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How I made good in Australia, some reminiscences

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Dr. Harold Gunatillake

In 1969, I returned to the island with my fellowship degree and intensive training with one of the famous surgeons in London, Mr Norman Tanner, having served as Senior Registrar at Queen Mary’s Hospital Orthopaedics. I still recollect the interview for the selection for this post, sitting in front of a panel of professionals and administrators and over 50 applicants sitting in the waiting room waiting for their interview for a single position. Many of them were locally qualified Britons. I was asked, “Mr Gun, what are your plans coming from Ceylon seeking positions in hospitals in the UK?”

My prompt reply was that I have been sent to the UK for specialized training to obtain the fellowship degree, return to Ceylon, and spread the ‘Gospel of the training obtained’ to serve my people. Further, I have been sent on a government scholarship to do so. Among many other eligible candidates, mainly Britons, I was selected for the position.

My dream then was to return and serve my people and aspire to be a top surgeon, hopefully following my gurus’ footsteps like Dr Anthonis and Dr Gunewardene, visiting Surgeons at Colombo Hospitals. After returning from the UK, I served as Resident Surgeon in the Accident Service, Colombo, followed by a short period as locum in Kandy and then transferred to Badulla Provincial Hospital as General Surgeon in 1970.

Something unique at the time I served as a Surgeon in Kandy was that when you are on call, the hospital sends the ambulance to your residence and drops you back at your home after attending to the surgical emergency. That system does not exist today after the invention of mobile telephones.

I recollect the 1971 Revolt (insurrection) when the Janatha Vimukthi Peramuna (JVP) insurrection against the Socialist United Front Government of Sri Lanka (then Ceylon) under Prime Minister Sirimavo Bandaranaike. The decision to revolt was taken by nine senior members of the JVP when they met at the Sangaramaya Temple of the Vidyodaya University on April 2, 1971, seeking to capture State power by attacking all the police stations in the country on the night of April 5, 1971.(Rohan Gunaratna: Sri Lanka: A Lost Revolution? The Inside Story of the JVP)

One Sunday morning, people with many gunshot injuries were brought to Badulla General Hospital (where I was stationed), and I spent a whole day in the operating theatre attending to the casualties. It was like a war zone. Some seriously head-injured patients were dispatched to General Hospital in Colombo.

During this grey period, the hospitals were short of most disposable items, including antibiotics like penicillin and saline transfusions among other essentials. Our wives had to queue up to purchase clothes from the CWE cooperative shops. Even for the essential provisions, there were long queues at the CWE. There were even bread queues at a later period. Private practice after hours was banned, and we were given Rs 500 per month as a non-pensionable allowance in lieu.

Life became hard and I was gloomy about the future; then the decision was made to leave the country for greener pastures. During this period I was offered a Senior Surgical Registrar’s position in the main General Hospital in Singapore. Dr N.M.Perera was the Minister of Finance during at the time. He stopped giving foreign exchange to anyone leaving the country to stop the ‘brain drain’ during that grey period. I resigned from government service and left for Singapore with my family with no money in my pocket. Still, we were lucky that Prof Kanaks, Anatomy Professor in the Teaching Hospital in Singapore, our one-time senior lecturer in Anatomy in Colombo Medical Faculty, was there to receive us at the airport and welcome us.

After serving for three years as Senior Surgical Registrar in Outram Road General Hospital, we decided to settle down in Australia. One incident there must be mentioned here, a most unique and exciting episode. As Senior Registrars, we got a date monthly to perform minor surgery under local anesthesia on outdoor patients. On one of my days on that duty, there was a shortage of ‘trolley boys’ – young boys coming from Malaysia to earn some pocket money.

As there were very few trolley boys on duty, I walked to the outpatient department, placed the patient on the trolley, wheeled him to the operating theatre and wheeled him back after the minor surgery to the OPD and wished him good luck. The next day this was highlighted in the Straits Times newspaper with the story that an Indian trolley boy had operated on a Chinese patient!

The high-ups in the department of health in Singapore were shocked and disturbed. After making inquiries, the hospital’s medical superintendent reported to the authorities that I had done the operation on this patient. I was summoned to the office where many officials from the department of health were present and I feared I was in trouble. I explained what happened and the circumstances and their faces changed and they thanked me.

