Opinion

Book on Rabies for the public – by Prof. Nimal Senanayake

Published

3 years ago

2023/05/4

Reviewed by Prof. N.A. de S. Amaratunga PhD, DSc

Prof. Nimal Senanayake MD, PhD. DSc, FRCP, professor emeritus, eminent neurologist and creative writer and producer of drama and films, continuing his commitment to write in Sinhala on important health issues for public education, has published the 17th in the series and the chosen subject is the deadly Rabies of which the public awareness could be insufficient from the point of view of prevention and treatment to prevent death. Prevention of onset of the disease is not difficult if treatment is instituted soon after a dog bite or bite by other animals, like bats carrying the virus. Prof. Nimal Senanayake (NS) deals with these aspects adequately and in simple prose in his little book of 165 pages.

NS showing his proclivity to drama and suspense starts in dramatic fashion, bringing in bats rather than dogs to begin his story describing cases of rabies in Texas 1951, Florida 1953, and Pennsylvania 1953, all due to attacks from the sky, as it were, all bitten by flying bats coming down and biting without any provocation. All these bats were not blood sucking vampire bats but apparently harmless insectivora. NS’s intention clearly is not just drama but to draw the attention of the reader to the strong possibility of bats developing as vectors of deadly viruses as was the case with Corona and several other virus diseases which NS has written about. NS has mentioned that Rabies following bat bite had occurred in Sri Lanka, too.

NS then embarks upon a very interesting journey, through history, starting with Diana the Roman Goddess of Wilderness and the Hunt, and traces back the history of Rabies to 4000 years. He mentions great philosophers Democritus (500 BCE), and Aristotle (384 – 322 BCE) and the father of medicine Hippocrates, who had written about disease due to animal bites. Greek physician Galen (129 – 200 CE) had recorded the natural history of rabies and also treatment measures, including wound care, some of which are still valid. NS has commented on Arabian writings on rabies which is noteworthy as early development of medicine happened in the Arabian civilisation.

After history, NS switches over to his usual practice, adopted throughout this series,where he asks critical questions and gives lengthy explanations. These questions are those that may arise in the minds of science writers, students, patients and ordinary people. They are designed to bring out the most important information that these categories must know about rabies and also lively anecdotes. This is a very effective and efficient method of conveying the knowledge with brevity and clarity, that the author has developed with his vast experience of teaching and practice of medicine.

Beginning with the virology of rabies, with a description of the rabies virus, the author covers the entirety of all aspects of the disease. He connects up the physiology of the virus with the pathogenesis of the disease, how the virus enters the tissues of the human body, proliferates and then gains access to the nervous system through the peripheral nerves. What happens in the brain, when the virus reaches it and affects the brainstem, limbic system, etc., would be of particular interest to the medical students.

How the author looks at every aspect is exemplified when a question is asked whether the person who attends to the wounds of the patient could contract the infection and the explanation that follows showing how it could happen. Then the author explains why and how rabies is known as hydro-phobia, the horrendous result that ensues when the extremely thirsty patient attempts to take some water into the mouth and try to swallow it is the reason that causes severe fear of water in the mind of the patient. The physiological basis for this undue fear of water, according to the author, is ‘conditioned reflex’ and this is illustrated with the famous experiment by Pavlov and his dog. Similarly, the patient is horrified of the wind blowing against his body which, like water, causes severe shivering and muscle contraction. A comprehensive description of the possible animals that could be a vector for rabies is given and also how careful people should be about their pets and the danger of being suddenly attacked by these animals who may appear to be harmless, is vividly described.

Though these symptoms are seen in the advanced state, the early symptoms could be similar to those of common cold except that there could be radiating numbness at the site of the wound. The wrong beliefs that the patient may bark like a dog or even bite others have no basis and the origin of these beliefs is explained. But the caregivers must be careful not to get contaminated by salivary secretions of the patient, even on a minor wound or scratch on their skin.

