Opinion
Yes indeed, Hippocrates is turning in his grave
My mind time travelled thirty-seven years to the auditorium, Rahula College, Matara. Being one of the two surgeons at the Base Hospital I was a man in demand whom the service receivers respected. My good lady and I were seated in the VIP row of seats and when the curtain raised there was a man hanging from a lamp post in an ill lit left hand corner of the stage. The narrator was late the H.A.Perera and in his inimitable style and signature voice loudly exclaimed “this man hanging here was the last honest man in the country”. The stage play was Maghatha. This was a satirical play depicting the hight of corruption and lawlessness prevailing at the time.
Sri Lanka even at this moment of time is not any better. There will come a time when honesty and truthfulness would make one disqualified to continue to live here. The country is full of dishonest people. Finding an honest man might well prove an exercise that would put Kisa Gothamie in the shade.
It was Monday the 7th November 2022, a public holiday and I had to visit the NHSL,Colombo to see a man who is a distant relative of ours but more importantly a man who did some excellent salvage job for me to make a brand new bathroom screwed up by the previous workmen, up to scratch again. As a result, in a way, I am indebted to him. Having recently had some Deja vu of the thel polim yugaya, I ventured out to bus and walk the trip which I enjoyed very much as the buses were almost empty.
I got to the hospital all right but finding the ward I needed to visit would have been an uphill task if not for an ex-trainee of mine who is at present a top orthopaedic surgeon at the NHSL, whom I met at the Consultants’ lounge. He said “Sir things are very different compared with the time you were a Consultant here. Even after introducing yourself as an ex senior surgeon the response, you receive might embarrass, frustrate, or even anger you. So let me call the ward” and so he did.
It was a medical ward shared between two consultant physicians. There was an air of busyness about the place because they were probably on acute take. Ward had been partitioned into what they called ‘cubicles’ but they were more like solid rectangles or cuboids. Patients of both consultants seemed haphasardly distributed in each ‘cubicle’. Normally in such situations the responsible Physicians name is displayed on the wall at the head end of the bed. No such name boards were visible in this ward. There were three intern house officers on the ward. They knew which cubicle they were responsible for but would definitely have not known the details of patient distribution in the ward. Apparently, the consultants did independent ward rounds but from what I saw those must be reminiscent of the doctor in the house or doctor on the go series. This arrangement is ideal for the two consultants to take every other day off unofficially. I don’t know whether this happens, but I would be very surprised if it didn’t.
My patient’s ordeal exemplifies the degree of confusion that was prevailing amongst the Medical staff of this ward. He is a 51 year old previously healthy teetotaller building supervisor who was suddenly struck down with an acute coronary ailment six weeks ago. Though there has been some delay he eventually had a stent inserted into one of the main arteries of his heart. After a few days in the cardiology unit, he was discharged with a number of tablets and capsules to swallow on a daily basis. All was good till 04 November, when he developed pain under the rib cage radiating to the back of the chest and up between shoulder blades. For all intent and purposes, it was a cardiac (heart) pain and he should have been admitted to the cardiology ward. Not to be. He was bundled into this medical ward. An ECG done on admission had shown some new changes signifying reduced blood supply to a part of the heart with no biochemical evidence of permanent damage to that part of the heart. The biochemical marker of heart muscle damage is Troponin. Hence this condition is called Troponin negative Acute Coronary Syndrome. The medical team in consultation with the cardiology Registrar has started him on anticoagulants (blood thinners). ECG done next mane was normal. Thank goodness for that. Cardiology Registrar never saw the patient physically. Telemedicine at its peak!
Even after my talking to the Consultants personally who promised that a transfer to cardiology would happen, the patient continued to camp in the medical ward for a few more days before being discharged. The scenario made me feel that the Registrars functioned independently of the consultants or communication between senior and junior medical staff was happening only at a very low ebb. Either way it was a dismal state of affairs. I am not sure whether this patient’s management conforms to the accepted norms currently used in the developed world.