Our migration to the ‘Lucky Country’

We were passed to come to Australia and in February 1975, we settled in the suburb Jannali in New South Wales. How we settled in Jannali, then mainly a white Australian suburb, was interesting. Through an Act of 1901, a White Australia policy effectively stopped all non-European immigration into the country contributing to the development of a racially insulated white society.

Mr Bates, the ex-Mayor of the Sutherland shire, was holidaying in Singapore with his partner. His travel guide was known to me; and when his partner had a medical emergency, the guide contacted me and I promptly attended to the need. Then, we hosted them to lunch in a nearby restaurant, the normal tradition in Singapore for entertaining visitors.

Mr Bates was very happy and asked me what he could do for me. I said we had been passed to come to Australia and were preparing ourselves for the change. He said, “please let me know if you are coming to Sydney.” He was waiting for us in his limousine when we landed at Sydney. We were taken to Jannali where he owned the ‘Bates Arcade,’ a commercial and residential block.

He introduced me to the bank manager and other important officials in Jannali, and our settling in was smooth and comfortable. I then had to find a surgical job in a hospital. The same week, I made an appointment with the Medical Superintendent of Sutherland hospital, three railway stations from Jannali. I was interviewed and was lucky to start work the following week as the Surgical Registrar to two surgeons. It was easy then to find a position with a British qualification without further local training.

The United Kingdom provides the largest source of overseas doctors or International Medical Graduates (IMGs) working in Australia. Of course, no doctor coming from another country, including Sri Lanka, is guaranteed work in Australia. I was privileged to get jobs in this hospital for Sri Lankan surgeons visiting Australia for extended holidays. At that time, we were registered as specialist surgeons with the right to private practice. Sutherland Hospital staff was friendly, and my working there was most pleasant. My two bosses loved me.

I must now relate a story of an experience working in that hospital. An affluent lady was admitted for surgery with a popliteal aneurysm. Popliteal means the back of the knee and the aneurysm is a bulge arising from the main artery there. This appears as a pulsating bulge and needs early surgery. In the seventies, we had no vascular surgeons and general surgeons did such specialized work.

One of my bosses got the retired Professor of Surgery from Sydney Hospital in the CBD to perform the surgery on this lady. It was fixed for a Sunday morning. My boss requested I assist this professor, and I was introduced to the professor as the best registrar to help in the operation. The professor did not look at me when my boss paid me that compliment; I realized he might not like ‘Indian-looking’ assistants. We scrubbed together before the procedure, but no word from him. I confidently assisted him in the surgical procedure without his saying anything during the operation.

At the end of the procedure, I wondered whether he would take an essential step in the last bite of the stitching in the closure of the incision in the opened blood vessel. In vascular surgery, before you take the last bite to close the cut, the distal clamp must be removed for the blood to gush through the wound to prevent air from getting into the vessel. Such air bubbles entering a blood vessel can travel towards the lungs and lead to an imminent death from air embolism.

I waited for that moment when he was attempting to close the last stitch without releasing the distal clamp in the vessel. I got my chance and shouted, “Sir, may I release this clamp”. He looked at me for the first time and nodded. After the operation, while leaving the operating theatre, this racist professor put his arm around my shoulder and politely asked, “tell me who you are?”

We sat in the lounge and became the best of friends. One piece of advice the professor gave me was not to waste time as a registrar and get into the private practice and “make your money.” I accepted his advice and got a position in a private practice group in the suburb of Cabramatta, occupied by primarily European migrants.

I did my surgery in Fairfield Heights Private Hospital. Everything was smooth, and the staff was most cooperative. Three months later, one of the staff nurses in that private hospital came to consult me professionally. She said while conversing that she was sent by the hospital matron on my first day in the operating theater there to check my competence.A great opportunity I enjoyed in Australia was that we could go for conferences overseas and claim a tax deduction for ourselves and our partners. In Sri Lanka, that is once in a lifetime event. I used that opportunity by attending cosmetic surgery conferences in various parts of the world and workshops on cosmetic procedures in Paris, Rome, and London.