The tragedy of the situation is that when the patient is not subject to severe muscle contraction and shivering he could be in his proper senses and he realises that he is facing a horrendous death. This state is really pathetic for everybody near and dear to the patient. Physio-pathological explanations of the often mysterious fearful clinical picture would be very useful to medical students. These fearful clinical features could be to some degree controlled with pain killers and sedatives. Apart from the nervous system other organs also may be invaded via the nerves and consequently heart failure and pneumonia could result. Merciful death would arrive with the patient going into coma due to the development of encephalitis which is not any different from other types of encephalitis.

After this comprehensive discussion on all the important aspects of rabies, the author talks about a rare type of rabies called paralytic rabies which is due to the spinal cord and the medulla oblongata being affected instead of the brain and brain stem. This condition is also known as the dumb or silent rabies as there is no violent spasms but a paralysis of limbs and other muscles. Yet slow death cannot be avoided. This type of rabies is more common with bat bites and there had been an outbreak of it of epidemic proportion in Trinidad in 1929 – 1931 period. Health authorities thought it was an outbreak of polio or botulism poisoning.

Author goes into details of diagnosis and draws our attention to the fact that the animal bite incident may even have been forgotten as onset of symptoms could be delayed. This makes diagnosis difficult and this is made worse by the fact that there may be several other conditions that may initially exhibit similar clinical features. NS with his usual thoroughness mentions that sometimes a person who has been bitten by a dog may undergo immense mental stress and go into hysteria which may simulate rabies!

NS gives a comprehensive description of tetanus which is one of the conditions that need to be differentiated in the diagnosis of rabies. Moreover tetanus could occur following bites by dogs and other animals who carry the bacterium that causes tetanus. In tetanus the bacteria do not travel upto the nervous system but the toxin it produces while proliferating in the depth of a wound could travel along nerves and effect the central nervous system. Spasms of muscles could result in a similar clinical picture to that of rabies though there are important differences that may help the doctor to suspect rabies. These differences are lucidly described by the author and illustrated with clear colour pictures which is a striking feature throughout the book which complements the text and adds value to the work. The fact that if adequate treatment is provided in good time tetanus could be fully cured which is not the case with rabies which needs to be nipped in the bud if it is to be cured is emphasized.

NS mentions botulinum toxin poisoning which is another condition that could mimic rabies. What is important to ordinary reader here is the fact that contaminated food, specially tinned fish that has gone bad could contain the toxin due to Clostridium botulinum contamination. NS does not forget to tell us how to detect the possibility of such contamination by an examination of the can of fish which would appear to be swollen and the fish would be blackish in colour. Other diseases that the author mentions, which may be clinically similar to rabies, are encephalitis caused by malaria, delirium tremens and poisoning by certain locally found wild fruits like “goda kaduru” and “attana” and also “ganja” which children may unknowingly consume.

Then the author deals with the tests that could be carried out to confirm the diagnosis particularly in the animal that had bitten the patient so that treatment could be started early to prevent death. He has a story to tell about the development of these tests and also the vaccines. He gives detailed account of how Frenchman Louis Pasteur succeeded in discovering anthrax causing bacteria in cattle and attempts at developing a vaccine against anthrax and also against rabies. Description of Pasteur’s attempt to experiment the rabies vaccine he had developed on a human being is full of drama and suspense. Scientific detail which could be boring is embellished with human drama which is a feature of NS’s writings that make them so readable. Author has written several pages on Louis Pasteur in order to emphasize the great importance of the ground breaking discoveries he had made which eventually helped mankind to combat many killer diseases caused by micro-organisms. The description of how Pasteur risks his life when he sucked into a tube saliva from a rabid dog is fascinating.

Next NS deals with the attempt at attenuation of the virus by Irish physician Sir David Semple (1856 – 1937) The attenuated virus could be used as the vaccine as it could initiate the development of immunity against the viral infection. Greater success was achieved by the efforts of Polish physician Hillary Koprowski (1960 -2013) and American bacteriologist Herald Cox (1907 – 1986) who used new methods to lessen the virulence of the virus. Methods of producing safe vaccines which may not have the complications of earlier varieties have taken vast strides with the development of DNA technology.

