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Dr Sabaratnam Sivakumaran, the philosopher-physician

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Dr. Sivakumaran

by Professor Panduka Karunanayake

The news of the passing away of Dr Sabaratnam Sivakumaran – one of our senior-most and most -respected medical specialists – left me shocked, because I was not aware that he was suffering from any recent illness or infirmity. Indeed, he had continued to carry out all his tasks in spite of his long-standing ailments, even starting work in the hospital at 6.30 in the morning. On the day before his death, he had collected a large number of MBBS answer scripts for scrutiny; after his death the next day, it was found that he had finished marking those too! I guess his Creator, while blessing him with the same number of hours in a day as the rest of us, also decided, quite justly and wisely, to bless him with good health right until the moment when his earthly years were exhausted. The Creator must have noted his irrepressible zeal to serve others.

During his time as a consultant physician in the National Hospital of Sri Lanka in Colombo, his peers and junior colleagues were fully aware of his clinical acumen, great care and thoroughness. But what set him apart was his total commitment to patient care, which reached up to such a height that it looked like a sacrifice in consonance with his Hindu spiritual background. He was well known to conduct ward rounds at least twice, and often thrice, each day. We seldom saw him at conferences held in five-star hotels, because doubtless he must have been working in his ward. But he was invariably present at almost all educational activities that were conducted within the hospital premises itself. There he has left an indelible mark in our education.

But he didn’t miss out on any new developments for not attending any conferences; he often did locum consultant work in the United Kingdom. Even here, it was impossible to say whether he was serving himself or serving our country, because he always came back with not only new ideas and experiences but also novel equipment and plans for modernising the NHSL.

He set up special units to conduct echocardiography, endoscopy and clinical physiological tests with the help of benefactors from the UK, at a time when those facilities were either non-existent or available only to a limited degree here. He asked all his colleagues to make use of them, and trained any junior trainee who had an interest on how to use them. Quite tellingly, he took care to ensure that these equipment were housed in special rooms away from his own ward whenever possible, so that anybody could use them freely without feeling any obligations towards him. By now, tens of thousands of patients must have benefitted from these efforts that he pioneered and established!

The time and trouble he took to teach medical students and train postgraduate trainees left us amazed. He was also completely fair and kind as an examiner. These qualities continued even after he retired from the Ministry of Health, when he continued to teach in the medical school at SAITM and work at the Neville Fernando Teaching Hospital Malabe.

He did all this with his signature smile, gentle and kind voice, casual and welcoming demeanour and simple dress code. I have never seen him angry. If you stopped to speak to him, you immediately knew that he had all the time that you needed with him – because his dedication to serve has thrown all personal comforts out.

But Dr Sivakumaran was not merely a physician with a ward and a commitment. His vision went beyond the ward and the hospital, to encompass the whole profession and state health service. He spent countless hours explaining to the medical administrators of his day about the importance of cadre projection and reforming the internship training of doctors.

In these, he was way ahead of the times, and (sadly, given our country’s resistance to change) even current times. His objective was not to aggrandise himself or to make the medical profession more powerful, but to make the service more effective, efficient and safe for patients. He even personally took up the task of preparing proposals and writing tons of documents. But where they all ended up in this country of ours is not something that one needs to elaborate on nor something that he himself was pleased about.

But why did I call him a philosopher-physician, like what Galen had recommended in medieval times and traditional healers in the Orient have been? Dr Sivakumaran’s extraordinary conduct as a physician and healer is best explained and easiest to understand when we take into account his deep spirituality, philosophical worldview and principled conduct. He was not a lay preacher or sonorous moraliser of any kind. He kept these thoughts mostly private to himself, but if anyone cared to broach them he would, of course, humbly join the conversation and enrich it. It is then that we would realise that Dr Sivakumaran’s behaviour was not an accident of circumstances or a series of ingrained habits, but rather the outer manifestation of deep thought and careful reflection.

Suddenly, what seemed like a series of simple sentences and gentle actions became the vigorous animation of a living philosophy. He once asked me whether I was a Buddhist (obviously because a Sinhalese can be either Buddhist or Christian). I thought for a while and answered, “I don’t know, Sir”. He was thrilled, enthused and immediately got into an animated conversation with me. Once I had explained my reasons, he confirmed: “Yes, you are a Buddhist.” That was more a statement of his correct understanding of Buddhism than any virtue of mine. If Galen’s philosopher-physician could live in the era of modernity, or an Oriental healer at heart could practise modern medicine, then Dr Sivakumaran was its personification.

