Features
Home as clinical setting for asymptomatic mild Covid-19 positive patients: What you should know
BY Dr Ruvaiz Haniffa
Head, Dept of Family Medicine Faculty of Medicine
University of Colombo And Past President Sri Lanka Medical Association
Introduction
Most people with COVID-19 develop mild or uncomplicated illness that can be managed at the primary care level, and the demand for primary care services will escalate during periods of increased transmission. Health policymakers at the national and subnational level will need to take appropriate action to support the role of primary care in the response, such as managing mild COVID-19 cases or recovery of hospitalized cases, identifying strategies to increase surge capacity, managing and maintaining stocks of personal protective equipment (PPE) and other essential supplies, and maintaining of essential services, while ensuring timely adaptation to address the needs of vulnerable groups.
With the rapidly increasing incidence of COVID-19 in Sri Lanka and the health systems possible inability to provide in hospital care for PCR positive COVID-19 patients; the HOME as a setting for clinical care provision for asymptomatic mild COVID -19 patients may indeed become possible or even necessary. In this context pre-emptive planning for provision of home-based care for carefully clinically triaged and selected patients becomes important.
As per the WHO, COVID-19 is classified in to 3 clinical entities- mild, moderate, and severe (Fig.1). People classified as having mild COIVID-19 with no symptoms should be able to stay at home, if adequately isolated from others. This also implies that if you are symptomatic even with mild COVID-19 you will require hospital admission.
See Fig.1
Care pathway for COVID-19 Positive Patients in Sri Lanka
Decision to care for COVID-19 patients at home.
This decision cannot and should not be made by the patient or the family. This decision must be made after clinical triage by a healthcare team which must include a family physician and social worker who is aware of the patient’s physical home infrastructure in addition to the past and current health status of the patient.
Home care should be considered for an adult or child with confirmed COIVD-19 when in patient care is unviable or unsafe (e.g. when heath care service capacity is insufficient). It must be understood that home care increases the risk of transmitting the virus to others at home. However, isolation of people at home and using the home as a clinical setting to provide care to carefully selected patients can make an important contribution to breaking the chain of transmission of the virus.
Home care (provided requirements are fulfilled) should ideally be considered for individuals under the age of 60yrs, do not smoke, are not obese and have no other diseases such as cardiovascular diseases, diabetes mellitus, chronic lung disease, cancer, chronic kidney disease or immune suppressed.
The decision as to isolate and care for an infected person at home depends on the following 3 factors.
1. Clinical evaluation of the COVID-19 patient
2. Evaluation of the home setting (Please see Box 1).
In the Sri Lankan context of considering home as clinical setting for COVID-19 home care the following in addition to Box 1 should also be considered.
2.1. Adequate floor space area with minimum two individual rooms, adequate natural ventilation and two toilets
2.2. Home should preferably have access to running water.
2.3. The infected patient/family should be equipped with communication facilities to contact healthcare providers routinely and in an emergency.
3. Ability to monitor the clinical evolution of the person at home.
What to monitor in a COVID-19 positive patient receiving home care
The patient and care giver must be adviced about the signs and symptoms of complications or how to recognize deterioration in their health status that requires medical attention.
The most important parameters to monitor in the home setting are fever, difficulty in breathing, fast or shallow breathing, blue lips or face, chest pain or pressure, confusion (which was not present earlier), inability to wake up, inability interact when awake and inability to drink or keep liquids down
. For infants in addition to these, grunting and inability to breast feed also must be considered. (Please note this list is not an exhaustive list and if you have any doubt, please contact healthcare team immediately)
Home pulse oximetry is a safe, non-invasive way to assess oxygen saturation in the blood and can support the early identification of low oxygen levels in patients with initially mild or moderate COVID-19 or when patient does not appear short of breath but their oxygen levels are lower than expected (Silent Hypoxia).Home pulse oximetry can identify individuals in need of medical evaluation, oxygen therapy or hospitalization, even before they show clinical signs of worsening signs or symptoms.
