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Childhood malnutrition: the double-edged sword

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BY Dr B. J. C. Perera

MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paed), MRCP(UK), FRCP(Edin), FRCP(Lon), FRCPCH(UK), FSLCPaed, FCCP, Hony FRCPCH(UK), Hony. FCGP(SL)

Specialist Consultant Paediatrician and Honorary Senior Fellow, Postgraduate Institute of Medicine, University of Colombo, Sri Lanka.

In an article published in the prestigious British Medical Journal as far back as 2004, titled “Is there hope for South Asia? Yes, if we can replicate the models of Kerala and Sri Lanka”, two erudite medical scholars Zulfiqar Bhutta and Samiran Nundy, held up our Motherland and its health system as a prototype for other countries in the region to follow. The authors noted that after gaining independence from the British, Sri Lanka invested heavily in education and health as a cornerstone of socioeconomic development. They also went to the extent of complimenting our country on achieving superlative results in achieving the very best health indices despite an ongoing civil war. The publication clearly documented that these results were due to committed political will, grassroots support, and an important policy plank based on primary healthcare, especially in maternal and child health, through a multi-layered health system with adequate provision of basic services at the community level. Indeed, we were top-of-the-pops in our Asian region.

Fast-forward 18 years. The very same British Medical Journal in an article published in November 2022, titled “Sri Lanka’s health crisis: Urgent action is needed to maintain vital services”, written by two Sri Lankan authors Shashika Bandara and Inosha Alwis, has taken an about turn of a complete 180 degrees. They state categorically that Sri Lanka is facing a severe political and economic crisis, and the health system is at risk of collapse. The authors say, “Interconnected challenges, including a severe shortage of essential medicines, a worsening socioeconomic landscape, and human rights violations, remain substantial threats to health in Sri Lanka”. Then the authors go on to describe two vitally important pieces of information that should make us sit up bolt-upright and take intense notice. They document that nearly six million Sri Lankans; three in every 10 households, are food insecure and face an 80% inflation rate for food. Then they go on to state that UNICEF estimates that over two million children in Sri Lanka require humanitarian assistance. The authors conclude that as far as policy imperatives go, Sri Lanka’s leaders need to improve their policy on health system strengthening in both the short term and the longer term.

All this brings us pointedly to the current situation regarding the fiasco in providing optimal nutrition for the children of our land. They are the jewels that would shape the future of our beautiful country. This author in an article titled: The “Feed a Child” initiative: A laudable effort of love from the Sri Lanka College of Paediatricians, published in The Island newspaper, as far back as 17th October 2022, in a telling lamentation stated “Childhood Malnutrition is the miserable topic of our times in the current fiasco of the crisis in our country. Many international organisations, as well as local authorities, have placed our land at the rock bottom of the abyss of childhood malnutrition”.

Then later on in that article, I went on to say “However, make no mistake, the current state of inadequate childhood nutrition is the harbinger of the resurgence of such dangerous forms of clinical states in the not-too-distant future. If steps are not taken to arrest the current trend, these would be the likely consequences that would threaten the lives of children”.

It is noteworthy that a so-called top legislator, not too long ago, in the citadel of the legislature, totally denied that there is childhood malnutrition in our country. That took place even despite compelling evidence to the contrary from several sources. The opposition, which usually breathes fire and shouts till they are hoarse, was silent. Their lot included several medical personnel too. Their silence too was deafening.

Then, hey presto., just a week after that incident, the same legislator had to eat humble pie and admit in the well of the citadel itself that childhood malnutrition was rampant. The opposition was still silent, perhaps in the belief that silence is golden, even when a person had lied through that person’s back teeth. As the former Prime Minister of Russia, Nikita Khrushchev once said about politicians “they are all the same”. Shame on all of them.

Here is something that is not all that well known. There is a gradual and most surreptitious increase in the number of low-birth-weight babies over the last couple of years. That is, at least in part, due to maternal malnutrition. The foetus needs all nutrients to grow within the womb and if the pregnant mother does not get sufficient essential nutrients in her diet, it will be the baby inside her who will suffer. That baby will be born malnourished.

The sword of childhood malnutrition is double-edged. It will lead to a stunted, frail, physically disadvantaged cluster of young people and adults. I do not have to spell out the obvious problems that may arise as a result of that. The other cutting edge of the sword is that we will have an intellectually disadvantaged and cognitively impoverished population as the growth of the young brain and the development of intellectual abilities depend on optimal nutrition. We have some of the best brains in our country at present. If we allow malnutrition to take root in our population, in 10 to 20 years, it may not be the case at all.