While I may have been a Buddhist as he exclaimed, Dr Sivakumaran was the kind of Hindu by practice (along with two other Hindu senior consultant physicians, who are thankfully still among us) who made me wish that I was a Hindu too! While (most of) the rest of us run helter-skelter in this confusing life – like animals in the middle of a forest fire looking for a patch of green grass – he walked through his life like an arrow piercing the opaque air and taking a straight line, reaching his goal as a human being with little sweat and a lot of smile. The reason for his success was simple: he knew that he was a human being first, and anything else only second.

That is how I am certain that he has now reached his goal – a goal that has many names but one origin, namely the supreme attainment that a human being is capable of, an attainment that is possible only through one’s thoughts and conduct and not through earthly possessions or accolades: spiritual perfection. People like Dr Sivakumaran show us that even a speck of dust in the universe can transcend universal laws, and become something more meaningful.

The writer wishes to thank Dr M.K. Ragunathan, senior consultant physician, for sharing valuable insights into Dr Sivakumaran’s life.



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Opinion

More about Premadasa

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In an article published in The Island of 01 May, Rohan Abeygunawardena has paid a glowing tribute to R. Premadasa. It is true Premadasa, as a man from a humble urban working class, was ambitious, and to boost his personal image he targeted the rural and the common man, marginalised by previous regimes. He set up projects to satisfy these folks and selected his own staff to carry out his orders to achieve what he desired. He got rid of those who were sticking to rules and regulations.

One such case is, J .R. Jayewardene brought in previous prestigious Civil Service officers to revamp the fading public service, and one such was the illustrious Chandi Chanmugam, as Secretary to the Treasury. He was called up by Premadasa and requested to provide funds for a welfare project and when he explained the difficulties, he was bluntly told that he (Premadasa) could find an officer who could make the funds available. In keeping with the traditions of the CCS, Chanmugam tendered his resignation. The vacancy was filled by R. Paskaralingam. When Secretaries questioned about funds, Paskaralingam, who chaired the Development Secretaries Committee, would say, “This is bosses orders, find the funds somehow. ” How the Secretaries provided funds is another story.

The next three projects to boost his image at government expense were the mobile office programme, the housing programme and Gamudawa.

As Assistant Secretary to the Ministry for Power and Energy, I was assigned to conduct the mobile service. As far as I could remember, the first Mobile Office was held in the Yapahuwa Electorate, in a village called Badalgama. The previous day, I rang up the area engineer and asked him to meet me at the school building, allocated for the Mobile Office, and to inform the UNP party supporter, who was to find accommodation for my overnight stay. When I arrived, the Area Engineer was there with men to make arrangements for the mobile office. Then two officers from the Presidential Mobile Office Division walked in and inquired as to why I had not hung a picture of Premadasa as he wanted his picture prominently displayed at Mobile Offices. When I said that I had no picture, they rushed back and came with a beautifully framed picture and hung it on the wall.

The following day, before going to the Mobile Office to take an oath, I went to my office to find that someone had garlanded the picture. It was later found that the clerk, who accompanied the area engineer, had overheard the conversation, knowing Premadasa’s whims and fancies.

The work started and as usual. Premadasa visited all offices and when he came to mine, I greeted him in the oriental fashion but his eyes were directed towards his picture and a beam of smile crossed his face. When leaving he said, “Carry on the good work.” Since then at every Mobile Office, I arranged for a special event for him to attend, such as the opening of a rural electrification project.

Gamudawa: This project was similar to the presidential mobile service. There was a variety show organised by the UNP supporters, and crowds dispersed happily. When the Gamudawa project was to be started, a request was made by the Presidential Secretariat to supply generators as the sites selected were far away from the transmission line. The then Chairman of the CEB, Prof. K. K. Y. W. Perera, who was also the Secretary to the Ministry for Power and Energy, politely replied requesting a payment to meet at least the cost. There was no reply and when I visited the Gamudawa held in Wellawaya, I saw CEB men operating the generators. On my return, I reported the matter to the Secretary to the Ministry and also the General Manager, CEB. They said that they were aware but remained silent.

At the first staff meeting, after the 1988 presidential election, Premadasa said, “Carry out my orders and those who do not agree could find other places.”

This was the start of deterioration in the power and energy sector. He brought in his own staff and the once well-managed sector fell into disarray. Premadasa removed Prof. Perera from the post of Chairman, CEB, and the Workshop Engineer, who supplied the generators without the knowledge of the management, was appointed Chairman, CEB, a reward for carrying out illegal orders! Having been in the state service for 40 years, I walked out happily without a farewell party. I took with me only a wooden block, on which my name was printed, and the Lion Flag, which I displayed at Mobile Offices.

