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Reminiscences of superlative lady: A beacon of service and ethics in healthcare

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By Dr B. J. C. Perera 

Specialist Consultant Paediatrician and Honorary Senior Fellow, Postgraduate Institute of Medicine, University of Colombo, Sri Lanka.

One of the most respected teachers in healthcare, and a fabulous doctor par excellence, Dr Mrs Nandrani Swarnamitta De Zoysa left this worldly life on the 24th of February 2024, following an 89-year-long fruitful sojourn on Mother Earth. That fateful and critical incident induced her close family, her loved ones, and all of us in the medical fraternity, to be submerged in a sea of intense sadness and despair. In the aftermath of that event, the annals of the healthcare history in Sri Lanka are likely to be made ever so resplendent and complete, with a substantial chapter dedicated to the illustrious life of Dr De Zoysa, as well as the tremendous and impactful contributions made by her. As the former Director of the Sri Lankan National Blood Transfusion Service, her name has been etched on a canvas of splendour with the artistic tools of dedication, innovation, and unwavering ethical principles. With heavy hearts, we bid farewell to an amazing human being, whose legacy would continue to inspire many a generation to come.

Dr Nandrani De Zoysa’s journey on planet Earth was marked by a relentless pursuit of excellence in serving humanity. Her tenure at the helm of the National Blood Transfusion Service (NBTS) of Sri Lanka was characterised by transformative initiatives that reshaped the landscape of blood donation and transfusion practices in Sri Lanka. The pioneering changes and streamlining of the functioning of the services of the NBTS initiated and propagated by her, are far too numerous to be chronicled in a short eulogy such as this. Suffice it to say that under her visionary leadership, the service evolved into a model of efficiency, safety, and compassion. What we see today in that institution are the rewards of the mission undertaken by a lady like no other.

One of Dr De Zoysa’s most significant contributions was her ground-breaking efforts in securing blood safety. Recognising the urgent need to mitigate the potential risks of infections that were known to be susceptible to transmission through blood and blood product transfusions, she took bold steps to introduce rigorous testing protocols, including screening donated blood for Human Immunodeficiency Virus (HIV) and Hepatitis B. Despite facing scepticism and opposition from some quarters, even from outside our shores, Dr De Zoysa remained steadfast in her commitment to prioritizing the safety of patients above all else. Her foresight and determination undoubtedly saved countless lives and set a precedent for ethical leadership in the provision of safe healthcare.

Beyond her professional achievements, Dr De Zoysa’s impact was deeply felt in the lives of the countless numbers of students she mentored and inspired. As a teacher, she possessed a rare combination of sublime intellect, empathy, and humility, instilling in her students not only the requisite knowledge but also the values of integrity and compassion. Many of the medical profession who had the privilege of being her students would unhesitatingly attest to the profound influence she had on their personal and professional development. I am only too well aware of her influence on some members of the medical fraternity as my late wife came under her tutelage when she was the Medical Officer of the Blood Bank in the Badulla General Hospital from 1979 to 1985. Madam De Zoysa treated her just as if she was her daughter. Even years later, when we met socially, her delight at seeing and interacting with both of us was very definitely nothing short of a splendid occasion of seminal camaraderie.

Dr De Zoysa’s contributions to healthcare were not confined to Sri Lanka. She was a respected figure in the international medical community, known for her expertise in blood transfusion practices and her unwavering advocacy for global health equity. Through her participation in conferences, collaborations with international organisations, and dissemination of research findings, she played a pivotal role in advancing the field of transfusion medicine on a global scale. What truly set Dr De Zoysa apart was her unwavering commitment to her principles and ethics, even in the face of adversity. She was a gentle yet resolute leader who stood firm and exhibited her courage in her convictions, never compromising on matters of integrity or patient safety. Her fantastic moral compass guided her every decision, earning her the admiration and respect of colleagues and peers alike.

In recognition of her outstanding contributions to the field of healthcare, Dr Nandrani De Zoysa was honoured with the prestigious National Titular Honour of Vidya Jyothi by the Executive President of Sri Lanka in 1988. This accolade, conferred just two years after the commencement of the award, underscored the magnitude of her achievements and the profound impact she had made in her field as the Director of the National Blood Transfusion Service. It was a fitting tribute to a visionary leader whose dedication and service had left an indelible mark on the healthcare landscape of Sri Lanka. Yet for all that, it was so humbling for all of us to see how lightly these accolades sat on her unassuming shoulders.

