Features

Medical doctors and self-treatment

Published

5 years ago

2021/02/21

by Dr. Lakshman Abeyagunawardene

At the outset, I wish to define who a “Medical Doctor” is for purposes of this article. This definition applies only to this article and nowhere else. By way of explanation, I would consider a “General Physician” (or any physician for that matter) as quite capable of treating any illness that could afflict anyone. But on the other hand, some doctors in the finer specialties like Pathologists, Radiologists and Community Medicine, would not do so with such confidence unless they have made a special effort to stay in touch with clinical medicine.

In general, it is as a General Practitioner that the average medical doctor is called upon to act when it comes to self-treatment or treatment of a relative or friend or in an emergency. Ayurvedic physicians and all other native doctors who are not registered in the Sri Lanka Medical Council have not been considered at all. Neither are Homeopathic doctors although they claim to have their own council. Needless to say, the many thousands of quacks who still enjoy a roaring practice in rural areas, rule themselves out!

Although I am an avid reader of feature articles and letters to the Editor especially on Sundays in the English newspapers, I have hardly seen any material dealing with the subject of “Medical Doctors and Self-treatment”. The reason may be that very few in the medical profession have the inclination to indulge in Sunday reading and the few who are talented and able to do so, do not have the time to engage in writing even as a hobby.

As a rule, I don’t even attempt to treat myself unless it is for a very common ailment. More importantly, what is required is the ability to differentiate a minor symptom from one that would be more serious and call for a specialist’s opinion.

Part time clinical work

There was a time when I was doing a job in my chosen field with absolutely no clinical work. But I always had a longing to stay in touch with patients and clinical work. It was also at a time when private practice for government doctors had just been introduced. I was the regular locum for a friend on most evenings.

My own rule on self-treatment applies not only to my own family but to the extended family as well. There was a time when the first person to contact in the case of my ageing parents, sister and brother would naturally be myself, but that responsibility has dwindled since my parents are now dead and gone, my sister is married with a grown son who is himself a doctor and my brother has lived in the US since the mid-seventies. Since my marriage, I had to look after my mother-in-law who was living with us, but that was only temporarily.

Under certain circumstances, especially for minor ailments, I treat myself and my family. In my own case, it is not difficult to decide when I should see a specialist doctor. But as far as possible, I encourage my family members to seek treatment from some other doctor (often a specialist). A medical doctor should also be well versed in first aid.

Follow-up of patients

To me, my part-time work was not merely a job that brought in extra remuneration. I often went out of my way to follow-up patients that I had referred to the major hospital in the area. Unlike the regular GP, due to the part-time nature of my work, I had much fewer patients to deal with. Thus patient follow-up was conveniently done, particularly as my own place of residence at that time was very close to the Colombo South Hospital to which the more serious patients were often referred.

Executive in distress

This is a little story that I will not forget easily and well-worth recalling when writing about my work as a part-time family practitioner. A middle-aged male patient was brought in very late one evening when we were about to pull down shutters for the day. He had laboured breathing and a noisy wheeze. But despite his apparent distress, he looked smart and was well-dressed. At first sight, even a qualified doctor would be inclined to think of the typical asthmatic that is regularly seen with the same symptoms.

However, a little bit of the history ascertained from the accompanying family members, often make the doctor think twice before coming to any conclusion regarding a probable diagnosis. In this case, the patient’s wife kept telling me in fluent English that her husband had never had such a problem before. That proved to be a crucial point. A quick physical examination and use of the stethoscope virtually confirmed my worst fears. The blood pressure being elevated, I was already thinking of a more serious condition than an ordinary attack of bronchial asthma. Having suspected acute left ventricular failure (LVF) commonly referred to as “cardiac asthma”, I lost no time in rushing off the patient immediately to hospital. I was well-aware of the limited facilities and resources available in a GP’s clinic to tackle such emergencies, and that time was of essence.

Without washing my hands off the case, I followed the patient in my own car as I was heading home in that same direction in any case. The doctor in the OPD at Kalubowila Hospital confirmed my tentative diagnosis, and after administering the urgently needed treatment in the OPD itself, admitted the patient to a medical ward immediately. Being a former employee of the hospital, I was able to facilitate the entire process.