Finally, NS writes about prevention and treatment of rabies which is of vital importance as about 55000 die worldwide annually mainly due to ignorance, negligence and lack of facilities for vaccination. What should be done after being bitten by an animal which could be a vector of rabies are clearly described. The use of Rabies Immunoglobulin (RIG) and Anti-rabies Vaccine (ARV) and their mode of action is given in detail. This section is very important for the student as well as lay persons. The final chapter on animal management from the point of view of rabies prevention would be very useful for everybody, specially people who keep pets, animal lovers and animal farm keepers.

Prof. Senanayake has produced yet again a compact little book, full of knowledge important for everybody, written in beautiful Sinhala prose, like a story, simplifying complex matters and vividly emphasizing where emphasis is necessary. This excellent piece of work would be of use to ordinary people, medical students, postgraduates, animal farmers, and doctors who practice bread and butter medicine everywhere in the country.

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Opinion

Are we reading the sky wrong?

Published

3 days ago

2025/12/26

Thilina Walpola

Rethinking climate prediction, disasters, and plantation economics in Sri Lanka

For decades, Sri Lanka has interpreted climate through a narrow lens. Rainfall totals, sunshine hours, and surface temperatures dominate forecasts, policy briefings, and disaster warnings. These indicators once served an agrarian island reasonably well. But in an era of intensifying extremes—flash floods, sudden landslides, prolonged dry spells within “normal” monsoons—the question can no longer be avoided: are we measuring the climate correctly, or merely measuring what is easiest to observe?

Across the world, climate science has quietly moved beyond a purely local view of weather. Researchers increasingly recognise that Earth’s climate system is not sealed off from the rest of the universe. Solar activity, upper-atmospheric dynamics, ocean–atmosphere coupling, and geomagnetic disturbances all influence how energy moves through the climate system. These forces do not create rain or drought by themselves, but they shape how weather behaves—its timing, intensity, and spatial concentration.

Sri Lanka’s forecasting framework, however, remains largely grounded in twentieth-century assumptions. It asks how much rain will fall, where it will fall, and over how many days. What it rarely asks is whether the rainfall will arrive as steady saturation or violent cloudbursts; whether soils are already at failure thresholds; or whether larger atmospheric energy patterns are priming the region for extremes. As a result, disasters are repeatedly described as “unexpected,” even when the conditions that produced them were slowly assembling.

This blind spot matters because Sri Lanka is unusually sensitive to climate volatility. The island sits at a crossroads of monsoon systems, bordered by the Indian Ocean and shaped by steep central highlands resting on deeply weathered soils. Its landscapes—especially in plantation regions—have been altered over centuries, reducing natural buffers against hydrological shock. In such a setting, small shifts in atmospheric behaviour can trigger outsized consequences. A few hours of intense rain can undo what months of average rainfall statistics suggest is “normal.”

Nowhere are these consequences more visible than in commercial perennial plantation agriculture. Tea, rubber, coconut, and spice crops are not annual ventures; they are long-term biological investments. A tea bush destroyed by a landslide cannot be replaced in a season. A rubber stand weakened by prolonged waterlogging or drought stress may take years to recover, if it recovers at all. Climate shocks therefore ripple through plantation economics long after floodwaters recede or drought declarations end.

From an investment perspective, this volatility directly undermines key financial metrics. Return on Investment (ROI) becomes unstable as yields fluctuate and recovery costs rise. Benefit–Cost Ratios (BCR) deteriorate when expenditures on drainage, replanting, disease control, and labour increase faster than output. Most critically, Internal Rates of Return (IRR) decline as cash flows become irregular and back-loaded, discouraging long-term capital and raising the cost of financing. Plantation agriculture begins to look less like a stable productive sector and more like a high-risk gamble.

The economic consequences do not stop at balance sheets. Plantation systems are labour-intensive by nature, and when financial margins tighten, wage pressure is the first stress point. Living wage commitments become framed as “unaffordable,” workdays are lost during climate disruptions, and productivity-linked wage models collapse under erratic output. In effect, climate misprediction translates into wage instability, quietly eroding livelihoods without ever appearing in meteorological reports.