In Sinhala, her second name Swarnamitta means “Golden Friend” and conveys the notion of a cherished and much-valued friend, symbolising qualities of warmth, sincerity, loyalty, and trustworthiness. That just about describes what she really was, and what she will always be, in the hearts of all of us.

As we reflect on Dr De Zoysa’s remarkable life and legacy, let us not mourn her passing but celebrate the enduring impact and influence of her contributions. She may have departed from this world, but her spirit lives on in the countless lives she touched and the principles she embodied. We are duty-bound to honour her memory by continuing to uphold her precious values of excellence, integrity, and compassion in all our endeavours, thereby keeping alive the flame of her wonderful heirlooms that she left behind for many a generation to come. That is the least we could do to present a supreme tribute to the memory of an individual who was ever so special and a beacon of hope. Madam De Zoysa may have left this mortal world forever, but her bequest of service and ethics will continue to reverberate, inspire, and guide us, and even those of many a future cohort to come, in the pursuit of a healthier, more equitable world, where our fellow human beings come first and foremost.

Dear Madam De Zoysa, the entire medical community would join me in expressing our fervent wish for you to attain the supreme bliss of nirvana through the shortest possible voyage in samsara.



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US foreign policy-making enters critical phase as fascist threat heightens globally

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Greater rapport: President Trump in conversation with President Putin. /The New York Times

It could be quite premature to claim that the US has closed ranks completely with the world’s foremost fascist states: Russia, China and North Korea. But there is no denying that the US is breaking with tradition and perceiving commonality of policy orientation with the mentioned authoritarian states of the East rather than with Europe and its major democracies at present.

Increasingly, it is seemingly becoming evident that the common characterization of the US as the ‘world’s mightiest democracy’, could be a gross misnomer. Moreover, the simple fact that the US is refraining from naming Russia as the aggressor in the Russia-Ukraine conflict and its refusal to perceive Ukraine’s sovereignty as having been violated by Russia, proves that US foreign policy is undergoing a substantive overhaul, as it were. In fact, one could not be faulted, given this backdrop, for seeing the US under President Donald Trump as compromising its democratic credentials very substantially.

Yet, it could be far too early to state that in the traditional East-West polarity in world politics, that the US is now squarely and conclusively with the Eastern camp that comprises in the main, China and Russia. At present, the US is adopting an arguably more nuanced approach to foreign policy formulation and the most recent UN Security Council resolution on Ukraine bears this out to a degree. For instance, the UN resolution in question reportedly ‘calls for a rapid end to the war without naming Russia as the aggressor.’

That is, the onus is being placed on only Ukraine to facilitate an end to the war, whereas Russia too has an obligation to do likewise. But it is plain that the US is reflecting an eagerness in such pronouncements to see an end to the Ukraine conflict. It is clearly not for a prolongation of the wasting war. It could be argued that a negotiated settlement is being given a try, despite current international polarizations.

However, the US could act constructively in the crisis by urging Russia as well to ensure an end to the conflict, now that there is some seemingly friendly rapport between Trump and Putin.

However, more fundamentally, if the US does not see Ukraine’s sovereignty as having been violated by Russia as a result of the latter’s invasion, we are having a situation wherein the fundamental tenets of International Law are going unrecognized by the US. That is, international disorder and lawlessness are being winked at by the US.

It follows that, right now, the US is in cahoots with those powers that are acting autocratically and arbitrarily in international politics rather than with the most democratically vibrant states of the West, although a facile lumping together of the US, Russia and China, is yet not possible.

It is primarily up to the US voting public to take clear cognizance of these developments, draw the necessary inferences and to act on them. Right now, nothing substantive could be done by the US voter to put things right, so to speak, since mid-term US elections are due only next year. But there is ample time for the voting public to put the correct perspective on these fast-breaking developments, internationally and domestically, and to put their vote to good use in upcoming polls and such like democratic exercises. They would be acting in the interest of democracy worldwide by doing so.

More specifically it is up to Donald Trump’s Republican voter base to see the damage that is being done by the present administration to the US’ standing as the ‘world’s mightiest democracy’. They need to bring pressure on Trump and his ‘inner cabinet’ to change course and restore the reputation of their country as the foremost democracy. In the absence of such action it is the US citizenry that would face the consequences of Trump’s policy indiscretions.

