Features

SOS to rescue Sri Lanka’s dying healthcare

Published

3 years ago

2023/07/16

Health workers hold placards during a demonstration against the island's deepening economic crisis in Colombo on April 6, 2022

By Krishantha Prasad Cooray

Someone in Sri Lanka, right now as I write, is distraught because a child, a parent or a loved one has died, is dying or is seriously ill due to lack of medicine and medical care.Some die because doctors just cannot handle the overwhelming number of patients, or they simply cannot afford the eyewatering private hospital charges.

In a world of increasingly glaring disparities, we could dismiss such situations as inevitable, especially in a time of unprecedented economic stress, but such dismissal can only be defended if all necessary steps have been taken to ensure that what is possible can indeed be delivered. It is abundantly clear that this is not the case.

We are not talking about critical care necessitating costly drugs and sophisticated surgery, but non-serious medical situations that can be and have been treated successfully in Sri Lanka.

In a time of crisis hard choices must be made. Priorities must be revisited and revised. Cutbacks are inevitable even when it comes to areas that have previously been treated as untouchable. This is true of households, and it is true of nations. Consumption patterns quickly change in poorer households. Relative luxuries are shelved, but a lot of care is taken to make sure that nutrition and health are not compromised beyond certain minimum levels. This is not hard to understand. In the end it is life that counts. It is the same with a country. A nation without people is not a nation. A nation in which people are sick and cannot get the treatment is a sick nation. No amount of debt restructuring can cure such a nation.

Professionals jumping ship

Falling ill even with a minor malady has become a major matter. The severe dearth of medicines and medical equipment and the growing cost of health care constitute one side of the problem. The other side is the prevailing trend of medical professionals leaving the country, especially the most qualified and competent among them. In fact, we often hear of the accomplishments of Sri Lankan doctors currently domiciled or having citizenship in other countries. A massive loss in and of itself, but one that can easily get much worse considering that the best among those who chose to stay are contemplating leaving or have already left.

The bottom line is that we just cannot let our doctors go. Each and every one of us will one day be forced to put our lives in the hands of a doctor. A doctor is a treasure. Doctors and nurses are invaluable. We need them and they need to be protected.

Some short-sighted commentators who perhaps cannot see beyond the rupees and cents of things have seen this as a positive trend, considering the possibility of dollar and euro remittances. But what happens when the best healers leave the country? Aren’t they also the ones who set the standards? Aren’t they the principal mentors of the next generation of physicians? And since most of them are not going abroad just for employment but are actually migrating with their families, how much will they remit, if at all? When doctors leave, there’s a very negative message being sent to everyone including other professionals: ‘leave if you can!’

Sri Lankan medical professionals are second to none in the world. This is true of doctors and other categories in the health sector such as nurses and medical technicians. They work tirelessly in less-than-ideal conditions. Despite meagre resources and having to attend on an inordinate number of patients, they are one of the main reasons why Sri Lanka’s health system is the envy of her neighbours and countries in the same or even higher brackets of economic prosperity. While there are those who chide doctors for engaging in private practice, it is often forgotten that the vast majority of them consider their work in the state-run hospitals as their primary vocation, despite the comparatively small remuneration package.

They don’t neglect this work. They not only work but incur the wrath of some who forget that Sri Lanka is not an affluent country and are ignorant of the fact that doctors in such countries see a fraction of the patients our doctors attend to for a fraction of the salary. We should not forget that even though working under extremely trying circumstances Sri Lankan doctors are among the most accessible professionals in the world.

Let us recall the adage, ‘people leave managers, not companies.’ It is applicable here. The one thing that can make a dent in the ongoing ‘brain drain’ is strong, compelling, articulate, and empathetic leadership.

Captain lacks support from crew

The onus in this crisis-ridden climate falls directly on President Ranil Wickremesinghe. In his favour is the fact that he had the self-belief that there was no one else to take control of a sinking ship. He’s steadied it, picked a course and although it is still taking in a lot of water, there’s hope that it will remain afloat.

