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Leptospirosis or ‘Rat Fever’ in Sri Lanka

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Dr B. J. C. Perera
MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paed),
MRCP(UK), FRCP(Edin), FRCP(Lond), 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)

Sri Lanka is grappling with a surge in leptospirosis cases at present. It is a bacterial disease often transmitted through contaminated water and soil. Following the recent devastating floods, the number of infections has skyrocketed, with over 10,000 cases reported so far, with a significant number of fatalities. In 2023, there were around 9,000 cases with over 200 deaths. In medical terminology, Leptospirosis is classified as a zoonotic disease, meaning that it can be transmitted between animals and humans.

Leptospirosis is caused by a bacterium called Leptospira icterohaemorrhagiae, commonly found in the urine of infected animals, particularly rodents. The disease is also known as “Rat Fever” as rats carry this organism and excrete it in their urine. When floodwaters contaminate the environment, these bacteria can spread widely. The organism is also found in agricultural plots such as paddy fields. People can contract the disease by wading through floodwaters, consuming contaminated food or water, or handling infected animals. Children are particularly vulnerable to catching the disease as they love to play in water-logged paddy fields and flood waters.

The organism enters the body of humans through breaks in the skin, and mucous membranes, or through the gastrointestinal tract. There has been an alarming spike that came in the aftermath of severe flooding in recent months, which has created ideal conditions for the spread of this potentially fatal disease. Floodwaters often mix with waste, animal urine, and other contaminants, creating an environment ripe for the proliferation of Leptospira bacteria. People’s unavoidable exposure to these waters, especially in rural and suburban areas, has significantly increased infection rates. Additionally, inadequate drainage systems, poor sanitation in flood-affected areas, and delayed medical interventions have amplified the crisis. The heavy toll on Sri Lanka’s healthcare system due to other ongoing challenges has also strained resources for managing the outbreak.

The symptoms of leptospirosis can range from a mild flu-like illness to a severe, life-threatening condition. In its early stages, it may present with fever, headache, chills, rigors or shaking episodes, vomiting, muscle aches which could be quite severe, and redness of the whites of the eyes due to bleeding. Some moderate to severely affected patients start to pass reddish urine due to bleeding from the genitourinary tract. The organism is labelled as icterohaemorrhagiae because the name implies two of the most devastating complications of the disease; ictero meaning jaundice signifying liver involvement, and haemorrhage implying a bleeding tendency. The initial mild phase of the illness often resolves on its own or with minimal treatment. Yet for all that, some patients progress to a more severe life-threatening form of the disease characterised by major bleeding tendencies, kidney failure, liver damage, brain involvement, respiratory distress, and end up in death. However, the real problem is that at the onset of the disease, it is impossible to predict the subsequent course the disease will take. It could be mild or it could sometimes end up in death, as seen at the two extreme ends. Therefore, once a firm or likely diagnosis of leptospirosis is made, the full course of treatment must be given, irrespective of even the initial mild nature.

If detected early, leptospirosis can be very effectively treated with appropriate antibiotics. The secret is to refrain from disregarding symptoms and taking meaningful steps to seek medical care early. This should be very clearly conveyed to the general public. In the more severely affected patients and those who present late and have complications of the disease, even intensive care management in a tertiary care hospital may be necessary. Severe liver and kidney failure need specific treatment to ensure recovery. Severe kidney failure may even need renal replacement therapy such as dialysis.

The best way to prevent leptospirosis is to avoid exposure to contaminated water and soil. This can be done by wearing protective gear such as waterproof high boots, gloves and long-sleeved clothing, particularly when working in flood-affected areas, avoiding wading through or swimming in floodwaters, drinking boiled or treated water, maintaining personal hygiene by washing hands thoroughly with soap and water after any activity that may have exposed one to contaminated water or soil, vaccinating pets against leptospirosis and controlling the rodent populations.

The government and public health authorities play a crucial role in preventing and controlling leptospirosis outbreaks. The measures to be taken include closely monitoring the number of cases and identifying areas at high risk, early detection and treatment of affected patients by providing timely diagnosis and treatment, educating the public about the risks of leptospirosis and the preventive measures that should be taken, and improving sanitation and hygiene as well as developing and implementing a comprehensive leptospirosis control programme.