President Premadasa also ordered that all policemen in the Eastern Province, surrender to the LTTE, with their weapons. The LTTE killed all of them, numbering over 600.

G. A. D. Sirimal
Boralesgamuwa

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Opinion

Postmortem reports and the pursuit of justice

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Ranga Nishantha Rajapakshe

A serious debate has erupted following a postmortem examination conducted on the body of Ranga Rajapakshe, who was found dead in his garden.

The controversy has arisen as Rajapakshe, an Assistant Director in the Finance Ministry, had been suspended over the diversion of 2.5 million dollars to a fraudulent account. Although the cause of death (COD) is obviously cardiorespiratory failure due to severe haemorrhage (loss of blood), whether the two cut wounds on his legs and on his left wrist were self-inflicted or caused by an external agency is what has led to this raging controversy.

A four-member ‘regional’ expert forensic panel (EFP) was appointed supposedly by the Secretary, Ministry of Health. The Judicial post mortem report was submitted within 24 hours. Many questions have risen as a result. Whether the expert forensic panel looked into all aspects of the death – and not only the injuries in the body of the deceased — has become a moot point.

Was the death due to self-inflicted cut injuries, i. e. suicide? Or, were they inflicted by another or others? If so, it becomes homicide or murder. If there have been any deficiencies in the procedure adopted by the expert forensic panel, whether they are errors, negligence or deliberate is what is reverberating on the social media and the public spaces.

One important point has to be mentioned at the outset. The JPM Report is still not in the public domain. Whether it would remain a privileged communication limited to the judiciary remains to be seen. Hence, none can come to definitive conclusions on the JPM findings – except judicious, informed speculation.

Judicial Post Mortem Examinations: Are they prone to error, negligence or deliberate falsification?

History tells us that all three of the above are possible. The fourth possibility is that it is none of the three above, but a legitimate, academically defensible difference of opinion. Neither medicine, nor forensics is an exact science.

Error

A cursory glance at information on the Internet gives us a reasonable overview of the issue of error. Of them, I quote only those that may be relevant to the issue at hand.

(1) Errors in post-mortem examinations can arise from procedural oversights, misinterpretation of findings, or lack of expertise, with major diagnostic error rates ranging from 8% to 24%.

(2) Common mistakes include misinterpreting postmortem changes as injuries, missing findings due to incomplete examination, and failing to secure the chain of custody.

(3) Incomplete Examination: Failing to examine all necessary body cavities or failing to perform histology/toxicology.

(4) Misclassification of Death Manner: Incorrectly labelling a death as natural vs. unnatural (e.g., suicide vs. homicide) due to overlooking evidence or biased interpretation.

Causes of Errors

(1) Systemic Issues: Heavy workloads, lack of specialised training, inadequate equipment, or poor communication between investigators and pathologists.

(2) External Pressure: Influences from law enforcement, media, or families that can bias the investigation.

(3) Inefficient Techniques: Relying on delegated assistants for vital dissections or conducting superficial examinations.

The above would suffice to give us an idea about lacunae and deficiency in JPM examinations that could lead to error. Those interested could go into the plethora of academic articles on this subject of error in JPMs.

Did any of the above lead to an outcome of error in the conclusions of the JMP Report by the expert panel?

Negligence

Negligence involves critical and serious errors that are inexcusable. These include inadequate body examination, failed scene investigations, missed evidence and speculative, premature reporting. These shortcomings can hinder legal proceedings, obscure causes of death, and lead to wrongful conclusions, with studies identifying major procedural errors, including failure to identify injuries or misinterpreting pathological findings.

We have no information whether the EFP had done a detailed site visit.

Deliberate falsification

Deliberate falsification or fraudulent autopsy reporting involves the intentional alteration of findings, documentation, or conclusions to misrepresent the cause or manner of death.

This misconduct can take many forms, including covering up homicide, misrepresenting police actions, or protecting influential individuals.

Forms of Deliberate Falsification include modification of Conclusions due to Forensic pathologists facing coercion from police, politicians, or families to change a homicide to an accidental death or natural causes. Intentional Neglect of Evidence: Failing to document injuries like strangulation marks or bruises to support a fabricated narrative of natural death. Issuing misleading or untrue post-mortem reports constitutes “serious” professional misconduct that is punishable by law.

There is absolutely no evidence that deliberate falsification has occurred in this case. But what I have attempted to inform the readers of is that such situations are well known.