Now to a suggestion for a remedy in the short-term, perhaps to be undertaken even in the longer term.

The government should make sure that ALL students in ALL the schools, right around the country, will be provided breakfast in the school. It need not be exotic food., even manioc, sweet potatoes, yams, rice, sambol, gravy and an egg would do. A glass of fresh liquid milk will be a real bonus if the authorities can manage it. All these will give the students sufficient calories and proteins to work on during the day. None of them will faint due to hunger and low blood sugar levels.

Then they will go to their classes and will be taught, and taught well. That is entirely up to the teachers.

During the lunch interval, ALL students in ALL the schools, right around the country, should be provided lunch in the school. A simple meal of rice and curry with all locally available ingredients. The authorities can alternate different carbohydrates such as rice, manioc, sweet potatoes, yams, etc., with some locally available lentils, vegetables, fish/meat/eggs or textured vegetable proteins (TVP).

Of course, all of this will need money., loads of it. The government will have to somehow provide it. Just tax the high flyers. An extra two to five per cent tax for all those who are earning more than five million a year will easily cover the cost. Of course, the authorities will have to round up those liable to it, irrespective of caste, creed, political affiliations, etc. The henchmen and henchwomen of politicians, as well as the latter breed themselves, should not be allowed to escape at all costs. In addition, I am quite sure that there will be many local philanthropists who would like to join in this initiative. Their voluntary contributions should be tax-free donations. Parents and well-wishers could be roped in to attend to the logistics of the entire initiative as well.

Now, here is the crunch. For a start, all children will attend school, even simply for food. If the children get some evening meal or dinner at home, it will be nice. But…, and this is a BIG BUT; in the case of severely impoverished families, even if the children do not get anything substantial to eat after they come home from school, it would not matter that much as their daily nutrition would already have been looked after by the government…, at least to a reasonable degree.

It is most definitely a tall order. Are the legislators up to this? It will need real patriotism to somehow achieve this plan. It should be reiterated that with great power comes even greater responsibility. With the all-encompassing power they wield, they should shoulder this responsibility. They owe it to the people of our island nation.

As to whether they are up to it, your guess is as good as mine. My considered opinion is that none of the current lots would fit the bill. We will need a benevolent and far-sighted statesman or stateswoman to get this job done. Once accomplished, the rewards would be very many.



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New mediation law for smarter dispute resolution of civil and commercial disputes – I

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The Mediation (Civil and Commercial Disputes) Bill  was passed by the Parliament on Thursday, June 11, 2026.  Harshana  Nanayakkara, Minister of Justice and National Integration, introduced the Bill, and explained its provisions and value for Sri Lanka and global developments in the use of mediation. Encouragingly, it was passed unanimously.

Sri Lanka’s commitment to provide legislative support for the use of mediation is timely and most welcome. Given that the backlog of cases pending before courts is over a staggering 1.1 million, it is clear that Sri Lanka is yet another country that remains challenged to find responses to make  dispute resolution more efficient. The impact of laws delays is serious and damaging not only to the disputants personally, but also for businesses and the economic development of the country. The delays in concluding cases impacts the economy adversely, both directly and indirectly,  but are often seen only as an access to Justice concern. This is unfortunate. In many jurisdictions across the globe, alternative dispute resolution processes (ADR), such as mediation, have been introduced to alleviate laws delays. While Sri Lanka enacted legislation (1988) to provide for mediation in respect of minor community disputes of a low monetary threshold, the enactment of the new law heralds a commitment to provide for the recognition of a disciplined regime for its use for higher value civil and commercial disputes.

The new law provides for the recognition of mediation as a dispute resolution option that can be voluntarily selected by parties, and for a governance regime to ensure that mediations are conducted in compliance with certain standards which are globally accepted. It provides statutory recognition to the principle that a mediated settlement agreement that has been signed by the disputants, is valid in law. It does not provide for any management control by government or establish entities. In addition to the voluntary reference by parties, a  court can also refer a dispute in an action before it, to mediation, at its discretion, after considering all  circumstances and if considered appropriate.  The voluntary nature of the process is not affected because, while the court can refer the dispute to mediation and the parties must then engage in the mediation, there is no compulsion for the parties to settle against their will.

The law sets out the obligations of Mediators, disputants and the Service Provider. Certain categories of disputes cannot be referred  to mediation.  These are disputes the settlement of which requires the inclusion of terms that can be given effect to, only on a decree of court, such as the termination of a marriage or a declaration of nullity of marriage or the adoption of a child or the partition of land to obtain rights in rem.  A schedule sets out eleven (11) categories of actions that cannot be settled by mediation. However,  matters relevant to such disputes may be mediated for the purpose of submitting terms of settlement to court for consideration of incorporation in a judgement, decree or order in compliance with applicable law.

