Features
Is Sri Lanka Medical Council fit for purpose?

By Dr Upul Wijayawardhana
Quite a number of my distinguished colleagues have written about the Sri Lanka Medical Council (SLMC) or held press conferences lately, but all of them addressed only one issue; the removal, by the Minister of Health, of the president and four members of the council appointed by her predecessor. Whilst my colleagues are questioning the legality of this action, the Minister contends that she has the authority to do so and justifies her action on the basis of the findings of the five-member committee she appointed. As we, doctors, as well as politicians, being equally unaware of the finer points of law, perhaps, it is best left for the judiciary to decide on the legality or otherwise of this decision. However, if the courts decide that the Minister of Health acted illegally, surely, she should resign, not only because of this but also because of her erratic behaviour during the grave health emergency we are going through. We do not seem to be very lucky with our Ministers of Health; one with the infamy of a bogus ‘crocodile’ press conference being replaced by another who pollutes rivers with pots of a concoction devised by a faith healer and then, adding insult to injury, by promoting an untested remedy invented by a Kali Amma inspired kapuwa to get rid Covid-19!
After going through the website of the SLMC and making comparisons with the only other regulatory body I am familiar with, the General Medical Council of UK (GMC), I have a greater concern; whether the SLMC, as constituted at present and the way it seems to be functioning, is fit for purpose. Not being sufficiently distinguished, I have not had the pleasure of serving on either of these august bodies but have had dealings with both, after being reported by my colleagues.
I still remember the day my good friend Dr S. J. Stephen came rushing to my humble abode in the Summit Flats the moment he learned that I had been reported to the SLMC by a close colleague of mine. He was so concerned he offered to retain a top lawyer for me. I was reported for advertising myself by doing programmes on radio and television! Nowadays many doctors seem to be doing these but at that time I happened to be the pioneer in TV health education programmes. I remember Sanath Liyanage, who produced the very popular educational programme “Neth Sera” for Rupavahini, telling me that the medical programmes were widely watched even in Jaffna though my discussions with a panel of experts was in Sinhala.
When SLMC requested my comments regarding the complaint all I did was to point out that I did these programmes on behalf of the Sri Lanka Medical Association (SLMA), in keeping with its policy of public education and with the approval of the SLMA council. The matter did not progress further, but many infuriated colleagues of mine urged me to report the person concerned for his unethical action, malicious reporting, etc., but I did not want to descend to his level.
In addition to being the Consultant Cardiologist, for a time I was the Clinical Director of Medicine at Grantham Hospital in the UK. A doctor of Indian origin, whose name incidentally was Vaidya (Physician in Sanskrit), whom I appointed as a Staff Grade Physician (a position just below a Consultant) was behaving erratically and in spite of numerous representations by me, no action was taken by the hospital administration. He was once caught trying to put a nail under one of the tyres of my car! His ire got worse when post-graduate trainees from Sri Lanka who worked with me started winning the hearts and minds of the staff and patients with their ability as well as attitude. I must say I am very proud of the 10 trainees I had who have excelled themselves in Sri Lanka. Dr Vaidya reported me to the GMC on many counts including ‘import of illegal Sri Lankan labour’! After detailed written submissions the GMC decided that there was no case against me for further investigation. I must admit that I had few sleepless nights fearing a GMC investigation, which is a harrowing experience.
After it was proved that Dr Vaidya forged a letter from the Post-graduate Dean the hospital was forced to suspend him though they did not find him guilty of racism in spite of his circulating a letter condemning Sri Lankan doctors and the medical education system in Sri Lanka! Fortunately, the GMC took a different view when he was reported. I was the key witness at the GMC inquiry against him and one of the trainees who had returned to Sri Lanka was also present as a witness at the GMC expense. Dr Vaidya was found guilty of racism and forgery, as well as a number of other offences and his name was erased from the medical register.
In the UK, it is very easy for anyone, even a patient, to find out whether a doctor is registered and is in the specialist register as the GMC maintains an excellent website. Also, there are clear instructions in the website how to make a complaint against a doctor. All complaints are investigated by the Medical Practitioners Tribunal Service (MPTS) and all decisions of the MPTS are available on their website for public perusal. A quick glance shows at least three doctors receiving warnings each month and a few more getting undertakings/suspensions. Thus, there is an active process for patient protection.
I was aghast when I went through the SLMC website, not only for its primitive nature but for the paucity of information. The only detailed part in the website is the history of the CMC/SLMC, perhaps, reflecting our national weakness of harking on past grandiosity! Though it claims that the SLMC “is a statutory body established for the purpose of protecting health care seekers” there is not a word on the website how disappointed ‘seekers’ could raise concerns! There is no way of finding out whether any strictures were passed on any doctor or whether they are registered. As a test, I entered the names of some my trainees to find out the registration status but only a recurring message ‘no matches found’ appeared. As it is rumoured that there are many fraudulent practitioners, surely, this facility should be available.
According to the SLMC website, its President still is Prof. Carlo Fonseka! Carlo must be conducting affairs from heaven! But that is not possible because Carlo did not believe in an afterlife, a topic we discussed when I met him last, a few months prior to his death. In spite of the claim “it is a body corporate having perpetual succession and a common seal”, the last available annual report is for 2010!
I can go on pointing out many deficiencies on the website. I am surprised that many distinguished members of the profession who sat on the council did not realise the importance of an up-to-date website which, in this era of electronic communication, is the face of any organisation.
The most damning aspect, of course, is the constitution of the SLMC where there is a total disregard for the principle of ‘conflict of interest’. No office-bearer of a trade union should sit on the council of a regulator as it may compromise decisions. Justice becomes a mockery if the same counsel appears for both the prosecution and the defence! Any office-bearer of a trade union, even if not barred from contesting, should be mandated to give up such positions if they decide to sit on the council of the SLMC, as they cannot have it both ways. I am surprised that ex-officio members like the Deans of the faculties of Medicine and the Director General of Health Services did not take a principled stand on this issue. Had they declined to sit with those on whose part there was a conflict of interest, the government would have had no choice but to amend legislation. Or, is it that no government can defeat the rice-mafia or doctors’ mafia?
Not only the website but also the SLMC itself needs an overhaul but it should not go the way the GMC did. Many doctors in the UK are taking early retirement or exploring other avenues as they perceive that the GMC has become a body that harasses doctors, after it was revamped following public pressure. I am sure with the vast potential of talent available in Sri Lanka a middle way could be found and the SLMC can become a regulatory body fit for purpose.
Features
Babies made using three people’s DNA are born free of hereditary disease