My visit was a little over 24 hours after all this had happened. Thanks to my ex-trainee, current Consultant Orthopaedic surgeon, I was greeted well by the doctor at the front desk who passed me on to the doctor my friend and ex-trainee had spoken to over the phone. She and the doctor in charge of the ‘cubicle’ escorted me to my patient. They were two lovely innocent looking girls who seemed trying to find their way around still.
They were thorough with the patient’s condition but didn’t seem to know much logistics around it. They didn’t know if an official referral had been made to the cardiologist who performed the index procedure. They perused the notes but couldn’t find one. They didn’t know which of the two consultants was on call. No consultant has visited the ward on Sunday. I was there till past midday on Monday (07) and didn’t see any consultant doing a round. My patient told me no consultant had gone round the ward on the whole of Monday too. Apparently, the young sweet innocent doctor was not that innocent, after all. She had made a long scribble in the notes without asking the patient a single question and without examining him at all. What a country and what a department of health services!
My response to the two young ladies was this. “Doctors, as budding consultants please remember these are the most vulnerable of human beings because they are acutely unwell. It is our duty to do our best for them. Always try to recognise an urgent situation and treat it to prevent it becoming an emergency. Public holidays are public holidays in which microorganisms are still active causing infection, blood clots still form on ulcerated plaques inside arteries causing acute arterial insufficiency in different parts of the body including the heart, blood pressures and sugars still keep going up and down unconcerned and a whole lot of other known and unknown pathological processes still go on unrelenting. Hence, if you are rostered for the weekend or the public holiday, please make sure your services are physically available. When I was here at the NHSL about twenty years ago there used to be a weekend and public holiday roster made by a man called Mr. Gamage without whom the director felt crippled. There were no computers and printers installed. A simple cyclostyling machine did the job. All wards, all consultants all clinical and other departments received a copy each. So, everybody knew who was on call. Every on-call consultant did a full ward round in the morning. If an emergency cropped up with one of his patients (rarely the case) needing a re-operation he did it himself without handing it over to the casualty team. Exotic investigations and high-tech interventions may well be needed but not the bread and butter of patient care. Awareness, availability ability and empathy constitute holistic care. Please don’t hold them back. Shower your patient with all of the above and you would be a great doctor”. They listened to me so intently in pin-drop silence that they looked as if they were devotees listening to a sermon delivered by Ven. Narada Thero of Vajiraramaya in the distant past.
Unlike in my active working days, in this day and age, even consultants get paid for extra duty they perform. They do get paid for working on holidays as well. Those who get paid for work they haven’t done are as guilty as those who wilfully robbed the country to drag us into economic doldrums. Also, crimes can be perpetrated by commission or by omission. Those who hold back their services to the sick, when rostered, commit a grave crime by omission specially if the juniors who have been entrusted the boss’s job miss an urgent situation which later becomes an emergency to which the poor patient succumbs.
This is in stark contrast to the time I was a trainee and then a consultant and a trainer. The second half of my internship in 1973 was with a tough boss but a great obstetrician Dr. D. E. Gunatilleke, who was to become the Professor of Obstetrics and Gynaecology, University of Ceylon, Colombo, the following year. We had a post MRCOG (part l) Registrar (called SHO those days) who came down to the De Soysa Hospital for Women to take up the job from being MOH Atakalampanna, an area in the Ratnapura Health District. He was a gentleman par excellence too. Being an inexperienced trainee, he was very worried about taking the lead so I almost became his equal instead of his intern. He used to talk to the boss through me. This was one of our emergency admission days and we had already done four Caesarean sections for the night when we received a patient transferred from the Base Hospital, Horana with the baby lying crosswise and the mum in labour. Baby’s hand has prolapsed into mum’s vagina. Baby was still alive but in distress. My Registrar the late Dr. Shanthan Perera said, “Machan boss has just returned home after doing the fourth section. I don’t feel confident to call him. Could you please help me with this? I readily obliged as I had a great rapport with my boss. I picked up the phone and spoke to him. “Sir I am awfully sorry to bother you at this ungodly hour especially knowing you have just returned home from hospital. We got this young lady whose second pregnancy has been complicated by her going into labour with a transverse lie of the foetus, hand prolapse and foetal distress. I have resuscitated her with intravenous fluids and intermittent boluses of 50% dextrose. She is on oxygen and an indwelling catheter is showing a good urine output. I have got blood cross matched and the theatre is ready” “Don’t worry Janapriya, I will be there in 10 minutes” Lo and behold he was there in little over five minutes––he lived at Rosemead Place––did a Caesarean section and extracted a healthy baby. It was 5 am and the fifth Caesarean section was done and dusted! Time for a cat nap before the next day starts.
