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Lady Ridgeway Hospital: A haven for sick children in Sri Lanka

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125 YEAR BIRTH ANNIVERSARY:

By Dr. B. J. C. Perera

Specialist Consultant Paediatrician

I wrote an article in The Island newspaper, under the aforesaid title, 12 years ago, on Monday 09th June 2008. I have retained that title but content of this article is different. It’s worth looking at this hospital from a more current perspective particularly since the Lady Ridgeway Hospital for Children (LRH) is celebrating its 125-year jubilee in October 2020.

The LRH had very humble beginnings. At the outset, 125 years ago, it was constructed from public donations; rupees 46,000/- to be exact, as a small 50 bedded hospital. Lo and behold, today, this magnificent edifice, with over 1,000 beds, is the largest children’s hospital in the world, I repeat, in the whole world. It has stood the test of time as the final port of call and a veritable haven for sick children of our homeland. It is the National Referral Centre for this entire nation. The hospital functions sans any and every mundane consideration such as ethnicity, caste, creed and wealth of children who are brought there. This glorious medical facility is one that is solely devoted to sick children. If there is anything fanciful that is needed to be done in Sri Lanka for a sick child, it could be done in this hospital. It now caters to every type of malady that affects children. You name any specialty for the care of a sick child; it is available here. Everything is provided entirely free-of-charge and it is the crowning glory and the feather in the cap of the paediatric component of our Free National Health Service, the pride of Sri Lanka.

 

To date, I have been a doctor for exactly 50 years and a Specialist Consultant Paediatrician for 42 years. Out of that long period of half a century of service to the nation, I have spent 16 years in the hospitals of Kandy, Badulla, Ratnapura, Kurunegala and Kalubowila. Compared to that, and in contrast, I have worked in the Lady Ridgeway Hospital, in different capacities, for a total of 17 years. My service at LRH culminated with my retirement from the Ministry of Health in 2007. In lighter vein, I have been properly ‘themparadufied’ in our health sector, both public and private. I have most definitely, seen it all.

Those really were the days, around half a century ago, when during my medical student apprenticeship and internship, I saw how Mother Nature used to take the lives of our children with all kinds of infectious diseases. The wards at LRH were full with cases of meningitis, pneumonia, whooping cough, diphtheria, polio, diarrhoea, dysentery, cholera, measles, tetanus, tuberculosis, chicken pox, hepatitis, amoebiasis and even rabies. In fact, this is a list of just only a few of them. Add to it, the ravages of under-nutrition leading to marasmus and kwashiorkor, extensive vitamin and micronutrient deficiencies and major uncorrectible congenital heart abnormalities, and what did we have? A hospital bursting at its seams with sick children. It was practically a place that spelt out the real meaning of human susceptibility to disease and even mortality. During certain times it was indeed a bit of a hell on earth. The deaths were totalling up to some very significant numbers. By today’s standards, they had very few things they could do for intractable heart failure, liver failure and kidney failure. All types of paediatric malignancies and cancers were practically untreatable. The doctors and Specialist Consultants, as well as all other grades of staff of yore fought as hard as ever, tooth and nail, to save all those severely ill children who were brought to the LRH. However, most unfortunately and ever so very often, to no avail whatsoever. The dice was dreadfully loaded against those unfortunate children, as well as against the healthcare workers who had to look after them. In those halcyon days, each ward had a Consultant, a Senior House Officer and just two interns; a totally inadequate number of medical personnel to cater to the intense daily needs. Work was absolutely horrendous. It was not unusual to see many dead bodies of ill-fated children being wheeled out of the wards regularly, day in and day out. It was such a distressing and depressing landscape. There was hardly any light at the end of the tunnel. Yet for all that, the staff fought on bravely and relentlessly to save the precious lives of little children. To their eternal credit, they managed to save quite a few of the very seriously ill ones too.