On the downside is the fact that he’s playing a lone hand for all intents and purposes. He has no team worth that name. So, it is a solo game. He’s a man with a country to worry about, walking a tight rope that is suspended over an abyss while detractors at either end tweak the rope. To use a cricketing analogy, he’s the only one in the team who can be called a halfway decent batsman and halfway decent bowler; except that he must keep wickets, coach the team and chase the red cherry simply because the fielders seem to have sprung roots.

All the more reason for the president, handicapped as he is, to take matters into his own hands. The time for outsourcing responsibility for the health sector is long past. He can and must speak to the medical fraternity. It is unlikely they’ll listen or be moved by anyone else. The President himself has to convince them of the plans to turn things around, what has been done, what is going to be done, and why their support at this hour is so crucial for the well-being of the country and its citizens.

Such an address is necessary but certainly far from sufficient. The health sector serves the public, but it includes private enterprises. We have channeling services, dispensaries, all kinds of clinics, laboratories, nursing homes, care giving outfits and fully fledged hospitals. These too are faced with the same human resources problems. On the other hand, the potential for the expansion of this segment of the sector, the setting up of new private hospitals for example, needs to be explored and facilitated. If the market is expanded leading to greater competition, private health care might become more affordable and therefore more accessible to a larger share of Lankans.

With proper policy backing, there’s nothing to stop reputed universities the world over partnering such private hospitals to train doctors, nurses, and other medical professionals. For all this, the regulatory mechanism needs to be revisited and streamlined. Again, the onus is on the president. He can and must take the initiative to create the conditions. He can and must lay the foundation to turn Sri Lanka into a medical tourism hub for the region where all these facilities are complemented by the focused and planned development of the indigenous medical system in the country.

The same goes for the pharmaceutical sector. The question of affordability can be resolved to a great extent if competition is encouraged, and mechanisms set in place to ensure standards. Resolving the criminally tragic situation prevailing in the NMRA – a direct result of interference by incompetent politicians – is an urgent must. Conditions can be created to encourage investors, local and otherwise, to set up such industries here in Sri Lanka. The ‘greener pastures’ that medical professionals seek abroad can be ‘grown’ right here in this island.

All hands on deck

The President could start by talking to the business leaders in and out of the health sector. They need to be convinced that the problem is serious, and he is serious about not just resolving immediate issues but setting the wheels in motion to make things work in the long run.

The President has to convince the professionals that it is worthwhile fighting this battle. He must give them a reason to stay. He has to say it and do it. He must show vision and develop a plan based on this vision. He must demonstrate commitment to execute this plan. He must put together a team that can support him. He must set deadlines and work towards meeting them. Dispatching acquaintances to deputise for him in the matter of investigating random allegations will just not do it. Simply put, problems of this nature cannot be outsourced.

There’s someone somewhere grieving over a loved one who passed away or is about to because of a condition that would have been curable if curable ailments of the system had been sorted out. The dying person or the person who died could be you or me. You or I could be the person grieving. It is nothing but a tragedy when someone cannot buy medicine for a child or a parent. It is downright uncivilized in fact. Only those in such situations truly understand the dimensions of the tragedy.

Unfortunately medical professionals are fighting a difficult battle, a battle which could be won if the relevant authorities opened their eyes, used their brains, and showed some kind of leadership. Politicians don’t need our health system. When they are unwell, they seek treatment not in our hospitals but abroad. The absolute majority of our people do not have that choice. They will live or die here. Can the President deliver for them?

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Features

More state support needed for marginalised communities

Published

11 hours ago

2026/02/13

Thilina Walpola

A landslide in the Central Province

Message from Malaiyaha Tamil community to govt:

Insights from SSA Cyclone Ditwah Survey

When climate disasters strike, they don’t affect everyone equally. Marginalised communities typically face worse outcomes, and Cyclone Ditwah is no exception. Especially in a context where normalcy is far from “normal”, the idea of returning to normalcy or restoring a life of normalcy makes very little sense.

The island-wide survey (https://ssalanka.org/reports/) conducted by the Social Scientists’ Association (SSA), between early to mid-January on Cyclone Ditwah shows stark regional disparities in how satisfied or dissatisfied people were with the government’s response. While national satisfaction levels were relatively high in most provinces, the Central Province tells a different story.