Those were the days. If I fall seriously ill, I will use my time machine and go back in time to be treated by one of those doctors and gentlemen. They had no flashy cars. They had no private practice or indeed extra duty payment or holiday pay. They had no CT and other scanners to help them with diagnostic work up. What they had in plenty were knowledge, skill, empathy and duty consciousness. They were honest, worked very hard and placed patient welfare at the pinnacle. Even a physically diminutive figure like the boss of mine I was referring to, stood head and shoulders above self-conceited big burley medical men of today proudly plying around in expensive top of the order automobiles.
It was Lord Moynihan, a pioneer surgeon who, seeing patients with advanced bladder cancer suffer with excruciating pain due to the cancer invading pelvic nerves said, “Lord, if you want to take me please do not take me through my bladder” I have modified this as per below,
Lord, if you want to take me please don’t torture me through the corridors of the hospitals of Sri Lanka, be it state run or privately owned but simply knock me down with a train, a bus, a lorry or a truck. I will accept it with grace and the drivers will go scot-free too.
Dr. M. M. Janapriya
Opinion
War with Iran and unravelling of the global order – II
Broader Strategic Consequences
One of the most significant strategic consequences of the war is the accelerated erosion of U.S. political and moral hegemony. This is not a sudden phenomenon precipitated solely by the present conflict; rather, the war has served to illuminate an already evolving global reality—that the era of uncontested U.S. dominance is in decline. The resurgence of Donald Trump and the reassertion of his “America First” doctrine reflect deep-seated domestic economic and political challenges within the United States. These internal pressures have, in turn, shaped a more unilateral and inward-looking foreign policy posture, further constraining Washington’s capacity to exercise global leadership.
Moreover, the conduct of the war has significantly undermined the political and moral authority of the United States. Perceived violations of international humanitarian law, coupled with the selective application of international norms, have weakened the credibility of U.S. advocacy for a “rules-based international order.” Such inconsistencies have reinforced perceptions of double standards, particularly among states in the Global South. Skepticism toward Western normative leadership is expected to deepen, contributing to the gradual fragmentation of the international system. In this broader context, the ongoing crisis can be seen as symptomatic of a more fundamental transformation: the progressive waning of a global order historically anchored in U.S. hegemony and the emergence of a more contested and pluralistic international landscape.
The regional implications of the crisis are likely to be profound, particularly given the centrality of the Persian Gulf to the global political economy. As a critical hub of energy production and maritime trade, instability in this region carries systemic consequences that extend far beyond its immediate geography. Whatever may be the outcome, whether through the decisive weakening of Iran or the inability of external powers to dismantle its leadership and strategic capabilities, the post-conflict regional order will differ markedly from its pre-war configuration. In this evolving context, traditional power hierarchies, alliance structures, and deterrence dynamics are likely to undergo significant recalibration.
A key lesson underscored by the war is the deep interconnectivity of the contemporary global economic order. In an era of highly integrated production networks and supply chains, disruptions in a single strategic node can generate cascading effects across the global system. As such, regional conflicts increasingly assume global significance. The structural realities of globalisation make it difficult to contain economic and strategic shocks within regional boundaries, as impacts rapidly transmit through trade, energy, and financial networks. In this context, peace and stability are no longer purely regional concerns but global public goods, essential to the functioning and resilience of the international system
The conflict highlights the emergence of a new paradigm of warfare shaped by the integration of artificial intelligence, cyber capabilities, and unmanned systems. The extensive use of unmanned combat aerial vehicles (UCAVs)—a trend previously demonstrated in the Russia–Ukraine War—has been further validated in this theatre. However, unlike the Ukraine conflict, where Western powers have provided sustained military, technological, and financial backing, the present confrontation reflects a more direct asymmetry between a dominant global hegemon and a Global South state. Iran’s deployment of drone swarms and AI-enabled targeting systems illustrates that key elements of Fourth Industrial Revolution (4IR) warfare are no longer confined to technologically advanced Western states. These capabilities are increasingly accessible to Global South actors, lowering barriers to entry and significantly enhancing their capacity to wage effective asymmetric warfare. In this evolving context, technological diffusion is reshaping the strategic landscape, challenging traditional military hierarchies and altering the balance between conventional superiority and innovative, cost-effective combat strategies.