Then, over many a decade, especially over the last few of them, the tide gradually turned. Successful vaccination almost totally removed some of the deaths and disabilities caused by a plethora of nasty infections. Many medical advances provided ways and means of dealing with former killer diseases. Improvements in heart surgery made it possible to treat at least a majority of congenital heart defects. When I finally reached the out-and-out hub of Paediatrics, which LRH was, in 1995, as a Specialist Consultant in charge of a unit, just about 25 years after my own internship at LRH, the scenery and settings had changed so much and well beyond belief that it was almost unrecognisable. In my ward I even had the absolute luxury of the services of a Senior Registrar, one who just needed two further years of training abroad before becoming a Consultant, four Postgraduate Registrars waiting to sit for the Final MD in Paediatrics Examination and four intern house physicians. The academic level of all those individuals who cared for my patients was absolutely top-class. They were right up-to-date in the sphere of scholarly paediatrics. They were all very fine and dedicated young doctors who would never ever allow a child to die without a steadfast and committed fight.

The advances in surgery were almost unbelievable. To top it all, around the time that I finally reached LRH as a Specialist Consultant, we had the services of several very fine Paediatric Surgeons whose handiwork in the Operating Theatres were almost too good to be true. Some of the recoveries from incredible surgical tragedies were really like those from the pages of volume of fiction. They were the work of gifted artists who wielded the scalpel with telling effect. One little anecdote that comes to mind is the surgical prowess of one particular general surgeon in lung operations. He was, and still is, quite a maestro at it. In those days that I was in charge of a unit, because of my personal interest in childhood respiratory disorders, we used to get quite a number of children with major lung problems which sometimes needed expert surgery. The usual practice was to send them off to the Colombo General Hospital Thoracic Unit for surgery. Lung surgery in children is a very tricky business. Things could go wrong at the drop of a hat. I somehow got to know that this particular young surgeon at LRH was so very good at it and I used to plead with him to get the surgery done at LRH itself. I used to say “Aney, please, please, PLEASE.., do it for me as a personal favour”. The very fine man that he was, and still is for that matter, he never ever refused. He has surgically taken off lobes of lungs and even the whole lung sometimes of my ill patients. True to life, those children recovered without any problems in about a week to 10 days. We never had even a single death after extensive lung surgery. They went home to a normal fruitful life and an entirely normal life-span. Just for the record, one could remove a major portion of the two lungs and still be able to lead a normal life with even a well-functioning half a lung. When I used to thank the surgeon profusely for doing it for me, he used to just smile and even feel a bit embarrassed.

It was all in a day’s work for him but for us, it was an absolute life-saver for our patients. In fact, that surgeon is still in active service at LRH. That is the quality of the Paediatric Surgeons that we have even today, with no exceptions whatsoever. Their commitment is truly wonderful. They will not let an unfortunate child suffer unnecessarily. They will fight on with every available means, daytime as well as well into the middle of the night, to save the lives of children to whom they had practically committed their professional lives. I have seen with my own eyes, these surgical colleagues leaving their families and their own little children at home to come to LRH in the middle of the night to perform life-saving surgical operations on our little patients.

Now, fast forward to 2020!!!! After my retirement in 2007, I now work only in the Private Sector and there are several instances where I have had to send patients to LRH for further investigation and treatment. One particular little tale comes to mind rather forcefully. A frantic mother of one of my regular patients telephoned me around mid-day, just about a couple of weeks ago because her little pre-schooler had taken an overdose of some medicines. My immediate advice over the phone was “please do not take the child anywhere other than to LRH. Do not go to any other place but rush him to LRH. Do not even bring him to me. I am just asking you to take the child to the very best place in the whole island”. They rushed him there and the staff attended to him pronto. He had what we call a stomach-wash performed on him, then they instilled some activated charcoal into the stomach, did some baseline blood tests and kept him in the ward. He did not turn even a hair and recovered within a couple of days. Incidentally, I think the mother threw my name around a bit and when the Consultant of the ward got to know, he had said “I trained under Dr BJC and we have done exactly what he would have done in the circumstances”. He was one of my Postgraduate Registrars and it was extremely nice of him to say those things. Of course, the mother and the relatives of the child were ever so pleased.