Only 35.2% of Central Province residents reported that they were satisfied with early warning and evacuation measures, compared to 52.2% nationally. The gap continues across every measure: just 52.9% were satisfied with immediate rescue and emergency response, compared with the national figure of 74.6%. Satisfaction with relief distribution in the Central Province is 51.9% while the national figure stands at 73.1%. The figures for restoration of water, electricity, and roads are at a low 45.9% in the central province compared to the 70.9% in national figures. Similarly, the satisfaction level for recovery and rebuilding support is 48.7% in the Central Province, while the national figure is 67.0%.

A deeper analysis of the SSA data on public perceptions reveals something important: these lower satisfaction rates came primarily from the Malaiyaha Tamil population. Their experience differed not just from other provinces, but also from other ethnic groups living in the Central Province itself.

The Malaiyaha Tamil community’s vulnerability didn’t start with the cyclone. Their vulnerability is a historically and structurally pre-determined process of exclusion and marginalisation. Brought to Sri Lanka during British rule to work for the empire’s plantation economies, they have faced long-term economic exploitation and have repeatedly been denied access to state support and social welfare systems. Most estate residents still live in ‘line rooms’ and have no rights to the land they cultivate and live on. The community continues to be governed by an outdated estate management system that acts as a barrier to accessing public and municipal services such as road repair, water, electricity and other basic infrastructures available to other citizens.

As far as access to improved water sources is concerned, the Sri Lanka Demographic Health Survey (2016) shows that 57% of estate sector households don’t have access to improved water sources, while more than 90% of households in urban and rural areas do. With regard to the level of poverty, as the Department of Census and Statistics (2019) data reveals, the estate sector where most Malaiyaha Tamils live had a poverty headcount index of 33.8%; more than double the national rate of 14.3%. These statistics highlight key indicators of the systemic discrimination faced by the Malaiyaha Tamil community.

Some crucial observations from the SSA data collectors who enumerated responses from estate residents in the survey reveal the specific challenges faced by the Malaiyaha Tamils, particularly in their efforts to seek state support for compensation and reconstruction.

First, the Central Province experienced not just flooding but also the highest number of landslides in the island. As a result, some residents in the region lost entire homes, access roadways, and other basic infrastructures. The loss of lives, livelihoods and land was at a higher intensity compared to the provinces not located in the hills. Most importantly, the Malaiyaha Tamil community’s pre-existing grievances made them even more vulnerable and the government’s job of reparation and restitution more complex.

Early warnings hadn’t reached many areas. Some data collectors said they themselves never heard any warnings in estate areas, while others mentioned that early warnings were issued but didn’t reach some segments of the community. According to the resident data collectors, the police announcements reached only as far as the sections where they were able to drive their vehicles to, and there were many estate roads that were not motorable. When warnings did filter through to remote locations, they often came by word of mouth and information was distorted along the way. Once the disaster hit, things got worse: roads were blocked, electricity went out, mobile networks failed and people were cut off completely.

Emergency response was slow. Blocked roads meant people could not get to hospitals when they needed urgent care, including pregnant mothers. The difficult terrain and poor road conditions meant rescue teams took much longer to reach affected areas than in other regions.

Relief supplies didn’t reach everyone. The Grama Niladhari divisions in these areas are huge and hard to navigate, making it difficult for Grama Niladharis to reach all places as urgently as needed. Relief workers distributed supplies where vehicles could go, which meant accessible areas got help while remote communities were left out.

Some people didn’t even try to go to safety centres or evacuation shelters set up in local schools because the facilities there were already so poor. The perceptions of people who did go to safety centres, as shown in the provincial data, reveal that satisfaction was low compared to other affected regions of the country. Less than half were satisfied with space and facilities (42.1%) or security and protection (45.0%). Satisfaction was even lower for assistance with lost or damaged documentation (17.9%) and information and support for compensation applications (28.2%). Only 22.5% were satisfied with medical care and health services below most other affected regions.

