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Editorial

Malaria must not be a forgotten disease

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Today (April 25) is World Malaria Day and we are privileged to offer our readers a most thought-provoking and informative article written by Emeritus Professor Kamini Mendis of the Colombo University who has contributed enormously to fight this once deadly disease not only here in Sri Lanka but also in the wider world through her work at the World Health Organization (WHO). Today’s generation, though bothered by the mosquito menace and at risk of other mosquito-borne diseases, are barely aware of what this scourge did to this country in the earlier part of the last century when swathes of the Kelani Valley and many parts of the dry zone were wracked by what was then a deadly disease. The lives it claimed and the misery it caused is now history.

Older readers would know that the founding leaders of the Lanka Sama Samaja Party (LSSP) won the affection of tens of thousands people, particularly in the Kelani Valley, for the succour they extended to families afflicted by the disease. That was very much a factor in the blossoming of the LSSP during its early years and the popularity of its leaders. In fact, as Prime Minister Dudley Senanayake used to say at political meetings in the dry zone during his day, opponents of the colonization schemes launched in the pre and post-Independence period would say that there were mosquitoes “as big as crows” in those areas! Nevertheless, people who left overcrowded wet zone villages to pioneer, with massive government support, irrigated agriculture in the relatively unpopulated dry zone prospered. Sadly many of their descendants are today victims of the human – elephant conflict triggered by mindless deforestation of more recent years.

Prof. Mendis makes the point that while today we may be beleaguered by many health problems, not least by the covid epidemic raging globally, malaria is no more. She says that the year 2012 saw the last case of malaria transmitted by a mosquito in this country. This, as she says, is a colossal achievement by any standard and despite anxieties and worries that the disease may return, the country has been kept clear of malaria transmission for nearly nine years now. But given the fact that we thought we had defeated malaria forever when we nearly eliminated the disease as far back as 1963, “it returned with a vengeance to devastate the country for the next 50 year.” That’s a clear indication of what can happen if the guard is let down as happened in the case of leprosy. In the context of the fact that a new and highly efficient vector mosquito transmitting malaria in urban areas in India has found its way here, there’s an ever present danger of the recurrence of the disease in Sri Lanka.

It is our good fortune that this country is blessed with specialists like Professor Mendis, with both the expertise and commitment to fight the disease, as well as communication skills to effectively convey the message of the ever-present danger of a recurrence. Alongside, she has presented simple and effective ways of meeting the threat. She says in her article that if physicians seeing fever cases, probes the patient’s history and finds that he/she had recently traveled abroad, then there is good reason to test for malaria using the tools readily available today. Business travelers, pilgrims, Lankans working abroad and even returning members of the armed forces and police posted for UN Peace Keeping duties in malarious countries may well carry the infection back home, she has said. Most ‘imported’ malaria infections are acquired in neighboring India and African countries, the article says. Thus a state-of-the-art surveillance scheme must be maintained to treat infected persons without delay to ensure they would not infect the mosquitoes that are a continuing stinging and buzzing menace in this country.

Out of sight out of mind is a well-worn cliché that nevertheless retains its validity. Given mankind’s current preoccupation with the covid pandemic, other dangers that continue to lurk around us can be easily forgotten as they too often are. This country took a lot of pride in the achievement of eradicating malaria using insecticides like DDT and later malathion. Yet we permitted the disease to return largely as a result of our own negligence and lack of civic consciousness among our people who uncaringly allowed mosquito breeding places to exist without let or hindrance. Apart from abandoned gem pits in the countryside and numerous other stagnant water bodies, urban dwellers with clogged gutters and drains, carelessly strewn containers, coconut shells etc. collecting water have seemingly forever allowed the mosquito problem to grow. This is despite the many dengue scares and near epidemics that have plagued us in the recent past. But malaria, in the words of Prof. Mendis, “is a rare and forgotten disease in the country today.” Such a situation obviously must not be allowed to persist and the Anti Malaria Campaign that has done yeoman service to this country in the past must be supported as best as we can.



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Editorial

Syrup in mouth and egg on face

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Friday 14th May, 2021

The incumbent government always finds itself up the creek, so to speak, by trying to delay the inevitable and defend the indefensible. The explosive spread of Covid-19, which has led to the current lockdowns, came about as the ruling politicians played politics with the pandemic prevention measures and baulked at imposing travel restrictions in April. Pressure is now mounting on the government from doctors to impose a quarantine curfew as the pandemic situation is taking a turn for the worse with the death toll increasing rapidly.

