMA for inviting me as the guest of honour at the inauguration ceremony of your annual academic sessions.

Coming here today is like getting back to my roots again. I was born and bred in Galle and had my entire primary and secondary education at Richmond College. Between 1982 and 1995 I was associated with the GMA in my capacity, first as a senior lecturer in medicine for two years and then for nine years as a Consultant Physician at the Teaching Hospital, Karapitiya.

I was the President of the Galle Medical Association in 1994.My colleague Prof. Ariyananda and I were the first two senior lecturers in the Dept. of Medicine, with Prof. Hettiarachchi as the head. We knew almost every student in the first few batches by name, taking a personal interest in their welfare, to make sure that they did well as doctors.

The academic and non-academic staff took it up as a personal challenge to prove that the Ruhuna Medical Faculty, though rather hastily established, was second to none in the island. Looking back, we can be happy that all did very well, most of them becoming very competent specialists in various fields, later on, and are providing an exemplary service here and abroad.

We started in the dilapidated buildings at Mahamodera and then moved into modern facilities at Karapitiya, which at that time was still a building site. The long-established Galle Clinical Society later merged with the relatively new Galle Medical Association under the presidency of the late Prof. Tommy Wickremanayake, the Dean of the Medical Faculty, at that time. This wonderful auditorium, named after him, is a tribute to the late Professor’s energy and determination to see that we had the best facilities in the Southern Province. He took me round this building site on several occasions, and I once nearly had an accidental fall trying to mount this stage, only half built at that time. Today I feel quite confident standing here on a firm foundation, a podium graced by many medical luminaries over more than 40 glorious years, in the service of medical education.

The Galle Medical Association has done justice to the ideals and aspirations of its founders. As a life member, I receive regular information of your activities. The Association is meeting amply the academic and non-academic needs of its membership. Your lecture series on beyond medicine; religious and sports activities, musical programmes, leisure trips, etc., would provide much relaxation outside the exhausting routine of medical practice. Your annual academic programme is not second to that of many professional Colleges and Associations based in Colombo or elsewhere in the country. This wide array of activities is indicative of an Association keen on providing an all-round service to its members and their families, as well as to the medical students. My congratulations to all concerned.

Your theme this year, “Preventing the Preventable,” is very timely. With the economic crisis we are experiencing, the age old saying “Prevention is better than cure” is more relevant today than ever before. Certainly, true in the case of prevention of diseases, I am concentrating today on other aspects of healthcare the doctors have overlooked and to a great extent failed to prevent their decline.

Preventing the Preventable; Preserving the Healthcare Services is my concern today.

All the remarkable achievements in the fields of communicable and non-communicable diseases, with world acclaimed health indices, are now being nullified by the economic crisis in which the healthcare services appear to be caught unawares. The shortage of drugs and other equipment, costing more and more with every passing day, has made it near impossible to give proper treatment to needy patients. I will not be surprised to hear of deaths due to lack of treatment in the near future. We already hear allegations, though authorities keep refusing to accept their responsibility, of deaths due to poor quality of drugs hastily imported to overcome shortages in a poorly planned system.

This is compounded by poor household incomes, high transport costs and other difficulties the patients experience in seeking medical care.

While most of the blame for this unfortunate situation falls on poor planning and corruption by the rulers, the medical profession, too, has failed in preventing this calamity. They have contributed by their irrational prescription habits, doing unnecessary investigations and the like, leading to a high cost in the delivery of healthcare. Irrational prescriptions contribute in a big way to multidrug resistance to antibiotics, as well. Poorly regulated private practice by doctors needs an overhaul. Exorbitant fees charged by some specialists are the talking point in the society. I need not bore you with details which should be well known to all of you by now.

We as a profession should not allow ourselves to be exploited by the profit-oriented private healthcare services and the pharmaceutical industry. The patients are compelled to pay a heavy price for our shortcomings in this regard. Thus, by our inaction in dealing with such, we have failed to prevent the gradual deterioration of the respect the society has for the profession.

Has the medical profession knowingly or unknowingly colluded with the misdeeds of the politicians? As an example, I wish the institutions, like the drug regulatory authority, NMRA, did more to prevent corruption and irregularities in the procurement of drugs. They have remained mostly silent knowing very well how their decisions regarding the registration of drugs are overruled or circumvented by politicians and administrators with ulterior motives.