This is not an argument for abandoning traditional climate indicators. Rainfall and sunshine still matter. But they are no longer sufficient on their own. Climate today is a system, not a statistic. It is shaped by interactions between the Sun, the atmosphere, the oceans, the land, and the ways humans have modified all three. Ignoring these interactions does not make them disappear; it simply shifts their costs onto farmers, workers, investors, and the public purse.

Sri Lanka’s repeated cycle of surprise disasters, post-event compensation, and stalled reform suggests a deeper problem than bad luck. It points to an outdated model of climate intelligence. Until forecasting frameworks expand beyond local rainfall totals to incorporate broader atmospheric and oceanic drivers—and until those insights are translated into agricultural and economic planning—plantation regions will remain exposed, and wage debates will remain disconnected from their true root causes.

The future of Sri Lanka’s plantations, and the dignity of the workforce that sustains them, depends on a simple shift in perspective: from measuring weather, to understanding systems. Climate is no longer just what falls from the sky. It is what moves through the universe, settles into soils, shapes returns on investment, and ultimately determines whether growth is shared or fragile.

The Way Forward

Sustaining plantation agriculture under today’s climate volatility demands an urgent policy reset. The government must mandate real-world investment appraisals—NPV, IRR, and BCR—through crop research institutes, replacing outdated historical assumptions with current climate, cost, and risk realities. Satellite-based, farm-specific real-time weather stations should be rapidly deployed across plantation regions and integrated with a central server at the Department of Meteorology, enabling precision forecasting, early warnings, and estate-level decision support. Globally proven-to-fail monocropping systems must be phased out through a time-bound transition, replacing them with diversified, mixed-root systems that combine deep-rooted and shallow-rooted species, improving soil structure, water buffering, slope stability, and resilience against prolonged droughts and extreme rainfall.

In parallel, a national plantation insurance framework, linked to green and climate-finance institutions and regulated by the Insurance Regulatory Commission, is essential to protect small and medium perennial growers from systemic climate risk. A Virtual Plantation Bank must be operationalized without delay to finance climate-resilient plantation designs, agroforestry transitions, and productivity gains aligned with national yield targets. The state should set minimum yield and profit benchmarks per hectare, formally recognize 10–50 acre growers as Proprietary Planters, and enable scale through long-term (up to 99-year) leases where state lands are sub-leased to proven operators. Finally, achieving a 4% GDP contribution from plantations requires making modern HRM practices mandatory across the sector, replacing outdated labour systems with people-centric, productivity-linked models that attract, retain, and fairly reward a skilled workforce—because sustainable competitive advantage begins with the right people.

by Dammike Kobbekaduwe

(www.vivonta.lk & www.planters.lk ✍️

Opinion

Disasters do not destroy nations; the refusal to change does

Published

4 days ago

2025/12/25

Sahan Weerasooriya

Floods caused by Cyclone Ditwah

Sri Lanka has endured both kinds of catastrophe that a nation can face, those caused by nature and those created by human hands. A thirty-year civil war tore apart the social fabric, deepening mistrust between communities and leaving lasting psychological wounds, particularly among those who lived through displacement, loss, and fear. The 2004 tsunami, by contrast, arrived without warning, erasing entire coastal communities within minutes and reminding us of our vulnerability to forces beyond human control.

These two disasters posed the same question in different forms: did we learn, and did we change? After the war ended, did we invest seriously in repairing relationships between Sinhalese and Tamil communities, or did we equate peace with silence and infrastructure alone? Were collective efforts made to heal trauma and restore dignity, or were psychological wounds left to be carried privately, generation after generation? After the tsunami, did we fundamentally rethink how and where we build, how we plan settlements, and how we prepare for future risks, or did we rebuild quickly, gratefully, and then forget?

Years later, as Sri Lanka confronts economic collapse and climate-driven disasters, the uncomfortable truth emerges. we survived these catastrophes, but we did not allow them to transform us. Survival became the goal; change was postponed.

History offers rare moments when societies stand at a crossroads, able either to restore what was lost or to reimagine what could be built on stronger foundations. One such moment occurred in Lisbon in 1755. On 1 November 1755, Lisbon-one of the most prosperous cities in the world, was almost completely erased. A massive earthquake, estimated between magnitude 8.5 and 9.0, was followed by a tsunami and raging fires. Churches collapsed during Mass, tens of thousands died, and the royal court was left stunned. Clergy quickly declared the catastrophe a punishment from God, urging repentance rather than reconstruction.