There were many other patients whom I had sent to LRH over several years and I have always asked them how it was at LRH when they came to me again. Every single time the mothers have said “It was a bit inconvenient for us but the child got star-class treatment and that really is what matters” or something basically to that effect. It has always warmed the cockles of my heart to hear such complimentary statements. My heart and soul have always been with LRH and anything unsavoury and disparaging said about that hospital would really hurt me to the core. We did care so much for the little children admitted under us and it is so good to see that those who have come after us do care as much, and are dedicated to the cause of providing the very best possible care for the patients as well.

Well, the Lady Ridgeway Hospital for Children, the mother of all hospitals in our resplendent isle, is 125 years old. If walls could talk, the walls of LRH would have all kinds of stories to tell. She would say how she had seen the worst of many diseases that affected children and also how things have changed over a century and a quarter of her existence. She would have a perpetual smile on her face in view of the progress achieved in caring for sick children, especially over the last few decades.

The lady needs to be feted and acclaimed on her 125th Birth Anniversary. The administrative staff, the doctors and all other grades of workers of LRH have planned a fitting celebration for her on the 01st of October 2020. In a glittering ceremony due to be graced by Prime Minister Mahinda Rajapaksa and Minister of Health of Sri Lanka Pavithra Wanniarachchi MP; they will acknowledge the priceless role played by LRH towards the healthcare of Sri Lankan Children. The ceremony will include the laying of the foundation stone for a new nine-storey building, opening of the new bone marrow transplant unit, opening of the new Operation Theatre Complex, official issuing of the hospital logo, formal release of the hospital song written by Dr. Rathnasri Wijesinghe with music compiled by Dr. Rohana Weerasinghe, and the commissioning of the new website for the hospital. These latest developments would help to make an excellent place for sick children, even a little bit of a better place for them.

All these would be a fitting and splendid accolade to an illustrious medical facility that is absolutely like no other. May she go from strength to strength and continue to be a dazzling beacon of excellence in healthcare for our children in this Pearl of the Indian Ocean.

Viva Lady Ridgeway Hospital, please do take a bow on your 125-year Birth Anniversary. It is the very least you so richly deserve, for the commitment that you have shown for the sick children of our beautiful Motherland. You are indeed a majestic haven of excellence for them.



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Features

Peace march and promise of reconciliation

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Peace walk in progress

The ongoing peace march by a group of international Buddhist monks has captured the sentiment of Sri Lankans in a manner that few public events have done in recent times. It is led by the Vietnamese monk Venerable Thich Pannakara who is associated with a mindfulness movement that has roots in Vietnamese Buddhist practice and actively promoted among diaspora communities in the United States. The peace march by the monks, accompanied by their mascot, the dog Aloka, has generated affection and goodwill within the Buddhist and larger community. It follows earlier peace walks in the United States where monks carried a similar message of mindfulness and compassion across communities but without any government or even media patronage as in Sri Lanka.

This initiative has the potential to unfold into an effort to nurture a culture of peace in Sri Lanka. Such a culture is necessary if the country as the country prepares to move beyond its history of conflict towards a more longlasting reconciliation and a political solution to its ethnic and religious divisions. The government’s support for the peace march can be seen as part of a broader attempt to shape such a culture. The Clean Sri Lanka programme, promoted by the government as a civic responsibility campaign focused on environmental cleanliness, ethical conduct and social discipline, provides a useful framework within which such initiatives can be situated. Its emphasis on collective responsibility and shared public space makes it sit well with the values that peacebuilding requires.

government’s previous plan to promote a culture of peace was on the occasion of “Sri Lanka Day” celebrations which were scheduled to take place on December 12-14 last year but was disrupted by Cyclone Ditwah. The Sri Lanka Day celebrations were to include those talented individuals from each and every community at the district level who had excelled in some field or the other, such as science, business or arts and culture and selected by the District Secretariats in each of the 25 districts. They were to gather in Colombo to engage in cultural performances and community-focused exhibitions. The government’s intention was to build up a discourse around the ideas of unity in diversity as a precursor to addressing the more contentious topics of human rights violations during the war period, and issues of accountability and reparations for wrongs suffered during that dark period.