I developed my technique of operative procedure for an operation called ‘Abdominoplasty’ to remove excess fat and skin from the flap that hangs like an apron in your abdominal wall. This technique was named after my name, “Gunatillake technique of abdominoplasty”, and I had the opportunity of describing this procedure at many conferences in cities like Paris, Rome, Florida, Los Angeles, Japan, Peru and Bangkok.I was the first cosmetic surgeon who performed liposuction- a procedure to suck fat out from redundant areas of your body. My first patient was a Mrs Elliot, and I remember my anaesthetist asking me whether I was performing “jungle surgery.”

During the past 20 years, I have engaged in writing health articles and publishing a health newsletter named “Health & Views”. I have produced over 75 YouTube videos on various topics, such as health, Sri Lankan historical events, and the present crisis in Sri Lanka, among others. I have written over 400 health articles which you can view most of them on my website: www.Doctorharold.com. I have written health articles for the now defunct Sunday Leader and the Sunday Island.

I have engaged in community activities among the expat Sri Lankan community in Australia, mainly in New, South Wales (NSW). I was the president of the Sri Lankan Association of NSW for two consecutive years-1997 and 1998. I was the first treasurer of the Sinhalese Cultural Forum. I have been engaged in giving public talks to our community on health topics and showing my videos on the LTTE war and the historical sites of Sri Lanka.

I am happy that I migrated to Australia as the healthcare system is high quality, timely and affordable. It is a very safe and stable country to live in, with a friendly, relaxed culture that makes it easier to achieve a comfortable lifestyle. It is a multicultural society and no more a whites-only country. Aboriginal people are well recognized and honored as the country’s first people. Their cultures, religions, and traditions are respected and they now participate in the celebrations of Australia Day on the January 26 each year.

I received an ‘Order of Australia’ medal last May. The award for medicine and community services to the Sri Lankan people is an excellent example of how foreign people are recognized for their achievements in this country. Australia is a country of opportunities for young people, whether locals or migrant youth with an open government with an ever-growing economy.I want to tell those young people who wish to leave Sri Lanka for a better life and higher education that they must think of Australia as a destination for achieving their dreams of improving their future.

About the author: Dr Harold Gunatillake, Health Editor, is a Member of the Academy of Medicine, Singapore. Member of the Australian Association of Cosmetic Surgery. Fellow of the Royal College of Surgeons (UK), Corresponding Fellow of the American Academy of Cosmetic Surgery. Member of the International Societies of Cosmetic Surgery, Fellow of the International College of Surgery (US). Australian diplomat for the International Society of Plastic, Aesthetic & Reconstructive Surgery. Board Member of the International Society of Aesthetic Surgery. Member of the American Academy of Aesthetic & Restorative Surgery. Life Member of the College of Surgeons, Sri Lanka. Bachelor of Medicine & Bachelor of Surgery (Cey). Government scholar for higher studies in the UK.

(This article is prepared as requested for the 75th Annual Celebration magazine of the Sri Lanka High Commission in Canberra, Australia)



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Features

‘Lord Edgware Dies’

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It has been some time since I read an Agatha Christie, the plot of which I cannot remember. So, I was delighted to find on the shelves of a friend Lord Edgware Dies, which I had a vague memory of, but no certainty about who had done it.

When I read it, I found that my memory of who was probably the killer was correct, but I could not be certain and the red herrings Christie threw in were so diverting that until almost the very end I wondered if I had been wrong.

The plot is very simple. Jane Wilkinson, who is married to Lord Edgware, tells him that she is desperate for a divorce since she is in love with a very proper Anglo-Catholic peer, Lord Melton, but Edgware refuses to divorce her. She asks Poirot to talk to him, which he does, and is surprised to find that Edgware has told Jane he is prepared to give her a divorce. This was, after he had categorically refused, through a letter, which Jane said she had not received.

That night Edgware is murdered, after Jane had been to see him, or so the butler said, and also Edgware’s secretary. But Jane had been that evening at a grand dinner many miles away, where a dozen fellow guests could swear to her presence.

