Features
Chikungunya Fever in Children
Chikungunya fever, a viral disease transmitted by mosquitoes, poses a significant health concern, particularly for children. It has been around in Sri Lanka sporadically, but there are reports of an increasing occurrence of it in more recent times. While often associated with debilitating joint pain in adults, its manifestations in children can present unique challenges. Understanding the nuances of this disease is crucial for effective management and prevention.
Chikungunya fever is caused by the chikungunya virus (CHIKV), an alphavirus transmitted to humans through the bites of infected Aedes aegypti and Aedes albopictus mosquitoes. These are the same mosquitoes that transmit dengue and Zika viruses, highlighting the overlapping risks in many areas of the world. It is entirely possible for chikungunya and dengue to co-circulate in the same area, leading to co-infections in individuals.
When a mosquito bites a person infected with CHIKV, it ingests the virus. After a period of growth and multiplication of the virus within the mosquito, the virus can be transmitted to another person through subsequent bites. Therefore, the mosquito acts as a vector or an intermediate transmitting agent that spreads the disease, but not as a reservoir of the disease. The spread of chikungunya is influenced by environmental factors that support mosquito breeding, such as stagnant water and warm climates. Urbanization and poor sanitation can exacerbate the problem by creating breeding grounds for these mosquitoes.
The clinical presentation of chikungunya in children can vary, ranging from mild to severe. While some infected children may even be asymptomatic and be normal for all intents and purposes, others can experience a range of symptoms, including a sudden onset of high fever, a common initial symptom. Pain in the joints of the body, while being a hallmark of chikungunya in adults, may be less pronounced in children. However, they can still experience significant discomfort and this must be kept in mind during processes of diagnosis and treatment. It is also important to remember that joint pains can present in various forms, as well as in different locations of the body. There is no characteristic pattern or sites of involvement of joints. Muscle aches and pains can accompany the fever and joint pain as well. A headache, too, could occur at any stage of the disease. Other symptoms may include nausea, vomiting, and fatigue as well.
A reddish elevated rash, referred to in medical jargon as a maculopapular rash, is frequently observed in children, sometimes more so than in adults. While chikungunya is known to cause such a rash, there is a specific characteristic related to nasal discoloration that is worth noting. It is called the “Chik sign” or “Brownie nose” and refers to an increased darkening of the skin, particularly on the nose. This discolouration just appears and is not associated with pain or itching. It can occur during or after the fever, and it can be a helpful clinical sign, especially in areas with limited diagnostic resources. While a generalised rash is a common symptom of chikungunya, a distinctive darkening of the skin on the nose is a particular characteristic that has been observed.
In some rare instances, particularly in infants and very young children, chikungunya can lead to neurological complications, such as involvement of the brain, known as encephalitis. This is associated with a change in the level of alertness, drowsiness, convulsions and weakness of limbs. Equally rarely, some studies indicate that children can experience bleeding tendencies and haemorrhagic manifestations more often than adults.
Diagnosis is typically made through evaluating the patient’s symptoms and medical history, as well as by special blood tests that can detect the presence of CHIKV antibodies (IgM and IgG) or the virus itself through PCR testing.
There is no specific antiviral treatment for chikungunya. Treatment focuses on relieving symptoms and allowing the body to recover on its own. Adequate rest is essential for recovery, and maintaining hydration is crucial, especially in children with fever. Paracetamol in the correct dosage can be used to reduce fever and pain. It is important to avoid aspirin, as it can increase the risk of a further complication known as Reye’s syndrome in children. In severe cases, hospitalisation and supportive care may be necessary.
While most children recover from chikungunya without any major issues, some may experience long-term sequelae. Joint pain can persist for months or even years in some individuals, impacting their quality of life. In rare cases, chikungunya can lead to chronic arthritis. Children that have suffered from neurological complications can have long term effects.
The ultimate outcome or prognosis for chikungunya in children is generally favourable. Most children recover fully within a few days or a couple of weeks. However, the duration and severity of symptoms can vary quite significantly.
Prevention is key to controlling the spread of chikungunya. Mosquito control is of paramount importance. These include eliminating stagnant water sources where mosquitoes breed, using mosquito repellents, wearing long-sleeved clothing and pants, using mosquito nets, especially for young children and installing protective screens on windows and doors. While a chikungunya vaccine is available, its current use is mainly for adults, especially those traveling to at risk areas. More research is being conducted for child vaccinations.
