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First do no harm, Primum non nocere

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Sudarshana syrup:

These are famous lines of high ethical and moral value which all physicians of allopathic system are expected to respect and adhere to.

Regardless of the system of medicine, all health workers’ final objective must be to care for the patients; for their betterment. In a broad sense, it goes beyond human, where all living beings, environment, etc.’ should be considered as in ONE Health Concept.

The earliest health systems were based on magic, witchcraft, superstitious beliefs, etc. With time, more refined systems, such as Ayurveda, and later allopathic, gradually replaced such early systems. At present, the allopathic system, based on empirical science, has been established throughout the world, in favour of other systems of health, over the past few centuries. However, it was the Ayurveda system, based mainly on herbs, which helped people look after their health needs, successfully, particularly in eastern cultures. 

In Sri Lanka, even at present, quite a significant population (10 – 15%) is heavily dependent on Ayurveda for their day-to-day health needs. Almost all people have taken medicines of herbal origin (e.g. coriander/Kottamalli, etc.) at some stage of their lives. Hence, the place for Ayurveda medicine is well established and never a doubt in Sri Lankan society. In fact, it is part of the Ministry of Health as the Indigenous Medicine Division.

The current COVID–19 pandemic is sweeping the entire world, in various proportions. With the initial successful containment of the epidemic, Sri Lanka is now suddenly confronted with a painful ground reality. Our country, and all concerned, were used to low numbers in terms of number of patients, and deaths, due to COVID–19, when compared to almost all developed countries. Therefore, the initial euphoria, enjoyed by all, is disappearing fast.

Under these chaotic circumstances, the integration of indigenous/Ayurveda system to local healthcare delivery system, needs to be recognized. Such integration is recommended by the WHO in 2014 (WHO Traditional Medicine Strategy 2014 – 2023, which is an ongoing activity).

As a government, it cannot ignore this need but has to work on a strategy to accommodate the integration. Under this context, Minister Channa Jayasumana’s attempt to introduce Sudarshana syrup to our system is justified and appropriate. In this endeavour, he has to be considered as a Minister, and not as a pharmacologist.  Hence, the unfair attack on Minister Jayasumana, on this matter, is not acceptable. The assault is beyond Minister Jayasumana and in fact the traditional Ayurveda system which has been trusted by many.

Also important to note is that the assessment tools used to assess allopathic drugs may not be suitable to assess the efficacy of Ayurveda medicines, due to two different bases of origin. I am certain that all pharmacologists are well aware of the ancient association between numerous allopathic drugs and herbs. A classic example would be the usage of Cinchona bark for fever for many centuries. Quinine, a drug which was used to combat malaria is extracted from Cinchona bark.

At this critical juncture, one has to be careful about our heeds and deeds; as such actions can undermine and discourage those who are tirelessly fighting hard the battle against COVID–19. If such deeds are responsible for breakdown of the system, the adverse consequences are not only to them but to all of us in the country, regardless of political parties, wealth, social class, ethnicities, etc. The ones who are unfairly critical could well and truly be the victims of the breakdown.

Therefore, all must be very genuine in their behaviour as the infection does not differentiate, based on the type of people in the country. The need of the hour is to stop all unfair attempts, which could hinder the preventive measures, and unite as one force to face this unprecedented challenge.  

Sri Lanka is now potentially facing a chaotic situation as our health sector and skilled human resources are struggling to cope up with the situation. It is very important to protect healthcare workers, particularly those who are involved in public health services (as the number is limited), security forces,   including the police, administrators and all others involved. Therefore, all precautions ought to be taken in order to minimize their exposure to the virus, as depletion in such human resources is not an option for our country. Under this circumstance, fresh thinking is essential with regard to the level of contact tracing as large numbers are reported on daily basis.  