Meanwhile, the political Opposition in the US too needs to get its act together, so to speak, and pressure the Trump administration into doing what is needed to get the US back to the relevant policy track. Needless to say, the Democratic Party would need to lead from the front in these efforts.

While, in the foreign policy field the US under President Trump could be said to be acting with a degree of ambivalence and ambiguity currently, in the area of domestic policy it is making it all to plain that it intends to traverse a fascistic course. As has been proved over the past two months, white supremacy is being made the cardinal principle of domestic governance.

Trump has made it clear, for example, that his administration would be close to ethnic chauvinists, such as the controversial Ku Klux Klan, and religious extremists. By unceremoniously rolling back the ‘diversity programs’ that have hitherto helped define the political culture of the US, the Trump administration is making no bones of the fact that ethnic reconciliation would not be among the government’s priorities. The steady undermining of USAID and its main programs worldwide is sufficient proof of this. Thus the basis has been adequately established for the flourishing of fascism and authoritarianism.

Yet, the US currently reflects a complex awareness of foreign policy questions despite having the international community wondering whether it is sealing a permanent alliance with the main powers of the East. For instance, President Trump is currently in conversation on matters in the external relations sphere that are proving vital with the West’s principal leaders. For example, he has spoken to President Emmanuel Macron of France and is due to meet Prime Minister Keir Starmer of the UK.

Obviously, the US is aware that it cannot ‘go it alone’ in resolving currently outstanding issues in external relations, such as the Ukraine question. There is a clear recognition that the latter and many more issues require a collaborative approach.

Besides, the Trump administration realizes that it cannot pose as a ‘first among equals’, given the complexities at ground level. It sees that given the collective strength of the rest of the West that a joint approach to problem solving cannot be avoided. This is particularly so in the case of Ukraine.

The most major powers of the West are no ‘pushovers’ and Germany, under a possibly Christian Democratic Union-led alliance in the future, has indicated as much. It has already implied that it would not be playing second fiddle to the US. Accordingly, the US is likely to steer clear of simplistic thinking in the formulation of foreign policy, going forward.

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Clean Sri Lanka – hiccups and remedies

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President AKD launching Clean Sri Lanka programme

by Upali Gamakumara,
Upali.gamakumara@gmail.com

The Clean Sri Lanka (CSL) is a project for the true renaissance the NPP government launched, the success of which would gain world recognition. It is about more than just cleaning up places. Its broader objectives are to make places attractive and happy for people who visit or use services in the country, focusing more on the services in public institutions and organisations like the SLTB. Unfortunately, these broader objectives are not apparent in its theme, “Clean Sri Lanka,” and therefore there is a misconception that keeping the environment clean is the main focus.

People who realise the said broader objectives are excited about a cleaner Sri Lanka, hoping the President and the government will tackle this, the way they are planning to solve other big problems like the economy and poverty. However, they do not see themselves as part of the solution.

From the management perspective, the CSL has a strategic plan that is not declared in that manner. When looking at the government policies, one can perceive its presence, the vision being “A Prosperous Nation and a Beautiful Life,” the mission “Clean Sri Lanka” and the broader objectives “a disciplined society, effective services, and a cleaner environment.” If the government published these as the strategy, there would have been a better understanding.

Retaining the spirit and expectations and continuing the ‘Clean Sri Lanka’ project is equally important as much as understanding its deep idea. For this, it needs to motivate people, which differs from those motivators that people push to achieve selfish targets. The motivation we need here is to evolve something involuntarily, known as Drivers. Drivers push for the survival of the evolution or development of any entity. We see the absence of apparent Drivers in the CSL project as a weakness that leads to sporadic hiccups and free flow.

Drivers of Evolution

Drivers vary according to the nature of envisaged evolution for progress. However, we suggest that ‘the force that pushes anything to evolve’ would fit all evolutions. Some examples are: ‘Fitting to survival’ was the driver of the evolution of life. Magnetism is a driver for the unprecedented development of physics – young Einstein was driven to enquire about the ‘attraction’ of magnets, eventually making him the greatest scientist of the 20th century.

Leadership is a Driver. It is essential but do not push an evolution continually as they are not sprung within a system involuntarily. This is one of the reasons why CSL has lost the vigour it had at its inception.