Chikungunya outbreaks can strain healthcare systems and have significant economic consequences. Public health initiatives aimed at mosquito control and disease surveillance are crucial for preventing and managing outbreaks.
Key considerations for children are that some of them, especially infants and young children, are more vulnerable to severe chikungunya complications and early diagnosis and supportive care are essential for minimising the risk of long-term sequelae. Preventing mosquito bites is the most effective way to protect children from chikungunya. By understanding the causation, clinical features, treatment, and prevention of chikungunya, parents, caregivers, and healthcare professionals can work together to protect children from this illness that could sometimes be quite debilitating.
Dr B. J. C. Perera
MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paed), MRCP(UK), FRCP(Edin), FRCP(Lond), 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.
Joint Editor, Sri Lanka Journal of Child Health and Section Editor, Ceylon Medical Journal
Founder President, Sri Lanka College of Paediatricians – 1996-97)
Features
Disaster-proofing paradise: Sri Lanka’s new path to global resilience
iyadasa Advisor to the Ministry of Science & Technology and a Board of Directors of Sri Lanka Atomic Energy Regulatory Council A value chain management consultant to www.vivonta.lk
As climate shocks multiply worldwide from unseasonal droughts and flash floods to cyclones that now carry unpredictable fury Sri Lanka, long known for its lush biodiversity and heritage, stands at a crossroads. We can either remain locked in a reactive cycle of warnings and recovery, or boldly transform into the world’s first disaster-proof tropical nation — a secure haven for citizens and a trusted destination for global travelers.
The Presidential declaration to transition within one year from a limited, rainfall-and-cyclone-dependent warning system to a full-spectrum, science-enabled resilience model is not only historic — it’s urgent. This policy shift marks the beginning of a new era: one where nature, technology, ancient wisdom, and community preparedness work in harmony to protect every Sri Lankan village and every visiting tourist.
The Current System’s Fatal Gaps
Today, Sri Lanka’s disaster management system is dangerously underpowered for the accelerating climate era. Our primary reliance is on monsoon rainfall tracking and cyclone alerts — helpful, but inadequate in the face of multi-hazard threats such as flash floods, landslides, droughts, lightning storms, and urban inundation.
Institutions are fragmented; responsibilities crisscross between agencies, often with unclear mandates and slow decision cycles. Community-level preparedness is minimal — nearly half of households lack basic knowledge on what to do when a disaster strikes. Infrastructure in key regions is outdated, with urban drains, tank sluices, and bunds built for rainfall patterns of the 1960s, not today’s intense cloudbursts or sea-level rise.
Critically, Sri Lanka is not yet integrated with global planetary systems — solar winds, El Niño cycles, Indian Ocean Dipole shifts — despite clear evidence that these invisible climate forces shape our rainfall, storm intensity, and drought rhythms. Worse, we have lost touch with our ancestral systems of environmental management — from tank cascades to forest sanctuaries — that sustained this island for over two millennia.
This system, in short, is outdated, siloed, and reactive. And it must change.
A New Vision for Disaster-Proof Sri Lanka
Under the new policy shift, Sri Lanka will adopt a complete resilience architecture that transforms climate disaster prevention into a national development strategy. This system rests on five interlinked pillars:
Science and Predictive Intelligence
We will move beyond surface-level forecasting. A new national climate intelligence platform will integrate:
AI-driven pattern recognition of rainfall and flood events
Global data from solar activity, ocean oscillations (ENSO, MJO, IOD)
High-resolution digital twins of floodplains and cities
Real-time satellite feeds on cyclone trajectory and ocean heat
The adverse impacts of global warming—such as sea-level rise, the proliferation of pests and diseases affecting human health and food production, and the change of functionality of chlorophyll—must be systematically captured, rigorously analysed, and addressed through proactive, advance decision-making.
This fusion of local and global data will allow days to weeks of anticipatory action, rather than hours of late alerts.
Advanced Technology and Early Warning Infrastructure
Cell-broadcast alerts in all three national languages, expanded weather radar, flood-sensing drones, and tsunami-resilient siren networks will be deployed. Community-level sensors in key river basins and tanks will monitor and report in real-time. Infrastructure projects will now embed climate-risk metrics — from cyclone-proof buildings to sea-level-ready roads.
Governance Overhaul
A new centralised authority — Sri Lanka Climate & Earth Systems Resilience Authority — will consolidate environmental, meteorological, Geological, hydrological, and disaster functions. It will report directly to the Cabinet with a real-time national dashboard. District Disaster Units will be upgraded with GN-level digital coordination. Climate literacy will be declared a national priority.
