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From Cylinder to Liquid Oxygen Plant

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Story of Oxygen supply at National Hospital –

The National Hospital of Sri Lanka (NHSL) is the largest and best equipped Teaching Hospital in the country with a bed strength of nearly 4,000. It has 26 operating theatres, 28 Intensive Care Units (ICU) and several institutes including one for Cardiology housed in a large number of buildings. It is located on a 32-acre land standing in the middle of Colombo.

NHSL is circled by a ring of busy public roads while some roads are running through the premises. Hospital premises and surrounding roads are always filled with hurriedly pacing medical staff, siren blaring ambulances, patient-carrying trolleys, distressed relatives and tired visitors. One would not miss the sight of a cylinders loaded truck crawling across in this melee and wonder why the truck. They ensure continuous and uninterrupted supply of most essential medical oxygen for the patients treated in ICUs and those undergoing surgery in operating theatres.

A few years ago, a visitor would not have missed the outside walls of these operating theatres and ICUs each of which decorated with 6-7 hanging jumbo oxygen cylinders. When I made the morning strolls down the hospital corridors my eyes always caught the sight of these cylinders. Oxygen is taken through a copper tubing system fixed to these cylinders to the respective destinations. i.e. Oxygen outlet in the bedside of patients treated in ICUs and in operating theatres. Hospital had a sufficient number of cylinders filled with oxygen. Employees efficiently replaced empty cylinders with new ones.

Every day employees collected empty cylinders, loaded them on a truck and transported to the Oxygen Company in Mattakkuliya for refilling. On certain days when the oxygen consumption was high, this operation has to be doubled. Hospital had its own truck and a group of specially trained skilled employees assigned for the task. Loading and unloading of these jumbo cylinders was a specialised job.

I noticed this operation during my afternoon inspection tour. In fact, the noise made in loading unloading as well as dismounting and mounting cylinders on the walls and the sight itself, to say the least, was a nuisance. Once the truck returned, the refilled cylinders were immediately distributed among the theatres and ICUs. Needless to say this was a hectic task considering the large number, and the spread of theatres and ICUs in the hospital.

There were tensed situations when the truck did not return on time due to a break down, a traffic congestion or an accident on the way. Thought of the delay of the truck with refilled oxygen cylinders gave me many sleepless nights. I was waiting to welcome the irritating noise made when cylinders fell on one another during unloading. While others were cursing, I got a sense of relief as it was an indication that the oxygen truck has arrived. My official residence was in very close proximity to the Merchants Ward where many cylinders were unloaded. No sooner had I heard the clattering sound than I ran to the window to witness the unloading.

As the Director of the country’s largest hospital, I was responsible for the overall smooth functioning of the hospital itself and that of men, material and machinery. And among all, ensuring the continuous and uninterrupted supply of oxygen for patients who were critically ill and those undergoing surgery was foremost.

Majority staff including doctors and nurses did not know the complexity behind the smooth flow of oxygen through the outlet whenever they open the valve to administer oxygen to a patient. Only a handful of people knew the complexity of the ‘oxygen supply operation’ in the hospital. It was a nightmare for me personally and all my predecessors.

While worrying over this cumbersome complex manual operation, I was wondering how fitting this type of oxygen supply for a Teaching Hospital of the magnitude of the National Hospital. My mind was busy in exploring and weighing alternatives.

While listening to the clattering of cylinders and watching the swift movements of workers’ hands in the unloading operation in the middle of the night, with a cup of steaming coffee in my hand, a thought struck my mind. I heard my own voice shouting over the clattering sound of falling cylinders; Hey! Man, be practical, install a Liquid Oxygen Plant in the hospital premises itself.

Early next morning ignoring the supervision tour, I was busy preparing a comprehensive proposal to the Ministry of Health with a clear justification of the investment. Having submitted the proposal followed by a few telephone calls the Ministry responded by approving the proposal.

The proposal was designed to have a Liquid Oxygen Plant with the highest capacity for the hospital and another with less capacity dedicated for the Institute of Cardiology located a little away from the main hospital premises across the street.

A few moons later, a Liquid Oxygen Plant near Ward 13 and a separate smaller plant on the premises of Institute of Cardiology rose to the sky. The copper pipelines were laid connecting all the operating theatres, intensive care units and high dependency units which required continuous uninterrupted supply of oxygen. The project was completed within a matter of a few months providing a great sense of relief to me.