Positive Response

The invitation to the international monks appears to have emerged from within Buddhist religious networks in Sri Lanka that have long maintained links with the larger international Buddhist community. The strong support extended by leading temples and clergy within the country, including the Buddhists Mahanayakes indicates that this was not an isolated effort but one that resonated with the mainstream Buddhist establishment. Indeed, the involvement of senior Buddhist leaders has been particularly noteworthy. A Joint Declaration for Peace in the world, drawing on Sri Lanka’s own experience, and by the Mahanayakes of all Buddhist Chapters took place in the context of the ongoing peace march at the Gangaramaya Temple in Colombo, with participation from the diplomatic community. The declaration, calling for compassion, dialogue and sustainable peace, reflects an effort by religious leadership to assert a moral voice in favour of coexistence.

The popular response to the peace march has also been striking. Large numbers of people have been gathering along the route, offering flowers, water and support to the monks. Schoolchildren have been lining the roads, and communities from different religious backgrounds extend hospitality. On the way, the monks were hosted by both a Hindu temple and a mosque, where food and refreshments were provided. These acts, though simple, carry a message about the possibility of harmony among Sri Lanka’s diverse communities. It helps to counter the perception that the Buddhist community in Sri Lanka is inherently nationalist and resistant to minority concerns that was shaped during the decades of war and reinforced by political mobilisation that too often exploited ethnic identity.

By way of contrast, the peace march offers a different image. It shows a readiness among ordinary people to embrace values of compassion and coexistence that are deeply embedded in Buddhist teaching. The Metta Sutta, one of the most well-known discourses in Buddhism, calls for boundless goodwill towards all beings. It states that one should cultivate a mind that is “boundless towards all beings, free from hatred and ill will.” This emphasis on universal compassion provides a moral foundation for peace that extends beyond national or ethnic boundaries. The monks themselves emphasised this point repeatedly during the walk. Venerable Thich Pannakara reminded those who gathered that while acts of generosity are commendable, mindfulness in everyday life is even more important. He warned that as people become unmindful, they are more prone to react with anger and hatred, thereby contributing to conflict.

More Initiatives

The presence of political leaders at key moments of the march has emphasised the significance that the government attaches to the event. Prime Minister Harini Amarasuriya paid her respects to the peace march monks in Kandy, while President Anura Kumara Dissanayake is expected to do so at the conclusion of the march in Colombo. Such gestures signal an alignment between political authority and moral aspiration, even if the translation of that aspiration into policy remains a work in progress. At the same time, the peace march has not been without its shortcomings. The walk did not engage with the Northern and Eastern parts of the country, regions that were most affected by the war and where the need for reconciliation is most acute. A more inclusive geographic reach would have strengthened the symbolic impact of the initiative.

In addition, the positive impact of the peace march could have been increased if more effort had been taken to coordinate better with other civic and religious groups and include them in the event. Many civil society and religious harmony groups who would have liked to participate in the peace march found themselves unable to do so. There was no place in the programme for them to join. Even government institutions tasked with promoting social cohesion and reconciliation found themselves outside the loop. The Clean Sri Lanka Task Force that organised the peace march may have felt that involving other groups would have made it more complicated to organise the events which have proceeded without problems.

The hope is that the positive energy and goodwill generated by this peace march will not dissipate but will instead inspire further initiatives with the requisite coordination and leadership. The march has generated public discussion, drawn attention to the values of mindfulness and compassion, and created a space in which people can imagine a different future. It has been a special initiative among the many that are needed to build a culture of peace. A culture of peace cannot be imposed from above nor can it emerge overnight. It needs to be nurtured through multiple efforts across society, including education, religious engagement, civic initiatives and political reform. It is within such a culture that the more difficult questions of power sharing, justice and reconciliation can be addressed in a constructive manner.

by Jehan Perera

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Regional Universities

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Development initiatives: Faculty of Technology, University of Jaffna and NCDB

The countryside and peripheral regions have been neglected in the national imagination for many decades. This has also been the case with regional universities which were seen as mere appendages to the university system, and sometimes created to appease political constituencies in the regions. The exclusion of the rural world and the institutions in those regions was not accidental nor inevitable, but the consequence of conscious policies promoted under an extractive and exploitative global order. Neoliberalism globalisation, initiated in the late 1970s with far-reaching policies of free trade and free flow of capital, or the “open economy,” as we call it in Sri Lanka, is now dying. The United States and the Western countries that promoted neoliberalism, as a class project of finance capital to address the falling profits during the long economic downturn in the 1970s, are themselves reversing their policies and are at loggerheads with each other. However, those economic processes will continue to have national consequences into the future.