Eight babies have been born in the UK using genetic material from three people to prevent devastating and often fatal conditions, doctors say.
The method, pioneered by UK scientists, combines the egg and sperm from a mum and dad with a second egg from a donor woman.
The technique has been legal here for a decade but we now have the first proof it is leading to children born free of incurable mitochondrial disease.
These conditions are normally passed from mother to child, starving the body of energy.
This can cause severe disability and some babies die within days of being born. Couples know they are at risk if previous children, family members or the mother has been affected.
Children born through the three-person technique inherit most of their DNA, their genetic blueprint, from their parents, but also get a tiny amount, about 0.1%, from the second woman. This is a change that is passed down the generations.
None of the families who have been through the process are speaking publicly to protect their privacy, but have issued anonymous statements through the Newcastle Fertility Centre where the procedures took place.
“After years of uncertainty this treatment gave us hope – and then it gave us our baby,” said the mother of a baby girl. “We look at them now, full of life and possibility, and we’re overwhelmed with gratitude.”
The mother of a baby boy added: “Thanks to this incredible advancement and the support we received, our little family is complete. “The emotional burden of mitochondrial disease has been lifted, and in its place is hope, joy, and deep gratitude.”
Mitochondria are tiny structures inside nearly every one of our cells. They are the reason we breathe as they use oxygen to convert food into the form of energy our bodies use as fuel.
Defective mitochondria can leave the body with insufficient energy to keep the heart beating as well as causing brain damage, seizures, blindness, muscle weakness and organ failure.
About one in 5,000 babies are born with mitochondrial disease. The team in Newcastle anticipate there is demand for 20 to 30 babies born through the three-person method each year.
Some parents have faced the agony of having multiple children die from these diseases.
Mitochondria are passed down only from mother to child. So this pioneering fertility technique uses both parents and a woman who donates her healthy mitochondria.
The science was developed more than a decade ago at Newcastle University and the Newcastle upon Tyne Hospitals NHS Foundation Trust and a specialist service opened within the NHS in 2017.

There was a case of epilepsy, which cleared up by itself and one child has an abnormal heart rhythm which is being successfully treated.
These are not thought to be connected to defective mitochondria. It is not known whether this is part of the known risks of IVF, something specific to the three-person method or something that has been detected only because the health of all babies born through this technique is monitored intensely.
Another key question hanging over the approach has been whether defective mitochondria would be transferred into the healthy embryo and what the consequences could be.
The results show that in five cases the diseased mitochondria were undetectable. In the other three, between 5% and 20% of mitochondria were defective in blood and urine samples.
This is below the 80% level thought to cause disease. It will take further work to understand why this occurred and if it can be prevented.

