Opinion

Doc Call 247: A labour of love that has indeed borne fruit

Published

3 years ago

2021/09/30

Dr B.J.C.Perera

MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paed), MRCP(UK), FRCP(Edin), FRCP(Lon), FRCPCH(UK), FSLCPaed, FCCP, Hony FRCPCH(UK), Hony. FCGP(SL)

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

On the 20^th of August 2021, The Island most kindly published an article of mine, where I stated that the Doc Call 247 initiative of the Sri Lanka Medical Association (SLMA) and SLT Mobitel, joined later by Dialog, Hutch and Airtel mobile communication providers, is a veritable labour of love. It was initiated as a hotline answered by Western qualified allopathic doctors to provide state-of-the-art information and advice on COVID-19, in all three languages, to the needy, in trying to fill a telling vacuum where the general public needed empathy, information and advice. The SLMA was ever so quick to recognise this dire need and act promptly in a gesture of goodwill to society in general.

In a landmark effort hitherto unseen, coordinated by Mobitel, the other three mobile communication providers selflessly put their collective shoulder to the wheel. Generally speaking, the mobile providers are continuously competing and vying with each other to get the greatest number of subscribers into each network. Here they sunk all their differences, perhaps for the very first time in this little island nation, and produced a magnificently coordinated venture of collaboration, completely free-of-charge to the entire country. It was a dazzling example of their commitment to Corporate Social Responsibility. All the callers needed to do was to dial 247 from any mobile service provider connection or dial 1247 from a Sri Lanka Telecom Land Line, all completely toll-free, to be connected to a qualified doctor for a maximum call duration of ten minutes. In an automated system that can process around 100 calls at any given time, the maximum waiting time or ‘lag time’ has been around 90 to 100 seconds. There were hardly any instances of the system being ‘engaged’ and uncontactable at any given time. The final common pathway was a dedicated network of Mobitel.

The people who answered the calls were all Registered Doctors practising Western Medicine, who selflessly gave of their time and effort, in a purely voluntary and sparkling gesture of commitment. It was without any remuneration whatsoever; just a gesture of compassion to help the people of our land. There were Specialist Consultants, experienced Grade Medical Officers and even most recently qualified men and women of medicine awaiting their internship; the young and the old and anyone who could spare even just a little time from their precious lives to help in this endeavour. The gesture of love has indeed borne fruit now and is just the personification of the immortal words of the poetry of volume II of John Bunyan, “You have not lived today, until you have done something for someone, who can never repay you”.

Up to the time of writing of this piece on 14^th September 2021, just about 30 days after the entire venture started, the network has handled around 44,000 telephone calls. At present, there are about 150 Consultants, around 500 Grade Medical Officers and around 100 Pre-Interns who have joined as volunteers into the system. In addition around 80 Sri Lankan doctors resident abroad too joined in. The expatriate doctors resident abroad have taken turns on a roster to cover the Sri Lankan nights due to the time differences in other parts of the world where they are residents. All these doctors of all types listed above have responded to emergencies, provided well-thought-out advice and even gone to the extent of discussing the problems with the seniors and the health authorities, and got back to the callers. Through the entire network, which is now linked to the Ministry of Health COVID-19 Resource Centre and the Suwaseriya Ambulance Service, they have responded magnificently to this hour of need of the men, women and children of our country. The numbers given above are just the number of calls. In most instances, entire families with several COVID-19 positive people had been the recipients of the services provided by the system. The doctors for their part, have taken great pleasure in giving back something to the people of this country who have funded and sponsored their professional advancement in healthcare. Some of these medical women and men have handled thousands of calls while others have responded to just hundreds of them. However, big or small, their contributions have made the entire venture a very successful one.

Answering around 44,000 calls from needy patients is a Herculean task. That is a kind of a superhuman response with a waiting time or lag time of under 2 minutes. What do all these numbers tell us? They very clearly show us that there is a crying need among patients and families afflicted and affected by COVID-19 for accurate information. It also portrays the anxiety and concerns amongst these people of our land. Each call represents a household where there may be many who are infected, but not tested often and not even represented in national data. It has been assessed that the average number of likely patients per call is around 4. In such a context, the system has tried to help around 150,000 men women and children of our country in just about 30 days. Our experience suggests that the vast majority of patients can be successfully managed at home, with a few simple instructions and guidance. However, to save lives, it is of paramount importance to detect the small number of people who need immediate care and refer them to hospitals for as early management as humanly possible. The system and the operators have striven so hard to do just that.

In this ground-breaking and history-making venture, without any exceptions worthy of note, the callers have been extremely grateful to the doctors who have always remained anonymous through the facilities built into the system. At the end of the conversations, many callers have deemed it fit to shower unrestricted praise on the responding doctors, the SLMA and the mobile service providers. They have invoked the blessings of the Triple Gem, Lord Buddha, Jesus Christ, Allah, Lord Shiva and many other deities on the doctor who responded to their call for help. Such gestures of gratitude have left some of the doctors visibly moved, even speechless and given them the kind of personal satisfaction that, in their own words, was just priceless. Indeed, many of them have had misty eyes due to the obvious appreciation expressed so frequently by the callers. As for me, from a personal perspective, it has been such a humbling and gratifying experience in my entire professional life to have done even a little towards the welfare of our Sri Lankan people.