The company which installed the two oxygen tanks is attending to maintenance and repairs. The company regularly monitors the level of consumption and replenishes the tanks. The hospital staff need not intervene.

Needless to mention the relief it brought to me. It was in the year 2006 during which the Hospital installed the two oxygen plants. Since then we did not have to wait for the truck or bother about cylinders. There has not been any loading unloading or clattering of cylinders. I wanted to ensure that my successors would have a permanent reliable source of Oxygen supply for our patients and avoid sleepless nights unlike me and my predecessors.

After the COVID-19 pandemic Oxygen has become the mostly used word among the healthcare workers. After retirement today, I reminisce my time as the Director of NHSL and recall how the disturbed night dawned upon me the idea to install a Liquid Oxygen Plant to ensure the continuous supply of Oxygen to patients gasping for oxygen.

Our neighbouring India is losing thousands of young lives a day due to unavailability of Oxygen. I am happy about the forethought I had 15 years ago long before the term ‘COVID-19 Pandemic’ entered our vocabulary.



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Echoes of NM’s dismissal may have an impact on present crisis

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by Tissa Vitarana

Dr. N. M. Perera, one of the greatest politicians and statesmen produced by our country, was born on June 6, 1905.

In recognition of his stature as a freedom fighter, a trade union leader, an authority who consolidated parliamentary democracy in the country, an economist who defended the rights of the developing world and sacrificed political power to defend minority rights, he remains in the heart of the people 43 years after his death. Each year on June 6, it has become customary to celebrate his birth anniversary by paying floral tribute at his statue in Colombo. Leaders of the Left and many other political parties participated, together with some leading supporters of the Lanka Sama Samaja Party (LSSP), which he had helped to form in 1935 with socialist objectives.

Among the chief speakers were the current Leader of the LSSP and the Chairman of the Dr.N.M.Perera Centre or his representative. Similar functions would be held at the statues in Thun Korale, Ruwanwella and Yatiyantota, in turn bi-annually.

As usual on June 6, 2021 the function was held, but only with three persons present as a token event, to conform with the three health regulations required to control the Covid 19 epidemic . As the present General Secretary of the LSSP I gave a short speech, the Chairman of the Dr.N.M.Centre who was unwell was represented by Ranil Vitarana, and the LSSP rank and file by Nuresh Rajapakse, a member of the PB whose ample size filled the space left by the absent LSSPers. We retired home to discuss how NM might solve the present crisis if he was alive.

The crisis that NM faced as the Minister of Finance in the SLFP/LSSP/CP Coalition Government in 1972 was far worse than what confronts us today. In 1972 there was the perennial crisis of over production that dogs the capitalist economic system. But in addition the fossil fuel price went up seven times due to the getting together of the oil producing countries to form a cartel, OPEC. The worst global drought in 30 years led to a severe food crisis, with thousands of deaths worldwide. As a result, due to the traditional import dependent policies of the UNP Governments, our people were in grave danger (e.g. the price of a ton of imported sugar went up from $ 40 to $ 600).

NM explained to the people the magnitude of the crisis and called upon the people to tighten belts, stop the import based luxury lifestyle, and develop an import substitution national economy, producing our food and developing value added industry (his budget allocation for science and technology was increased four times). The bulk of the burden should not be passed on to the people but borne by government and the rich. The direct personal tax on the rich was raised to a maximum of 75% (today it is only14%). He managed to balance the budget and in one year in office earn more than the loss. The strict import restrictions reduced the foreign trade deficit and helped to cut down foreign borrowing. The foreign debt was reduced to the lowest in our history.

Today the biggest problem is the high cost of living, mainly due to huge profits made by rapacious middlemen (big mill owners, local money lenders to farmers such as traders etc.). To end this NM and the coalition developed the producer cooperatives (such as farmers) and the consumer cooperatives as genuine peoples’ organizations. By direct dealings between the two he wiped out the profiteering of the middlemen. The cooperatives were so successful that NM brought down the price of essentials to affordable levels, and even gave a measure of rice free. The result was that no one died of starvation unlike in other parts of the world. Due to the opposition of the traders, outsourcing to them was not possible. The result was long queues at the co-ops. This and the other shortcomings were exploited by the media controlled by the rich to lay the blame on the government. They hid the global nature of the problem, but blamed the government.