People Power and Community Preparedness
We will train 25,000 village-level disaster wardens and first responders. Schools will run annual drills for floods, cyclones, tsunamis and landslides. Every community will map its local hazard zones and co-create its own resilience plan. A national climate citizenship programme will reward youth and civil organisations contributing to early warning systems, reforestation (riverbank, slopy land and catchment areas) , or tech solutions.
Reviving Ancient Ecological Wisdom
Sri Lanka’s ancestors engineered tank cascades that regulated floods, stored water, and cooled microclimates. Forest belts protected valleys; sacred groves were biodiversity reservoirs. This policy revives those systems:
Restoring 10,000 hectares of tank ecosystems
Conserving coastal mangroves and reintroducing stone spillways
Integrating traditional seasonal calendars with AI forecasts
Recognising Vedda knowledge of climate shifts as part of national risk strategy
Our past and future must align, or both will be lost.
A Global Destination for Resilient Tourism
Climate-conscious travelers increasingly seek safe, secure, and sustainable destinations. Under this policy, Sri Lanka will position itself as the world’s first “climate-safe sanctuary island” — a place where:
Resorts are cyclone- and tsunami-resilient
Tourists receive live hazard updates via mobile apps
World Heritage Sites are protected by environmental buffers
Visitors can witness tank restoration, ancient climate engineering, and modern AI in action
Sri Lanka will invite scientists, startups, and resilience investors to join our innovation ecosystem — building eco-tourism that’s disaster-proof by design.
Resilience as a National Identity
This shift is not just about floods or cyclones. It is about redefining our identity. To be Sri Lankan must mean to live in harmony with nature and to be ready for its changes. Our ancestors did it. The science now supports it. The time has come.
Let us turn Sri Lanka into the world’s first climate-resilient heritage island — where ancient wisdom meets cutting-edge science, and every citizen stands protected under one shield: a disaster-proof nation.
Features
The minstrel monk and Rafiki the old mandrill in The Lion King – I
Why is national identity so important for a people? AI provides us with an answer worth understanding critically (Caveat: Even AI wisdom should be subjected to the Buddha’s advice to the young Kalamas):
‘A strong sense of identity is crucial for a people as it fosters belonging, builds self-worth, guides behaviour, and provides resilience, allowing individuals to feel connected, make meaningful choices aligned with their values, and maintain mental well-being even amidst societal changes or challenges, acting as a foundation for individual and collective strength. It defines “who we are” culturally and personally, driving shared narratives, pride, political action, and healthier relationships by grounding people in common values, traditions, and a sense of purpose.’
Ethnic Sinhalese who form about 75% of the Sri Lankan population have such a unique identity secured by the binding medium of their Buddhist faith. It is significant that 93% of them still remain Buddhist (according to 2024 statistics/wikipedia), professing Theravada Buddhism, after four and a half centuries of coercive Christianising European occupation that ended in 1948. The Sinhalese are a unique ancient island people with a 2500 year long recorded history, their own language and country, and their deeply evolved Buddhist cultural identity.
Buddhism can be defined, rather paradoxically, as a non-religious religion, an eminently practical ethical-philosophy based on mind cultivation, wisdom and universal compassion. It is an ethico-spiritual value system that prioritises human reason and unaided (i.e., unassisted by any divine or supernatural intervention) escape from suffering through self-realisation. Sri Lanka’s benignly dominant Buddhist socio-cultural background naturally allows unrestricted freedom of religion, belief or non-belief for all its citizens, and makes the country a safe spiritual haven for them. The island’s Buddha Sasana (Dispensation of the Buddha) is the inalienable civilisational treasure that our ancestors of two and a half millennia have bequeathed to us. It is this enduring basis of our identity as a nation which bestows on us the personal and societal benefits of inestimable value mentioned in the AI summary given at the beginning of this essay.
It was this inherent national identity that the Sri Lankan contestant at the 72nd Miss World 2025 pageant held in Hyderabad, India, in May last year, Anudi Gunasekera, proudly showcased before the world, during her initial self-introduction. She started off with a verse from the Dhammapada (a Pali Buddhist text), which she explained as meaning “Refrain from all evil and cultivate good”. She declared, “And I believe that’s my purpose in life”. Anudi also mentioned that Sri Lanka had gone through a lot “from conflicts to natural disasters, pandemics, economic crises….”, adding, “and yet, my people remain hopeful, strong, and resilient….”.