The war further exposed and deepened the weakening of global governance institutions, particularly the United Nations. Many of these institutions were established in 1945, reflecting the balance of power and geopolitical realities of the immediate post-Second World War era. However, the profound transformations in the international system since then have rendered aspects of this institutional architecture increasingly outdated and less effective.
The war has underscored the urgent need for comprehensive international governance reforms to ensure that international institutions remain credible, representative, and capable of addressing contemporary security challenges. The perceived ineffectiveness of UN human rights mechanisms in responding to violations of international humanitarian law—particularly in contexts such as the West Bank and the Gaza Strip, and more recently in Iran—has amplified calls for institutional renewal or the development of alternative frameworks for maintaining international peace and security. Moreover, the selective enforcement of international law and the persistent paralysis in conflict resolution mechanisms risk accelerating the fragmentation of global norms. If sustained, this trajectory would signal not merely the weakening but the possible demise of the so-called liberal international order, accelerating the erosion of both the legitimacy and the effective authority of existing multilateral institutions, and deepening the crisis of global governance.
Historically, major wars have often served as harbingers of new eras in international politics, marking painful yet decisive transitions from one order to another. Periods of systemic decline are typically accompanied by instability, uncertainty, and profound disruption; yet, it is through such crises that the contours of an emerging order begin to take shape. The present conflict appears to reflect such a moment of transition, where the strains within the existing global system are becoming increasingly visible.
Notably, key European powers are exhibiting a gradual shift away from exclusive reliance on the U.S. security umbrella, seeking instead a more autonomous and assertive role in global affairs. At the same time, the war is likely to create strategic space for China to expand its influence. As the United States becomes more deeply entangled militarily and politically, China may consolidate its position as a stabilising economic actor and an alternative strategic partner. This could be reflected in intensified energy diplomacy, expanded infrastructure investments, and a more proactive role in regional conflict management, advancing Beijing’s long-term objective of reshaping global governance structures.
However, this transition does not imply a simple replacement of Pax Americana with Pax Sinica. Rather, the emerging global order is likely to be more diffuse, pluralistic, and multilateral in character. In this sense, the ongoing transformation aligns with broader narratives of an “Asian Century,” in which power is redistributed across multiple centers rather than concentrated in a single hegemon. The war, therefore, may ultimately be understood not merely as a geopolitical crisis, but as a defining inflection point in the reconfiguration of the global order.
Conclusion: A New Era on the Horizon
History shows that major wars often signal the birth of new eras—painful, disruptive, yet transformative. The present conflict is no exception. It has exposed the vulnerabilities of the existing world order, challenged U.S. dominance, and revealed the limits of established global governance.
European powers are beginning to chart a more independent course, reducing reliance on the U.S. security umbrella, while China is poised to expand its influence as an economic stabiliser and strategic partner. Through energy diplomacy, infrastructure investments, and active engagement in regional conflicts, Beijing is quietly shaping the contours of a more multipolar world. Yet this is not the rise of Pax Sinica replacing Pax Americana. The emerging order is likely to be multilateral, fluid, and competitive—a world in which multiple powers, old and new, share the stage. The war, in all its turbulence, may therefore mark the dawn of a genuinely new global era, one where uncertainty coexists with opportunity, and where the next chapter of international politics is being written before our eyes.
by Gamini Keerawella
(First part of this article appeared yesterday (08 April)
Opinion
University admission crisis: Academics must lead the way
130,000 students are left out each year—academics hold the key
Each year, Sri Lanka’s G.C.E. Advanced Level examination produces a wave of hope—this year, nearly 175,000 students qualified for university entrance. Yet only 45,000 will be admitted to state universities. That leaves more than 130,000 young people stranded—qualified, ambitious, but excluded. This is not just a statistic; it is a national crisis. And while policymakers debate infrastructure and funding, the country’s academics must step forward as catalysts of change.