The leptospirosis outbreak in Sri Lanka serves as a stark reminder of the importance of preparedness and prevention. By understanding the risks, taking necessary precautions, and supporting public health efforts, we can effectively mitigate the impact of this deadly disease. While individual actions are vital, controlling a public health crisis of this magnitude requires coordinated efforts by health authorities, local governments, and communities. Public Awareness Campaigns are vital and authorities should disseminate information through media about the risks, symptoms, and preventive measures for leptospirosis. Improving sanitation, addressing waste management and improving drainage systems can reduce contamination in flood-prone areas. This crisis also highlights the need for long-term investments in infrastructure, sanitation, and healthcare to build resilience against future outbreaks.

For now, raising awareness and taking immediate action are the most powerful tools to save lives. If you suspect you may have been exposed to leptospirosis or are experiencing any of the symptoms, seek medical attention immediately. Early diagnosis and treatment can significantly improve the chances of recovery. By working together, we can protect ourselves and our communities from the dangers of leptospirosis.

This article is for informational purposes only and should not be considered as binding medical advice. The general public must consult appropriate medical personnel without any delay, as and when required.



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US withdrawal from UNHRC, a boon to political repression and ultra-nationalism

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President Trump in a meeting with President Putin. The New York Times

The US’ reported withdrawal from the UNHRC and some other vital UN agencies could be seen as a fillip to anti-democratic and ultra-nationalistic forces worldwide. Besides, the stark message is being conveyed that the developing regions of the world would from now on suffer further impoverishment and powerlessness.

The UNHRC needs to be more effective and proactive in bringing to book those states that are lagging in upholding and implementing human rights standards. But thus far it has been notable in the main in only ‘naming and shaming’ periodically those countries that stand accused of human rights and associated violations. More states and their rulers who have proved notorious violators of International Law, for instance, need to be brought to justice.

Hopefully, the UNHRC would be more dynamic in carrying out its responsibilities going forward but it needs material, moral and financial sustenance in increasing measure as it goes about trying to implement its brief. By withdrawing its support for the UNHRC at this juncture the US has further weakened the body and thereby provided a stimulant to the forces of repression worldwide.

What ought to be equally disquieting for the ethically-conscious is the withdrawal of US support for the WHO, the UN agency for Palestinian refugees or the UNRWA and the Paris Climate Agreement. With these actions the US under President Donald Trump has forfeited all claims to being the world’s foremost democracy. It could no longer lead from the front, so to speak, in championing human rights and democratic development.

It is no coincidence that almost at the time of these decisions by the US, President Trump is meeting with Israeli Prime Minister Benjamin Netanyahu. At the time of writing what transpired at these talks is not known to the public but it is plain to see that under the ultra-rightist Israeli Prime Minister, there would be no easy closure to the Middle East conflict and the accompanying blood-letting.

This is in view of the fact that the hawkish Trump administration would be hand-in-glove with the Netanyahu regime right along. There would be no political solution in the foreseeable future nor could it be guaranteed by the main stakeholders to the Middle East question that the current ceasefire would continue.

As mentioned in this column before, Israel would need strong security guarantees from the Palestinian camp and its supporters before it sits earnestly at the negotiating table but a policy of repression by the Israeli state would in no way help in resolving the conflict and in ushering even a measure of peace in the region. With the staunch support of the Trump administration the Netanyahu regime could stave off Palestinian resistance for the time being and save face among its supporters but peace in the Middle East would continue to be a lost cause.

The issues in focus would only be further compounded by the US decision to cease support for the rehabilitation and material sustenance of Palestinian refugees. This policy decision would only result in the further alienation and estrangement of Palestinians from the Western world. Consequently, Intifada-type uprisings should only be expected in the future.

As should be obvious, the US decision to pull out of the WHO would further weaken this vital agency of the UN. A drop in material, medical and financial assistance for the WHO would translate into graver hardships for the suffering civilians in the world’s conflict and war zones. The end result could be the alienation of the communities concerned from the wider international community, resulting in escalating law and order and governance issues worldwide. Among other things, the world would be having on its hands aggravating identity politics consequent to civilian publics being radicalized.

Considering the foregoing, the inference is inescapable that the US is heading in the direction of increasing international isolation and a policy of disengaging from multilateral institutions and arrangements geared to worthy causes that could serve world peace. As matters stand, it would not be wrong to conclude that the Trump administration is quite content with the prevailing ‘international disorder’.

One of the most negative consequences of the US decision to pull out of the UNHRC is the encouragement the forces of repression and ultra-nationalism could gain by it. In almost all the states of South Asia, to consider one region that is notable from this viewpoint, the forces of ultra-nationalism and majoritarian chauvinism could be said to be predominant.