“Ayubowan! I am Anudi Gunasekera from Sri Lanka. It is with immense pride that I represent my Motherland, a nation of resilience, timeless beauty, and a proud history, Sri Lanka.
“I come from Anuradhapura, Sri Lanka’s first capital, and UNESCO World Heritage site, with its history and its legacy of sacred monuments and stupas…….”.
The “inspiring words” that Anudi quoted are from the Dhammapada (Verse 183), which runs, in English translation: “To avoid all evil/To cultivate good/and to cleanse one’s mind -/this is the teaching of the Buddhas”. That verse is so significant because it defines the basic ‘teaching of the Buddhas’ (i.e., Buddha Sasana; this is how Walpole Rahula Thera defines Buddha Sasana in his celebrated introduction to Buddhism ‘What the Buddha Taught’ first published in1959).
Twenty-five year old Anudi Gunasekera is an alumna of the University of Kelaniya, where she earned a bachelor’s degree in International Studies. She is planning to do a Master’s in the same field. Her ambition is to join the foreign service in Sri Lanka. Gen Z’er Anudi is already actively engaged in social service. The Saheli Foundation is her own initiative launched to address period poverty (i.e., lack of access to proper sanitation facilities, hygiene and health education, etc.) especially among women and post-puberty girls of low-income classes in rural and urban Sri Lanka.
Young Anudi is primarily inspired by her patriotic devotion to ‘my Motherland, a nation of resilience, timeless beauty, and a proud history, Sri Lanka’. In post-independence Sri Lanka, thousands of young men and women of her age have constantly dedicated themselves, oftentimes making the supreme sacrifice, motivated by a sense of national identity, by the thought ‘This is our beloved Motherland, these are our beloved people’.
The rescue and recovery of Sri Lanka from the evil aftermath of a decade of subversive ‘Aragalaya’ mayhem is waiting to be achieved, in every sphere of national engagement, including, for example, economics, communications, culture and politics, by the enlightened Anudi Gunasekeras and their male counterparts of the Gen Z, but not by the demented old stragglers lingering in the political arena listening to the unnerving rattle of “Time’s winged chariot hurrying near”, nor by the baila blaring monks at propaganda rallies.
Politically active monks (Buddhist bhikkhus) are only a handful out of the Maha Sangha (the general body of Buddhist bhikkhus) in Sri Lanka, who numbered just over 42,000 in 2024. The vast majority of monks spend their time quietly attending to their monastic duties. Buddhism upholds social and emotional virtues such as universal compassion, empathy, tolerance and forgiveness that protect a society from the evils of tribalism, religious bigotry and death-dealing religious piety.
Not all monks who express or promote political opinions should be censured. I choose to condemn only those few monks who abuse the yellow robe as a shield in their narrow partisan politics. I cannot bring myself to disapprove of the many socially active monks, who are articulating the genuine problems that the Buddha Sasana is facing today. The two bhikkhus who are the most despised monks in the commercial media these days are Galaboda-aththe Gnanasara and Ampitiye Sumanaratana Theras. They have a problem with their mood swings. They have long been whistleblowers trying to raise awareness respectively, about spreading religious fundamentalism, especially, violent Islamic Jihadism, in the country and about the vandalising of the Buddhist archaeological heritage sites of the north and east provinces. The two middle-aged monks (Gnanasara and Sumanaratana) belong to this respectable category. Though they are relentlessly attacked in the social media or hardly given any positive coverage of the service they are doing, they do nothing more than try to persuade the rulers to take appropriate action to resolve those problems while not trespassing on the rights of people of other faiths.
These monks have to rely on lay political leaders to do the needful, without themselves taking part in sectarian politics in the manner of ordinary members of the secular society. Their generally demonised social image is due, in my opinion, to three main reasons among others: 1) spreading misinformation and disinformation about them by those who do not like what they are saying and doing, 2) their own lack of verbal restraint, and 3) their being virtually abandoned to the wolves by the temporal and spiritual authorities.
(To be continued)
By Rohana R. Wasala ✍️
Features
US’ drastic aid cut to UN poses moral challenge to world
‘Adapt, shrink or die’ – thus runs the warning issued by the Trump administration to UN humanitarian agencies with brute insensitivity in the wake of its recent decision to drastically reduce to $2bn its humanitarian aid to the UN system. This is a substantial climb down from the $17bn the US usually provided to the UN for its humanitarian operations.