There was a solution however to the mystery of two Jane Wilkinsons, namely a skilful impersonator called Carlotta Adams who, in the opening chapter had impersonated Jane Wilkinson, who had also been at the performance. But when Poirot goes to see her, he finds that she had been found dead on the morning after Edgware had been killed, of an overdose. And in her bag was a gold case, with a strange inscription, that contained the drug, along with a pair of pince-nez.

Her maid said she had written a letter to her sister in America and posted it the previous night. Poirot asks Inspector Japp to get the letter, and a transcript is received from America, and in it the name of Edgware’s nephew Ronald Marsh is mentioned; he had taken Carlotta to dinner after her performance, with which the book opens, and had then set her a challenge. Japp arrests Marsh, but Poirot is not happy and asks for the original of the letter, which the sister sends him. That shows that a page is missing, and the tear is obvious, though that raises the question as to why it had not simply been cut.

Matters are further complicated by the fact that Marsh had gone in a taxi to the Edgware house, along with Edgware’s daughter Geraldine, in the interval of an opera which had previously seemed to provide them with cast iron alibis. Geraldine had gone in to fetch her pearls so that Marsh could raise money he needed, and thus had an opportunity to kill Edgware, as did Marsh, for the driver said he had got out of the taxi while waiting and gone into the house.

Agatha Christie

Marsh explained why he had gone to the house on the night of the murder as having followed Bryan Martin, an American actor, who had been in love with Jane, whom he saw go into the house with a key. But there was no one visible when he entered, and Geraldine almost immediately came down and they left together. And Martin too has become an object of suspicion to Poirot, for he had been to see him before the murders were discovered with a story of being followed by a man with a gold tooth – a story Poirot immediately realized was false when he was asked how old the man was, and was told he was young, for young people did not have gold teeth.

A heap of French money Edgware had got for a trip to Paris was missing, but since Marsh had no need for it after his cousin’s offer of help, Poirot deduces that it must have been taken by the butler, who has disappeared. Christie has stressed that he is astonishingly handsome, unusual in a butler, and Poirot notes a resemblance to Martin, so he thinks the mysterious man going into the house must have been him.

Incidentally, later Poirot assumes that Edgware’s change of mind was because he was involved in some scandal, and I believe Christie intends us to see the cause of this in his handsome butler, though this is not specified.

Meanwhile, Poirot has asked Japp to find out the provenance of the case found in Carlotta’s handbag, and it turns out to have been made in Paris, specially commissioned, and collected by a woman with pince-nez.

But then another murder occurs—that of another guest at the grand dinner, which provided Jane with her alibi. The victim is an actor who had been bemused when Jane, at a lunch, thought the Judgment of Paris referred to the city. He told Hastings he wanted to see Poirot, but was killed before he could get to the appointment. Poirot had rushed there when told about his request, but it was too late.

Meanwhile, Poirot has tried out the pince-nez on Edgware’s secretary, but she could not see through these. It was only a chance remark heard outside the theatre that led him to try them out on Wilkinson’s maid Ellis, a spare pair that had been appropriated for the night of the murders.

Poirot then lays things out, having summoned Martin and told him that he probably suppressed Edgware’s letter, as he had been dropped by then and he did not want Jane to marry another. But after teasing Martin, Poirot says that Jane was in fact the murderer, and she got Carlotta to impersonate her at the dinner while she went to the house and killed her husband. After meeting Carlotta later and checking with her through a call that she had not been rumbled, Jane had gone ahead with the murder – she put veronal into her drink and the case with veronal into the handbag. She forgot to take out the pince-nez she had used earlier to imitate an American. Carlotta had registered as the American in a hotel and Jane had gone to see her, and there they exchanged identities. After seen the letter, she made use of it by tearing off the page that referred to her, and the S of She, so that the person who had challenged Carlotta to impersonate her seemed to be a man.

There is a coda in which Jane, condemned to death, writes to Hastings, still full of pride at her ingenuity hoping she will be remembered.