Restoring services proved nearly impossible in some areas. Road access was the biggest problem. The condition of the roads was already poor even before the cyclone, and some still haven’t been cleared. Recovery is especially difficult because there’s no decent baseline infrastructure to restore, hence you can’t bring roads and other public facilities back to a “good” condition when they were never good, even before the disaster.

Water systems faced their own complications. Many households get water from natural sources or small community projects, and not the centralised state system. These sources are often in the middle of the disaster zone and therefore got contaminated during the floods and landslides.

Long-term recovery remains stalled. Without basic infrastructure, areas that are still hard to reach keep struggling to get the support they need for rebuilding.

Taken together, what do these testaments mean? Disaster response can’t be the same for everyone. The Malaiyaha Tamil community has been double marginalised because they were already living with structural inequalities such as poor infrastructure, geographic isolation, and inadequate services which have been exacerbated by Cyclone Ditwah. An effective and fair disaster response needs to account for these underlying vulnerabilities. It requires interventions tailored to the historical, economic, and infrastructural realities that marginalized communities face every day. On top of that, it highlights the importance of dealing with climate disasters, given the fact that vulnerable communities could face more devastating impacts compared to others.

(Shashik Silva is a researcher with the Social Scientists’ Association of Sri Lanka)

by Shashik Silva ✍️

Features

Crucial test for religious and ethnic harmony in Bangladesh

Published

1 day ago

2026/02/12

Sahan Weerasooriya

A political protest that led to governmental change in Bangladesh mid last year. (photograph: imago)

Will the Bangladesh parliamentary election bring into being a government that will ensure ethnic and religious harmony in the country? This is the poser on the lips of peace-loving sections in Bangladesh and a principal concern of those outside who mean the country well.

The apprehensions are mainly on the part of religious and ethnic minorities. The parliamentary poll of February 12th is expected to bring into existence a government headed by the Bangladesh Nationalist Party (BNP) and the Islamist oriented Jamaat-e-Islami party and this is where the rub is. If these parties win, will it be a case of Bangladesh sliding in the direction of a theocracy or a state where majoritarian chauvinism thrives?

Chief of the Jamaat, Shafiqur Rahman, who was interviewed by sections of the international media recently said that there is no need for minority groups in Bangladesh to have the above fears. He assured, essentially, that the state that will come into being will be equable and inclusive. May it be so, is likely to be the wish of those who cherish a tension-free Bangladesh.

The party that could have posed a challenge to the above parties, the Awami League Party of former Prime Minister Hasina Wased, is out of the running on account of a suspension that was imposed on it by the authorities and the mentioned majoritarian-oriented parties are expected to have it easy at the polls.

A positive that has emerged against the backdrop of the poll is that most ordinary people in Bangladesh, be they Muslim or Hindu, are for communal and religious harmony and it is hoped that this sentiment will strongly prevail, going ahead. Interestingly, most of them were of the view, when interviewed, that it was the politicians who sowed the seeds of discord in the country and this viewpoint is widely shared by publics all over the region in respect of the politicians of their countries.

Some sections of the Jamaat party were of the view that matters with regard to the orientation of governance are best left to the incoming parliament to decide on but such opinions will be cold comfort for minority groups. If the parliamentary majority comes to consist of hard line Islamists, for instance, there is nothing to prevent the country from going in for theocratic governance. Consequently, minority group fears over their safety and protection cannot be prevented from spreading.

Therefore, we come back to the question of just and fair governance and whether Bangladesh’s future rulers could ensure these essential conditions of democratic rule. The latter, it is hoped, will be sufficiently perceptive to ascertain that a Bangladesh rife with religious and ethnic tensions, and therefore unstable, would not be in the interests of Bangladesh and those of the region’s countries.

Unfortunately, politicians region-wide fall for the lure of ethnic, religious and linguistic chauvinism. This happens even in the case of politicians who claim to be democratic in orientation. This fate even befell Bangladesh’s Awami League Party, which claims to be democratic and socialist in general outlook.