The Consultant Physician who happened to be a friend told me later that the patient would have definitely died had treatment been delayed any longer. The heart condition that manifested itself as a full-blown illness at such a relatively early age was due to undetected, untreated and hence uncontrolled hypertension (high blood pressure), which he had been living with for several years. The patient (who made a full recovery) and his wife were later virtually falling over each other in expressing to me their genuine appreciation and gratitude. Some years later, I heard that my patient, who was a top executive in a reputed mercantile establishment at the time of his illness, had later been made a Director in the same company!

Ulterior Motives

Under normal circumstances, such unusual dedication to the welfare of patients would have obviously aroused suspicion in the mind of the established doctor under whom the “locum” doctor worked. More often than not, “locums” did that with ulterior motives, “cultivating” patients for a practice that they themselves were planning to set up in the same area undercutting the erstwhile employer. But in my case, the employers being my personal friends who were well-aware of my life’s goals, ambitions and future plans, were convinced that I had no such ideas or tricks up my sleeve. My “follow-up” of patients only helped my friends with their own practice.

A few years prior to that, I consulted a Consultant Dermatologist who went through the routine of prescribing steroidal creams in the usual ascending order in terms of strength, and in the absence of progress, then went on to investigate further to rule out conditions like Bowen’s Disease (a form of skin cancer). The Consultant did a skin biopsy and various blood tests and although they proved to be negative, I was relieved. My objective right along had been to rule out such more serious condition. I stopped consulting the doctor, and was without a Dermatologist for a couple of years. I resorted to self-treatment again as I knew very well that skin ailments are difficult to treat and the best I could do was to keep it under control.

Summary

In summary, a medical doctor whatever field he or she has specialized in, should be confident enough to treat his or her own self initially and offer appropriate advice to family, friends and neighbours, including first aid. If not, the five years of training a medical doctor undergoes, would be in vain. I should know because when flying, I have heard that familiar announcement many times, calling for volunteers from medical doctors to help out the cabin crew as they have a passenger who is ill on board the aircraft.

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Features

From stabilisation to transformation without delay

Published

1 hour ago

2026/05/26

Sahan Weerasooriya

At a symposium on reconciliation organised by the National Peace Council last week, more than 250 religious clergy, civic activists and political representatives from different communities gathered to discuss the country’s future. Speaking at the event, Minister Bimal Rathnayake explained the government’s approach to national reconciliation. He said the government viewed the country’s recovery in terms of a three stage process. The first stage was stabilisation, the second was development and the third was transformation. Reconciliation, he implied, would come in that final stage. The participation of Opposition Leader Sajith Premadasa at the same symposium, and the constructive nature of his comments, strengthens that hope.

When the present NPP government took office in 2024, the country was emerging from one of the gravest crises in its post Independence history. The economic collapse of 2022 had led to shortages of fuel, food, medicines and electricity. Inflation soared, foreign reserves disappeared and long queues became part of daily life. The political upheaval that followed culminated in the resignation of former President Gotabaya Rajapaksa after mass public protests under the banner of the Aragalaya movement. The country was then governed by a leadership that spoke the language of reform and reconciliation but was widely perceived as lacking a direct popular mandate.

Sri Lanka’s past experience suggests that stabilisation and transformation cannot be treated as entirely separate stages. Postponing reconciliation until some future moment risks repeating the failures of the past. If transformation is endlessly delayed until a supposedly perfect moment arrives, there will always be new crises and new reasons for postponement. Minister Rathnayake’s contention that the government’s immediate priority has necessarily been stabilisation flows from the government’s awareness of the precarious situation the country is. Over the past two years, the government has succeeded to a significant extent in restoring economic and political stability. Inflation has reduced, shortages have ended and public institutions have regained a degree of functionality.

Guaranteed Changes

On the other hand, the country’s development continues to face challenges due to adverse global conditions, including disruptions caused by conflict in the Middle East and extreme weather events that have affected tourism, trade and the cost of living. The danger is that reconciliation may be indefinitely postponed in the name of stabilisation. This danger can be reduced if the government works proactively with the opposition and civil society to commence practical measures of transformation now rather than later. The participation of Opposition Leader Sajith Premadasa at the symposium, and the constructive nature of his comments, has strengthened the sense that bipartisan engagement on reconciliation may now be possible.