CSL is a teamwork. It needs ‘Drives’ for cohesion and to push forward continually, like the Quality Improvement Project of the National Health Service (NHS) in England. Their drivers are outlined differently keeping Aims as their top driver and saying: Aims should be specific and measurable, not merely to “improve” or “reduce,” engage stakeholders to define the aim of the improvement project and a clear aim to identify outcome measures.

So, we think that CSL needs Aims as defined by NHS, built by stakeholder participation to help refine the project for continuous evolution. This approach is similar to Deming’s Cycle for continual improvement. Further, two more important drivers are needed for the CSL project. That is Attitudinal Change and Punishment. We shall discuss these in detail under Psychoactive Environment (pSE) below.

Aside from the above, Competition is another driver in the business world. This helps achieve CSL objectives in the private sector. We can see how this Driver pushes, with the spread of the Supermarket chains, the evolution of small and medium retail shops to supermarket level, and in the private banks and hospitals, achieving broader objectives of CSL; a cleaner environment, disciplined behaviuor, efficient service, and the instillation of ethics.

The readers can now understand the importance of Drivers pushing any project.

Three Types of Entities and Their Drives

We understand, that to do the transformation that CSL expects, we need to identify or adopt the drivers separately to suit the three types of entities we have in the country.

Type I entities are the independent entities that struggle for their existence and force them to adopt drivers involuntarily. They are private sector entities, and their drivers are the commitment of leadership and competition. These drivers spring up involuntarily within the entity.

Type II are the dependent entities. To spring up drivers of these entities commitment of an appointed trustee is a must. Mostly in state-owned entities, categorized as Boards, Authorities, Cooperations, and the like. Their drivers do not spring up within or involuntarily unless the leader initiates. The Government of a country also falls into this type and the emergence of drivers depends on the leader.

Type III entities have neither independent nor dependent immediate leader or trustee. They are mostly the so-called ‘Public’ places like public-toilets, public-playgrounds, and public-beaches. No team can be formed as these places are open to any, like no-man-land. Achieving CSL objectives at these entities depends on the discipline of the public or the users.

Clean Sri Lanka suffers the absence of drivers in the second and third types of entities, as the appointed persons are not trustees but temporary custodians.

The writer proposes a remedy to the last two types of entities based on the theory of pSE explained below.

Psychoactive Environment (pSE) –
The Power of Customer Attraction

Research by the writer introduced the Psychoactive Environment (pSE) concept to explain why some businesses attract more customers than others who provide the same service. Presented at the 5th Global Conference on Business and Economics at Cambridge University in 2006, the study revealed that a “vibe” influences customer attraction. This vibe, termed pSE, depends on Three Distinct Elements, which can either attract or repel customers. A positive pSE makes a business more attractive and welcoming. This concept can help develop Drivers for Type II and III entities.

pSE is not an all-inclusive solution for CSL, but it lays the foundation for building Drivers and motivating entities to keep entrants attractive and contented.

The structure of the pSE

The three distinct Elements are the Occupants, Systems, and Environment responsible for making a pSE attractive to any entity, be it a person, institution, organization, or county. Each of these elements bears three qualities named Captivators. These captivators are, in simple terms, Intelligent, Nice, and Active in their adjective forms.

pSE theorizes that if any element fails to captivate the entrant’s mood by not being Intelligent, Nice, or Active, the pSE becomes negative, repelling the entrant (customer). Conversely, the positive pSE attracts the entrants if the elements are Intelligent, Nice, and Active.

For example, think person who comes to a Government Office for some service. He sees that the employees, service, and environment are intelligent, nice, and active, and he will be delighted and contented. He will not get frustrated or have any deterioration in national productivity.

The Significance of pSE in CSL

The Elements and the Captivators are universal for any entity. Any entity can easily find its path to Evolution or Progress determined by these elements and captivators. The intangible broader objectives can be downsised to manageable targets by pSE. Achievements of these targets make the entrants happy and enhance productivity – the expectation of Clean Sri Lanka (CSL).

From the perspective of pSE, now we can redefine the Clean Sri Lanka project thus:

To make the Elements of every entity in Sri Lanka: intelligent, Nice, and Active.

How Would the pSE be A Remedy for The Sporadic Hiccups?