Yet for all that, we cannot say that we have sufficient numbers of volunteer doctors to cater to the tremendous demand. We do appreciate the fact that doctors are very busy people with the current pandemic, trying hard to get on with their own lives while having to balance many things in their homes as well. It is to their eternal credit that with all their commitments, they are able to give even an hour or two a day to this endeavour. There are no fixed duty hours or rotas for the doctors. They can ‘opt in’ and ‘opt out’ of the system at the press of a couple of buttons on their mobile telephones. If you do not wish to be disturbed at night and ‘opt out’, the system will not bother you. The entire endeavour has been designed to be ever so flexible simply because of these considerations. There are close to 25,000 registered doctors who practise Western medicine in Sri Lanka. If just one-fifth of them, just 4000 to 5000 or so, agree to give an hour of their precious time every day, or even every other day, we will be able to run the system that has the potential to handle around 100 calls at any given time; ever so efficiently, and smoothly, to the very benefit of our people.

SO…, THIS IS A FERVENT CLARION CALL AND A VERY SINCERE APPEAL TO ALL DOCTORS IN SRI LANKA, TO LEND A HAND TO THIS HUMANITARIAN INITIATIVE. All they need is a Mobitel connection and if they do not have one already, Mobitel will provide them one with a SIM Card, free of charge. A Mobitel connection is needed to get into the system as the final common pathway is through a Mobitel network.

Finally…, take a bow…, Mobitel, Dialog, Hutch and Airtel, the system operators and the Special Working Group of the SLMA, the President, Secretary and the Council of the SLMA, and all the volunteer doctors who are the backbone of this initiative, for a splendid job so very well done. I am quite sure that if that legend of yore, Muhammad Ali, the champion heavyweight boxer who immortalised his own words, “I am the greatest” was alive today, he would be quite happy to unhesitatingly paraphrase his words to say “YOU ARE THE GREATEST”.

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Opinion

Learning from global models to address flooding and water shortage in Sri Lanka

Published

3 days ago

2025/03/27

Sahan Weerasooriya

by Sudharman Siripala

Sri Lanka is grappling with the increasing threat of climate change, which has led to unpredictable weather patterns. The country faces a dangerous combination of flooding in some regions and water shortages in others, a situation exacerbated by shifting rainfall patterns. Rivers originating in the Central Hills, such as the Mahaweli, Kalu, and Kelani, flow through much of the country, but these water sources are not being distributed evenly. Districts like Monaragala and Hambantota, located in the dry zone, are experiencing severe water shortages. To address this challenge, experts suggest the development of an interconnected river system to harness excess water during floods and redirect it to drier areas, ensuring a year-round water supply for agriculture and daily use.

Global Case Studies in River Management

Several countries facing similar water-related challenges have implemented successful water management systems that Sri Lanka could adapt to its unique circumstances:

The Netherlands – Room for the River Programme

The Netherlands, a country prone to flooding, widened its rivers and relocated dikes to create floodplains. This approach allows rivers to overflow without damaging urban areas, while preserving water flow and natural habitats. Sri Lanka could apply this concept by designating specific riverbank areas for temporary flood storage.

China – South-North Water Transfer Project

China’s massive project channels excess water from the flood-prone Yangtze River to drier northern regions. This system of canals and reservoirs could inspire Sri Lanka to divert water from rivers in the Central Hills to drier areas in the south and east.

Bangladesh – River Interlinking Projects

Bangladesh has implemented river interlinking projects to redistribute water from flood-prone rivers, such as the Brahmaputra, to drier regions. Sri Lanka could link its major rivers like the Mahaweli and Kelani to smaller rivers in water-scarce districts to balance water distribution.

India – National River Linking Project

India’s National River Linking Project connects major rivers to manage both floods and droughts. Sri Lanka could use similar strategies, connecting rivers around the 500-foot contour line in the Central Hills to help distribute water more effectively.

United States – Mississippi River and Tributaries Project

The Mississippi River system combines levees, floodways, and diversion channels to manage flooding. Sri Lanka could adopt similar flood-control measures in vulnerable river basins such as the Kelani and Kalu.

Japan – Underground Reservoirs and Flood Channels

Japan’s G-Cans Project in Tokyo channels excess water into underground reservoirs to prevent urban flooding. A similar underground system could be implemented in Colombo and other flood-prone cities in Sri Lanka.

Singapore – Marina Barrage

Singapore’s Marina Barrage serves as both a flood control measure and a water supply resource. Sri Lanka could develop similar systems to control flooding in urban areas and ensure water availability during dry spells.