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Desilt reservoirs, learn from our ancient irrigation systems

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Polgolla

by Prof. O. A. Ileperuma

Silting of reservoirs is a major problem today affecting our hydropower production and irrigation systems. The main Mahaweli reservoirs are silted to a considerable extent reducing the water holding capacity of them. Due to poor soil management practices, floodwaters deposit large amounts of silt in these reservoirs. When the Polgolla reservoir was fully drained about two years back, one could see mountains of silt in the lower reaches of the reservoir. A rough estimate is that 50% of the total capacity of these reservoirs has been lost to siltation. This is a serious issue which affects not only power and agriculture but also flood control.

Our ancient irrigation systems ensured that desilting of reservoirs took place under royal decree where all users of the reservoirs were ordered to carry out desilting of reservoirs during the dry season. The clay thus collected was used in making bricks for the construction of great stupas which dot the landscape of our ancient kingdoms. This ensured that the reservoirs had their full capacity filled with water for the next cultivating season. Our ancient kings were clever enough not to construct reservoirs by blocking main rivers such as the Mahaweli. A classic example is the Minipe left canal where they tapped only the surface water of Mahaweli. Even the bigger tanks such as Nuwara Wewa and Parakrama Samudraya were fed with minor rivulets. There were also other ingenious features in the cascade irrigation systems built by the ancient kings, such as mud sluice canals and forest reservations between the reservoirs in the cascade system. These reservations helped trap silt and remove excess nutrients, which could otherwise contribute to increasing salinity as water flowed from one reservoir to another.

Victoria

Moragahakanda

A classic engineering marvel is the former Yoda Ela, which carries water from Kalawewa to Nuwara Wewa and Tissa Wewa. It is 87 km long although the straight distance between these points is only about 40 km. The gradient of this canal is about 10 cm per km or 6 inches per mile. Yodha Ela functions as a moving reservoir and feeds about 4,600 hectares of paddy lands. It is a winding canal with about 120 smaller reservoirs on its way. It was constructed during the reign of King Dhatusena around 459 AD and later expanded by King Parakramabahu by connecting more reservoirs to the network. Unfortunately, during the Mahaweli project our modern-day engineers constructed a concrete canal replacing the winding path of this Yoda Ela also called Jaya Ganga. This effectively removed the ability of the old Yoda Ela to remove silt and nutrients. The bank of this Ela has wet zone trees such as jak and areca nut growing well. They take up the nutrients from the flowing stream making the water suitable for irrigation later.

Ancient Mesopotamian civilisations depended on dams constructed along the two main rivers, Euphrates and Tigris. After continuous irrigation of their fields over several thousand years, salinity of the irrigated lands increased making them unsuitable for agriculture. People died due to famine and this clearly illustrates the danger of blocking main rivers for agriculture. There is scientific evidence that the salinity of paddy soils in the Mahaweli C area is increasing.

We saw the devastation caused by Cyclone Ditwah. The sluice gates of the Kotmale Reservoir were opened, and Kandy and Peradeniya were flooded. If the reservoir had had greater storage capacity, couldn’t the opening of the gates have been delayed? This may not be an argument that modern-day engineers would readily accept, and I am not an irrigation expert. These ideas may well be naïve. But most of us tend to think of reservoirs mainly in terms of hydropower generation and irrigation, while their role in flood control receives much less attention. The question therefore deserves serious consideration. Could restoring lost reservoir capacity through desilting help improve our ability to manage extreme rainfall and reduce flood risks?

Desilting our reservoirs should be considered a national priority.

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Losing out to Ethiopia

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From Trailblazer to Tailender

Export diversification – Missing the wood for the trees – Part III

by Gomi Senadhira

In Sri Lanka, the word “Ethiopia” is often used as disparaging slang to describe individuals or areas experiencing extreme poverty, starvation, or severe economic hardship. This linguistic habit originated in the 1980s with the Western media coverage of the devastating Ethiopian famine of 1983-85. That media coverage shocked the world but also left an outdated and offensive global stereotype that the country is permanently starving. Much has changed since then. By now, with an annual growth rate of around 9%, it is the fastest-growing economy in sub-Saharan Africa. Ethiopia has also emerged as a highly competitive exporter and is challenging not only its competitors in the region but also countries like Sri Lanka. This article is on how Sri Lanka has lost ground to Ethiopia (and a few other countries) in the GCC markets for agricultural and floricultural products.