We have seen two possible reasons for sporadic setbacks and the discontinuity of some projects launched by the CSL. They are:

The absence of involuntary Drivers for evolvement or progress

Poor attitudes and behaviors of people and leaders

Remedy for the Absence of Drivers

Setting up a system to measure customer or beneficiary satisfaction, and setting aims can build Drivers. The East London NHS principles help build the Aims that drive type II & II entities. The system must be designed to ensure continual improvement following the Deming Cycle. This strategy will create Drivers for Type I & II entities.

This process is too long to explain here therefore we refrain from detailing.

Attitudinal Change

The most difficult task is the attitudinal and behavioural change. Yet it cannot be postponed.

Punishment as a strategy

In developed countries, we see that people are much more disciplined than in the developing countries. We in developing countries, give credit to their superior culture, mitigating ours as rudimental. The long experience and looking at this affair from a vantage point, one will understand it is not the absolute truth. Their ruthless wars in the past, rules, and severe punishment are the reasons behind this discipline. For example, anyone who fails to wear a car seatbelt properly will be fined 400 AUD, nearly 80,000 LKR!

The lesson we can learn is, that in Sri Lanka, we need strong laws and strict punishment together with a type of strategic education as follows.

Psychological Approach as a Strategy

The psychological theory of attitude formation can be used successfully if some good programmes can be designed.

All attitude formations start with life experience. Formed wrong or negative attitudes can be reversed or instilled with correct attitudes by exposure to designed life experiences. The programmes have been developed using the concepts of Hoshin Kanri, Brainstorming, Cause-and-Effect analysis, and Teamwork, in addition to London NTS Quality Improvement strategies.

The experience and good responses we received for our pSE programs conducted at several institutions prove and have built confidence in our approach. However, it was a time, when governments or organisations did not pay much attention to cultural change as CSL expects in the country.

Therefore, we believe this is a golden opportunity to take the CSL supported by the pSE concept.

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Visually impaired but ready to do it their way

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The visually impaired artistes. From Left: Theekshana (rhythm guitar and vocals), Sadun (vocals and keyboards) Akila, (keyboards and vocals), Navoda (drums), Samudra (compere and vocals), Randi (violin and vocals), Sethini (keyboards and vocals), Rashini (keyboards and vocals), Dinesh (percussion and vocals), Tharidu (lead guitar and vocals) and Jonathan (bass guitar and vocals), with Melantha Perera (behind – centre)

Although they are visually impaired youngsters, under the guidance of renowned musician Melantha Perera, these talented individuals do shine bright … hence the name Bright Light.

Says Melantha: “My primary mission is to nurture their talent and ensure their sustainable growth in music, and I’m thrilled to announce that Bright Light’s first public performance is scheduled for 7th June, 2025. The venue will be the MJF Centre Auditorium in Katubadda, Moratuwa.”

Melantha went on to say that two years of teaching, online, visually impaired youngsters, from various parts of the island, wasn’t an easy ride.

There were many ups and downs but Melantha’s determination has paid off with the forming of Bright Light, and now they are gearing up to go on stage.

According to Melantha, they have come a long way in music.

“For the past few months, we have been meeting, physically, where I guide them to play as a band and now they show a very keen interest as they are getting to the depth of it. They were not exposed to English songs, but I’ve added a few English songs to widen their repertoire.

Melantha Perera: Invented a notation
system for the guitar

“On 7th June, we are opening up for the public to come and witness their talents, and I want to take this product island-wide, giving the message that we can do it, and I’m hoping to create a database so there will be a following. Initially, we would like your support by attending the show.”

Melantha says he didn’t know what he was getting into but he had confidence teaching anyone music since he has been in the scene for the past 45 years. He began teaching in 2015,

“When I opened my music school, Riversheen School of Music, the most challenging part of teaching was correcting tone deaf which is the theoretical term for those who can’t pitch a note, and also teaching students to keep timing while they sang and played.”

Melantha has even invented a notation system for the guitar which he has named ‘MelaNota’. He has received copyrights from the USA and ISO from Australia, but is yet to be recognised in Sri Lanka.

During Covid-19, Melantha showcased MelaNota online and then it was officially launched with the late Desmond De Silva playing one of his tunes, using MelaNota.

Melantha says that anyone, including the visually impaired, can play a simple melody on a guitar, within five minutes, using his notation system.

“I’ve completed the system and I’m now finalising the syllabus for the notation system.”

Melantha has written not only for the guitar, but also for drums, keyboards, and wind instruments.

For any queries, or additional information, you could contact Melantha at 071 454 4092 or via email at thebandbrightlight@gmail.com.

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