The new law also provides that in a mediation, certain  key principles of the process must be complied with. These include the  confidentiality and the without prejudice rule in respect of matters discussed at the mediation; the  rule that Mediators must be neutral and impartial; the party centric nature of the process that provides primacy to the wishes of the disputants including that it is they that determine the outcome and that a settlement is reached only if all disputants agree to the terms; the noncoercive role of the mediator whose duty is to facilitate and manage the process using mediation specific skills and techniques, but is debarred from imposing a decision. Although a settlement agreement is valid in law, provision is included to obtain a decree of court, based on the terms of the settlement. A mediated settlement agreement can be set aside on an application made to court, on specific limited grounds which are provided for, including that it is offensive to the public policy of the country. If the parties are unable to agree on a settlement, a certificate of non-settlement is issued. The provisions of the law are based on international best practices and principles articulated in the 1988 UN Mediation Convention  (the Singapore Convention) and the UNCITRAL model law.

The popularity of mediation has grown for its value in being time efficient, cost effective and party centric. Parties have control over the outcome and have the space to discuss their concerns, fears and interests and need never agree to settle unless fully satisfied that settlement terms address their interests. Disputants are free to walk out of a mediation process at any time, if dissatisfied with the progress. The discussions are confidential and a valuable feature is that the process offers an opportunity to reduce acrimony which is prevalent in most disputes, and to restore fractured relationships which is very important in family  and  business related disputes. This benefit and the prospects for governments to reduce the cost of the administration of justice, by using mediation,  is articulated in the preamble to the 2018 UN Convention on International Settlement Agreements Resulting from Mediation (2018) which states that the use of mediation results in significant benefits.

 Pursuant to the interest generated within the country regarding the value of using Mediation for commercial dispute resolution, and heralding what we like to see as the initial steps of a Mediation boom in the country, several positive advancements have taken place –

*    Parties have opted to include mediation in the dispute resolution clause in contracts;

*    Given that mediating disputes requires  very specialised techniques and skills, many professionals, including predominantly Lawyers, have engaged in training programmes offered by international training bodies that offer accreditation;

*    Trained Mediators are engaged in an effort to form themselves as a professional Organisation;

*    Mediation  Advocacy training programmes have been held to train Lawyers on their niche role in the mediation process. That role is distinctly different to that of a court Lawyer who’s obligations are centred on an adversarial approach where the dispute is adjudicated in terms of the law alone.  Hence lawyers need training to be useful within a non-adversarial process which is party centric and has a focus on reaching a settlement, based on the interests of disputants.

*    Sri Lanka enacted the Recognition and Enforcement of International Mediated Settlement Agreements Act No. 5 of 2024 (the UN Mediation Convention Act) and ratified the Convention becoming the 14th country to do so. Sri Lanka will be seen as an investor friendly country in respect of dispute resolution where mediation is used, since it offers an enforcement regime which is recognised universally.

*    The landmark determination of the Supreme Court (SC SD 22 of 2025) in the challenge by the Bar Association to the constitutionality of the Mediation (Civil and Commercial Disputes) Bill, found that none of the provisions of the Bill were unconstitutional and gave a judicial sign off to statutory provisions that seek to ensure that mediation services are provided in this country, in a disciplined manner in compliance with universally accepted standards.

*    Perhaps, inspired by the statutory obligation imposed on judges to attempt pretrial settlement of disputes, in terms of the Small Claims Court Act and the Small Claims Court Procedure Act (both of 2022) and the Civil Procedure Code provisions on Pretrial Conference and Pretrial Orders, 125 District Judges were recently trained (with support from the ADB) in Mediation. The training provided a dual benefit – it provided training in  skills that are required to settle disputes and equally importantly, provided a comprehensive understanding of how mediation will function when judges themselves refer disputes for settlement by private mediators.

*    Trained Mediators are already conducting mediations with success.

*    A not-for-profit guarantee company, the International ADR Centre – www.iadrc.lk ) was established in 2018  as a joint venture of the Ceylon Chamber of Commerce and the Institute for the Development of Commercial Law & Practice (ICLP) to promote ADR and is actively engaged in promoting mediation through training, disseminating information and creating awareness among stakeholders, including the business sector.   In addition to the International ADR Centre, “Udecide”  is a project that promotes training of mediators and other activities that enrich the mediation culture.

*    Commercial Mediation has been included in the Masters level programme at the Colombo University;

*    The Sri Lanka Law College offers a component on Mediation in the Post Attorney Diploma programme, which commenced recently.

