By Dr Upul Wijayawardhana
Whatever the intervention, be it drugs, devices or surgery, it has the potential to do harm: this is an accepted dictum in science-based modern medicine. However, no intervention is recommended unless benefits far outweigh any potential harm. Further, there is continuing surveillance to spot any unexpected dangers, a higher degree of observation being mandated for any new interventions. In the British National Formulary (BNF), which lists all drugs approved for use, some drugs have a ‘black triangle’ to indicate that they are under enhanced surveillance. All drugs are dispensed in the UK with patient information leaflets. The most important method of surveillance used in the UK is the ‘Yellow card scheme’, which is run by the Medicines and Healthcare products Regulatory Agency (MHRA). Any adverse event can be reported to the MHRA, on this readily accessible system, by any healthcare professional, a patient or even a carer. MRHA monitors these adverse events and takes whatever action necessary which may amount, in rare instances, to even the total withdrawal of the drug.
Such safeguards, whether they exist in ‘alternative medicine’ or who applies them, is a moot point at the present time as many wonder drugs are being paraded a cure for COVID-19, which has snuffed out almost one and a half million lives around the world. Some may argue that ‘alternative medicine’ does not need such safeguards as they use natural products. But, are all-natural products safe? Not so! What is conveniently forgotten is that many plants have highly toxic compounds. After all, the belladonna plant, which belongs to the same family as tomatoes, potatoes and brinjal, is called deadly nightshade as it can kill. However, atropine extracted from it is widely used in modern medicine. Sweet potato, though called a potato, does not belong to the nightshade family and that is why we can enjoy a ‘mallum’ made out of the leaves though we cannot do the same with potato leaves. I dare not eat wild mushrooms that sprout in my garden as I lack the expertise to identify what may kill me! I can cite many more examples.
School holidays were what we longed for in our childhood although we had to undergo a ritual purge! My parents were teachers, but they were heavily influenced by Ayurveda, perhaps because one of my paternal aunts was married to an Ayurvedic physician. Ayurveda recommends cleansing the bowel, perhaps, due to the lack of understanding of the basic physiology that the normal bowel is always clean. We had to have a purgative, usually aralu infused king coconut water, at least once a year. Even the worst food poisoning I have had never produced such a violent diarrhoea. I still remember this unnecessary, misguided torture which could have killed us, but we survived, maybe because the human body has evolved to face dangers!
During my working life in Sri Lanka, I saw many patients who had complications, the commonest being jaundice, which may have been caused by Ayurvedic preparations but, unfortunately, there was no authority to report to and no action could be taken. I am sure many morbidities are simply overlooked due to the total lack of any surveillance.
I remember a patient whose heart was seriously affected by medication used in another ‘alternative medicine’ system. Before coronary angiography (taking x-ray pictures after injecting a radio-opaque dye to the arteries that supply blood to the heart muscle) was started in Sri Lanka and at a time when medicine in Singapore was not that advanced, one of my professional ‘risks’ was having to accompany VIPs and friends to London for this procedure. I had to take my own leave for these trips and I never charged a penny from any Sri Lankan but that is another story. This was a rich businessman who was married to a much younger beautiful woman. I was with him when his coronary angiogram was done in a private hospital in London, and it was normal except that heart muscle function was severely impaired. On detailed questioning he admitted to taking a medication which he said he obtained from a ‘native physician’ as he did not want to disappoint his young wife, in the pre-Viagra era! I could not investigate as he refused to divulge any further details.
As heavy metals can impair heart muscle function, my suspicion was that my friend was using a preparation with a compound of a heavy metal and advised him strongly to stop it, pointing out that if he continued, he would develop severe heart failure. He took my advice and the function of his heart muscle improved gradually, which I could demonstrate by serial echocardiography, a procedure using reflected ultrasound to produce a 2D picture of the heart. Over two years, his heart muscle function normalised and he was overjoyed. When I reviewed him a year later, I found that his heart muscle function to be impaired again. When I asked him whether he had started that again, his response was “How did you know?” Thus, there was no doubt that his heart muscle dysfunction was due to that particular drug.
Science-based modern medicine we practise has evolved from empirical systems of the past and uses many drugs but they undergo a process of rigorous testing. When a drug is considered to be useful, it undergoes testing in at least three phases, as I mentioned in my article, “Peddling snake oil” (The Island, 17 October). Therefore, I was taken aback when wide publicity was given in the media that an Ayurvedic physician had developed a drug that cured Covid-19. In fact, The Island of December 3 carried a photograph of our Health Minister tasting the decoction but I doubt anybody taking her seriously. After all, she is the one who kissed the Chinese lady off with COVID-19 and dropped pots in rivers at the behset of a faith healer. Rather than allowing experts, who have the knowledge of the behaviour of this deadly virus, to do their job, playing politics is not only laughable but dangerous. Media reports stated that this decoction was tested by some specialist physicians in the government sector and they found that PCR positive patients tested negative after this decoction. That simply is the wrong yardstick to use as all who recover would become PCR negative, as the body develops antibodies to get rid of the virus. After extensive trials, it was shown that the antiviral remdesivir may shorten the duration of the illness and that dexamethasone significantly reduced the death rate in hospitalised patients. To claim that any drug is a cure without testing it properly is the height of absurdity and supporting these wild claims only amounts to misleading the public. Compared to many other countries, Sri Lanka is still doing very well and the best way to fight this deadly virus is preventing its spread by physical distancing, wearing masks and washing hands, till an affordable vaccine becomes available.