We have it on the authority of Taslima Nasrin in her ground-breaking novel, ‘Lajja’, that the Awami Party was not of any substantial help to Bangladesh’s Hindus, for example, when violence was unleashed on them by sections of the majority community. In fact some elements in the Awami Party were found to be siding with the Hindus’ murderous persecutors. Such are the temptations of hard line majoritarianism.

In Sri Lanka’s past numerous have been the occasions when even self-professed Leftists and their parties have conveniently fallen in line with Southern nationalist groups with self-interest in mind. The present NPP government in Sri Lanka has been waxing lyrical about fostering national reconciliation and harmony but it is yet to prove its worthiness on this score in practice. The NPP government remains untested material.

As a first step towards national reconciliation it is hoped that Sri Lanka’s present rulers would learn the Tamil language and address the people of the North and East of the country in Tamil and not Sinhala, which most Tamil-speaking people do not understand. We earnestly await official language reforms which afford to Tamil the dignity it deserves.

An acid test awaits Bangladesh as well on the nation-building front. Not only must all forms of chauvinism be shunned by the incoming rulers but a secular, truly democratic Bangladesh awaits being licked into shape. All identity barriers among people need to be abolished and it is this process that is referred to as nation-building.

On the foreign policy frontier, a task of foremost importance for Bangladesh is the need to build bridges of amity with India. If pragmatism is to rule the roost in foreign policy formulation, Bangladesh would place priority to the overcoming of this challenge. The repatriation to Bangladesh of ex-Prime Minister Hasina could emerge as a steep hurdle to bilateral accord but sagacious diplomacy must be used by Bangladesh to get over the problem.

A reply to N.A. de S. Amaratunga

A response has been penned by N.A. de S. Amaratunga (please see p5 of ‘The Island’ of February 6th) to a previous column by me on ‘ India shaping-up as a Swing State’, published in this newspaper on January 29th , but I remain firmly convinced that India remains a foremost democracy and a Swing State in the making.

If the countries of South Asia are to effectively manage ‘murderous terrorism’, particularly of the separatist kind, then they would do well to adopt to the best of their ability a system of government that provides for power decentralization from the centre to the provinces or periphery, as the case may be. This system has stood India in good stead and ought to prove effective in all other states that have fears of disintegration.

Moreover, power decentralization ensures that all communities within a country enjoy some self-governing rights within an overall unitary governance framework. Such power-sharing is a hallmark of democratic governance.

Features

Celebrating Valentine’s Day …

Published

1 day ago

2026/02/12

Sahan Weerasooriya

Valentine’s Day is all about celebrating love, romance, and affection, and this is how some of our well-known personalities plan to celebrate Valentine’s Day – 14th February:

Merlina Fernando (Singer)

Yes, it’s a special day for lovers all over the world and it’s even more special to me because 14th February is the birthday of my husband Suresh, who’s the lead guitarist of my band Mission.

We have planned to celebrate Valentine’s Day and his Birthday together and it will be a wonderful night as always.

We will be having our fans and close friends, on that night, with their loved ones at Highso – City Max hotel Dubai, from 9.00 pm onwards.

Lorensz Francke (Elvis Tribute Artiste)

On Valentine’s Day I will be performing a live concert at a Wealthy Senior Home for Men and Women, and their families will be attending, as well.

I will be performing live with romantic, iconic love songs and my song list would include ‘Can’t Help falling in Love’, ‘Love Me Tender’, ‘Burning Love’, ‘Are You Lonesome Tonight’, ‘The Wonder of You’ and ‘’It’s Now or Never’ to name a few.

To make Valentine’s Day extra special I will give the Home folks red satin scarfs.

Emma Shanaya (Singer)

I plan on spending the day of love with my girls, especially my best friend. I don’t have a romantic Valentine this year but I am thrilled to spend it with the girl that loves me through and through. I’ll be in Colombo and look forward to go to a cute cafe and spend some quality time with my childhood best friend Zulha.

JAYASRI

Emma-and-Maneeka

This Valentine’s Day the band JAYASRI we will be really busy; in the morning we will be landing in Sri Lanka, after our Oman Tour; then in the afternoon we are invited as Chief Guests at our Maris Stella College Sports Meet, Negombo, and late night we will be with LineOne band live in Karandeniya Open Air Down South. Everywhere we will be sharing LOVE with the mass crowds.

