By CHANDRE DHARMAWARDANA
A recent newspaper headline carried a “Plea to try traditional medicine before importing billions worth of anti-COVID-19 vaccines”. There are two questions to examine here. (a) In a country afraid of even burying post-Covid corpses and insisting on cremations, should one “release” infectious patients to practitioners of traditional medicine who come in all shades and colours? Should the much abused precautionary principle be applied here? (b) If the country uses indigenous preparations, will it save billions?
We answer these two questions, and then discuss their rationale. (a) Patients who wish to be treated by traditional medical practitioners should be ALLOWED to do so, as long as they use registered practitioners. Secondly, (b) using scientific medicine and its vaccines is not only EFFECTIVE, but also MUCH CHEAPER and safer.
Choice of the treatment is open to patient
Sri Lanka reports 50,000 Covid cases since the pandemic began, together with a death toll of approximately 250 in early January 2021. This means, given 200 patients, there is going to be only ONE fatality. Of course, this low fatality rate is partly due to the success of Sri Lanka’s doctors. It is also established that many fatalities are cases of “co-morbidity”, with diabetes, cardio-vascular problems, or asthma and respiratory health problems.
So the threat of the pandemic is not its mortality rate, but its rapid infectiousness. The pandemic generates large numbers of patients, saturating hospitals and exhausting the staff. Many homes are too poor and unequipped to isolate sick individuals. Thus they need hospitalisation. So, many who need hospitalistion do not need special procedures and intensive care, but they need health care.
The known biochemistry and physiology of viral infections suggest that a good course of action is to treat the patient’s fever, body pains and other symptoms, and allow the patient to rest, sleep well, and hydrate well. Then the normal defence mechanisms of the body kick in and the viral infection passes away, just as with common influenza. So, if the patient wishes to use traditional medications, the main difference for Covid-19 is proper isolation — to prevent the infection spreading to caregivers and others.
So, patients may choose Indigenous medicine, and that choice should be respected if quarantine requirements can be ensured. The patient uses “pas-panguva” and other brews, special preparations based on herbs like “rasakinda (Tinospora Cordifolia), veni-ael-gaeta (Coscinium fenestratum), heen-bin kohomba (andrographis paniculata), pitawakka (Phyllanthus Niruri) etc., as recommended by a traditional herbalist. Heen bin-kohomba is also well known in Chinese herbal medicine. It is said to be officially prescribed for Covid in Thailand. A perusal of the “Vattoru” (herbal lists) given by the late Ven. Ananda Maithreeya, is sufficient to identify the herbs of interest for the relevant class of infections. The pharmacological properties, and botanical details of many local herbs and plants are given in the website https://dh-web.org/ place.names/bot2sinhala.html that I have developed over decades.
All these herbal medications, even the recommended “best ones”, are much less efficacious than, say, acetaminophen (paracetamol, Tylenol, Panadol) in lowering fever and body pain. Rasakinda extracts, even when given in high doses, take over two hours to bring down the fever of laboratory mice tested in clinical studies, while acetaminophen does it at a much lower dose, and within half an hour. Furthermore, many herbs like “heen-bin kohomba” or “Rasakinda” – while more effective than the ubiquitous “pas-panguva”, also have adverse consequences (see our website).
In contrast, acetaminophen is very safe even for pregnant mothers, and the reported problems have arisen from “human error” or “patient folly”. Indigenous medicine lacks effective antipyretics like acetaminophen or ibuprofen. Of course, some say, “we let nature take its course”, and do not lower the fever! But high fever can have adverse effects, and the febrile sick find it hard to sleep and get rest.
Nevertheless, if someone chooses traditional medicine for a Corona-SARS type infection, they should have their wish, subject to proper quarantine procedures that hospitals of indigenous-medicine can easily provide. Such hospitals should have the right to transfer patients to hospitals practicing scientific medicine, if the health of the patient needs it.
Covid vaccine is far cheaper than Traditional Medicine.