This author is of the view that if home care for mild asymptomatic COVID-19 positive patient is recommended the minimum requirement should also include the possession or access to a finger pulse oximeter.
What should be done to prevent other people in the house from becoming sick if a person with COVID-19 is being cared for at home?
It is highly recommend that the patient, caregiver/s are given a simple and short orientation programme to use the provided equipment and to create awareness on the ‘red-flag’ signs to look out for and contact the primary health care provider for further instructions.
There are several precautions that can prevent the spread of COVID-19 to other people in the house:
The ill person should stay in a separate room. If this is not possible, then keep at least a 1-metre distance from them. The sick person and anyone else in the same room should wear a medical mask.
Provide good ventilation in the room of the ill person and shared spaces, and open windows if possible and safe to do so.
The ill person should wear a medical mask as much as possible, in particular when not alone in the room and when at least a 1-metre distance from others cannot be maintained. Limit the patient’s movement around the house and minimize shared spaces. Ensure shared spaces (e.g. kitchen, bathroom) are well ventilated.
Visitors should not be allowed in the home.
Limit the number of caregivers to one person with no underlying conditions, if possible.
Caregivers and household members should wear a medical mask while in the same room with an ill person, not touch their mask or face during use, discard the mask after leaving the room, and wash their hands afterward.
The ill person should have dedicated dishes, cups, eating utensils, towels and bed linens. They should be washed with soap and water, and not shared.
Frequently touched surfaces by the ill person should be cleaned and disinfected at least daily.
Everyone in the household should wash their hands with soap and water regularly, especially:
– after coughing or sneezing
– before during and after you prepare food
– before eating
– after using the toilet
– before and after caring for the ill person
– when hands are visibly dirty
A cough or sneeze should be covered with a flexed elbow or a disposable tissue that is discarded immediately after use.
The waste from the ill person should be packed in strong closed bags before disposal.
The household (patient and care giver/s) should be encouraged to have steady supply of masks (essential, 3 ply surgical mask would do), face shield (optional), disposable or washable overalls (optional), 70% alcohol hand sanitizer (optional in the presence of clean running water and soap)
How long should people with COVID-19 stay at home and in isolation?
People with COVID-19 who are cared for at home should stay in isolation until they are no longer able to transmit the virus to others:
Those with symptoms should stay isolated for a minimum of 10 days after the first day they developed symptoms, plus another 3 days after the end of symptoms – when they are without fever and without respiratory symptoms.
People without symptoms should stay isolated for a minimum of 10 days after testing positive.
Please check with you Family Physician/PHI for updated release from home isolation guidelines as they subject to update.
Conclusion
Primary care is an essential foundation for the global response to COVID-19. Primary care plays a significant role in gatekeeping and clinical responses: identifying and triaging possible COVID-19 cases, making an early diagnosis, helping vulnerable people cope with their anxiety about the virus, and reducing the demand for hospital services. The role of primary care has been increasingly important as cities imposed strict control measures including non-pharmaceutical interventions and as larger hospitals closed their outpatient departments during periods of increased transmission.
There also is an increasing role of home care for COVID-19 cases within communities supported by a strong primary care system, which strengthens the trust between health-care workers and communities. A response built around primary care has also been a more cost-effective measure.
The SARS-CoV-2 Virus is doing its job. Are we as individuals, families and communities doing our job to prevent the spread of the virus? None of us will be safe until all of us are safe.
The government/health authorities by allowing the home care of mild asymptomatic COVID-19 patients are taking us the people of Sri Lanka into their confidence and giving us responsibility to actually be part of the clinical care process of COVID-19 management in Sri Lanka. Let us not disappoint the government/health authorities by misusing, manipulating, and abusing the trust they have placed in us. Let us show them that we the people of Sri Lanka if given responsibility will deliver on in it in the context of home care for COVID-19 patients.
Reference
1.
Home care for patients with suspected or confirmed COVID-19 and management of their contacts. Interim guidance 12th August 2020. Updated 2nd March 2021.