Functioning of the Sri Lanka Medical Council is being looked down upon by many in the profession itself. The amendments to the Act governing the SLMC has been proposed over many years to broad base its membership to include non-medical professionals and make it more effective in its primary duties of regularizing medical practice, maintaining discipline in the profession and maintaining good standards of medical education. Politicians have so far failed to enact them. With poor standards of medical education, due to shortages in staff and other facilities in hastily established new medical schools, SLMC has been largely silent on these aspects. At present it appears that the medical trade unions and indirectly the political influence are hampering its proper functioning. As a result the SLMC remains mainly a body for holding the ERPM for foreign medical graduates and registering the medical practitioners. Our professional associations should be more involved in its affairs and add their voice for reforms.

I have been a member of the SLMC for 10 years in the past. But your chief guest as its immediate past president, who was removed from the post in a most unprofessional way by the politicians, with perhaps the connivance of our own colleagues, will be in a better position to address these issues. That action initiated by our own professional colleagues has now established a precedent for the Health Minister to have a bigger say in the SLMC affairs, seriously undermining its autonomy.

In my address to the Colombo Medical Congress a year ago, I stressed how our Professional Colleges and Associations kept a blind eye without getting involved and having their say in the administration of the health service. Even when there was an uprising asking for a system change, the medical profession remained largely silent without adding their voice. This was in stark contrast to the legal profession who stood up with the people asking for justice. By remaining ‘respectable’, confining ourselves to academic activity only, we have allowed our efforts at improving services to the public and training postgraduates to become meaningless. As a result, we are now spending tax payers’ money for training specialists for service abroad. With an unprecedented exodus of locally trained doctors and other healthcare staff, we are helping richer countries to serve their citizens better. The world-acclaimed health indices we have achieved by hard work over the years are becoming irrelevant with rampant malnutrition and other maladies affecting a significant proportion of the people.

Even the few medical men who dared to warn the authorities publicly on impending childhood malnutrition in their area had to face disciplinary action. The services of an alumnus of the Ruhuna medical faculty have been terminated as a result. Unfortunately, there is hardly any protest heard from the trade unions or other medical organizations against such action, at a time when elsewhere numerous unlawful activities and rampant corruption remain unpunished.

As much as the people are asking for all 225 in the Parliament to be thrown out, there are loud whispers in the society that the medical profession, too, is corrupt exploiting the people in various ways. There is no use in our grumbling about any shortcomings of doctors and incidents of medical negligence being highlighted in mass media regularly. Naturally, the good work done by the doctors will not be talked about with praise as that is the minimum the society expects from us.

It is high time our annual conferences and other meetings had a regular session or symposia on various aspects of the doctor in society, discussing our own faults and ways of rectifying them. All Colleges, especially those dealing with clinical disciplines coming into direct contact with the public daily, should communicate regularly with their members on these issues. They should also keep a close watch on the activities of health-related institutions like the SLMC and the NMRA already referred to, and intervene where necessary, without waiting till it is too late.

Thus, prevention in broader terms involves not only prevention of diseases but also prevention of other irregularities in the administration of health and questionable practices of our own colleagues that have a direct bearing on the health of the people. The medical profession, despite its many shortcomings, is still respected and influential. Our strong voice will be heard by the rulers, medical administrators and the general public.With these thoughts let me conclude by wishing you all a very successful and enjoyable annual sessions. I wish you all a very good evening.

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Related Topics:Sarath Gamini De Silva Sri Lanka Medical Council Students

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Features

The hard challenge of clinching a political settlement in the Middle East

Published

6 hours ago

2026/07/23

Sahan Weerasooriya

Bruised hearts: Displaced Palestinian civilians in the Gaza.(Photo by Mustafa Hassona/Anadolu via Getty Images)

Despite some sections of the Trump administration persisting with the view that the possibility could not be entirely ruled out of there being a diplomatic solution to the current US-Iran hostilities in West Asia, the skeptic could not be blamed for thinking otherwise. The intensity, scale and frequency of the tit-for-tat strikes by the antagonists over the past few days against selected military targets and civilian infrastructure in particular in West Asia make the adoption of this stance excusable.

The continuing hostilities render the mentioning of the MOU signed between the warring parties in mid-June a laughable matter. While it could very well be that the foes are wishing privately for a cessation of hostilities before long, what seems to be uppermost on their minds right now is to negotiate with each other from a position of strength. This strategy compels them to incapacitate each other militarily to the extent possible, lest they have to concede too much to each other during negotiations. Hence the stepped-up hostilities.