Unfortunately, such forces seem to be on the rise once again in even post-Hasina Bangladesh. In Sri Lanka these forces are somewhat dormant at present but they could erupt to the surface, depending on how diligently the present government guards against their rise.

However, the government of Sri Lanka could not be said to be going the extra mile currently to blunt the appeal of ultra-nationalism, whether it is of the Southern kind or of the Northern kind. Crunch time for the Sri Lankan state would come when it has to seriously cooperate with the UNHRC and help bring those accused of war crimes in Sri Lanka to justice. On whether it could cooperate in this exercise would depend the democratic credentials of the present regime.

The cumulative result of the Trump administration weakening the UN and its agencies would be the relentless rise of anti-democratic, fascistic and repressive regimes the world over. Given this backdrop, one could expect the war in the Ukraine and those wasting civil wars in Africa to rage on. In the case of the Ukraine, the possibility of the US and NATO not being of one mind on ways of ending the war there, could render closure of the conflict any time soon impossible.

However, waiting on the US with the expectation that it would be pulling itself together, so to speak, before long and addressing the issue of international law and order would be tantamount to handing over the world to a most uncertain future. It is highly unlikely that the Trump administration would prove equal to the challenge of bringing even a measure of order out of the current global chaos, given the primacy it would be attaching to what it sees as its national interest.

Rather than wait in suspense, democracy oriented sections the world over would do well to come together in a meeting of minds, with the UN playing a catalytic role in it, to figure out how they could pool all the resources at their command to bring about a world order that would be more respectful of International Law in word and spirit.

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‘The Onset: A Short Story’: A philosophical drama attempting to redefine perception and cinema

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A scene from the movie with Hannah Brennen and Matt Heakes

Debut filmmaker, Thevin Gamage, presents a bold challenge to the time-honoured conventions of cinema. Through his daring short film, Thevin invites audiences to reconsider ‘the truth’ of cinematic rules. The 180-degree rule is broken with seamless subtlety, and a fresh perspective is offered on breaking the fourth wall.

This 13+ minute dialogue-driven drama, ‘The Onset: A Short Story’ featuring two actors and created with the collaboration of a debut cinematographer, was shot entirely in his living room—a testament to ingenuity and creative audacity.

The film not only aims to redefine the language of cinema but also thematically contests one of Plato’s most renowned teachings—The Allegory of the Cave. Thevin offers a fresh lens to examine ‘truth’ blending bold cinematic innovation with a philosophical exploration of perception, arrogance, and enlightenment.

At its heart, this story reflects the universal tension between belief and truth, highlighting the cost of breaking free from illusions. His debut is both a defiant act of rebellion and a bold invitation to shape the evolution of future cinema, leaving audiences with as many questions as answers.

Born into a family of artists in Sri Lanka, Thevin, grew up surrounded by a legacy of creativity yet confined by the traditional expectations of society. His parents achieved success as actors and later as entrepreneurs.

For Thevin, questioning the rules was not rebellion for its own sake—it was a search for freedom, truth, and new perspectives. This drive began in childhood, where strict parental expectations collided with his innate creativity. Movies became his escape, a lens through which he experienced life, love, and possibility.

Yet it wasn’t until his late twenties, after years of academic success and professional detours that he finally embraced his calling as a filmmaker. His audacious short film bridges his personal journey with his artistic vision. By breaking the 180-degree rule and redefining the fourth wall, the film demonstrates that cinematic rules can evolve—not as acts of rebellion, but as purposeful explorations of storytelling.

In the spirit of art and its boundless novelty, Thevin Gamage seeks to induct exactly that: originality.

His debut film is a bold exploration of cinematic boundaries and philosophical inquiry, redefining two foundational principles of cinema. This film invites audiences to experience a narrative that subtly bends the historical rules of the 180-degree rule and the fourth wall—often without them even realizing it.

This debut dares you.

It’s a resolute challenge to tradition and a provocative reminder that “rules” are just a few letters that form a word.

****

About young filmmaker

Thevin Gamage

Thevin Gamage is a South Asian filmmaker whose journey reflects both a profound reverence for tradition and an unrelenting desire to transcend it.

