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First do no harm, Primum non nocere



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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Save us from our govt.!



When watching daily news bulletins, on several local TV channels, one could observe two significant matters.

One is how Gotabaya Rajapaksa shamelessly meets foreign diplomats and officers of international organizations, who are well aware of the grave situation of the country, and also the prime reason for it.

Remember, as kids, how we hide from our parents, or teachers, when some small mistake happens – that is because we were ashamed, and afraid of punishment. And ther, too, it would have been only our own mistake, not by the whole family of ours!

Next is how the Police and armed forces are let loose on the men, women and children who have been waiting in queues for hours or days. The authorities are not finding ways to stop queuing or at least maintain some order at those places, but chastise the people, for electing as Basil Rajapaksa had said, a stupid, clueless president and an incompetent government.

The greatest disasters we have faced since Independence are the JVP insurrection, the LTTE war and the tsunami in 2004, and during those times the people were protected by then governments; now Sri Lankans have to struggle against the government, which is steadily throttling them to death.


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Challenges, and need for an all-party govt.



Whoever wants to take charge, must first disclose how they are going to set about it. making statements that ‘WE WILL PUT IT INTO ORDER’ is not acceptable. Even SJB, the main Opposition party, hasn’t put forward at least an outline plan as to how they will set about it.

What did the current President promise? What did the current PM promise.? What are their results? Can the country afford more of such vague promises? Three months have gone and still there is no plan from any Party in Parliament. How can any country or institution assist one who has no plan?

Challenges are many and very unpopular decisions have to be made. Resistance from entrenched interests, such as trade Unions, including the GMOA, some corrupt business interests, political interests, mafias, monopolies, etc., has to be countered. Are they prepared to overcome them?

Why go far? Are they prepared to reduce the Parliamentary allocation substantially, and even reduce the number of MPS from 225 to about 150 – on par with countries of similar size, population, GDP, etc.

Parties trying to form a Govt. must first agree amongst them on their Plan, at least on the following:

(i) on their strategy to get Foreign Exchange to purchase limited quantities of fuel for essential services, food, medicines. and fertiliser for the next 6-9 months. Their strategy to increase exports, foreign employment and foreign investment so as to increase Foreign Exchange in the short and medium term. With current conditions it is futile to expect tourists to come to Sri Lanka.

(2) as to how to balance the budget. Are they unitedly prepared to close down or privatize CEB, CPC, AirLanka and Water Board, etc.? Budgetary Allocation for Defence is another, which has to be drastically reduced, the developed countries spend only 2 to 3 % of their GDP on Defence. What does SL do? Out of the Defence allocation, Navy must have the major component for they have to patrol the sea area, which is many times larger than SL land area. SL sea resources are at risk from illegal fishing, human smuggling and illegal dumping, etc.

 (3) Are they prepared to close down unnecessary Ministries, Corporations, and Departments, most of which were created for the benefit of politicians, especially for Ministerial Positions.

(4) Staff levels in Ministries, Departments. Corporations that are to function, have to be drastically reduced, so that they could function efficiently and cost effectively. Reducing staff will also reduce the need for large office spaces, electricity, telephone cost etc.

(5) What are their plans to support and or rehabilitate the staff so retrenched.?

(6) Their plan for distribution of essentials? Rationing?

(9) Can they agree on a small, efficient and capable cabinet? Let not the country have too many Ministers and or Officials telling the country different versions, confusing the people as to which is correct, and that too hoping that at least one will be correct.

(10) How will they source the revenue? Are they prepared to increase the direct tax component to 60% or even 75 % for the present? The majority of the population have been badly affected due to the current crises. Their only crime being they misused their votes. They should not be burdened further with indirect taxes. To reduce their burden indirect taxes have to be the lesser component of the revenue, at least for the present.

(11) Can they do away with duty free cars, and all other special privileges given to some sections of the society. All Laws must be equally applicable to all. Other than the First citizen of the country, all others (be it state employees or Parliamentarians) must be taxed on the same basis as others.

All Parties joining must undertake that they will no longer do politics with these issues, nor will they withdraw from the interim govt when it undertakes unpopular decisions on above issues. They must all commit to swim or sink together.