2.
Role of primary care in the COVID-19 response. Interim guidance. Revised and republished as of April 9th, 2021 (Originally published 26th March 2020).
Features
‘Building Blocks’ of early childhood education: Some reflections
In infancy and childhood is laid the groundwork for an integrated personality in the making, in preparation for adaptation to the outside world. The malleability of the nervous system [neuroplasticity] due to its extensive growth during early childhood, considered to be the critical period for learning, offers the potential to bring about lifelong benefits in terms of social, emotional and intellectual development.
My goal in this brief article is to reflect on the essential elements [‘building blocks’] of education in early childhood which help to lay the foundation for positive outcomes in later life. It is intended to encourage conversation amongst the general readership of this important topic, especially the parents of young children, as learning begins at home.
Critical Period for learning
Early childhood usually covers the age range from infancy to about eight years of age, during which period most of the brain growth takes place. The prefrontal cortex of the brain responsible for higher cognitive functions [e. g. planning, decision making etc.] continues to mature into the mid-twenties. That isn’t to say that learning processes could not continue throughout life.
Current Community Attitudes towards Education
Let us first examine the current public attitudes towards education in general. Proficiency in reading, writing, math and science are regarded as the core academic literacies on which all other learning rests, and on which future success in life depends. The Arts and Humanities, a group of disciplines that study aspects of human society and culture, are placed lower in the hierarchy in the academic curriculum and are often considered supplementary. Their value in enhancing human ideals is often ignored. In a technologically advancing world we live in, the contribution of the study of the arts and humanities towards boosting the economy is brought into question.
The above attitude has created a highly competitive, exam driven, and hence stressful, academic environment for our children in their formative years. There are excessive demands placed upon them to achieve academically, exacerbated by parental pressure – overt or covert. Attendance at paid ‘tuition classes’, after hours, to supplement learning at school is considered essential to gain higher grades at exams, in order to be competitive in entering tertiary institutions and in enhancing career prospects. The love of learning is lost.
Many children find no time for reflection, or to read outside the curriculum to broaden their understanding about life. There is a perception in the community of a decline in literacy and sensibility in the young and their tendency to lean towards much less civilising forms of entertainment and communication, which is at the root of most of our social ills, compounded by the economic ills that currently plague us. Alarmingly, a recent survey by the College of Community Physicians of Sri Lanka has revealed that over 200 adolescents have committed suicide in 2024, which they, reportedly, attribute to their indulgence in social media. But at the heart of it is the breakdown of social order resulting in a lack of ‘meaning’ in life, as once postulated by the renowned French Sociologist, Emile Durkheim.
Family Milieu
The developing child requires the provision of certain environmental conditions, based on common principles, to complement the innate biological drive which we call instinct. Of vital importance is the family milieu, its stability and its ability to meet the child’s emotional needs. From an emotional point of view, the child needs to feel safe, and experience the contentment in the parent’s inter-relationship, in order to set the ground for learning. In addition, it helps for the parents to model the love of learning and of knowledge through communication in words and in actions.
In an ideal world, a child’s parents and teachers ought to be equally committed towards helping the child develop a love of learning. In some instances a teacher must shoulder most of the work – for instance, when parents are busy making a living or have had a limited education themselves.
Enrichment Strategies
Let us reflect on some of the enrichment strategies in early childhood education which would bring about a balance in the curriculum.
The Arts
“Engagement of children in the arts has the power to console, transform, welcome, and heal. It is what the world needs now” [Yo Yo Ma, Cellist]
The arts are commonly used as enrichment strategies in Early Childhood Education. They include music, dance, drama, and Visual and literary arts. The strengths developed through the arts during the early formative years have the potential to enhance other spheres of learning, and performance in later life. By eliciting emotions in the listener, the arts, as both Aristotle and Freud asserted, has the capacity to be therapeutic by being cathartic.