One man refused to accept paralysis as destiny. Sebastião José de Carvalho e Melo, later known as the Marquês de Pombal, responded with cold clarity. His famous instruction, “Bury the dead and feed the living,” was not heartless; it was revolutionary. While others searched for divine meaning, Pombal focused on human responsibility. Relief efforts were organised immediately, disease was prevented, and plans for rebuilding began almost at once.

Pombal did not seek to restore medieval Lisbon. He saw its narrow streets and crumbling buildings as symbols of an outdated order. Under his leadership, Lisbon was rebuilt with wide avenues, rational urban planning, and some of the world’s earliest earthquake-resistant architecture. Moreover, his vision extended far beyond stone and mortar. He reformed trade, reduced dependence on colonial wealth, encouraged local industries, modernised education, and challenged the long-standing dominance of aristocracy and the Church. Lisbon became a living expression of Enlightenment values, reason, science, and progress.

Back in Sri Lanka, this failure is no longer a matter of opinion. it is documented evidence. An initial assessment by the United Nations Development Programme (UNDP) following Cyclone Ditwah revealed that more than half of those affected by flooding were already living in households facing multiple vulnerabilities before the cyclone struck, including unstable incomes, high debt, and limited capacity to cope with disasters (UNDP, 2025). The disaster did not create poverty; it magnified it. Physical damage was only the visible layer. Beneath it lay deep social and economic fragility, ensuring that for many communities, recovery would be slow, uneven, and uncertain.

The world today offers Sri Lanka another lesson Lisbon understood centuries ago: risk is systemic, and resilience cannot be improvised, it must be planned. Modern climate science shows that weather systems are deeply interconnected; rising ocean temperatures, changing wind patterns, and global emissions influence extreme weather far beyond their points of origin. Floods, landslides, and cyclones affecting Sri Lanka are no longer isolated events, but part of a broader climatic shift. Rebuilding without adapting construction methods, land-use planning, and infrastructure to these realities is not resilience, it is denial. In this context, resilience also depends on Sri Lanka’s willingness to learn from other countries, adopt proven technologies, and collaborate across borders, recognising that effective solutions to global risks cannot be developed in isolation.

A deeper problem is how we respond to disasters: we often explain destruction without seriously asking why it happened or how it could have been prevented. Time and again, devastation is framed through religion, fate, karma, or divine will. While faith can bring comfort in moments of loss, it cannot replace responsibility, foresight, or reform. After major disasters, public attention often focuses on stories of isolated religious statues or buildings that remain undamaged, interpreted as signs of protection or blessing, while far less attention is paid to understanding environmental exposure, construction quality, and settlement planning, the factors that determine survival. Similarly, when a single house survives a landslide, it is often described as a miracle rather than an opportunity to study soil conditions, building practices, and land-use decisions. While such interpretations may provide emotional reassurance, they risk obscuring the scientific understanding needed to reduce future loss.

The lesson from Lisbon is clear: rebuilding a nation requires the courage to question tradition, the discipline to act rationally, and leadership willing to choose long-term progress over short-term comfort. Until Sri Lanka learns to rebuild not only roads and buildings, but relationships, institutions, and ways of thinking, we will remain a country trapped in recovery, never truly reborn.

by Darshika Thejani Bulathwatta
Psychologist and Researcher

Opinion

A wise Christmas

Published

5 days ago

2025/12/24

Sahan Weerasooriya

Important events in the Christian calendar are to be regurlarly reviewed if they are to impact on the lives of people and communities. This is certainly true of Christmas.

Community integrity

Years ago a modest rural community did exactly this, urging a pre-Christmas probe of the events around Jesus’ birth. From the outset, the wisemen aroused curiosity. Who were these visitors? Were they Jews? No. were they Christians? Of course not. As they probed the text, the representative character of those around the baby, became starkly clear. Apart from family, the local shepherds and the stabled animals, the only others present that first Christmas, were sages from distant religious cultures.