Beyond the Numbers: A National Responsibility
Education is the backbone of Sri Lanka’s development. Denying access to tens of thousands of qualified students risks wasting talent, fueling inequality, and undermining national progress. The gap is not simply about seats in lecture halls—it is about the future of a generation. Academics, as custodians of knowledge, cannot remain passive observers. They must reimagine the delivery of higher education to ensure opportunity is not a privilege for the few.
Expanding Pathways, Not Just Campuses
The traditional model of four-year degrees in brick-and-mortar universities cannot absorb the demand. Academics can design short-term diplomas and certificate programmes that provide immediate access to learning. These programmes, focused on employable skills, would allow thousands to continue their education while easing pressure on degree programmes. Equally important is the digital transformation of education. Online and blended learning modules can extend access to rural students, breaking the monopoly of physical campuses. With academic leadership, Sri Lanka can build a reliable system of credit transfers, enabling students to begin their studies at affiliated institutions and later transfer to state universities.
Partnerships That Protect Quality
Private universities and vocational institutes already absorb many students who miss out on state admissions. But concerns about quality and recognition persist. Academics can bridge this divide by providing quality assurance and standardised curricula, supervising joint degree programmes, and expanding the Open University system. These partnerships would ensure that students outside the state system receive affordable, credible, and internationally recognised education.
Research and Advocacy: Shaping Policy
Academics are not only teachers—they are researchers and thought leaders. By conducting labour market studies, they can align higher education expansion with employability. Evidence-based recommendations to the University Grants Commission (UGC) can guide strategic intake increases, regional university expansion, and government investment in digital infrastructure. In this way, academics can ensure reforms are not reactive, but visionary.
Industry Engagement: Learning Beyond the Classroom
Sri Lanka’s universities must become entrepreneurship hubs and innovation labs. Academics can design programmes that connect students directly with industries, offering internship-based learning and applied research opportunities. This approach reduces reliance on classroom capacity while equipping students with practical skills. It also reframes education as a partnership between universities and the economy, rather than a closed system.
Making the Most of What We Have
Even within existing constraints, academics can expand capacity. Training junior lecturers and adjunct faculty, sharing facilities across universities, and building international collaborations for joint programmes and scholarships are practical steps. These measures maximise resources while opening new avenues for students.
A Call to Action
Sri Lanka’s university admission crisis is not just about numbers—it is about fairness, opportunity, and national development. Academics must lead the way in transforming exclusion into empowerment. By expanding pathways, strengthening partnerships, advocating for policy reform, engaging with industry, and optimizing resources, they can ensure that qualified students are not left behind.
“Education for all, not just the fortunate few.”
Dr. Arosh Bandula (Ph.D. Nottingham), Senior Lecturer, Department of Agricultural Economics & Agribusiness, Faculty of Agriculture, University of Ruhuna
by Dr. Arosh Bandula
Opinion
Post-Easter Sri Lanka: Between memory, narrative, and National security
As Sri Lanka approaches the seventh commemoration of the Easter Sunday attacks, the national mood is once again marked by grief, reflection, and an enduring sense of incompleteness. Nearly seven years later, the tragedy continues to cast a long shadow not only over the victims and their families, but over the institutions and narratives that have since emerged.
Commemoration, however, must go beyond ritual. It must be anchored in clarity, accountability, and restraint. What is increasingly evident in the post-Easter landscape is not merely a search for truth, but a contest over how that truth is framed, interpreted, and presented to the public.
In recent times, public discourse has been shaped by book launches, panel discussions, and media interventions that claim to offer new insights into the attacks. While such contributions are not inherently problematic, the manner in which certain narratives are advanced raises legitimate concerns. The selective disclosure of information particularly when it touches on intelligence operations demands careful scrutiny.