Prof Mary Herbert, from Newcastle University and Monash University, said: “The findings give grounds for optimism. However, research to better understand the limitations of mitochondrial donation technologies, will be essential to further improve treatment outcomes.”
The breakthrough gives hope to the Kitto family.
Kat’s youngest daughter Poppy, 14, has the disease. Her eldest Lily, 16, may pass it onto her children.
Poppy is in a wheelchair, is non-verbal and is fed through a tube.
“It’s impacted a huge part of her life,” says Kat, “we have a lovely time as she is, but there are the moments where you realize how devastating mitochondrial disease is”.

Despite decades of work there is still no cure for mitochondrial disease, but the chance to prevent it being passed on gives hope to Lily.
“It’s the future generations like myself, or my children, or my cousins, who can have that outlook of a normal life,” she says.
The UK not only developed the science of three-person babies, but it also became the first country in the world to introduce laws to allow their creation after a vote in Parliament in 2015.
There was controversy as mitochondria have DNA of their own, which controls how they function.
It means the children have inherited DNA from their parents and around 0.1% from the donor woman.
Any girls born through this technique would pass this onto their own children, so it is a permanent alteration of human genetic inheritance.
This was a step too far for some when the technology was debated, raising fears it would open the doors to genetically-modified “designer” babies.
Prof Sir Doug Turnbull, from Newcastle University, told me: “I think this is the only place in the world this could have happened, there’s been first class science to get us to where we are, there been legislation to allow it to move into clinical treatment, the NHS to help support it and now we’ve got eight children that seem to free of mitochondrial disease, what a wonderful result.”
Liz Curtis, the founder of the Lily Foundation charity said: “After years of waiting, we now know that eight babies have been born using this technique, all showing no signs of mito.
“For many affected families, it’s the first real hope of breaking the cycle of this inherited condition.”
[BBC]
Features
Western proxy war in Ukraine could be approaching dangerous tipping point

Fast-breaking developments in US-Russia relations and US-Ukraine ties could very well be pointing to the wasting war in the Ukraine theatre currently approaching a dangerous tipping point. The US has reached the crucial decision to equip Ukraine with the necessary lethal arms to counter Russia’s ongoing missile and drone strikes on it and if implemented could mark a qualitatively new phase in the conflict between the West and Russia in Ukraine, which could have serious implications for regional and even world peace.
‘We want to make sure Ukraine can do what it wants to do, US President Donald Trump is quoted as saying following a recent meeting he had with NATO chief Mark Rutte in Washington, subsequent to indicating that the US will be sending ‘top of the line weapons’ to Ukraine through NATO countries. Such weaponry could include Patriot air defence systems which are generally seen as an effective answer in particular to Russia’s air strikes on Ukraine.
Meanwhile, Ukrainian President Volodymyr Zelensky is on record that he had thanked the US President for his ‘willingness to support Ukraine and to continue working together to stop the killings and establish a lasting and just peace.’
Going ahead, the West would need to bear in mind that the supplying of exceptionally lethal arms to the Ukraine through its mediation could be seen by the Putin regime as hostile acts directed at the Russian state. That is, the West would be considered as involving itself physically in the ongoing hostilities between Russia and the Ukraine, necessitating the West, and more specifically NATO countries, to brace for Russian military strikes on them. Needless to say, such an eventuality would bode ill for international stability and peace.
Accordingly the West would need to assess very finely the consequences of its decisions on the Ukraine front. While the US President’s recent statements on these questions could be seen by some as mere rhetoric Trump is also on record as having indicated that his patience is wearing thin with Putin over the central issue of bringing peace to the Ukraine.
Inasmuch as Trump needs to trod gingerly going ahead so must Putin. In the event of full scale hostilities breaking out between the East and West in the Eastern European theatre no camp would stand to gain; this ought to be plain to the main antagonists, since they are evenly matched in terms of military capability. Even if the conflict in the Ukraine stagnates at a proxy stage, the costs for both sides would be staggering in human and material terms. Russia would need to recollect Afghanistan and the US would need to take itself back to the numerous proxy wars it fought in the then Third World.
However, although there are great uncertainties and perils for the world in the event of the current proxy war in the Ukraine degenerating into a more frontal East-West military confrontation in Europe, President Trump could be considered as holding the ‘Trump card’ to force a negotiated end to the present crisis.
This ‘Trump card’ takes the form of the economic strife which may descend upon the world in the event of the Trump administration going fully ahead with its ‘reciprocal tariff’ based trade wars with the majority of countries.
The US under President Trump may not be the most popular major power but it continues to be critical to the world’s current economic health. However much unpalatable it may be, the truth is that the economic vibrancy and prosperity of the US are key to many a country’s material survival. This is on account of the multiple economic linkages between the US and the rest of the world. The weaker the economy the greater is its dependence on the US and its largesse. For example, Sri Lanka knows this only too well.
The Trump administration is on record that it would be imposing what are described as ‘secondary tariffs’ on those countries whose economic operations are even indirectly benefiting Russia and if implemented could bring about crippling economic hardships for quite a few countries.
Major economic powers, China and India, are fully aware of these consequences. This is the reason why they would prefer not to undermine current economic arrangements between them and the US and between the latter and the rest of the world.
The above positions should not be misunderstood to mean that the rest of the world should be in a subservient relationship with the US. There is no question of the US exercising some sort of suzerainty over the rest of the world. This is not the case but in international relations the primacy of economics over politics may need to be recognized; economic realism needs be a cornerstone of foreign policy.
It would be quite some time before the BRICS grouping reaches the commanding heights of the world economy. Right now, it would be self-defeating, given the US’ continued economic power, for the South in particular to gloss over the might of the West and depend lopsidedly on the BRICS powers for its entire economic sustenance and survival. Indeed, a Non-aligned foreign policy remains best for the South.
It does not follow from the above considerations that the West could continue to turn a blind eye to the dangers posed to it and the world from the Ukraine conflict. Immense caution and foresight would need to go into its moves to arm Ukraine with its more sophisticated and exceptionally lethal weaponry. A cornered enemy in the battlefield, suffering overwhelming losses, cannot be expected to be continually discreet. With its patience relentlessly wearing thin it could unleash its Weapons of Mass Destruction, thus driving the world to the brink of destruction.
Accordingly, it is hoped that better counsel would prevail over all concerned and that differences would be resolved at the negotiating table. May be harsh economic realities would come to dictate terms and propel the quarters concerned to give cool rationality rather than the avarice born of self-aggrandizement a chance in their dealings with each other.
Features
Shah Rukh Khan – secret to looking young