Besides food shortages a major problem was the shortage of medicine in government hospitals and the high cost of medicines in private pharmacies. Prof.Senaka Bibile, a member of the LSSP, came up with his Medicinal Drug Policy, which was accepted by WHO. NM strongly supported it and it was implemented. The outcome was that medicines for practically every disease was available in all government hospitals free of charge. The shortages were overcome, unlike the situation that prevails today. The foreign drug companies got their governments to intervene and promise a large sum of money to the government to overcome the crisis, provided the NM and the LSSP was expelled. The finance portfolio was taken away from him, and he was given a minor post which he refused and the LSSP was forced out of the Government.

The CP left the next year and the SLFP suffered a major defeat in the 1977 general election. The UNP led by JR Jayewardene came to power in 1977 and opened the door for the commencement of the process of change referred to as neoliberalism. This ideology led by the USA reached its zenith throughout the capitalist world, most of all in America. But it was a failure. It was rejected by the Sri Lankan people at the last presidential and general election.

The anti-UNP political parties helped form the SLPP-led government and are committed to do everything possible to solve the economic, social and health problems facing the country and people.

Like NM, I and the LSSP are very happy that the neoliberal foreign market dependent policies have been rejected, and the commitment is to establish an indigenous economy, where local agriculture and value added industry are to be developed. A major problem is the Covid 19 coronavirus epidemic. In view of my training in virology and experience here and abroad in association with WHO, I could have made some contribution to overcome this problem. In addition where local value added industry is concerned I have already made a significant contribution as the Minister of Science and Technology when Mahinda Rajapaksa was President.

In the four years I established 263 Vidatha Centres, one in each division, and helped 12,300 micro, small and medium entrepreneurs to develop island-wide (17 exporters, 64 suppliers to Cargills and other food chains, and 53 to hotels). To promote large scale industry for the export market I set up a Hi-tech Centre, SLINTEC, with emphasis on nanotechnology near Colombo. But it would appear that I am not fit to be a minister, leave alone a cabinet minister. I wonder whether what happened to NM and Senaka Bibile had any bearing on this.

But why was Prof Sirimali Fernando, Senior Professor in Medical Microbiology at Sri Jayawardenapura University left out. For her post-graduate research in London she not only worked in the field of Virology, but also used the PCR. She could have seen that the PCR test (and the RAT) were properly standardized to give reliable results. Control of the epidemic will be difficult with many false positives and negatives.

You can understand what a person of NM’s stature felt when he was kicked out of the finance ministry, when what has happened to me is related. The only occasion that I could express my views was when the Health Advisory Committee of Parliament met on one occasion, at very short notice, with the Minister in the chair. I proposed that a National Committee of party leaders in Parliament be set up to interact with the minister to exchange views so that we all unite to fight this common enemy. Then truly national Covid committees could cooperate down to village level in the interest of all the people.

The minister turned this down and said that this Health Committee will meet twice a month and any party leader is free to come. Four months have gone and this committee has not met once since then. Secondly I proposed that as community spread had begun a new community based approach was necessary to control the spread and I gave an outline of the necessary measures. She rejected my assessment and approach, stating that it was still in the cluster stage. I said that the cluster approach could continue where indicated, but my proposal too should be implemented. She rejected this proposal.

I might mention that the day Dr. Fernandopulle was appointed as minister she invited me to meet her and I had a fruitful discussion with her for more than an hour. I hope that she will get the necessary support.

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Monastic food – vegetarian food (mildly selective)

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I was directed to the film series on food on Netflix titled Chef’s Table and enjoyed watching the first of series three. It was on the South Korean Zen Buddhist nun, Jeong Kwan, and her preparations of monastic food.

Jeong Kwan

(born 1957) is a Zen Buddhist and chef of . She lives in the Chunjinam Hermitage at the in , where she cooks for fellow nuns and monks, as well as occasional visitors. She had no formal culinary training but is now directing the preparation of vegetarian food in a café in Korea and has visited China and Japan as ‘food ambassador’. Temple food is literally food consumed by ascetic Buddhist nuns and monks. Since their goal is enlightenment, achieved by both mind and body, ascetic food aims at this great achievement – enlightenment.