The celebrated Sathasivam case illustrates the earliest instance in Sri Lanka, in which there was conflicting forensic evidence from two highly eminent forensic professors. Professor GSW de Saram, the first professor of forensic medicine, faculty of medicine, of the then University of Ceylon and JMO, Colombo was the most pre-eminent forensic expert in Ceylon who gave evidence for the prosecution and Sir (Prof.) Sydney Smith, world renowned professor of forensic medicine, University of Edinburgh who gave contrary forensic evidence on behalf of the defence. This conflict in the forensic evidence was a key factor that resulted in Sathasivam’s acquittal

I list below, a few JPM discrepancies and conflicting JPM reports that are now in the public domain in the recent past in Sri Lanka:

1. The death of a student at the University of Ruhuna raped and killed on the Matara beach, considered a suicide when circumstantial evidence indicated thugs of a well-known politician were involved in the incident. I was on the academic staff of the faculty of Medicine, University of Ruhuna at that time and came to know several details that had not come into the public domain.

2. The conflicting PM reports on the “disappearance” of the kidneys of a child at LRH, which was originally given as a medical death and later judgement given as a homicide. The child’s good kidney had been removed when the nephrectomy had to be done on the damaged kidney.

3. The infamous JPM report first given on Wasim Thajudeen’s killing. This falsification was done by a very senior JMO.

4. Lasantha Wickrematunga’s death, which was originally attributed to shooting but subsequently found to be due to stabbing with a sharp implement.

5. The RTA death of a policeman on a motorcycle (his wife and children were also seriously injured) in Boralesgamuwa due to the drunk driving by a female specialist doctor. The first JMO report stated that the doctor had not been under the influence of alcohol until CCTV evidence was presented to the Court that showed her drinking in a club that night. The police informed Court that the breathalyser test had confirmed that the doctor was under the influence of alcohol.

These are some of the well-known instances that there had been conflicting JMO reports. Furthermore, there have been several JMO reports where death in police custody was falsely documented in the JPM or JMO reports to safeguard the police involved in torture.

I know of one case personally, where a doctor from Nagoda Hospital, Kalutara was hauled up by the Sri Lanka Medical Council (of which I was a member for 10 years) for falsifying his JPM report of a death of a young man in police custody to safeguard the policemen concerned.

Why do JMOs falsify JMO reports?

Based on reports and studies, primarily focusing on the context of Sri Lanka, allegations of false or misleading judicial medical reports by Judicial Medical Officers (JMOs) arise from a combination of systemic, ethical, and external pressures rather than a single cause.

Reports indicate that instances of faulty reporting often stem from several factors. The main factor being political and external influence. These are likely in high-profile cases; JMOs may face pressure to tailor reports to suit the interests of powerful individuals or to minimize the culpability of suspects.

It has been seen that some reports are deemed erroneous or contradictory due to negligence, improper reporting procedures, or a lack of understanding of the ethical responsibilities of their role as JMOs. The police sometimes exert influence to speed up investigations, leading to “shortcuts”, where evidence is not properly scrutinised, or reports are tailored to support a premeditated narrative rather than scientific findings.

To be fair by JMOs, it must be said that false history or narratives given by victims and or perpetrators mislead the JMO. Victims or suspects may provide false history during the medical examination to protect themselves or to misdirect investigations.

The dearth of experienced forensic specialists can lead to inexperienced officers handling complex forensic cases. It has been the practice in many instances that Magistrates make specific requests that the PM examination be transferred to an experienced and senior forensic expert.

The subversion of justice is not limited to our part of the world. It happens everywhere. The judiciary, the legal and medical professions can work together to deliver justice to the impoverished and unempowered masses.

 

by Prof. Susirith Mendis
susmend2610@gmail.com

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Opinion

Security, perception, and trust: Sri Lanka’s delicate balancing act

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Sri Lanka today stands at a sensitive crossroads where national security, economic recovery, and intercommunal trust intersect. Recent developments including heightened security measures around areas popular with Israeli tourists and the arrest of local youth under suspicion have sparked understandable concern, especially within the Muslim community. These reactions are not mere emotional outbursts. They reflect deeper anxieties about fairness, dignity, and equal treatment under the law.

At the same time, it would be a grave mistake to ignore the broader security environment. In the post-Easter Sunday attack reality, intelligence-led policing often operates in a preventive mode. Locations associated with foreign nationals, including Israeli visitors, have featured in past threat assessments as potential soft targets. In such circumstances, even routine inquiries can appear intrusive. This is the uncomfortable truth of modern counter-terrorism: it is cautious, sometimes heavy-handed, and frequently misunderstood by the very communities it seeks to protect.