People are surprised to hear that vaccines and “Western Treatment” are much cheaper than local brews or herbal medications. A 500 mg tablet of acetaminophen at the State Pharmaceutical Corporation costs Rs 1.00 (or at most Rs 3.00 if a name brand is purchased). Three such tablets, costing Rs 3 per day is usually enough to control fever. A packet of Paspanguva costs Rs 200-400, and usually at least 4-5 packets may be needed since viral infections take 7-10 days to heal. The total cost of the “Western treatment” may be Rs 21, while the cost of the herbal treatment using 5 packets of “paspanguva” is about Rs 1500, i.e., 70 times more expensive. In addition, if other less common preparations (e.g., using Rasakinda, or Heen Bim Kohomba) were used, the cost would be even more.
So, the treatment of an uncomplicated viral infection using indigenous medicine is about a hundred times more expensive than using scientific medicine. The latter is also less prone to side effects (e.g., for complications from Rasakinda or Bin Kohomba, see our plant website).
It is also claimed that various special brews like the “Dhammika Peniya“, or the “Sudharshana” brew etc., can cure or protect against Covid-19 infections. Owing to politicisation, and opposition to any scientific review as being a part of “Western Hegemony”, no peer-reviewed clinical studies are available. How preparations saturated with sugar can be approved for invalids who may well be diabetic is unclear. However, assuming that accredited medical personnel of the Dept. of Indigenous Medicine accept the brews, we include them in our discussion.
The Dhammika Peniya (containing honey, nutmeg, and two undeclared ingredients) is said to cost about Rs 6.000- Rs 8,000, and needs to be taken during four days to obtain a cure. Assuming that a US dollar is Rs 200, a bottle of the “Peniya” costs $30-40. According to reports, such a bottle may be adequate for two people. Hence the cost of immunization, or treatment with the “Peniya” is $15-20 per person. The other available local preparations are as costly. They are in extreme short supply, the price would move up, and there would be no more at any price.
Unlike the “Peniya”, extensive clinical trials have been used with the Pfizer-Biontech vaccine, the Moderna vaccine, as well as with the AstraZeneca Oxford vaccine. The Oxford vaccine is the most convenient for Sri Lanka, as it does not need ultra-cold storage. It is said to cost about $2., i.e., 7-10 times CHEAPER than the “Dhammika Peniya”, the performance of which is unknown.
If approximately 65-70% of the adult population were vaccinated, “herd immunity” is said to set in, benefiting the whole population. Sri Lanka’s adult population is about 14 million; the approximate cost of the vaccine for 70% (9.5 million) is $19 million. Sri Lanka can do it, and has led the way in South Asia in the past, in successful vaccination programs to counter common diseases where traditional treatments failed.
To assume that 9.5 million doses of the Dhammika Peniya (or the preparations offered by its competitors) are available at any price is pure fantasy. Nevertheless, even at $20 per portion of a local brew, the local treatment will cost the country $190 million, not including organizational costs.
Sri Lanka should avoid becoming the country that made a pooja of $190 million to “Kali Amma”, and yet earned the Wrath of the Goddess – “Deva Udahasa“. If Peniya fails to work, it is surely not the fault of the “Kapuva“, but a “Deva-Udahasa”!
(The author maintains a website, viz., dh-web.org/place.names/bot2sinhala.html on local plants, ethno-botany, phyto-chemistry and plant pharmacology.)
Regulate sports in popular schools ahead of big matches
The Big Matches between popular schools in Colombo and main outstation cities are round the corner. In the past school sports was in the hands of former sportsmen and sportswomen who loved the game as well as their school. They devoted their time and money to coach the budding youth without any monetary gain for themselves.