The bustling Chef

Jeong Kwan ran away from her home in a northern province of South Korea at age 17, leaving her family of seven siblings. At 19 she joined an order of Zen nuns and took to cooking with joy, food for the nuns and monks in an adjoining monastery. She had learned to turn out noodle dishes when she was just seven years old. She refers to her being chef to monks and nuns as her way of spreading the Dhamma as food is a very important component of ascetic life, the food certainly not to be relished, drooled over, hungered for, but eaten mindfully to sustain the body in health and thus contribute to the development of the mind.

Jeong Kwan’s recipes use aubergines, tomatoes, plums, oranges, pumpkin, tofu, basil, chilli pepper, and other vegetables and of course rice or noodles. vegan, Jeong Kwan’s recipes omit garlic, green onions and leeks, which are believed to be mildly aphrodisiacal. In the Netflix film I watched, this fairly well set nun with a serene face and charming smile, grows all the vegetables used in her menus. She sows seeds or plants seedlings, tends then lovingly and then harvests what she needs day by day. She says however: “It’s up to nature and the plants themselves to stay alive. Time flows for them and for myself at the same pace.” Her philosophy on cooking monastic food is: “We cook food that can become one with the person eating it; then it functions like medicine inside our bodies.”

Most of what she used in the film were familiar to me. There was nelum ala or the ‘yam’ of the lotus used; and various leaves she gathered. She uses oil fairly freely in her preparation. I don’t know what oil it was. And of course kimchi is an integral part of what she serves each nun in small dishes; the typical Korean dish always present, made from a certain kind of cabbage dipped in sauces. Nun Kwan dipped into large clay pots of sauces, some of which were very old, the sauces I mean.

 

Vegetarian and Vegan

It is apt to define these two terms here. A vegetarian is one who does not eat meat or fish and sometimes other animal products, especially for moral, religious or health reasons.

A vegan is one who abstains from the use of animal products particularly in diet and believes in the “philosophy that rejects the commodity status of animals.” There are degrees of veganism. The term was coined by Dorothy Morgan and Donald Watson in November 1944. (Wikipedia)

 

Food served at meditation retreats

I wrote a fortnight ago about my experiences of meditation retreats at Parappuduwa Nuns’ Island off Ratgama, Dodanduwa, while Ayya Khema was living there and later; and about 10-day and shorter retreats undertaken at Dhamma Khuta Vipassana Bhavana Centre in Hindagala, Peradeniya. Both places were vegetarian. At Parappuduwa we served ourselves from dishes placed on a trestle table, after the resident nuns and any foreign persons in prolonged retreat, had had their meal. I recollect Ayya Khema would remain in her seat supervising us! I once reached out for a dish to pass on to my neighbour who I thought needed some from that dish. Ayya Khema reprimanded me for reaching out for a dish. I did not explain it was not for me but for another that I did what I did. Extreme respect!

At Dhamma Khuta we went up to the food tables in a two queues – men and women – and held out our plates for rice first and then down the line for the vegetable curries; just four sans red chilly, and a salad or leaf sambal. Everything was served in measured quantities. This was lunch at 11.15 – 11.30. We were served dessert, mostly fruit or a prepared simple pudding. For breakfast we were served boiled seed like green gram, followed by a cup of tea. We were allowed to keep tea and sugar in our dormitories and expected to drink plain tea after noon, which unfortunately some did not follow, copiously adding milk and even snacking, just as they broke the Golden Silence rule. In the evening at around 6.00 we were given the choice of half a glass of fruit juice or a mug of plain tea. Those on medicines were served a couple of biscuits and a banana.

Recollections are many but I will narrate just two. At the first ten-day meditation retreat at the newly constructed and not quite complete Dhamma Khuta picturesque Centre right on top of a hill, with Ven Goenkaji and wife living in the bungalow on the premises, we were rather choc-a-bloc since the organizers wanted to accommodate as many as possible at this unique retreat. We were three in most dormitory rooms with the previous meditators accommodated in the now defunct tea factory below, necessitating an arduous van ride in rain and mud and fog.

One of my roommates was obviously rich and definitely fussy, and oldish. She brought along a huge suitcase which covered half the floor of the room. My small bed was against the opposite wall so I had no jumping across or alongside it. She even brought a winter coat! Before bed there was a ritual she followed: munched crackers and cheese, thala guli and drained a mugful of beverage – cocoa or chocolate made with the hot water given each of us in our flasks after the evening gilanpasa.