Born into a family of artists in Sri Lanka, Thevin was shaped by a legacy of creativity and resilience. His grandfather, Sri Lanka’s first film makeup artist, pioneered his craft with remarkable dedication, laying the foundation for a family deeply rooted in the arts. Though Thevin never met him, his grandfather Regie de Silva’strailblazing work ethic and passion for storytelling helped shape the family ethos, inspiring Thevin’s mother and, in turn, Thevin himself. Reggie was the first Sri Lankan makeup artist. He went to India for his studies in makeup artistry and was active during the era when B.A.W. Jayamanne and Rukmani Devi pioneered the Sri Lankan film industry.

Thevin’s mother, Kumudumali De Silva, a celebrated Best Supporting Actress winner two decades ago and recent Lifetime Achievement Award honoree for her contributions to the wedding industry, met his father, Nihal Gamage, while on set. Together, they transitioned from the entertainment industry to entrepreneurial success, founding a wedding photography and bridal dressing business. Their ventures flourished, even leading to the publication of their own wedding magazine, providing a middle-class life of success and recognition.

Despite these creative roots, societal expectations in Sri Lanka compelled Thevin to pursue academics. After excelling at the University of Toronto with a degree in Political Science, Economics, and Psychology, Thevin still yearned for storytelling. In his late twenties, after years of professional detours, he enrolled in film school and committed fully to his craft.

Operating outside the framework of traditional film production companies, Thevin embraced the challenges of independence. From conceptualization to execution, his debut film is a testament to his determination, ingenuity, and unwavering commitment to his vision. His journey as an independent filmmaker exemplifies the power of creative freedom to challenge norms and shape unique perspectives.

Thevin’s work invites audiences to question, reimagine, and ultimately transform their understanding of storytelling. His journey is not just one of artistic pursuit but an act of defiance—an effort to inspire others to embrace the power of the arts and forge paths beyond traditional norms.

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Top three at 40th Mrs World pageant

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Mrs World – South Africa: Tshego Gaelae (L) / First Runner-up – Sri Lanka: Ishadi Amanda (M) / Second Runner-up – Thailand: Ploy Panperm (R)

While South African model Tshego Gaelae becomes the first Black woman to win the Mrs. World title in its 40-year history, we, too, were in the spotlight, at the finals.

Ishadi Amanda took the No. 02 slot, being the first runner-up at the prestigious pageant, held in Las Vegas, USA, from 29-30 January, 2025.

Thailand’s Ploy Panperm was placed third, as the second runner-up.

Sri Lanka’s Ishadi had support from the audience when her name was announced as one of the three finalists.

The Mrs World pageant winner, from South Africa, expressed her thanks on Instagram, saying, “To God be the glory. Thank you so much for the love and support, I am beyond grateful and elated! My beautiful South Africa, the crown is coming home,” she shared with her followers, encapsulating her elation and gratitude.

The Mrs World pageant, established in 1984, stands as the first international beauty contest solely for married women, providing a platform for married contestants to showcase not just their beauty, but also their intellect and community outreach efforts.

Before being picked as the winner, Mrs South Africa was asked: “What is the biggest challenge you have faced and achieved?” And her answer was brilliant:

Rosy Senanayake: Mrs World 1984

“I was so stressed on social media. Social media people should use it to share knowledge and good things. But it’s used to stress people out. But I stood up for myself without that social media pressure. I used the same social media that stressed me out to share good thoughts and hope to get to the victorious place I am today.”

Gaelae’s success is a testament to the ideals celebrated by the pageant, where diversity and empowerment take centre stage.

Gaelae balances her roles as a devoted mother, wife, labour relations manager, and model.

Being the first black woman to clinch the title at the Mrs World pageant has ignited a sense of pride and celebration among South Africans.

The Mrs South Africa Organisation, which played a crucial role in supporting Gaelae’s remarkable journey, also expressed their pride through a statement: “From Soweto to Vegas and now the World, @mrsworldpageant The Crown is Coming Home! Thank you to everyone who supported our queen on her incredible Journey.”

Gaelae returned home to a triumphant celebration fit for a queen.

At the airport to welcome her were her family, friends, church community, the Mrs South African team board and alumni, and the Executive Mayor of Johannesburg.

The crowning of the 40th Mrs World winner

And, guess what? Gaelae is now in touch with me!

Second Runner-up Mrs Thailand Ploy Panperm is quoted as having said: “I believe that modern married women have the potential to excel in multiple roles – as wives, mothers and even as beauty queens – embodying intelligence, talent and beauty.”

For the record, it was our very own Rosy Senanayake who brought Sri Lanka fame at this pageant … being crowned Mrs World at the very first Mrs World pageant, in 1984.

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