Now it transpires that this ‘physician’ is just a kapuwa in a kovil! Are we living in a fool’s paradise?
Govt.’s choice is dialogue over confrontation
By Jehan Perera
Preparing for the forthcoming UN Human Rights Council cannot be easy for a government elected on a nationalist platform that was very critical of international intervention. When the government declared its intention to withdraw from Sri Lanka’s co-sponsorship of the October 2015 resolution No. 30/1 last February, it may have been hoping that this would be the end of the matter. However, this is not to be. The UN Human Rights High Commissioner’s report that will be taken up at the forthcoming UNHRC session in March contains a slate of proposals that are severely punitive in nature and will need to be mitigated. These include targeted economic sanctions, travel bans and even the involvement of the International Criminal Court.
Since UN Secretary General Ban Ki-Moon’s visit in May 2009 just a few days after the three-decade long war came to its bloody termination, Sri Lanka has been a regular part of the UNHRC’s formal discussion and sometimes even taking the centre stage. Three resolutions were passed on Sri Lanka under acrimonious circumstances, with Sri Lanka winning the very first one, but losing the next two. As the country became internationally known for its opposition to revisiting the past, sanctions and hostile propaganda against it began to mount. It was only after the then Sri Lankan government in 2015 agreed to co-sponsor a fresh resolution did the clouds begin to dispel.
Clearly in preparation for the forthcoming UNHRC session in Geneva in March, the government has finally delivered on a promise it made a year ago at the same venue. In February 2020 Foreign Minister Dinesh Gunawardena sought to prepare the ground for Sri Lanka’s withdrawal from co-sponsorship of UN Human Rights Council resolution No 30/1 of 2015. His speech in Geneva highlighted two important issues. The first, and most important to Sri Lanka’s future, was that the government did not wish to break its relationships with the UN system and its mechanisms. He said, “Sri Lanka will continue to remain engaged with, and seek as required, the assistance of the UN and its agencies including the regular human rights mandates/bodies and mechanisms in capacity building and technical assistance, in keeping with domestic priorities and policies.”
Second, the Foreign Minister concluding his speech at the UNHRC session in Geneva saying “No one has the well-being of the multi-ethnic, multi-lingual, multi-religious and multi-cultural people of Sri Lanka closer to their heart, than the Government of Sri Lanka. It is this motivation that guides our commitment and resolve to move towards comprehensive reconciliation and an era of stable peace and prosperity for our people.” On that occasion the government pledged to set up a commission of inquiry to inquire into the findings of previous commissions of inquiry. The government’s action of appointing a sitting Supreme Court judge as the chairperson of a three-member presidential commission of inquiry into the findings and recommendations of earlier commissions and official bodies can be seen as the start point of its response to the UNHRC.
The government’s setting up of a Commission of Inquiry has yet to find a positive response from the international and national human rights community and may not find it at all. The national legal commentator Kishali Pinto Jayawardene has written that “the tasks encompassed within its mandate have already been performed by the Lessons Learnt and Reconciliation Commission (LLRC, 2011) under the term of this President’s brother, himself the country’s Executive President at the time, Mahinda Rajapaksa.” Amnesty International has stated that “Sri Lanka has a litany of such failed COIs that Amnesty International has extensively documented.” It goes on to quote from the UN High Commissioner for Human Rights that “Domestic processes have consistently failed to deliver accountability in the past and I am not convinced the appointment of yet another Commission of Inquiry will advance this agenda. As a result, victims remain denied justice and Sri Lankans from all communities have no guarantee that past patterns of human rights violations will not recur.”
It appears that the government intends its appointment of the COI to meet the demand for accountability in regard to past human rights violations. Its mandate includes to “Find out whether preceding Commissions of Inquiry and Committees which have been appointed to investigate into human rights violations, have revealed any human rights violations, serious violations of the international humanitarian law and other such serious offences.” In the past the government has not been prepared to accept that such violations took place in a way that is deserving of so much of international scrutiny. Time and again the point has been made in Sri Lanka that there are no clean wars fought anywhere in the world.