I’m sure the whole of Sri Lanka is eagerly looking forward to the arrival of Bollywood heartthrob Shah Rukh Khan, due in Colombo, next month, for the grand opening of the City of Dreams.
What makes Shah Rukh Khan standout is not only his acting prowess but also his looks.
At 59-plus, he looks absolutely great … or, let’s say, simply awesome.
Generally, people in their late fifties, or even in their mid-fifties, look frail, and some can’t even walk steadily.
So, what is Shah Rukh Khan’s secret to looking young, and, remember, he will be hitting 60 on 2nd November, 2025!
Yes, diet, is given top priority where Shah Rukh Khan is concerned.
While many of us need around four meals a day, Shah Rukh focuses on two main meals a day – lunch and dinner – and avoids snacking or elaborate dishes.
His meals often include sprouts, grilled chicken, broccoli, and sometimes dhal. And don’t we all love dhal!
While he enjoys sharing meals with others when he’s with family or travelling, even if it means indulging in richer dishes, like biryani or parathas, his core diet remains consistent, he says.
Wonder what would be his menu during his very short stay in Sri Lanka! Perhaps traditional Indian foods like tandoori chicken and mutton biriyani, roti, parathas, food cooked with ghee! He also likes the drink lassi, I’m told.
Perhaps, we should also ask him to check out some of our dishes, as well … a good rice and curry menu, with dhal!
It isn’t diet alone that has given Shah Rukh his young look but, he says, exercise, too, has played an important part, especially where his physique is concerned.

Young Shah Rukh Khan in the early ‘90s
Shah Rukh refers to his fitness journey during the pandemic, saying during the pandemic he decided to work hard on his body.
He focused on building a strong physique, and, by exercising consistently, he achieved a body he is proud of today.
Another factor responsible for his leaner, healthier body, and a sharper appearance, is that he has completely quit smoking
This major lifestyle change has also helped him maintain a leaner, healthier body, and a sharper appearance, he says.
Strangely, his sleep routine is totally different to what experts say. We are told that we need between seven and nine hours of sleep per night for optimal health.
Shah Rukh admits he has an unusual sleep schedule and this generally happens when he has a busy shooting schedule.
He usually goes to bed around 5.00 am and sleeps for about four–five hours. Even though it’s not ideal, he manages it around his busy shooting schedule.
In fact, Shah Rukh is a night person and usually loves working in the night. He also loves night shoots. He had said, “I usually head to bed around 5.00 am. On shooting days, I wake up by 9 or 10 in the morning. After coming back home late at night — sometimes around 2.00 am — I take a shower and get a workout in before I finally sleep.”
On the work front, he will be seen next in the movie ‘King’, due for a grand release in 2026.
Shah Rukh Khan continues to inspire millions with his commitment to fitness and I hope Sri Lankans will take a cue from this Bollywood heartthrob and maintain a leaner, healthier body.
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