 We have no time to go through all these time consuming and labour-intensive steps, during a crisis period of this nature, as human catastrophe is lurking. Edward Jenner, in 1796, would not have been able to vaccinate a child against Smallpox if he had to go through all steps for approval, before vaccination. It means the world would not have been able to eradicate Smallpox, in 1977. Another example would be the story of the Anti-Rabies Vaccination.  Louis Pasteur, in 1885, decided on his own, in good faith, and vaccinated a boy who was bitten severely by a rabid dog. The boy would have faced a certain death if not for the vaccination. He survived the episode to tell the story and work for Pasteur Institute later.

I fully agree that before carrying out research and giving drugs, present standard protocols, e.g. ethical clearance, etc., should be adhered to. But, at times of crisis or disaster, what is done in good faith is acceptable.   

 

Prof Ananda Jayasinghe

Professor in Community Medicine

Faculty of Medicine

University of Peradeniya

 

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Opinion

A journalist of courage and deep conviction

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Robert Fisk (12 July 1946 – 30 October 2020) was a legendary journalist and author who penned down meticulously the sufferings of millions of people reporting not from secondary sources or keeping a safe distance from the theatres of the war but from the battle front, endangering his own life. He was attacked many times, once even with the possibility of losing his life.

by SUBRATA MUKHERJEE

During the period of the Cold War, North America and Europe never became war zones and the battle for ideological domination shifted to the non-European world primarily West Asia (Middle East) and Southeast Asia. This led to untold suffering for ordinary people in these areas. Whereas Southeast Asia has now settled for a relatively peaceful order, many regions of West Asia are still riven by strife and uncertainty.

Robert Fisk (12 July 1946 – 30 October 2020) was a legendary journalist and author who penned down meticulously the sufferings of millions of people reporting not from secondary sources or keeping a safe distance from the theatres of the war but from the battle front, endangering his own life. He was attacked many times, once even with the possibility of losing his life.

Fisk’s journalistic career began with covering the conflict in Northern Ireland as a London Times correspondent in 1972. His reports annoyed British authorities as it tilted towards the republicans. He earned in the process a massive following. Out of his reports he published a book The Point of No Return: The Strike which Broke the British in Ulster in 1975. In his Ph.D. thesis he explained the issues connected with Irish neutrality during the Second World War. Later on, he took up Irish citizenship.

He also had a stint in Portugal during the 1974 Carnation Revolution (April Revolution), which not only ended the authoritarian regime in Portugal but also led to the demise of Portuguese colonialism in Africa. But the most important evolution in his journalistic career was his appointment by The Times as its Middle East correspondent in 1976.

For the next forty-four years from Beirut where he witnessed fifteen years of Lebanese Civil War (1975-90), he reflected on the unfoldment of history in the region full of bloody conflicts, ethnic cleansing, wars, revolutions and uprisings. His parting of ways with The Times came in 1988, when he sent a report on the US warship Vincennes having shot down an Iranian civil airline. Fisk’s scoop was not published because by the time the report reached the newspaper editorial office the ownership of the newspaper had gone to media Mughal Robert Murdoch. He was also advised to take up more balanced reporting. Fisk switched to left-leaning British newspaper The Independent, where he spent the rest of his journalistic career (His contributions to both newspapers were re-published in The Statesman.)

As part of his journalistic requirements Fisk travelled extensively. That included Algeria, Libya, the Balkans and Turkey, strife torn homelands of Kurds and Afghanistan. What made his reporting different from other journalistic accounts was his understanding of both colonial and postcolonial history in comprehending contemporary conflicts in West Asia. He was trenchant in his criticism of the Western powers led by the USA and Israel as their policies and machinations had humiliated local people fuelling their anger.

Even when he was grievously injured after being attacked by Afghan refugees in Pakistan he wrote that this “brutality entirely the product of others, of us – of me who had armed their struggle against the Russians, and ignored their pain and laughed at their civil war and then armed and paid them again for the war for civilization” just a few miles away and then bowled their homes and ripped up their families and called them ‘collateral damage’.

In 1982, Fisk was amongst the few journalists to enter the Palestinian refugee camps in Sabra and Shatila where more than a thousand unarmed people were massacred by pro-Christian, Lebanese militia in the presence of Israeli armed personnel. He described this as a war crime. In 1993 in Sudan, he was the first Western journalist to interview Osama Bin Laden, whom he subsequently met twice. The title of his article was “Anti-Soviet Warrior puts his army on the road to peace”.