Music
Neuroscientists have shown that, due to the plasticity of the brain in young children, music training tended to enhance the auditory [hearing] pathways in the brain, and hence, the development of phonological awareness [responsiveness to contrasting sounds]. Phonological awareness is considered to be an important precursor to reading skill and the ability to rhyme. In addition, ‘Music is the language of emotions’, encouraging children to gain awareness of their own emotions in addition to making aesthetic judgements.
Drama
Research studies show that enacting stories in the classroom in comparison to dramatic performances on stage by children have several beneficial effects such as better understanding of the stories enacted and the appreciation of new stories. In addition, such classroom performances of stories enriched oral language development and reading skills, including an eagerness to read, and surprisingly, even writing skills.
Visual Arts
Engagement of children in visual art involves much more than learning the techniques of drawing and painting. Long periods of engagement in the craft provides a framework for enhancing thinking skills – to be more focussed and persistent in one’s work; to enhance the power of imagination; to generate a personal viewpoint or express a feeling state; and to encourage the child to reflect on and to make a critical judgement of their own work. Similarly, by entering into a conversation with the children after encouraging them to look closely at a piece of art, tended to heighten their observation skills. There is evidence that these habits of mind acquired from the engagement of children in visual arts could be ‘transferred’ to other areas of learning, and stand in good stead in employment in later life.
Reading
According to the British neuropsychologist, Andrew Ellis, the brain was never meant to read, in terms of human evolution: “There are no genes or biological structures specific to reading.” Reading had to be learned, requiring the integration and synchronisation of several systems of the brain acquiring a new neuronal circuitry for the purpose – perceptual, cognitive, phonemic, linguistic, emotional and motor. Reading, as it develops, aided by an environment that lures the child to read would lead to further enhancement of the cognitive capacity of the brain – an important dynamic in childhood education.
The more young children, are read to, and are engaged in conversation that flows on from stories read [‘conversational reading’], the more they begin to love books, increase their vocabulary and their knowledge of grammar, and appreciate the sounds that words generate – evidently, best predictors of later reading interest and critical thinking. Conversational reading is a technique where the parent or educator engages with the child in a conversation while reading a book, asking open-ended questions to encourage active participation and deeper comprehension, eg. entering into a dialogue about the story while reading it together.
In addition, reading enhances the child’s self-worth and personal identity [emotional experience of reading].
What better way for children to be introduced to the world that they are to be part of than to be immersed in a story that is all about beings and the environment that surrounds them? What better way for children to learn about ideas and speech patterns, how people react and interact, and how dialogue reveals more about a person than what they say, and about interpersonal relationships. Sadly, children with reading disability have a greater tendency to develop emotional and conduct disorders needing remedial support.
Children’s Literature
It is claimed that appropriate works of children’s literature, read or enacted, help the developing children build empathy and compassion – desirable human ideals that can persist through to adult life – by placing themselves in the shoes of fictional characters and simulating what the characters in the narrative are experiencing. One could argue that the same could be achieved in real life by interacting with others but does not have the advantage of having access to the inner lives of individuals as depicted in well-crafted fictional works.
There is no better way to convey moral instruction than by vicarious learning through reading. As the legendary Russian author, Leo Tolstoy, propounded in his popular monograph, ‘What Is Art?’, the value in a piece of literary art is to be judged by its ability to make the reader morally enlightened.
There is no better way for children, while gaining the aesthetic rewards of a narrative, to enhance their thinking and reasoning, generate creativity, and introduce them to a life rich in meaning.