Kay Jay (Singer)

I will stay at home and cook a lovely meal for lunch, watch some movies, together with Sanjaya, and, maybe we go out for dinner and have a lovely time. Come to think of it, every day is Valentine’s Day for me with Sanjaya Alles.

Maneka Liyanage (Beauty Tips)

On this special day, I celebrate love by spending meaningful time with the people I cherish. I prepare food with love and share meals together, because food made with love brings hearts closer. I enjoy my leisure time with them — talking, laughing, sharing stories, understanding each other, and creating beautiful memories. My wish for this Valentine’s Day is a world without fighting — a world where we love one another like our own beloved, where we do not hurt others, even through a single word or action. Let us choose kindness, patience, and understanding in everything we do.

Janaka Palapathwala (Singer)

Janaka

Valentine’s Day should not be the only day we speak about love.

From the moment we are born into this world, we seek love, first through the very drop of our mother’s milk, then through the boundless care of our Mother and Father, and the embrace of family.

Love is everywhere. All living beings, even plants, respond in affection when they are loved.

As we grow, we learn to love, and to be loved. One day, that love inspires us to build a new family of our own.

Love has no beginning and no end. It flows through every stage of life, timeless, endless, and eternal.

Natasha Rathnayake (Singer)

We don’t have any special plans for Valentine’s Day. When you’ve been in love with the same person for over 25 years, you realise that love isn’t a performance reserved for one calendar date. My husband and I have never been big on public displays, or grand gestures, on 14th February. Our love is expressed quietly and consistently, in ordinary, uncelebrated moments.

With time, you learn that love isn’t about proving anything to the world or buying into a commercialised idea of romance—flowers that wilt, sweets that spike blood sugar, and gifts that impress briefly but add little real value. In today’s society, marketing often pushes the idea that love is proven by how much money you spend, and that buying things is treated as a sign of commitment.

Real love doesn’t need reminders or price tags. It lives in showing up every day, choosing each other on unromantic days, and nurturing the relationship intentionally and without an audience.

This isn’t a judgment on those who enjoy celebrating Valentine’s Day. It’s simply a personal choice.

Melloney Dassanayake (Miss Universe Sri Lanka 2024)

I truly believe it’s beautiful to have a day specially dedicated to love. But, for me, Valentine’s Day goes far beyond romantic love alone. It celebrates every form of love we hold close to our hearts: the love for family, friends, and that one special person who makes life brighter. While 14th February gives us a moment to pause and celebrate, I always remind myself that love should never be limited to just one day. Every single day should feel like Valentine’s Day – constant reminder to the people we love that they are never alone, that they are valued, and that they matter.

I’m incredibly blessed because, for me, every day feels like Valentine’s Day. My special person makes sure of that through the smallest gestures, the quiet moments, and the simple reminders that love lives in the details. He shows me that it’s the little things that count, and that love doesn’t need grand stages to feel extraordinary. This Valentine’s Day, perfection would be something intimate and meaningful: a cozy picnic in our home garden, surrounded by nature, laughter, and warmth, followed by an abstract drawing session where we let our creativity flow freely. To me, that’s what love is – simple, soulful, expressive, and deeply personal. When love is real, every ordinary moment becomes magical.

Noshin De Silva (Actress)

Valentine’s Day is one of my favourite holidays! I love the décor, the hearts everywhere, the pinks and reds, heart-shaped chocolates, and roses all around. But honestly, I believe every day can be Valentine’s Day.

It doesn’t have to be just about romantic love. It’s a chance to celebrate love in all its forms with friends, family, or even by taking a little time for yourself.

Whether you’re spending the day with someone special or enjoying your own company, it’s a reminder to appreciate meaningful connections, show kindness, and lead with love every day.

And yes, I’m fully on theme this year with heart nail art and heart mehendi design!

Wishing everyone a very happy Valentine’s Day, but, remember, love yourself first, and don’t forget to treat yourself.

Sending my love to all of you.