With time, the celebration of Christmas saw a sharp reversal. The church claimed exclusive ownership of an inclusive gift and deftly excluded ‘outsiders’ from full participation.

But the Biblical version of the ‘wise outsiders’ remained. It affirmed that the birth of Jesus inspired the wise to initiate a meeting space for diverse religious cultures, notwithstanding the long and ardous journey such initiatives entail. Far from exclusion, Jesus’ birth narratives, announced the real presence of the ‘outsider’ when the ‘Word became Flesh’.

The wise recognise the gift of life as an invitation to integrate sincere explanations of life; true religion. Religion gone bad, stalls these values and distorts history.

There is more to the visit of these sages.

Empire- When Jesus was born, Palestine was forcefully occcupied by the Roman empire. Then as now, empire did not take kindly to other persons or forces that promised dignity and well being. So, when rumours of a coming Kingdom of truth, justice and peace, associated with the new born baby reached the local empire agent, a self appointed king; he had to deliver. Information on the wherabouts of the baby would be diplomatically gleaned from the visiting sages.

But the sages did not only read the stars. They also read the signs of the times. Unlike the local religious authorities who cultivated dubious relations with a brutal regime hated by the people, the wise outsiders by-pass the waiting king.

The boycott of empire; refusal to co-operate with those who take what it wills, eliminate those it dislikes and dare those bullied to retaliate, is characteristic of the wise.

Gifts of the earth

A largely unanswered question has to do with the gifts offered by the wise. What happened to these gifts of the earth? Silent records allow context and reason to speak.

News of impending threats to the most vulnerable in the family received the urgent attention of his anxious parent-carers. Then as it is now, chances of survival under oppressive regimes, lay beyond borders. As if by anticipation, resources for the journey for asylum in neighbouring Egypt, had been provided by the wise. The parent-carers quietly out smart empire and save the saviour to be.

Wise carers consider the gifts of the earth as resources for life; its protection and nourishment. But, when plundered and hoarded, resources for all, become ‘wealth’ for a few; a condition that attempts to own the seas and the stars.

Wise choices

A wise christmas requires that the sages be brought into the centre of the discourse. This is how it was meant to be. These visitors did not turn up by chance. They were sent by the wisdom of the ages to highlight wise choices.

At the centre, the sages facilitate a preview of the prophetic wisdom of the man the baby becomes.The choice to appropriate this prophetic wisdom has ever since summed up Christmas for those unable to remain neutral when neighbour and nature are violated.

Wise carers

The wisdom of the sages also throws light on the life of our nation, hard pressed by the dual crises of debt repayment and post cyclonic reconstruction. In such unrelenting circumstances, those in civil governance take on an additional role as national carers.

The most humane priority of the national carer is to ensure the protection and dignity of the most vulnerable among us, immersed in crisis before the crises. Better opportunities, monitored and sustained through conversations are to gradually enhance the humanity of these equal citizens.

Nations in economic crises are nevertheless compelled to turn to global organisations like the IMF for direction and reconstruction. Since most who have been there, seldom stand on their own feet, wise national carers may not approach the negotiating table, uncritically. The suspicion, that such organisations eventually ‘grow’ ailing nations into feeder forces for empire economics, is not unfounded.

The recent cyclone gave us a nasty taste of these realities. Repeatedly declared a natural disaster, this is not the whole truth. Empire economics which indiscriminately vandalise our earth, had already set the stage for the ravage of our land and the loss of loved ones and possessions. As always, those affected first and most, were the least among us.

Unless we learn to manouvre our dealings for recovery wisely; mindful of our responsibilities by those relegated to the margins as well as the relentles violence and greed of empire, we are likely to end up drafted collaborators of the relentless havoc against neighbour and nature.

If on the other hand the recent and previous disasters are properly assessed by competent persons, reconstruction will be seen as yet another opportunity for stabilising content and integrated life styles for all Lankans, in some harmony with what is left of our dangerously threatened eco-system. We might then even stand up to empire and its wily agents, present everywhere. Who knows?

With peace and blessings to all!

Bishop Duleep de Chickera