“There are perhaps no days of our childhood we lived fully as those we spent with a favourite book…they have engraved in us so sweet a memory, so much more precious to our present judgement than what we read then with such love…”
[‘On Reading’, by Marcel Proust 1871-1922, French novelist and literary critic]
Children’s Poetry
We are endowed with a rich poetic tradition that extends as far back as the Sinhala language and its precursors. Over the centuries the lyrical content mirrored the changing socio-cultural and political landscape of our country. During the pre-independence era, there was a revival of lyrical output from men of vision aimed at enhancing the creativity and sensibility of the young, to prepare them for the challenges of a free nation, and enhance their sensibility. Foremost among this group of poets were: ‘Tibetan’ [Sikkimese] monk, Ven. S. Mahinda, Ananda Rajakaruna and Munidasa Kumaratunga. Their poems that lured the children most were about nature. Simple and well crafted, they were designed to draw children to the lap of Mother Nature, to admire her beauty and to instil in them a lasting imagery and a feeling of tranquillity. Ananda Rajakaruna’s ‘Handa’ [the moon], ‘Tharaka’ [Stars], ‘Kurullo’ [birds], ‘Ganga’ [The river]; Rev. S. Mahinda’s ‘Samanalaya’ [The Butterfly], ‘Rathriya’ [The Night]; Munidasa Kumaratunga’s ‘Morning’, which captures the breaking dawn, ‘Ha Ha Hari Hawa’ [About the Hare], are amongst the most popular. They are best recited in the original language as any attempt at translation would seriously damage their musical and lyrical qualities.
Narrative Art
Martin Wickremasinghe [1890-1976] was ahead of his time in recognising the importance of children’s literature and its positive impact on their psychosocial and intellectual development. He argued a case for establishing a tradition of children’s literature anchored in our heritage, and in keeping with the degree of maturity of the child; and that the work be presented in a simple and pleasurable form mixed with moral instruction in the right measure. He observed that a nation without children’s literature rooted in its heritage may face intellectual and moral decline. He asserted that children’s books should only be written by those who understood the developing mind.
In his publication, ‘Apey Lama Sahithyaya’ [Our Children’s Literature] Martin Wickremasinghe acknowledges past contributions to our children’s literature by prominent writers. Piyadasa Sirisena, Munidasa Kumaratunga, G. H. Perera and others transformed folk tales into prose and poetry for children. V, D, de Lanarolle was a pioneer in writing children’s stories for supplementary reading, naming his series, ‘Vinoda Katha’ [Pleasurable Stories]. Edwin Ranawaka translated children’s stories, from English to Sinhala, to suit the local readership. Martin Wickremasinghe’s own Madol Duwa, and G. B. Senanayake’s Ranarala and Surangana Katha were significant contributions to our children’s literature. Munidasa Kumaratunga took an innovative approach in producing ‘Hath Pana’ [Seven Lives], ‘Heen Seraya’ {Slow Pace], ‘Magul Kema’ [Wedding Feast] and ‘Haawage Waga’ [The Hare’s Tale] which gained immense popularity.
Despite the above, Martin Wickremasinghe argued that we have been slow in developing children’s literature of our own, although such a literary genre has been established in the west, for example, the Aesop’s Fables and the Fairy Tales of Hans Christian Anderson.
Aesop’s Fables, thought to have been narrated by a slave who lived in ancient Greece [whose identity remains obscure in history], have survived the test of time as a conveyor of values and virtues for children to reflect on, and to generate a conversation facilitated by their teacher. The allegorical tales, much admired by children [and adults!], are aimed at both entertaining and imparting moral wisdom with the use of animal characters having human attributes [Anthropomorphism] and their social interactions. The brief and lucidly told tales – 200 or more – laden with worldly wisdom, have the potential to generate a literate population, when introduced during early childhood. Let me remind you of few popular fables with their core messages: ‘The Hare and the Tortoise’ [Slow and steady wins the race]; ‘The Lion and the Mouse’ [No act of kindness, no matter how small, is ever wasted]; ‘The Cock and the Jewel’ [The value of an object lies in the eyes of the beholder]
The Fairy [fantasy] Tales of Hans Christian Andersen [1805-1875] continues to feed the imagination of growing-up children through his portrayal of unique and unforgettable characters – witches, beasts and fairies – with features of human life. The tales of the Danish master story-teller, translated into many languages, have gained universal appeal amongst children as he weaves his vastly entertaining stories such as Thumbelina, The Tin Soldier, and The Emperor’s New Clothes etc. based on fantasies with a lesson to convey. In addition to entertainment and instruction, his tales portray universal human conditions such as joy, sorrow, fear, pride, abandonment, resoluteness etc. and allow children to recognise their own feeling states, which the psychoanalysts believe is therapeutic.