At the heart of such policies is the neoliberal city, which has become the centre of the economy with expanding financial businesses and a real estate boom. Such financialised cities also had their impact on universities, in lower income countries, where commercialised education with high fees, rising student debt, research for businesses and transnational educational linkages with branch campuses of Western universities, have become a reality.

In the case of Sri Lanka, while neoliberal policies began with the IMF and World Bank Structural Adjustment Programmes, in the late 1970s, the long civil war forestalled the accelerated growth of the neoliberal city. I have argued, over the last decade and a half, that it is with the end of the civil war, in 2009, coinciding with the global financial crisis, that a second wave of neoliberalism in Sri Lanka led to global finance capital being absorbed in infrastructure and real estate in Colombo. The transformation of Colombo into a neoliberal city was overseen by Gotabaya Rajapaksa as Defence Secretary with even the Urban Development Authority brought under the security establishment. While Colombo was drastically changing with a skyline of new buildings and shiny luxury vehicles drawing on massive external debt, there were also moves to promote private higher education institutions. The Board of Investment (BOI) registered many hundred so-called higher education institutions; these were not regulated and many mushroomed like supermarkets and disappeared in no time when they incurred losses.

In contrast to these so-called private higher education institutions that proliferated in and around Colombo, Sri Lanka, drawing on its free education system, has, over the last many decades, also created a number of state universities in peripheral regions. However, these regional universities lack adequate funding and a clear vision and purpose. The current conjuncture with the neoliberal global order unravelling, and the immediate global crisis in energy and transport are grim reminders of the importance of local economies and self-sufficiency. In this column I consider the role of our regional universities and their relationship to the communities within which they are embedded.

Regional context

The necessity and the advantage of robust public services is their reach into peripheral regions and marginalised communities. This is true of public transport, as it is with public hospitals. Private buses will always avoid isolated rural routes as their margins only increase on the busy routes between cities and towns. And private hospitals and clinics flock to the cities to extract from desperate patients, including by unscrupulous doctors who divert patients in public hospitals to be served in the private health facilities they moonlight. Similarly, it is affluent cities and towns that are the attraction for private educational institutions.

Public institutions, including universities, can only ensure their public role if they are adequately funded. Over the last decade and a half, with falling allocations for education, our state universities have been pushed into initiating fee levying courses, both at the post-graduate level and also for undergraduate international students. These programmes are seen as avenues to decrease the dependence of universities on budgetary support. However, the reality is that it is only universities in Colombo that can draw in students capable of paying such high fees. Furthermore, such fee levying courses end up pushing academics into overwork including by offering additional income.

Therefore, allocations for underfunded regional universities need to be steadily increased. Housing facilities and other services for academics working in rural districts would ensure their continued presence and greater engagement with the local communities. Increased time away from teaching and research funding earmarked for community engagement will provide clear direction for academics. Indeed, such funding with a clear vision and role for regional universities can provide considerable social returns. In a time when repeated crises are affecting our society, agricultural production to bolster our food system as well as rural income streams and employment are major issues. Here, regional universities have an important role today in developing social and economic alternatives.

Reimagining development

In recent months, there have been interesting initiatives in the Northern Province, where the Universities of Jaffna and Vavuniya have been engaging state institutions on issues of development. In an initiative to bring different actors together, high level meetings have been convened between the staff of the Agriculture Faculty and officials of the Provincial Agriculture Ministry to figure out solutions for long pending agricultural problems. Similar meetings have also been organised between provincial authorities and the Faculties of Technology and Engineering in Kilinochchi. These initiatives have led to academics engaging communities and co-operatives on their development needs, particularly in formulating new development initiatives and activating idle projects and assets in the region. Such engagement provides opportunities for academics to share their knowledge and skills while learn from communities about challenges that lead to new problems for research.