Sri Lanka’s legal and institutional framework is clear on the sensitivity of such matters. The Official Secrets Act (No. 32 of 1955) places strict obligations on the handling of information related to national security. Similarly, the Police Ordinance and internal administrative regulations governing intelligence units emphasize confidentiality, chain of command, and the responsible use of information. These are not mere formalities; they exist to safeguard both operational integrity and national interest.
When individual particularly those with prior access to intelligence structures enter the public domain with claims that are not subject to verification, it raises critical questions. Are these disclosures contributing to justice and accountability, or are they inadvertently compromising institutional credibility and future operational capacity?
The challenge lies in distinguishing between constructive transparency and selective exposure.
The Presidential Commission of Inquiry into the Easter Sunday Attacks provided one of the most comprehensive official examinations of the attacks. Its findings highlighted a complex web of failures: lapses in intelligence sharing, breakdowns in inter-agency coordination, and serious deficiencies in political oversight. Importantly, it underscored that the attacks were not the result of a single point of failure, but a systemic collapse across multiple levels of governance.
Yet, despite the existence of such detailed institutional findings, public discourse often gravitates toward simplified narratives. There is a tendency to identify singular “masterminds” or to attribute responsibility in ways that align with prevailing political or ideological positions. While such narratives may be compelling, they risk obscuring the deeper structural issues that enabled the attacks to occur.
Equally significant is the broader socio-political context in which these narratives are unfolding. Sri Lanka today remains a society marked by fragile intercommunal relations. The aftermath of the Easter attacks saw heightened suspicion, polarisation, and, in some instances, collective blame directed at entire communities. Although there have been efforts toward reconciliation, these fault lines have not entirely disappeared.
In this environment, the language and tone of public discourse carry immense weight. The framing of terrorism whether as a localized phenomenon or as part of a broader ideological construct must be handled with precision and responsibility. Overgeneralization or the uncritical use of labels can have far-reaching consequences, including the marginalization of communities and the erosion of social cohesion.
At the same time, it is essential to acknowledge that the global discourse on terrorism is itself contested. Competing narratives, geopolitical interests, and selective historiography often shape how events are interpreted. For Sri Lanka, the challenge is to avoid becoming a passive recipient of external frameworks that may not fully reflect its own realities.
A professional and unbiased approach requires a commitment to evidence-based analysis. This includes:
· Engaging with primary sources, including official reports and judicial findings
·
· Cross-referencing claims with verifiable data
·
· Recognizing the limits of publicly available information, particularly in intelligence matters

It also requires intellectual discipline the willingness to question assumptions, to resist convenient conclusions, and to remain open to complexity.
The role of former officials and subject-matter experts in this discourse is particularly important. Their experience can provide valuable insights, but it also carries a responsibility. Public interventions must be guided by professional ethics, respect for institutional boundaries, and an awareness of the potential impact on national security.
There is a fine balance to be maintained. On one hand, democratic societies require transparency and accountability. On the other, the premature or uncontextualized release of sensitive information can undermine the very systems that are meant to protect the public.
As Sri Lanka reflects on the events of April 2019, it must resist the temptation to reduce a national tragedy into competing narratives or political instruments. The pursuit of truth must be methodical, inclusive, and grounded in law.
Easter is not only a moment of remembrance. It is a test of institutional maturity and societal resilience.
The real question is not whether new narratives will emerge they inevitably will. The question is whether Sri Lanka has the capacity to engage with them critically, responsibly, and in a manner that strengthens, rather than weakens, the foundations of its national security and social harmony.
In the end, justice is not served by noise or conjecture. It is served by patience, rigor, and an unwavering commitment to truth.
Mahil Dole is a former senior law enforcement officer and national security analyst, with over four decades of experience in policing and intelligence, including serving as Head of Counter-Intelligence at the State Intelligence Service of Sri Lanka and a graduate of the Asia Pacific Center for Security Studies in Hawai, USA.
by Mahil Dole
Former Senior Law Enforcement Officer National Security Analyst; Former Head of Counter-Intelligence, State Intelligence Service)
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