The above shows that the east and west can meet on the ground of universal values, exemplified by the arts, and that human reason – the capacity of humans to think, understand and form judgement – is the true guide in life.
In sum, although reading, writing and mathematics in early childhood education are considered the core academic literacies on which other learning rests, and on which success in life depends, current research indicates that arts education through the development of certain habits of the mind could enhance academic achievement. It is thought that high arts involvement in children tend to augment their cognitive functions [eg. attention and concentration], thinking and imaginative skills, organisational skills, reflection and evaluation, which could be ‘transferred’ to other domains of the school curriculum, including science. This is in addition to the role the arts could play in enhancing interpersonal skill and emotional well-being, in conveying moral instruction, and in the exercise of empathy. As such, one could argue a case for a well-rounded system of education incorporating the arts to be introduced during early childhood.
I apologise for my ignorance in the Arts and Literature in Tamil.
Desirable Qualities of Educators
The above ideal could only be achieved through greater investment in training competent teachers in early childhood education. What ought to be the desirable qualities of an early childhood educator? It is my view that the teacher should a] have a good understanding of childhood development – physical, psychological and intellectual – and have the capacity to appreciate individual differences; b] possess ‘age-related’ conversational skills with the children – to listen and to allow free expression, with the aim of encouraging self-exploration of their work; c] have the ability to enhance children’s self-esteem while being able to set limits when necessary, within a framework of caring; d] understand the need to liaise with the parents; and, most of all, e] have a passion for educating children.
Educational Reform
Our nation is in need of a national policy on early childhood education as part of an overall plan on educational reform. It is expected that the powers that be will address a range of issues in planning of services: the inequity in access to Early Childhood Education; integration of early childhood education with the mainstream educational facilities; quality assurance and monitoring; and most importantly, greater investment in training of competent instructors in early childhood education, and creating opportunities for the teachers to be engaged in continuing education and peer review. It is hoped that the government will be able to create a framework for laying the groundwork for restructuring Early Childhood Education – a worthy cause in nation building.
Source Material
Winner, E. [2019]. How Art Works – A psychological Exploration. Oxford University Press.
Willingham, Daniel T. [2015]. Raising Kids Who Read. Jossey Bass – A Wiley Brand.
Wickremasinghe, Martin. [Second Edition 2015]. Apey Lama Sahithya [Our Children’s Literature]. Sirasa Publishers and Distributors.
Hans Christian Andersen. Andersen’s Fairy Tales. Wilco Publication 2020 Edition.
Aesop’s Fables. Wilco Publication 2020 Edition
[The writer is a retired Consultant Psychiatrist with a background of training in Adult General Psychiatry with accredited training in Child and Adolescent Psychiatry, in the UK. He is an alumnus of Thurstan College, Colombo, and the Faculty of Medicine, University of Peradeniya. Resident in Perth, Western Australia, he is a former Examiner to The Royal Australian and New Zealand College of Psychiatrists, and the recipient of the 2023 Meritorious Award of the RANZCP [WA Branch]]
by Dr. Siri Galhenage ✍️
sirigalhenage@gmail.com
Features
Where stone, memory and belief converge: Thantirimale’s long story of civilisation
At the northern boundry of Anuradhapura, where the Malwathu Oya curves through scrubland and forest and the wilderness of Wilpattu National Park presses close, the vast rock outcrop of Tantirimale rises quietly from the earth.
Spread across nearly 200 acres within the Mahawilachchiya Divisional Secretariat Division, this ancient monastic complex is more than a place of worship. It is a layered archive of Sri Lanka’s deep past — a place where prehistoric life, early Buddhist devotion, royal legend and later artistic traditions coexist within the same stone landscape.