Laden in the first interview revealed that he was a construction engineer and an agriculturalist. But instead of taking the road of peace he became the most dreaded terrorist who successfully planned and meticulously executed the killing of 3,000 innocent people in the destruction of the Twin Towers in New York in 2001. Laden praised Fisk for his neutrality. The latter tried to remain neutral but severely condemned the brutal attack and also reminded the need to highlight and investigate the motivation of the attackers.

Fisk examined in detail the Israeli-Palestinian animosity, the US led invasion of Kuwait and Iraq and the US entry into Afghanistan. He was critical of the former as he pointed out that there were no weapons of mass destruction. The US bombing of Kosovo under NATO auspices and other involvements of the USA in the Middle East were examined critically by him. Though he was critical of the USA, he was a frequent visitor and popular speaker in the USA. He analysed war but despised it as he was a proclaimed pacifist.

Regarding being neutral as a journalist, Fisk had this to say “if you watch wars the old ideas of journalism that have to be neutral and take nobody’s side is rubbish. As a journalist you have got to be neutral and unbiased on the side of those who suffer”. His magnum opus The Great War for Civilization (2005) chronicled critically the relationship of former colonial powers with the ordinary people of Arabia. His journalistic outpouring was always controversial and divisive. Some even blamed him for self-promotion and for being biased.

The most serious controversy came up during the ongoing civil war in Syria. Fisk accompanied the Syrian army while fighting the Islamic State (ISIS) and Syrian independent militias. However, though he was critical and condemned the Syrian army’s atrocities before, he exonerated President Assad in 2018 for lack of evidence of using chemical weapons in Duma. A follow up book to the Great War for civilization would be published posthumously which would cover the period of US intervention in Iraq to present times.

Fisk was winner of many journalistic awards and is widely revered in the Arabian Peninsula. He was a critic like IF Stone. His journalistic accounts were not based on official briefing as these did not fully and properly reflect the actual situation. His account of the protracted civil war in Lebanon was published as Pity the Nation, a phrase that he borrowed from Khalil Gibran (18831931). He referred to reporting that was not based on first hand accounts as ‘Hotel Journalism’. He looked to journalism as search for truth and his enduring legacy is the dedication of his entire journalistic career to search for roots of conflicts and war.

(The Statesman/ANN)

The writer is a retired Professor of Political Science, University of Delhi

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Opinion

Who cares for our dumb friends?

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On 29/11/20 Al Jazeera had shown ‘Kavaan’ being transferred to Cambodia, where he would live the rest of his life in a sanctuary for elephants. Kaavan was a gift from Sri Lanka to Pakistan. I understand he had been very cruelly handled and a certain group had been agitating for some time for his release. Firstly, why should we gift our elephants to anyone? Secondly who owns the elephants in the wild and Pinnawela? Is it the party in power who owns these elephants? Elephants are gifted to countries and places of worship, and most times the treatment meted out to the elephants is disgusting!

I wondered why Kaavan was not brought back to Sri Lanka. We are supposed to be very religious, but the way we treat our animals is shocking.

Recently a dog had been injured by sniffing a “hakka patas” and his mouth was blown off. The dog was a female and pregnant. Fortunately, some kind organization took charge of the dog. It had five pups, and a couple of days later passed away. Fortunately, the pups are taken care of. Cruelty to animals goes on daily, but unfortunately there are no laws for punishment. The existing laws go back to the year dot!

Once again appeal to the President to have the Animal Welfare Bill’ passed as soon as possible. I am aware, Mr. President, that you have enough on your plate, but I am sure some sort of priority will be given to our “dumb friends”

 

SITA UNDUGODAGE

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Opinion

China has overtaken the US – says IMF

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It was expected but not so swiftly, possibly the Covid-19 has expedited what was inevitable. A report published in “The Our Asian Times” on 1st December 2020, titled ” IMF Admits China Has Overtaken The US As The World’s Largest Economy; But Why Is The Media Silent?” says the world has to wake up to the new reality – China is the undisputed new economic super power.