Considering that the US has hitherto been the UN’s biggest aid provider, it need hardly be said that the US decision would pose a daunting challenge to the UN’s humanitarian operations around the world. This would indeed mean that, among other things, people living in poverty and stifling material hardships, in particularly the Southern hemisphere, could dramatically increase. Coming on top of the US decision to bring to an end USAID operations, the poor of the world could be said to have been left to their devices as a consequence of these morally insensitive policy rethinks of the Trump administration.
Earlier, the UN had warned that it would be compelled to reduce its aid programs in the face of ‘the deepest funding cuts ever.’ In fact the UN is on record as requesting the world for $23bn for its 2026 aid operations.
If this UN appeal happens to go unheeded, the possibilities are that the UN would not be in a position to uphold the status it has hitherto held as the world’s foremost humanitarian aid provider. It would not be incorrect to state that a substantial part of the rationale for the UN’s existence could come in for questioning if its humanitarian identity is thus eroded.
Inherent in these developments is a challenge for those sections of the international community that wish to stand up and be counted as humanists and the ‘Conscience of the World.’ A responsibility is cast on them to not only keep the UN system going but to also ensure its increased efficiency as a humanitarian aid provider to particularly the poorest of the poor.
It is unfortunate that the US is increasingly opting for a position of international isolation. Such a policy position was adopted by it in the decades leading to World War Two and the consequences for the world as a result of this policy posture were most disquieting. For instance, it opened the door to the flourishing of dictatorial regimes in the West, such as that led by Adolph Hitler in Germany, which nearly paved the way for the subjugation of a good part of Europe by the Nazis.
If the US had not intervened militarily in the war on the side of the Allies, the West would have faced the distressing prospect of coming under the sway of the Nazis and as a result earned indefinite political and military repression. By entering World War Two the US helped to ward off these bleak outcomes and indeed helped the major democracies of Western Europe to hold their own and thrive against fascism and dictatorial rule.
Republican administrations in the US in particular have not proved the greatest defenders of democratic rule the world over, but by helping to keep the international power balance in favour of democracy and fundamental human rights they could keep under a tight leash fascism and linked anti-democratic forces even in contemporary times. Russia’s invasion and continued occupation of parts of Ukraine reminds us starkly that the democracy versus fascism battle is far from over.
Right now, the US needs to remain on the side of the rest of the West very firmly, lest fascism enjoys another unfettered lease of life through the absence of countervailing and substantial military and political power.
However, by reducing its financial support for the UN and backing away from sustaining its humanitarian programs the world over the US could be laying the ground work for an aggravation of poverty in the South in particular and its accompaniments, such as, political repression, runaway social discontent and anarchy.
What should not go unnoticed by the US is the fact that peace and social stability in the South and the flourishing of the same conditions in the global North are symbiotically linked, although not so apparent at first blush. For instance, if illegal migration from the South to the US is a major problem for the US today, it is because poor countries are not receiving development assistance from the UN system to the required degree. Such deprivation on the part of the South leads to aggravating social discontent in the latter and consequences such as illegal migratory movements from South to North.
Accordingly, it will be in the North’s best interests to ensure that the South is not deprived of sustained development assistance since the latter is an essential condition for social contentment and stable governance, which factors in turn would guard against the emergence of phenomena such as illegal migration.
Meanwhile, democratic sections of the rest of the world in particular need to consider it a matter of conscience to ensure the sustenance and flourishing of the UN system. To be sure, the UN system is considerably flawed but at present it could be called the most equitable and fair among international development organizations and the most far-flung one. Without it world poverty would have proved unmanageable along with the ills that come along with it.
Dehumanizing poverty is an indictment on humanity. It stands to reason that the world community should rally round the UN and ensure its survival lest the abomination which is poverty flourishes. In this undertaking the world needs to stand united. Ambiguities on this score could be self-defeating for the world community.
For example, all groupings of countries that could demonstrate economic muscle need to figure prominently in this initiative. One such grouping is BRICS. Inasmuch as the US and the West should shrug aside Realpolitik considerations in this enterprise, the same goes for organizations such as BRICS.
The arrival at the above international consensus would be greatly facilitated by stepped up dialogue among states on the continued importance of the UN system. Fresh efforts to speed-up UN reform would prove major catalysts in bringing about these positive changes as well. Also requiring to be shunned is the blind pursuit of narrow national interests.
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