The private sector was actively engaged in the drafting of the  Mediation Bill under the leadership of the International ADR Centre, which held many stakeholder consultations to obtain feedback from those that were conversant with the subject. The Centre had previously assisted the government to draft the UN Mediation Convention Act (Act No. 5 of 2024).

Several international Organisations that previously provided for resolution of disputes by arbitration, have provided for institutional rules to provide mediation services. These include WIPO and the ICC. Specifically, in relation to Investor State dispute resolution (ISDR), the  International Bar Association (IBA) adopted its  Mediation  Rules in 2012 and ICSID (of the World Bank group) adopted its Mediation Rules in 2022.  UNCITRAL, which is currently working on reforming  ISDR, promotes mediation, observing that the use of mediation could reduce the costs of ISDS and also preserve relationships between the investor and the State. UNCITRAL has formulated provisions on and Guidelines for, Mediation for investor state dispute resolution.

(To be continued)

by Dhara Wijayatilake
Attorney-at-Law; Former Secretary to the Ministry of Justice; Director and Secretary General of the International ADR Centre.

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A Testament to the Sri Lankan family

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The passing of Dr. Devanesan Nesiah a few days ago brought back memories that spanned more than four decades. Devanesan signed the witness register at my marriage in 2002. It was a year of hope. The Ceasefire Agreement between the government and the LTTE had brought a respite from a war that had devastated the country for nearly two decades. The possibility of peace seemed real. It was fitting that Devanesan should be present on that occasion because his entire life was dedicated to building bridges across divides and seeking rational and humane solutions to conflict. He was a friend, mentor, and guide whose life embodied values that Sri Lanka, indeed the world, needs today.

In reflecting on Dr. Nesiah’s life, we need to be reminded that the forces that unite us as a people in Sri Lanka are stronger than those that divide us, and that the bonds of human affection can transcend even the deepest divisions of ethnicity, history and politics. I first met him in 1984. I had just had my very first newspaper article published in the Jaffna-based Saturday Review. The editor was Gamini Navaratne, a Sinhalese. This was a reminder that even during the darkest period of ethnic conflict, the bonds between communities remained strong. The article I had written was based on my encounters with the anti-Tamil violence of July 1983.

At that time, Dr Nesiah was the Government Agent of Jaffna. Tens of thousands of Tamil people who had fled violence in the south had been transported to the north by a government that had failed to protect them. He came up to me at an event, introduced himself, and told me that he liked what I had written. He also said that he would soon be leaving for Harvard University’s Kennedy School of Government and that we could meet there. Over the next three years, Devanesan and his wife Anita adopted me into their family.  I used to visit them two or three times a week, not only to be given meals by Anita but to discuss matters with Devanesan.  These included the academic papers and newspaper articles that were written. Later, Anita earned her PhD in religion and served on the boards of many civic organisations, including the National Peace Council.

Practical Solution

In 1992, we had both returned to work in Sri Lanka when Devanesan invited me to accompany him to Jaffna to celebrate the eightieth birthday of his father, K Nesiah, the distinguished educationist affectionately known as Professor Nesiah. The older Nesiah had been a leading member of the Jaffna Youth Congress. This remarkable movement championed complete independence from British rule, national unity, and the eradication of social inequalities based on caste and communal identity.

At a time when many feared that independence would lead to majoritarian domination, the leaders of the Youth Congress chose instead to place their faith in a shared Sri Lankan future. They believed that people from different communities could build a common nation while preserving their distinctive identities. So did Devanesan.  This vision remains relevant today. It needs to be actualized.

The tragedy of Sri Lanka’s post-independence history is not that diversity exists. Diversity exists in every society. The tragedy is that we often allow diversity to become a source of fear, though we share many of the same values of family, hospitality, respect for elders and compassion towards others. During our visit to Jaffna in 1992, we met representatives of the LTTE administration, including Raheem. The discussion turned to the controversial issue of merging the Northern and Eastern Provinces. Dr Nesiah argued that if the merger could not be achieved due to political opposition, it might be more rational to seek greater powers for provincial councils instead. Raheem disagreed.  Devanesan was interested in finding practical ways to achieve justice and coexistence. That was characteristic of him.

Devanesan Nesiah was a student of conflict and strategy. He became a doctoral student of Professor Thomas Schelling, who would later receive the Nobel Prize for his pioneering work on conflict and cooperation. Schelling’s insight was that even in the midst of conflict, there are usually common interests that adversaries share. Even adversaries locked in a struggle usually depend on each other for the outcome they each want. The challenge is to identify those common interests and build upon them. Conflict is not simply a contest between enemies. It is also a search for ways to coexist. Together as students and peace practitioners, we applied those theories to the Sri Lankan context to understand what was going on and to share that understanding with the Sri Lankan people.