“Thantirimale is not a site that belongs to a single period,” says Dr. Nimal D. Rathnayake, one of the principal investigators who has been studying the area together with Ayoma Rathnayake and Eranga Sampath Bandara. “What we see here is continuity — people adapting to the same environment across thousands of years, leaving behind traces of belief, survival and creativity.”
Traditionally, the Thantirimale temple is believed to date back to the third century BC, placing it among the earliest Buddhist establishments in Sri Lanka.
The Mahavansa records that civilisation in this region developed following the arrival of Prince Vijaya, whose ministers were tasked with establishing settlements across the island. One such settlement, Upatissagama, founded by the minister Upatissa, is often identified as the ancient precursor to present-day Thantirimale.
Yet archaeology offers a deeper and more complex story. Excavations conducted in and around the rock shelters reveal that indigenous tribal communities lived at Thantirimale long before the rise of the Anuradhapura kingdom. These early inhabitants — likely ancestors of today’s Veddas — used the caves as dwellings, ritual spaces and meeting points thousands of years before organised monastic life took root.
“The rock shelters were not incidental,” Dr. Rathnayake explains. “They were deliberately chosen spaces — elevated, protected and close to water sources. This landscape offered everything prehistoric communities needed to survive.”
Over centuries, Thantirimale accumulated not only material remains, but also names and legends that reflect shifting political and cultural realities.
During the reign of King Devanampiyatissa, the area was known as Thivakkam Bamunugama, suggesting a Brahmin presence and ritual importance. Another strand of tradition links Thantirimale to Prince Saliya and Ashokamala, the royal lovers exiled for defying caste conventions.
Folklore holds that they lived in this region for a time, until King Dutugemunu eventually pardoned them and presented a golden butterfly-shaped necklace — the Tantiri Malaya — believed to have given the site its present name. Linguistic traditions further suggest an evolution from “Thangaathirumalai”, pointing to South Indian cultural influences.
Tantirimale also occupies a revered place in Buddhist memory. According to tradition, Sanghamitta Maha Theri rested here for a night while transporting the sacred sapling of the Jaya Sri Maha Bodhi from Jambukola to Anuradhapura. That brief pause transformed the rock into sacred ground, forever linking Tantirimale to one of the most powerful symbols of Sri Lankan Buddhism.
Among the most striking monuments at the site is the unfinished Samadhi Buddha statue, carved directly from a massive cube-shaped rock.
- A greater Portion of the Painted Surface of Cave NO.2
- Leatherback Sea Turtle
- The Crocodile or Land Monitor
Standing about eight feet tall, the statue bears a remarkable resemblance to the celebrated Samadhi Buddha of the Polonnaruwa Gal Viharaya. Guardian deities flank the central figure, while behind it a dragon pearl is supported by two lions — a motif associated with protection, sovereignty and cosmic balance. Dwarf figures decorate the seat, adding layers of symbolic meaning and artistic refinement.
“What is extraordinary here is the ambition of the sculpture,” says Dr. Rathnayake. “This was clearly intended to be a monumental work.” Excavations around the statue have uncovered stone pillars and evidence of a protective roof, indicating that artisans worked under shelter as they shaped the figure.
The statue’s incomplete state is most plausibly explained by the foreign invasions and political instability that marked the later Anuradhapura period. Stylistic features suggest that the work continued into, or was influenced by, the Polonnaruwa period, underscoring Thantirimale’s enduring importance long after Anuradhapura’s decline.
Nearby lies another monumental expression of devotion — the reclining Buddha statue, measuring approximately 45 feet in length. Unlike the Samadhi statue, this figure has been detached from the living rock and is dated to the late Anuradhapura period. Its scale and proportions closely resemble Polonnaruwa sculpture, reinforcing the idea of a continuous artistic and religious tradition that transcended shifting capitals and dynasties.
Yet the most ancient and fragile heritage of Thantirimale is found not in its monumental statues, but in two adjacent caves within the monastic complex. Their walls still bear the fading traces of prehistoric rock paintings dating back nearly 4,000 years. First recorded by John Still in 1909, these paintings were later documented and analysed by scholars such as Somadeva.