The urgency of transformation came through strongly in the presentations made by representatives of the Sri Lanka Tamil and Malaiyaha Tamil communities. ITAK parliamentarian S.Shritharan spoke of the frustration caused by unresolved post war issues in the north and east. He referred to disputes regarding land occupied during the war years, including controversies linked to Buddhist temples and state sponsored settlement activity in areas claimed by local communities. He also pointed to the continuing large scale presence of the security forces in the north and east nearly two decades after the end of the war. These grievances have remained central to Tamil political discourse since the end of the armed conflict in 2009. Families displaced by war continue to seek the return of ancestral lands. Civil society organisations in the north have repeatedly called for greater civilian control over local administration and a reduction in military involvement in civilian life.

Academic research and practical work on the ground have shown that reconciliation cannot be separated from questions of dignity, equality and justice. Former minister Mano Ganesan, leader of the Democratic People’s Front, focused on the longstanding problems faced by the Malaiyaha Tamil community. He spoke passionately about continuing housing shortages, landlessness and economic marginalisation, issues that have persisted since Independence. He also highlighted the devastating impact of recent extreme weather events on estate communities that remain socially and economically vulnerable. The condition of the Malaiyaha Tamil community remains one of the enduring social justice issues in Sri Lanka.

After Independence in 1948, a large proportion of them were denied citizenship and voting rights through legislation that rendered them stateless. Though citizenship rights were eventually restored, the social and economic consequences of exclusion continue to be felt generations later.

Many families still lack secure housing and land ownership despite their immense contribution to the country’s plantation economy. Minister Rathnayake’s responses to both these concerns were politically significant. He argued that recent political developments, including the declining influence of narrow ethnic politics across communities, indicated a major shift in public attitudes. According to him, the political ground has changed in ways that make it increasingly difficult for politicians who rely primarily on ethnic division and communal insecurity to retain public support.

Inter-Connected

There is evidence to support the assessment about the changing political grounding which sees future prospects in the resolution of long standing problems. . The economic collapse of 2022 affected all communities alike and generated a new politics centred on governance, anti corruption, accountability and economic justice. The Aragalaya protests brought together Sinhalese, Tamils and Muslims in a common demand for political change. Although ethnic grievances have not disappeared, the crisis created space for a broader understanding that the country’s future depends on cooperation rather than division. Opposition Leader Premadasa’s comments at the symposium reflected this changing political climate. He emphasised that national reconciliation could not be separated from economic justice and the need to address disparities between regions and social classes.v He also mentioned the need for civil society organisations to take this message to the community. This wider understanding of reconciliation is important because ethnic inequality and economic inequality have often reinforced each other in Sri Lanka’s history.

Academic studies have identified the denial of citizenship rights after Independence as a historic injustice that set back the Malaiyaha community for decades. The challenge now is to ensure that transformation becomes part of the stabilisation and development process itself. Practical first steps are both possible and necessary. The release of civilian lands still under state control, greater devolution of administrative authority, reduction of military involvement in civilian affairs, language equality in public administration and accelerated housing and land ownership programmes in the plantation sector are all measures that can begin immediately without waiting for a final stage of transformation.

The government’s recent commitment that provincial council elections will finally be held this year is therefore significant. These elections have been repeatedly postponed by successive governments. Holding them would not solve the ethnic conflict by itself. But it would signal a willingness to restore democratic institutions and share power in a meaningful way.

Sri Lanka has repeatedly postponed difficult reforms in the hope that a more convenient political moment would eventually arrive. But opportunities are invariably created and fought for instead of being provided as a gift by a benevolent government.

The present moment, shaped by the economic crisis and public demand for accountable government, offers a rare opportunity to move simultaneously towards stability, development and reconciliation. Provincial council elections can be the first meaningful step. But they must not be the last.

by Jehan Perera

Features

Researchers to shape new environmental policy framework

Published

1 hour ago

2026/05/26

Sahan Weerasooriya

Some of the researchers at the meeting

In a significant move aimed at steering Sri Lanka’s environmental governance towards a more science-based and evidence-driven path, the Ministry of Environment has initiated a new collaborative mechanism to integrate leading researchers into national policy formulation and conservation planning.

The initiative was discussed at a high-level meeting chaired by Dr. Dammika Patabendi at the Ministry of Environment on Tuesday, where top environmental scientists, wildlife experts and researchers were invited to contribute towards what officials described as a “strategic transition” in the country’s environmental management framework.