Thailand – Chao Phraya River Basin Management

Thailand uses diversion channels in the Chao Phraya River Basin to prevent flooding in Bangkok and direct water to agricultural areas. Sri Lanka could replicate this by creating diversion channels to supply water to its agricultural zones.

Actionable Solutions for Sri Lanka

Develop an Interconnected River System

Establish water diversion channels along the 300-500 meter contour lines of the Central Hills to capture excess rainfall during floods and redirect it to drier areas.

Build Reservoirs and Storage Tanks

Construct reservoirs to store diverted water, ensuring a steady supply for agriculture and domestic use. Sri Lanka has around 14,000 ancient tanks out of 30,000 that could be revitalized for this purpose.

Improve Urban Flood Defenses

Drawing inspiration from Japan and Singapore, build underground reservoirs and flood channels in cities like Colombo to mitigate urban flooding.

Strengthen Watershed Management

Restore natural floodplains and create wetlands to absorb excess rainwater, as seen in the Netherlands, helping to reduce flood risks.

Encourage Public-Private Partnerships

Foster collaboration between the public and private sectors to fund large-scale water management infrastructure, leveraging models from China and the United States.

Leverage Technology

Utilise modern forecasting and real-time water management systems, similar to those in Bangladesh and Thailand, to monitor water levels and manage river flows dynamically.

International Collaboration

Form partnerships with countries that have successfully implemented flood control and water management systems to share expertise and technology.

Sri Lanka’s dual challenges of flooding and water scarcity, compounded by climate change, require immediate action. By developing an interconnected river system and learning from successful global water management models, Sri Lanka can mitigate the effects of floods while ensuring a sustainable water supply for agriculture and daily life. It is crucial for the country to act now, as these solutions have the potential to transform Sri Lanka’s water management system for the better.

Sudharman Siripala Managing Director of Geoinformatics Group and a Registered Licensed Surveyor, specializes in geo-spatial applications. He also serves as a freelance value chain consultant for Vivonta Green Tech Consultants (www.vivonta.lk)

Opinion

Doctor’s plight

Published

3 days ago

2025/03/27

Sahan Weerasooriya

Some people have found fault with a female doctor for not coming forward to identify her rapist and help make him pay for his crime.

Do they not realise the emotional toll of facing her rapist again?

There should be a way for survivors to testify directly to the judge without enduring such distressing encounters. Making a victim relive her trauma in this manner is akin to subjecting her to the ordeal all over again.

A Ratnayake

Opinion

Developing attitudes of schoolchildren for development

Published

5 days ago

2025/03/25

Sahan Weerasooriya

Sri Lanka was once at an economically comparable level with some of the world’s most developed countries in the 19th century. However, despite our country’s potential, we are still striving to fully develop. Many people often blame politicians, government officers, or various sectors for the situation. However, I believe the root cause of these issues lies not in any individual or group, but in the lack of good attitudes within our society.

We are investing significant resources into our education system, which is funded by the taxes of hard- working citizens. However, when we examine the outcomes, we realise that the academic achievements of our graduates alone are not enough. There are instances where professionals, despite having the necessary qualifications, fail to uphold ethical standards. In some cases, this even results in malpractice or harmful actions that damage our country’s reputation and progress. This highlights the gap between academic success and real-world responsibilities.

The education system, which is currently focused on competitive exams and rote learning, does not emphasise the development of attitudes and character in students. While our students are academically capable, many lack the qualities required to contribute positively to society. This lack of focus on social values, such as patriotism, selflessness and respect for elders, is holding us back from achieving the level of progress we deserve.

To address these concerns, I wrote to His Excellency, the President of Sri Lanka, on 24th September 2024, proposing education reforms that emphasise not only academic qualifications but also attitudes, ethics, and social responsibility. I suggested a holistic approach to university admissions and government recruitment, incorporating moral integrity, character, and extracurricular involvement, key traits for fostering well- rounded, responsible citizens. More importantly, I strongly recommended introducing a compulsory school subject, with both theory and practical components, focused on attitude development, which would be evaluated in university admissions. Encouraging extracurricular participation alongside academics will help shape ethical and socially responsible individuals.

I am pleased to inform you that the President, recognising the importance of these reforms, has directed the relevant ministries (by a letter dated 24th October 2024) to explore integrating these ideas into the education system. This marks a crucial step in transforming the values and attitudes of our youth for the nation’s benefit.

However, meaningful change requires collective effort. Parents, teachers, students, and citizens all play a role in shaping Sri Lanka’s future. Together, we must instill responsibility, ethics, and patriotism in the next generation. I invite you to share your thoughts and suggestions on further enhancing the values and attitudes of our youth. Your feedback will be invaluable in building a brighter future for Sri Lanka, one driven not just by knowledge, but by integrity and character.

Dr. Mahesh Premarathna

Research Fellow, National Institute of Fundamental Studies, Sri Lanka Email: mahesh.pr@nifs.ac.lk