The paintings include human figures, animals, geometric patterns and symbolic motifs, suggesting ritual practices, storytelling and shared cultural memory. “If Tantirimale functioned as a common meeting place for independent territorial groups,” Dr. Rathnayake observes, “then these images may represent a shared visual narrative — a way of communicating identity and belief beyond spoken language.”
One of the caves, previously known to contain both human and animal figures, has deteriorated significantly and now requires urgent conservation intervention. The second cave, however, offers a rare and intriguing glimpse into prehistoric ecological awareness.
Among the animal figures are two images believed to represent a Leatherback Sea Turtle and either a crocodile or land monitor, measuring 18 and 13 centimetres respectively. The turtle depiction is particularly striking for its anatomical accuracy — the ridges on the carapace are clearly visible, aligning closely with known herpetological characteristics.
“These details suggest close observation of nature,” says Dr. Rathnayake. Archaeological evidence supports this interpretation. According to earlier studies, sea turtles were transported to Anuradhapura as early as 800 BC. During the Gedige excavations in 1985, bones of the Olive Ridley sea turtle were discovered, possibly used for ornaments or utilitarian objects. Images of land monitors and crocodiles are common in dry-zone rock art, reflecting both ecological familiarity and subsistence practices, as Veddas are known to have consumed the flesh of land monitors.
Today, Thantirimale stands at a critical crossroads. Encroaching vegetation, weathering stone, fading pigments and increasing human pressure threaten a site that encapsulates millennia of human adaptation, belief and artistic expression. For Dr. Rathnayake and his team, the need for protection is urgent.
“Thantirimale is not just an archaeological site or a temple,” he says. “It is a living record of how humans have interacted with this landscape over thousands of years. Preserving it is not simply about protecting ruins — it is about safeguarding the long memory of this island.”
In the quiet of the rock shelters, where prehistoric hands once painted turtles, hunters and symbols of meaning, Thantirimale continues to whisper its story — a story written not in ink or inscription, but in stone, pigment and belief.
By Ifham Nizam ✍️
Features
Coaching legend Susantha calls time on storied career
Veteran athletic coach Susantha Fernando called time on his illustrious career in the state service recently. Fernando, who began his career as a physical education teacher was the Assistant Director of Education (Sports and Physical Education- Central Province Sports Schools) at the time of his retirement last month.
Susantha was responsible for transforming the then little known A. Ratnayake Central, Walala, into an athletics powerhouse in the schools sports arena. His sheer commitment in nurturing the young athletes at Walala not only resulted in the sports school winning accolades at national level but also produced champions for Sri Lanka in the international arena.
These pictures are from the event to launch his autobiography Dekumkalu Kalunika and the felicitation ceremony organised by Tharanga Gunaratne, Director of Education at Wattegama Zone to felicitate him following his retirement.
Former Walala athletes, his fellow officials and a distinguished gathering including former Director of Education Sunil Jayaweera were gathered at the venue to felicitate him.
- Susantha Fernando with his family members
- Susantha with his wife, Ranjani, sons, Shane and Shamal and daughter Nethmi
- Tharanga Gunaratne, Director of Education at Wattegama Zone addressing the gathering
- Sisira Yapa, who delivered the keynote address at the book launch
- Former Director of Sports of the Ministry of Education Sunil Jayaweera
- Susantha’s first international medallist marathoner D.A. Inoka
- A dance item in progress
- Susantha Fernando with his wife Ranjani
- Susantha with his mother
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Features7 days agoSurprise move of both the Minister and myself from Agriculture to Education
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Features6 days agoExtended mind thesis:A Buddhist perspective
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Features7 days agoThe Story of Furniture in Sri Lanka
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Opinion5 days agoAmerican rulers’ hatred for Venezuela and its leaders
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Features7 days agoWriting a Sunday Column for the Island in the Sun
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Business3 days agoCORALL Conservation Trust Fund – a historic first for SL