The discussions focused on strengthening the scientific basis of environmental conservation programmes and national policy decisions while creating a more research-friendly environment for academics and field scientists engaged in biodiversity and ecological studies.

Particular attention was paid to long-standing concerns raised by researchers regarding procedural and operational difficulties encountered when conducting studies in collaboration with the Department of Wildlife Conservation and the Forest Department.

Minister Patabendi stressed the need for environmental policies to be guided by credible scientific data rather than ad hoc administrative decisions, ministry sources said.

Among the key proposals discussed was the establishment of a streamlined mechanism that would reduce bureaucratic obstacles faced by researchers in obtaining approvals, accessing field sites and sharing scientific findings with state institutions.

The Minister highlighted the importance of building stronger partnerships between policymakers and the scientific community at a time when Sri Lanka is grappling with escalating environmental challenges including deforestation, biodiversity loss, human-elephant conflict, climate-related disasters and ecosystem degradation.

Environmentalists attending the meeting had also highlighted the urgent necessity of incorporating empirical research into national decision-making processes to ensure long-term ecological sustainability and better resource management.

The meeting brought together several of Sri Lanka’s leading environmental researchers and academics including Rohan Pethiyagoda, Saminda Fernando, Sewwandi Jayakody, Samantha Gunasekara, Dinidu Devapura, Himesh Jayasinghe, Manoj Prasanna, Mendis Wickramasinghe and Suranjan Karunarathna.

Director General of Wildlife Conservation Ranjan Marasinghe also participated in the deliberations.

Officials said the proposed framework is expected to pave the way for a more transparent, data-oriented and scientifically credible environmental governance structure capable of addressing emerging conservation challenges more effectively.

The government expects the new mechanism to support the implementation of practical and scientifically robust programmes aimed at safeguarding Sri Lanka’s ecological future while enhancing cooperation between state agencies and the country’s growing community of environmental researchers.

By Ifham Nizam

Features

Back home … for a special occasion

Published

1 hour ago

2026/05/26

Sahan Weerasooriya

Seven Notes: Sri Lankans based in Dubai – with Niluk (second from left)

Niluk Uswaththa, of Seven Notes fame, based in Dubai, surprised many when he and his wife Apeksha, turned up in Colombo, last week … unannounced.

Yes, they had a purpose in their surprise visit … to wish Apeksha’s mum for her birthday, which was on Monday, 18th May, and what a surprise it turned out to be!

In an exclusive chit-chat with The Island, Niluk said that the scene in Dubai is improving and Seven Notes do have work coming their way.

Since the members of Seven Notes are all employed (doing day jobs), they operate only on Saturdays and Sundays.

Niluk: Didn’t come prepared to perform, but obliged
friends in Galle

In fact, to get to Colombo for the birthday surprise (on Monday, 18th May), the band had to skip their 17th May, Sunday gig.

“Although it’s a short vacation, my wife and I are enjoying the setup here,” said Niluk, adding that they spent two days in Galle and that their next destination is Anuradhapura.”

Niluk didn’t come prepared to perform, but he obliged the crowd present, at a friend’s birthday celebrations, in Galle, singing and playing guitar.

They are scheduled to leave for their home, in Dubai, in the first week of June.

Seven Notes is an outfit made up of Sri Lankans and the band has been around for almost nine years.

Niluk came into their scene nearly seven years ago.

“When I went to Dubai, I had offers coming my way but it was Seven Notes that impressed me because of their acoustic style.”

The Dubai’s entertainment scene is showing clear signs of bouncing back and even levelling up in the next few months.

Niluk and Apeksha: Enjoying their short vacation

After a slowdown earlier this year due to regional tensions, shows and festivals are back on the calendar, and organisers say late 2026 could be the busiest concert season in years.

Time Out Dubai says “the 2026 concert calendar is filling up nicely” and “the city is ready to party once again” after some reschedules.

Dubai Summer Surprises in July brings retail activations, comedy nights, and indoor art exhibitions.

Organisers point to a backlog of postponed events that are being rescheduled for late 2026 and early 2027.

Yes, Dubai is calm on the surface but on alert. Life is mostly normal in the city, but there’s a “balancing act” as people watch for escalation.