Rational Empathy

Dr Nesiah spoke his mind, truth to power. He was a man of logic, rationality, and principle. His integrity came at a cost. His public service career experienced many ups and downs because he refused to accommodate irrational or corrupt demands. There were periods when he was sidelined into that administrative limbo known as the “pool” and assigned no substantive responsibilities for refusing to give in to political demands. Like the rest of his larger family, most notably the Hoole family of Jaffna, he would not abandon his principles. In 2018, to protest the action of President Maithripala Sirisena in sacking the then government he returned his Deshamanya Award (Pride of the Nation) national civil honourn which was soon thereafter overturned by the Supreme Court as being unconstitutional. His commitment was not to personal advancement, but to what he believed was right.

My wife Sumadhu recalls a story he told her. One day, while travelling on official duty, he told her how he had seen a thalagoya, a monitor lizard, trussed up and being taken away for slaughter. The sight of the creature’s suffering affected him deeply. He said he saw tears in its eyes and described the moment of awakening. From that day onwards, he gave up eating meat.

The story brings to mind the biblical story of the conversion of St Paul on the road to Damascus and the Buddhist exhortation, “May all living beings be well and happy.” But the deeper significance lies not in religious comparison. It lies in the awakening of empathy.

That was the essence of Dr Devanesan Nesiah’s worldview. The prejudices that society often imposes through ethnicity, religion, caste, or gender had little hold on him. He saw them as human constructs that often served to privilege some while excluding others. Such were his values that made him an extraordinary human being. Dr. Nesiah lived according to that understanding. He showed that integrity can survive amidst conflict. He reminded us that reason and compassion are not opposites but partners, that what unites us as Sri Lankans inhabiting our common island home has always been greater than what divides us, and we need to build our institutions accordingly.

I am proud that he was my friend. I am grateful that he was my mentor.

by Jehan Perera

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City of Dreams …Heartbeat of Colombo

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Enroute

If Colombo’s nightlife had a pulse, you’d find it 23 floors up, at Gatz, City of Dreams, Cinnamon Life.

The entertainment lounge has shed its old skin and stepped out supper-club style — think dim lights, clinking glasses, and live music that doesn’t ask you to choose between dinner and a show. You get both.

What’s more, at the new look Gatz the music never stops and it’s all happening seven nights a week … with live entertainment, and this is the scene, beat by beat:

Monday and Tuesday: Top Hats with Daniella/Naomi, from 7.00 pm onwards.

Sohan, Kamal Munasinghe (GM, Cinnamon Life) and Imran of
Funtime Entertainments

One of Colombo’s most sought-after bands is now a Monday-Tuesday ritual.

With a super repertoire, Top Hats can swing from lounge jazz to dancefloor fire. Big venues love them. Now Gatz gets to claim them.

Wednesday: Enroute with Gananath & Debbie – from 7.00 pm onwards.

Want New York at sunset? This is it. Gananath & Debbie transport you straight to the heady days of Frank Sinatra, Dean Martin, and Ray Charles …old-school cool, live and unfiltered.

Thursday to Sunday: Terry & the Big Spenders – from 8.00 pm onwards.

Terry & The Big Spenders

The crowd favourite. A super big band sound that owns the 70s, 80s and 90s.

If you’ve been waiting for horns, harmonies, and nostalgia with volume, Terry & the Big Spenders deliver it nightly. No wonder they’re a huge hit.

Gatz is now an entertainment lounge, in Supper Club style, with Happy Hour very day, from 6.00 pm to 8.00 pm because the night, they say, should start with a toast.

And, from July, weekends at the Gatz go global. Local and foreign guest stars will be around to entertain you. Gatz is certainly booking big.

Wow! That would be another exciting experience for those patronising the most talked about venue in town.

In charge of the new setup is our legendary entertainer/singer Sohan Weerasinghe, along with Imran of Funtime Entertainment.

The twosome, with invaluable assistance from the General Manager, Kamal Munasinghe, and the entire team at Cinnamon Life, have built Gatz into more than a venue. They have turned it into the “Heartbeat of the City.”

So come for happy hour. Stay for Terry’s horns, Sing-along with Enroute and Dance with Top Hats, all on the 23rd floor, and while Colombo sparkles below the bands will take you higher.

Remember, the heartbeat is loudest at Gatz.

Top Hats

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