None of those who served as Ministers in failed Governments, or who were Ministers in MR’s Govts which decided on vanity projects, should not be given Ministerial positions. Same should apply to those Parliamentarians who voted for the 17 ,18,19 and 20th amendments should be excluded, as it shows they neither have principles, nor care for the country. Corrupt and convicts too should be kept out. KNOWLEDGE AND CAPABILITY should be the criteria in the selection of the Ministers. Those who are unable to deliver within 3 months must be made to stand down.

To the party leaders who want to form the government, may I say, first divulge your plan to the country.

Please, do not tell the country that you have a better plan. You can afford to fail but not the country or its people at large!


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Fuel tokens, a big farce



A file photo of fuel tokens being issued

The Minister of Power and Energy who covers a very responsible Ministry, was selected by the President probably due to his membership of the ‘Viyath Maga’, has undoubtedly proved to be a very inefficient Power and Energy Minister, and a complete failure without any doubt.

He is very capable of giving false hopes always of fuel and gas laden ships arriving on Sri Lanka shores, which have proved to be absolutely wrong. One wonders whether it is a gimmick to keep the fuel and gas starved motorists happy, and avoid the unending queues at fuel stations. This has proved to be a wrong system.

In order to control the daily queues, and knowing there will be no fuel ships for some time, he introduced the fuel token system out of the blues, and with no proper organizational effort. The policy announced regarding the token system, was to enable vehicle drivers to enter the fuel stations on a pre-selected day of the week, allocated to him/her, and dependent on the last digit of the vehicle number plate. This was again to avoid the long queues, according to the Power and Energy Minister.

With the latest innovative fuel token system announced, I visited the petrol station, in close proximity to my home on Monday 27th June, with much hope, and was among the first hundred with the details of my address, profession, NIC Number and contact mobile number. The relevant officer, who recorded the details, informed me that this was a pilot project, from Ratmalana to Moratuwa, and that when the fuel arrives at the petrol station, I will receive an SMS requesting me to report at the petrol station, at the allocated time, once again to avoid queues. But I did not receive the fuel token as it was not available. I was told that there was no necessity to have the token, as I will receive the SMS on my mobile phone.

The following day I received news that the fuel tokens are being issued. When I visited the fuel station, to obtain the token, there were four different long queues, along the road registering three-wheelers, motorcycles, vehicles needing diesel, and cars needing petrol. I met the S LAF officer, registering the cars queued up on the Galle Road, and told him that I am already registered in the book he was entering details and requested the token, which was denied to me. As the queues were there during the next two days, I visited the fuel shed on day four (30th June) when the officer was registering a few people. When my turn came, I showed the serial number and my name registered therein. I was told to wait until the SMS was received. He said that my registration will be cancelled if the token was given at a later date! Then I met the SL Air Force official and explained my position. He then approved the issue of the token. The delay in obtaining the token was nearly 15 minutes. By this incident it was evident that the advice given to Air Force officers to register and issue tokens was not properly given.

I was surprised to receive the token which was a slip of paper, with dimensions only 10cm x 6 cm. Inside it there were printed, Name of the Fuel Station, Type of fuel, Contact Number, Name, NIC Number, Vehicle No, , Date , Time, Signature of authorized Officer and Signature of vehicle Owner. With a microscopic piece of paper, it was with great difficulty that the necessary details were entered.

However, congratulations to the Minister of Power and Energy for drying up all the CEYPETCO FUEL STATIONS in The Island, without fuel for another three weeks or more, without queues, due to lack of fuel. Also causing unending long queues by supporting the LANKA IOC Fuel Stations, to issue your Fuel without Tokens at a higher price.

I politely ask you, Minister Kanchana, is not this another gimmick of yours to handover the CEYPETCO fuel stations to LANKA I O C?

So, we now know the reason for the latest gimmick of the Minister of Power and Energy to issue fuel tokens.

Do you now realise in your conscience, the problems created by you, especially to three-wheeler drivers, who are dependent on a daily living for their families by earning from hires, and now completely out of any earnings to feed their children, to give even a single meal?

Without creating further problems please resign from your post as the Minister of Power and Energy.


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