However, even on the question of there being a negotiated political settlement in the West Asian theatre in the longer term, the skeptic could come to be seen as scoring over the optimist. Developments on the ground account for this.

At the time of writing Israel’s Netanyahu government is going ahead in fairly care-free fashion with the establishment of more Jewish settlements in the Gaza and the West Bank, and it’s all happening under the apparently complacent gaze of the US. In fact, some quarters estimate that Israel is in control of some 65% of the Gaza Strip. Ethnic cleansing, that is, is being drastically stepped-up.

Accordingly, in terms of the power relations of West Asia, the world is almost back to the status quo of the late forties of the last century when the state of Israel was established and the Palestinians were reduced to a microscopic minority in the land they came to inhabit. Therefore, even the impartial observer would be compelled to ask: ‘Will a negotiated peace be ever possible in the Middle East?’

The humanist in the observer would prefer to answer this question in the affirmative and it is indeed the ideal stance to adopt considering the staggering human and material costs of the conflict. But the way ahead to peace could be expected to be highly hazardous and arduous. Among other odds, it would also prove an uphill endeavour to win minds and hearts.

The US’ Trump administration would need to be counted out in this pursuit. This is on account of the fact that it has been far too wayward in its management of West Asian affairs in particular over the past couple of years. Given its unpredictable character it is a matter for conjecture whether it could be counted on to live up to its commitments.

Moreover, Israel could be expected to ‘go it alone’ in the Middle East regardless of whether US help is coming or otherwise. It has indicated as much in recent times and Israel could be doubted on this score only at the doubter’s peril. Because time and again Israel has demonstrated that it could steadfastly defend its interests even single-handedly in the Middle East. History bears this out.

However, a durable alliance with the US would stand Israel in good stead. On the matter of military and intelligence assistance, for example, the US’s help proved invaluable for Israel in the past and going forward this is bound to be so as well. Moreover, it is unlikely that the Trump administration would give up on Israel, considering that a strong Israel is crucial for the furtherance of the US’ strategic and economic interests in West Asia.

But whether the above factors would have a considerable bearing on the question of working out a durable solution to the West Asian tangle is an entirely different matter. Israel, as in the case of the Palestinian enclaves, is acutely security conscious and would need to satisfy itself fully that it could live in a security environment that would guarantee its complete safety, going forward.

The Middle East is badly in need of another peace effort on the lines of the Oslo Accords of the mid-nineties that brought the key actors together and helped hammer out a solution that addressed some of their notable concerns. To be sure, that process did not prove to be the ideal answer to the tangle, but it yielded some respite to the region and drove home that one-time sworn foes could indeed negotiate with a degree of success. The West Bank authority, although falling short of fulfilling some key Palestinian aspirations, is testimony that a degree of success is possible if the intent is right.

Given the current realities of West Asia, peace-making is bound to be an uphill challenge. The violence faced in recent times by the Palestinian community, in particular, has been nothing less than mind-numbing. Merciless has been the violence visited on them by the Israeli side. In such circumstances, durable peace in the region could smack of an idealist’s dream.

Nevertheless, there needs to be urgently, a meeting of minds over the divides. The US would need to be counted out as an honest broker in bringing the sides together but the rest of the West would do well to step up to the challenge.

In this exercise the onus would be on the world’s democracies to take the initiative and doggedly stay the course. An acceptable combination would be the EU and the UN. Given their credentials, the main sides in West Asia ought to find them the least controversial.

Even if the relevant institutional and political arrangements could be shored up to take a reconciliation process forward, winning hearts and minds for the peace drive would prove a grueling challenge. Over the past few years in particular tens of thousands of hearts and minds on both sides of the divide have been bruised badly in the runaway murderous violence that has come to define the Middle East.

These badly scarred personalities would need to experience healing without much delay. It is therefore a multi-faceted challenge that is at hand. Since wide-ranging expertise would be needed in the healing process, people’s participation in peace-making, ranging over the divides, would need to be made a durable reality. It will be a time for enthroning humanity and ensuring the rejection of all forms of violence and coercion.