International organisations that stands for the principles of international human rights will necessarily be acting according to their mandates. These include seeking the intervention of international judicial mechanisms or seeking to promote hybrid international and national joint mechanisms within countries in which the legal structures have not been successful in ensuring justice. The latter was on the cards in regard to Resolution 30/1 from which the government withdrew its co-sponsorship. The previous government leaders who agreed to this resolution had to publicly deny any such intention in view of overwhelming political and public opposition to such a hybrid mechanism. The present government has made it clear that it will not accept international or hybrid mechanisms.
In the preamble to the establishment of the COI the government has made some very constructive statements that open up the space for dialogue on issues of accountability, human rights and reconciliation. It states that “the policy of the Government of Sri Lanka is to continue to work with the United Nations and its Agencies to achieve accountability and human resource development for achieving sustainable peace and reconciliation, even though Sri Lanka withdrew from the co-sponsorship of the aforesaid resolutions” and further goes on to say that “the Government of Sri Lanka is committed to ensure that, other issues remain to be resolved through democratic and legal processes and to make institutional reforms where necessary to ensure justice and reconciliation.”
As the representative of a sovereign state, the government cannot be compelled to either accept international mechanisms or to prosecute those it does not wish to prosecute. At the same time its willingness to discuss the issues of accountability, justice and reconciliation as outlined in the preamble can be considered positively. The concept of transitional justice on which Resolution No 30/1 was built consists of the four pillars of truth, accountability, reparations and institutional reform. There is international debate on whether these four pillars should be implemented simultaneously or whether it is acceptable that they be implemented sequentially depending on the country context.
The government has already commenced the reparations process by establishing the Office for Reparations and to allocate a monthly sum of Rs 6000 to all those who have obtained Certificates of Absence (of their relatives) from the Office of Missing Persons. This process of compensation can be speeded up, widened and improved. It is also reported that the government is willing to consider the plight of suspected members of the LTTE who have been in detention without trial, and in some cases without even being indicted, for more than 10 years. The sooner action is taken the better. The government can also seek the assistance of the international community, and India in particular, to develop the war affected parts of the country on the lines of the Marshall Plan that the United States utilized to rebuild war destroyed parts of Europe. Member countries of the UNHRC need to be convinced that the government’s actions will take forward the national reconciliation process to vote to close the chapter on UNHRC resolution 30/1 in March 2021.
Album to celebrate 30 years
Rajiv Sebastian had mega plans to celebrate 30 years, in showbiz, and the plans included concerts, both local and foreign. But, with the pandemic, the singer had to put everything on hold.
However, in order to remember this great occasion, the singer has done an album, made up of 12 songs, featuring several well known artistes, including Sunil of the Gypsies.
All the songs have been composed, very specially for this album.
Among the highlights will be a duet, featuring Rajiv and the Derena DreamStar winner, Andrea Fallen.
Andrea, I’m told, will also be featured, doing a solo spot, on the album.
Rajiv and his band The Clan handle the Friday night scene at The Cinnamon Grand Breeze Bar, from 07.30 pm, onwards.
LET’S DO IT … in the new normal
The local showbiz scene is certainly brightening up – of course, in the ‘new normal’ format (and we hope so!)
Going back to the old format would be disastrous, especially as the country is experiencing a surge in Covid-19 cases, and the Western Province is said to be high on the list of new cases.
But…life has to go on, and with the necessary precautions taken, we can certainly enjoy what the ‘new normal’ has to offer us…by way of entertainment.
Bassist Benjy, who leads the band Aquarius, is happy that is hard work is finally bringing the band the desired results – where work is concerned.
Although new to the entertainment scene, Aquarius had lots of good things coming their way, but the pandemic ruined it all – not only for Aquarius but also for everyone connected with showbiz.
However, there are positive signs, on the horizon, and Benjy indicated to us that he is enthusiastically looking forward to making it a happening scene – wherever they perform.
And, this Friday night (January 29th), Aquarius will be doing their thing at The Show By O, Mount Lavinia – a beach front venue.
Benjy says he is planning out something extra special for this particular night.
“This is our very first outing, as a band, at The Show By O, so we want to make it memorable for all those who turn up this Friday.”
The legendary bassist, who lights up the stage, whenever he booms into action, is looking forward to seeing music lovers, and all those who missed out on being entertained for quite a while, at the Mount Lavinia venue, this Friday.
“I assure you, it will be a night to be remembered.”
Benjy and Aquarius will also be doing their thing, every Saturday evening, at the Darley rd. Pub & Restaurant, Colombo 10.
In fact, they were featured at this particular venue, late last year, but the second wave of Covid-19 ended their gigs.
Also new to the scene – very new, I would say – is Ishini and her band, The Branch.
Of course, Ishini is a singer of repute, having performed with Mirage, but as Ishini and The Branch, they are brand new!
Nevertheless, they were featured at certain five-star venues, during the past few weeks…of their existence.
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