In the past, economists have traditionally been using the index called MER, which means Market Exchange Rate, to calculate the GDP when comparing the economic performance of different countries. This method has been viewed with extreme suspicion as it doesn’t reflect the real figures because it underestimates the buying power of currencies of many countries. More reliable and now widely accepted yardstick called the Purchasing Power Parity (PPP) which is used by IMF, enables you to compare how much you can buy for your money in different countries.

To explain this further, according to the traditional exchange rate, one US Dollar is equivalent to 6.9 Chinese Yuan, but 6.9 Yuan can buy in China more than one US Dollar in America. On this basis 99 trillion Yuan the Chinese produced in 2019, is equal to USD 26 trillion which is much greater than the USD 21.4 trillion America actually produced in 2019. This is the PPP method which is said to be better than the MER method to compare economies.

The IMF is clear in its report, it says “PPP eliminates differences in price levels between economies and thus compares national economies in terms of how much each nation can buy with its own currency at the prices items sell locally. Using the PPP method, the Chinese economy is determined to be USD 24.2 trillion compared to America’s USD 20.8 trillion”. This is a huge difference, for USD 3.4 trillion is lot of money.

After the IMF, the CIA also decided to switch from MER to PPP in its Annual Assessment of National Economies. The CIA Fact Book notes “The official exchange rate measure of GDP is not an accurate measure of China’s output; GDP at the official exchange rate (MERGDP) substantially understates the actual level of China’s situation, GDP at purchasing power parity provides the best measure for comparing output across countries”

Everybody knows that IMF is pro-US in its approach in matters of global finance and economy. In the 1970s, the IMF and the World Bank were restructured to serve neoliberalism which the US and Europe embraced and forced on the rest of the world, letting loose the market forces which have really ravaged the economies of the poor countries. Therefore the IMF could be considered a tool of the US and Western powers. It would not dare lie regarding the economy of its biggest sponsor. The CIA is the central intelligence service of the USA and it is advising the US government about the seriousness of the problem due to Chinese ascendancy. CIA too , will not give wrong information to the US government.

One cannot be surprised by the Chinese phenomenon. It’s economy has been growing at the mind-boggling rate of 10% in the last 30 years. Only the Covid-19 succeeded in bringing it down and that too, by a small margin. China is expected to contribute 1/4 th of the global growth next year, mainly in the manufacturing sector.

Joseph Needham who had studied ancient Chinese science and technology, has commented on the capability of the Chinese and the uniqueness of their culture.. The methods adopted by the Chinese have bewildered Western social scientists and economists. Some believe that it is the habit of thrift of the people that had contributed to the economic growth as the rate of savings in China ranges around 25%. Others think it is due to the concept of Township and Village Enterprises that has been adopted recently. However, Needham and his associates think the close affinity between the Chinese people and the government to be the secret of their success.

The world has to come to terms with China. The Western countries cannot continue to treat China as an outcast and do its utmost to undermine its development and spread of influence. Australia for instance, supports all such efforts of the US though China is its biggest trade partner. It had agreed with the US policies regarding sanctions on China and implemented similar measures, but complains to the WTO when China retaliates.

One hopes, for the sake of world peace and prosperity that these big powers would stop their childish rivalry and work together. One hopes the new US President Joe Biden would change their policy towards China. He must realize that greater benefit would result to the US, as well as the world by adopting a lesser confrontational approach. If the US and China come to be lesser rivals and greater trade partners the rest of the world could be expected to be more peaceful and conciliatory. Middle East could be less of a cauldron, South Asian rivals may mend fences. China itself would be less belligerent in its neighborhood.

More money would be available everywhere for health and education, employment and culture as the defense budget could be cut as there is no need to spend on weapons as there is no threat of war.

But is this wishful thinking. Would weapons industry allow Biden, even if he wants to, to make peace when their economy, employment, growth and power depends on the perpetuation of a war situation cold or hot in the world.

N. A. de S. Amaratunga

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