One of the most rewarding engagements I have been part of is an internship programme for the Technology Faculty of the University of Jaffna, where four batches of final year students, from food technology, green farming and automobile specialities, have been placed for six months within the co-operative movement through the Northern Co-operative Development Bank. This initiative has created a strong relationship between the Technology Faculty and the co-operative movement, with a number of former students now working fulltime in co-operative ventures. They are at the centre of developing solutions for rural co-operatives, including activating idle factories and ensuring quality and standards for their products.

I refer to these concrete initiatives because universities’ role in research and development in Sri Lanka, as in most other countries, are often narrowly conceived to be engagement with private businesses. However, for rural regions, the challenge, even with technological development, is the generation of appropriate technologies that can serve communities.

In Sri Lanka, we have for long emulated the major Western universities and in the process lost sight of the needs of our own youth and communities. Rethinking the development of our universities may have to begin with an understanding of the real challenges and context of our people. Our universities and their academics, if provided with a progressive vision and adequate resources and time to engage their communities, have the potential to address the many economic and social challenges that the next decade of global turmoil is bound to create.

Ahilan Kadirgamar is a political economist and Senior Lecturer, University of Jaffna.

(Kuppi is a politics and pedagogy happening on the margins of the lecture hall that parodies, subverts, and simultaneously reaffirms social hierarchies)

by Ahilan Kadirgamar

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‘Disco Lady’ hitmaker now doing it for Climate Change

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The name Alston Koch is generally associated with the hit song ‘Disco Lady.’ Yes, he has had several other top-notch songs to his credit but how many music lovers are aware that Alston is one of the few Asian-born entertainers using music for climate advocacy, since 2008.

He is back in the ‘climate change’ scene, with SUNx Malta, to celebrate Earth Day 2026, with the release of ‘A Symphony for Change’ – a vibrant Dodo4Kids video by Alston.

The inspiring musical video highlights ocean conservation and empowers children as future climate champions, honouring Maurice Strong’s legacy through education, creativity, and global collaboration for a sustainable planet.

The four-minute animated musical, composed and performed by platinum award-winning artiste Alston Koch, brings to life a resurrected Dodo, guiding children on a mission to clean up marine environments.

With a catchy melody and an uplifting message, the video blends entertainment with education—making climate awareness accessible and engaging for the next generation.

SUNx Malta is a Climate Friendly Travel system, focused on transforming the global tourism sector that is low-carbon, SDG-linked, and nature-positive.

Professor Geoffrey Lipman, President of SUNx Malta, described the project as a joyful collaboration with purpose:

“It’s always a pleasure to produce music with Alston for the good of our planet. And this time, to incorporate our Dodo4Kids in the video urging the next generation of young climate champions to help save our seas.”

For Alston, now based in Australia, the collaboration continues a long-standing journey of climate-focused creativity:

Says Alston: “I have been working on climate songs since the first release, in 2009, of the video ‘Act Now.’ Since then, I’ve performed at major global events—from Bali to Glasgow. I wrote this song because the climate horizon is darkening, and our kids and grandkids are our best hope for a brighter future.”

Alston’s very first climate song is ‘Can We Take This Climate Change,’ released in 2008.

It was written by Alston for the World Trade Organisation presentation, in London, and presented at ‘Live the Deal Climate Change’ conference in Copenhagen.

The Sri Lankan-born singer was goodwill ambassador for the campaign, and the then UK Minister Barbara Follett called it a “gift in song to the world suffering due to climate change.”

Alston said he wrote it after noticing butterflies, birds, and fruit trees disappearing from his childhood days.

In 2017, his creation ‘Make a Change’ was released in connection with World Tourism Day 2017.

Alston Koch’s work on climate advocacy is pretty inspiring, especially as climate change is now creating horrifying problems worldwide, and in Sri Lanka, too.

Alston also indicated to us that he has plans to visit Sri Lanka, sometime this year, and, maybe, even plan out a date for an Alston Koch special … a concert, no doubt.

Can’t wait for it!

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