The next recollection is me, a novice, standing at the narrow food table with helpers on the opposite side, ready with ladles. On the first day of the retreat, I stood at the rice dish at lunch, waiting for the server to give me another spoonful. I thought the amount served was totally inadequate. A slight wave of her palm to indicate I move on was missed by me. She then moved me to the curries with a big wave of her hand. The point in this story is that by the end of the retreat, say seventh day to tenth, I found the rice served me was too much and waved away the second spoon ready to descend on my plate. Even the measured, restricted quantity was found to be too much as the mind got calmer and body felt rested.

With Ven Goenkaji, samples of the cooked curries were taken to him to be tasted and passed as OK. At latter retreats, maybe Brindley Ratwatte or Damayanthi performed that task to see that not too much spices were added. But bland though the food was, it was so very well cooked by the village women who came to help. We ate with gratitude in our hearts to them, the organizers of the retreats and even the farmers.

A very significant point was that with the glass of juice or tea and the fresh cool water off the clay pots placed at strategic positions, I slept more soundly than at home. I found the cup of tea made before going to bed totally unnecessary and even impeded sound sleep until woken at predawn 3.30.

Conclusion: we normally eat far too much, especially at dinner!

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The Rajeewa Jayaweera I Knew

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For a fleeting period, Air Lanka (before its change to SriLankan) lit up the Oman sky, but it was all too brief, as was the life of the initiator of this success. We commemorate the first death anniversary of Rajeewa Jayaweera and recall with pride the achievements of this dynamic individual who left a significant imprint of Sri Lanka’s landscape among those living in the gulf states.

As a journalist my association with Rajeewa spanned over a decade in the nineties. He was a “stoic and principled” administrator who was forthright and considered in his views. As Manager of the Sri Lankan airline in Oman, he delivered exceptional service not only to our community in many ways over the period of his tenure, but also to those Gulf travelers visiting our island. I was amazed at his dedication, determination and discipline; he did not waver in his search for perfection.

When Rajeewa arrived in Oman in the second half of the nineties, Sri Lanka’s National airline was in the doldrums and was considered “just another airline” competing for a share of the Gulf’s travel market catering mainly to the Lankan workforce. Rajeewa’s vision was different, his desire was to raise the standard of the airline to be on par with the best, but he had to contend with the bureaucrats in Colombo. He faced up to the challenge. Not afraid to speak his mind and to take a firm position on issues that were

important to him and the airline, his persistence to enhance the image of the airline succeeded, commencing with the shifting of the airline’s office premises after 13 long years to a prestigious and prominent location. The airline’s logo was displayed for all to see.

This was followed by familiarisation tours to our Emerald Isle for foreign journalists and travel agents and Rajeewa accompanied them as tour guide, mesmerizing reporters with his in-depth knowledge of Sri Lanka’s history and attractions to leave them in awe.  Rajeewa was a true ambassador for the country and its airline, just like his late father, Stanley Jayaweera, a career diplomat of repute. In 1997, to coincide with 50-years of Sri Lanka’s Independence, Rajeewa hosted Air Lanka’s first-ever glamorous “Top Agents Awards” ceremony at the Muscat Holiday Inn.  The invitees were treated to an extravaganza of what Sri Lanka had to offer interspersed with a cultural show, traditional dancing, and authentic Sri Lankan cuisine courtesy of Jetwing’s finest chefs.  Rajeewa’s positive charm instantly propelled the

airline into the limelight, winning hearts and minds of the Gulf’s expatriate community resulting in Air Lanka becoming the preferred carrier of choice for their holidays. As a disciplinarian he may not have endeared himself to many, but he stood tall with his direct and “no nonsense” approach which provided the basis for the airline’s success in the Sultanate.

After completing his term in Oman, Rajeewa was transferred to Madras and then Paris continuing his drive in these two cities to improve the image of Sri Lanka’s national airline.

In later years Rajeewa bemoaned the plight of Sri Lanka’s national airline and mismanagement.  He had a fierce loyalty for the airline and represented his country with pride and would have been an ideal member to serve on the SriLankan Airlines board with his vision and experience. Unfortunately, those with vested interests thought otherwise and the island nation’s loss was Qatar Airways gain. Those who associated closely with Rajeewa will remember him as a strict disciplinarian with a strong work ethic and an abundance of skill. He was an outstanding role model for young people in particular. He was a beautiful, kind and much-loved friend. We are sad beyond words and extend our deepest condolences to Rajeewa’s family.

 

Clifford Lazarus

New Zealand

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