But, see what has happened today. Sports coaches selected by the schools demand millions of rupees to coach the students. And this is readily agreed and paid by the school authorities. In the good old days the members of School teams were provided free meals during match days and also Sports equipment. But it is not so now. The school earn millions of rupees from big matches played for a duration of two, or three days in some cases, and this money could be utilised to buy the required cricket gear such as bats, pads gloves, boots, etc,. I understand a pair of cricket boots is in the region of Rs.18,000 to 25,000. Can a poor village lad who is enrolled to an affluent schools in Colombo, based on his performance in Education and Cricket afford this? These lads should be given all the support to continue in their respective sports rather than drop out due to financial constraints
Coaches in some schools are in the payroll of big-time businessmen whose children are, in the so called pools. Parents of children engaged in a particular sport should not be permitted to come in as sponsors as this would be rather unethical.
The Big Matches between popular boys schools are around the corner and I suggest that the Sports Ministry ensures performance based selections rather than on other criteria.
‘Post turtle’ revisited
I have written about this amusingly thought-provoking creature, the ‘post turtle’ to ‘The Island’ around three years ago (appeared in the opinion column of The Island newspaper on the 19th of June 2018, titled ‘The post turtle era’). The story, which I am sure most of you have heard/read already, is obviously not a creation of mine and I happened to come across it somewhere, sometime ago.
And for the benefit of those, who haven’t heard the story, it goes like this:
“While surturing a cut on the hand of an old Texas rancher, the doctor struck up a conversation with the old man. Eventually, the topic got around to politics and then they discussed some new guy, who was far too big for his shoes, as a politician.
The old rancher said, ‘Well, ya know he is a post turtle’. Not being familiar with the term, the doctor asked him what a ‘post turtle was’.
The old rancher said, ‘When you are driving down a country road and you come across a fence post with a turtle balanced on top, well, that’s your ‘post turtle’.
The rancher saw a puzzled look on the doctor’s face, so he went on to explain. ‘You know, he didn’t get up there by himself, he doesn’t belong up there, he doesn’t know what to do while he is up there, and you just wonder what kind of a dumb ass put him up there in the first place’.”
Now I was having this nice, little siesta, the other day and suddenly there appeared ‘the turtle’ in front of me, sitting on a fence post, seemingly doing a precarious balancing act as the post itself was too high for it to give it a try to jump down to the ground. Not that it probably wanted to do it anyway for it looked quite contended and happy sitting there doing absolutely nothing. And no doubt some loyal and dumb all rolled into one, must have put him up there and been feeding it well too, for it looked quite contended and fat showing a thick head that kept turning to the left and then to the right, while its tongue kept on lolling out as if it was saying something, which must have been absolute gibberish and rubbish anyway.
What a fitting and symbolic representation,
I mean this ‘post turtle’, of the lot, or the majority of it sitting across ‘the oya’, I mused on after I woke up from my snooze.
Many of them get there thanks to the gullible voter, who while ticking the boxes, thinks: he/she will surely deliver the goods this time as promised!
And those two-legged post turtles inside the edifice, bordering the Diyawanna, like the one in the story, keep uttering sheer rubbish and spitting out incomprehensible mumbo jumbo, all in return with thanks to those, who tick the boxes in their favour.
Their statements such as ‘what is oxygen for, to eat?’, is just one among many such stupendously stupid utterances of theirs and I don’t want to tire you with the rest, for they are well known and far too many.
Now I have only one question for you before I end this:
When are we going stop being ‘those dumb asses’, once and for all?
Abuse of use of title Professor
I read with much interest the letter by Mr. Nissanka Warakaulle, regarding the above matter, in the issue of the Sunday Island of 18th April 2021. I agree fully with the contents of his letter. He should be very familiar with the regulations as he is a former Registrar of the University of Colombo. I wish to highlight another instance where it is abused. In the 1970s, the title of Associate Professor was created. Until then there were only three categories of Professors. Firstly the holder of the Chair, secondly a co-Professor and thirdly, an Emeritus Professor. There were also, Lecturers, Senior Lecturers and Readers. The title of Reader was replaced with the title Associate Professor, which is meant to be a designation, to be used after the name. However, this category of academics started using it as a pre-fix, dropping the word Associate!
Profesor Sanath P. Lamabadusuriya MBE
Emeritus Professor of Paediatrics,
University of Colombo
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