Sri Lanka – A Pioneer in the Agriculture and Floricultural Market in the GCC

As discussed in Part II of this article, by the mid-1980s Sri Lanka had established a strong foothold in the GCC’s fruit, vegetable, and floricultural market. Geographical proximity and well-established shipping and air links gave Sri Lanka a strong comparative advantage over Southeast Asian and African nations. Thailand, Vietnam, and Kenya were not even in the market. At that time, Ethiopia was experiencing (as BBC news reports described) “a biblical famine”.

The market was not very large, but it was lucrative and growing. Trade Minister Lalith Athulathmudali as well as the Chairman of the Export Development Board, Victor Santiapillai, who visited Kuwait (and the GCC countries), recognised the market potential for these products and encouraged us to continue with our work. The minister was particularly keen to further develop links between the market for these products, exporters, and his Export Production Villages (EPVs). So, it was becoming a successful case not only for export diversification but also for transferring gains from exports directly to rural households.

From Trailblazer to Tailender

As a result, even by the beginning of this century Sri Lanka had a larger market share than most of its competitors from Asia or Africa. But since then, our competitiveness has weakened significantly. The tables below provide a comparative snapshot of Sri Lanka’s performance vis-à-vis Thailand, Vietnam, Kenya and Ethiopia in the GCC market for vegetables, fruits and floricultural products. As illustrated therein, in 2001 Sri Lanka was ahead of Thailand, Kenya and Ethiopia in this small but rapidly growing market. Since then, we have fallen behind Thailand, Kenya and many other countries in that lucrative market. If this trend continues, Sri Lanka will fall behind Ethiopia within the next few years. (See Table 1)

In the GCC market for vegetables (covered in HS chapter 07), Sri Lanka was ahead of most other competitors in 2001. As illustrated in Table 1 , Sri Lanka had failed to develop this market, while Thailand, Kenya, and even Ethiopia had very efficiently increased their market shares. The GCC is a market to which Sri Lanka can supply some vegetables, like cabbages, by sea. It appears Sri Lanka had also failed to exploit this mode of supply.

We can see a similar trend in the market for fruits. Vietnam, Kenya, and Thailand have emerged as major players, while exports from Sri Lanka have staggered on slowly. In this segment, Vietnam has emerged as a leading player during the last twenty years and the GCC imports from Viet Nam have shot up from US$44 thousand in 2001 to US$346 million by 2024. In part one of these articles, I discussed the remarkable increase of jackfruit exports from Vietnam “…just $3 million in 2015 to an impressive $236.8 million in 2023” while most of our jackfruit production rots under the trees. This explains how countries develop their markets, geographically and product-wise. (See Table 2)

Sri Lanka’s performance has been weakest in the market for floricultural products (HS Chapter 06), which groups live trees, cut flowers, and ornamental foliage. When we first entered the market in the 1980s, the market was dominated by the Netherlands, and Kenya and Ethiopia were not even in the market. At that time, we identified the Gulf states as a market where Sri Lanka could have a dominant presence due to geographical proximity. Even in 2001, Sri Lanka was ahead of Kenya, Ethiopia, and Thailand. But by now, Kenya has emerged as the dominant supplier. Ethiopia is also expanding its market share and is the third-largest exporter. (See Table 3)

Missing the Wood for the Trees

In the mid-1980s, Sri Lanka first established its foothold in the GCC market. Since then, Thailand, Vietnam, Kenya, and even Ethiopia have moved well ahead of us and have become leading players. Why did we lag behind in our export diversification efforts in general and, more particularly, in the GCC market?

The reasons are very clear. After the initial attempts in the 1980s and early 1990s, Sri Lanka has not been proactively involved in identifying, developing, and promoting new products and markets, or protecting and further developing new markets already established. The focus has simply been on traditional exports: tea, coconut, cinnamon, and garments, while other products were almost ignored. In essence, we have been and continue to focus intensely on a narrow group of products and markets, and we have lost sight of the bigger picture.

(The writer can be reached at senadhiragomi@gmail.com)

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