Features

Amazing Thailand …right here in Colombo

Published

6 hours ago

2026/07/23

Sahan Weerasooriya

For many Sri Lankans, Thailand is the go-to holiday — beaches, temples, food, and that famous warm hospitality.

In fact, I’ve been to Amazing Thailand 24 times myself, and was honoured with the Friends of Thailand International Media Award by the Tourism Authority of Thailand for promoting Thai tourism.

The good news I have for you today is that you don’t even need a passport to get a taste of Amazing Thailand.

The Royal Thai Embassy, in Colombo, is bringing a vibrant slice of Thailand, to the city of Colombo, with Thai Festival 2026 — a cultural experience like never before.

Whether you are an avid enthusiast of Thai culture, a total novice, or simply just interested in exploring foreign cultures, Thai Festival 2026 is going to be the perfect opportunity for you to get more than just a glimpse into one of the most celebrated cultural heritages in South East Asia. And ENTRANCE IS FREE.

The festival will be held on the 1st and 2nd of August, 2026, at Siam Nivasa, 43, C.W.W. Kannangara Mawatha, Colombo 7, and the East Parking Area, of the Colombo Municipal Council, from 11:00am to 5:00pm.

Both days will be full of live entertainment, and dispersed throughout with Thai cultural displays, including exhilarating traditional dance performances and breathtaking Muay Thai demonstrations.

Exploring art and craft specific to Thailand, tasting irresistible authentic Thai cuisine, and playing arcade games, are just a few more fun-filled events available for visitors at the festival premises.

An array of Thai products will also be available for purchase.

While at the festival, you will find Sri Lankan Alumni from Thai universities sharing their experiences with you and willing to answer any questions you might have, related to studying abroad in Thailand.

You can also register for the Muay Thai workshop that will be happening on the 7th and 8th of August, 2026, in Colombo.

Irresistible authentic Thai cuisine

Visitors can also stand a chance to win traditional Thai souvenirs, get exclusive photo opportunities, and, the big one — to enter the raffle draw, at the end of each day, for the grand prize of an all-inclusive round trip to Thailand.

Be sure to avail yourself of this exceptional opportunity and add a cultural spin to your weekend.

To keep up with the latest updates on Thai Festival 2026, head over to the Thai Festival official social media pages.

The Royal Thai Embassy in Colombo official webpage:

https://colombo.thaiembassy.org

Official social media:

Facebook: @RTEColombo

Instagram: @thaiembassysrilanka

Thai Festival official social media:

Facebook: Thai Festival in Colombo

Instagram: @thaifestival_colombo

TikTok: @thaifestival.incolombo

Features

Thicker, stronger hair …

Published

6 hours ago

2026/07/23

Sahan Weerasooriya

Hair fall, in this heat, can be so frustrating, and noticing a thin patch is even more worrying. The good news is … yes, with a little care and kitchen ingredients, you can nourish your scalp and support healthy regrowth.

Try these four easy home remedies … even our grandmothers trusted:

* Coconut Oil and Curry Leaves Tonic:

Warm 04 tablespoons of coconut oil, with a handful of curry leaves, till the leaves turn black. Cool, strain, and massage into scalp 02-03 times a week. Leave for 01 hour, or overnight.

Why:

Coconut oil deeply nourishes, while curry leaves help strengthen roots and add shine.

* Onion Juice for Spot Treatment:

With cotton, dab the juice of 01 small onion, directly on the thin/bald patches. Leave for 20-30 minutes, and then wash with a mild shampoo. Use twice a week.

Why:

Rich in sulfur, onion juice helps boost blood circulation to the scalp.

* Aloe Vera and Castor Oil Mask:

Mix 02 tablespoons of fresh aloe vera gel and 01 tablespoon castor oil and apply to the scalp, focusing on thinning areas. Leave for 45 minutes, and then rinse with cool water.

Why:

Aloe vera soothes the scalp, while castor oil coats hair to make it look thicker.

* Fenugreek and Curd Strengthening Pack:

You will need 02 tablespoons fenugreek seeds, soaked overnight, and 02 tablespoons plain curd.

Grind to a paste, apply to scalp for 30 minutes, and then wash.

Why:

Fenugreek strengthens strands and reduces breakage.

Extra Tips for Healthy Hair:

Avoid tight hairstyles that pull on the scalp.

Eat iron and protein rich foods: greens, dhal, eggs, fish.

Use lukewarm water, not hot.

Be gentle when brushing and drying.