Yet, security effectiveness ultimately depends on legitimacy. When segments of the population begin to believe that certain groups are being disproportionately scrutinised whether that perception is accurate or not public confidence erodes. A dangerous narrative is quietly taking root in parts of the Muslim community: that Israeli visitors are receiving heightened protection while local citizens, particularly Muslims, face heightened suspicion. Whether this reflects operational reality or perception alone, it must be addressed with urgency and transparency. In matters of security and social cohesion, perception often carries as much weight as fact.

Equally troubling is the risk of politicisation. Isolated incidents are already being amplified, reframed, and at times distorted to serve narrow political interests. Islamophobia remains a potent and dangerous weapon in the hands of opportunistic actors. When legitimate security concerns are conflated with communal targeting, or when routine policing is portrayed as systemic discrimination, the result is a toxic cycle of mistrust that benefits no one except those who wish to see Sri Lanka divided.

Sri Lanka cannot afford this trajectory.

Tourism remains a vital pillar of our economic recovery. Israeli tourists, like visitors from every other nation, contribute meaningfully to local economies, especially in Arugam Bay, Weligama, and the southern coast. Ensuring their safety is not a political concession; it is a basic sovereign responsibility. However, that responsibility must never be implemented in a manner that undermines the rights and dignity of Sri Lankan citizens.

The way forward demands balance, discipline, and foresight. Here are five practical steps that can help restore both security and trust;

First, strengthen communication.

When arrests or detentions occur under security-related suspicion, law enforcement agencies must explain the basis within legal limits, clearly and promptly. Silence creates a vacuum that speculation quickly fills. In the age of social media, every unexplained action becomes fertile ground for rumours. A short, factual statement can prevent days of damaging speculation.

Second, ensure operational professionalism.

Security operations must remain intelligence-driven rather than perception-driven. Officers on the ground need proper sensitisation training on the broader societal impact of their conduct. A question asked in the wrong tone, a stop conducted without explanation, or a detention perceived as arbitrary can damage community relations for years. Professionalism is not a weakness, it is the hallmark of effective policing in a diverse society.

Third, institutionalise community engagement.

Trust cannot be built reactively after tensions flare. It must be cultivated continuously through structured dialogue. The Muslim community has historically played a vital role in supporting national security efforts. That partnership must be nurtured, not weakened by avoidable missteps. Regular meetings between security agencies, community leaders, and civil society organisations can help identify problems early and prevent misunderstandings from escalating.

Fourth, craft a clear national narrative.

Sri Lanka must consistently and publicly reaffirm one simple principle: we protect all citizens and visitors alike equally under the law. Security is not selective; it is universal. Political leaders, religious figures, and media outlets must reinforce this message without ambiguity. Mixed signals only fuel suspicion.

Fifth, exercise political and media restraint.

Exploiting security incidents for short-term political gain whether by inflaming communal fears or by painting the state as either weak or biased is deeply irresponsible. Leadership at this moment requires maturity, not rhetoric.

The media, too, must resist the temptation to sensationalise. Responsible reporting is a national duty, not an optional extra.

Sri Lanka’s greatest strength has always been its remarkable ability to absorb

complexity without fracturing. We have emerged from a brutal civil war, survived the Easter Sunday tragedy, and navigated multiple economic crises. But this strength is not automatic. It must be actively maintained through wise policy, honest communication, and genuine inclusivity.

The current situation is not yet a crisis. It is, however, a clear warning. Handled with wisdom and fairness, it can become an opportunity to strengthen security practices, rebuild trust, and reinforce social cohesion. Mishandled, it risks deepening divides that both domestic extremists and external actors would be quick to exploit.

The real test before us is not whether we prioritise security or rights. The true challenge is whether we are capable of safeguarding both with fairness, clarity, and quiet confidence.

Sri Lanka has faced far greater tests in its history. What we need now is not more division, but renewed commitment to the values that have held this nation together: justice, equality, and mutual respect.

The choice is ours. Let us choose wisely.

By Mahil Dole SSP Rtd

Mahil Dole, SSP (Retired), is the former Head of the Counter-Terrorism Division of the State Intelligence Service of Sri Lanka, and has served as Head of the Sri Lankan Delegation at three BIMSTEC Security Conferences. With over 40 years of experience in policing and intelligence, he writes on regional security, interfaith relations, and geopolitical strategy.

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