As if the current health problems were not enough, some SLPP politicians are trying to justify their campaign to promote the Dhammika peniya as a cure for Covid-19; their efforts have left the government with egg on its face. An expert committee has determined that the shaman’s herbal concoction has no therapeutic value, but State Minister of Indigenous Medicine Promotion, Rural and Ayurvedic Hospitals Development and Community Health, Sisira Jayakody, says he is convinced otherwise!

Most government politicians consider themselves more knowledgeable than doctors. Minister Jayakody cut a very pathetic figure, trying to defend the Dhammika peniya, in a television interview, yesterday. Claiming that the expert committee, which rejected the syrup as useless, had not selected samples thereof properly, he insisted that two physicians at a government hospital had vouched for the efficacy of the concoction and recommended it. He did not name them.

Minister Jayakody took the wily shaman and his peniya to Parliament, of all places, and presented it to Speaker Mahinda Yapa Abeywardena himself; Health Minister Pavithra Wanniarchchi took a swig of it at a media briefing, thereby endorsing it to all intents and purposes. Thousands of people from different parts of the country converged on a village, where the shaman sold the syrup at Rs. 10,000 a bottle and made a killing! Those who jostled and shoved to secure the syrup must have contracted Covid-19 and caused the formation of peni clusters across the country. This aspect of the shaman’s syrup has gone unnoticed.

Now that Minister Jayakody has publicly stated that two government doctors conducted clinical trials, as regards the Dhammika peniya, at a state-run hospital and recommended it, it is incumbent upon the Health Ministry to initiate an investigation. These doctors have committed a serious offence by testing the shaman’s syrup on patients, endorsing it and misleading the government and the public.

Let Jayakody be made to name the doctors involved in the fraud. The government must explain why no action has been taken to prevent the shaman from continuing to the public into buying his syrup; he is still selling the concoction. Is it that the government has refrained from taking any action against the shaman because some of its politicians are benefiting from his largesse?

 

Vaccine queues

 

The health authorities are trying their best to prevent people from gathering in large numbers and to make them maintain physical distancing, but large crowds can be seen at vaccination centres, where no physical distancing is maintained. There are complaints of inordinate delays and politicians and their supporters jumping the queue, but nobody in authority seems to care.

A mass vaccination drive is no easy task, given the financial and logistical constraints. The frontline health workers conducting the national vaccination programme are overworked, and some lapses on their part are inevitable. But such problems are aggravated when all the people to be vaccinated in a Grama Niladari division are made to rush to their vaccination centre together and wait.

Why should hundreds of people be asked to gather at vaccination centres and stand in winding queues for many hours, exposed to the scorching sun, rain and, above all, the runaway virus, to receive the jab? People to be inoculated in a particular area can be divided into groups and time slots allocated to them so that all of them do not have to rush and wait for long hours.

The vaccination process should be streamlined for the benefit of the public as well as the health workers who are going beyond the call of duty to save lives. Politicians are another problem; they must be prevented from visiting the vaccination centres and becoming a public nuisance.

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Editorial

Beds and talkathons

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Thursday 13th May, 2021

The government has bowed to the inevitable at last. Countrywide travel restrictions are now in force. Belated as this measure may be, it will go a long way towards curtailing the rapid spread of the pandemic. If only the government had summoned the political moxie to do so during the recent festive season. It is hoped that the unruly government politicians who think they know better than doctors will desist from bulldozing the health authorities into lifting movement restrictions in their constituencies purportedly for the sake of daily wage earners.

The ruling SLPP has undertaken to manufacture 10,000 beds for the Covid-19 treatment centres. This campaign has drawn heavy criticism from the Opposition and a section of the media; it is viewed as an exercise aimed at gaining political mileage and covering up the many failings of the ruling coalition. True, nothing is devoid of politics in this country, and the bed-manufacturing mission smacks of a political project intended to shore up the government’s crumbling image, but its importance and usefulness cannot be discounted. The demand for more beds is bound to increase exponentially as infections surge. What other political parties should do is to stop scoffing at the SLPP project and make a contribution to the country’s fight against the pandemic. They can get together and provide pillows, bed sheets, pillowcases and other such materials for the benefit of the Covid-19 patients receiving residential treatment.

Meanwhile, there has been a call for an all-party conference to discuss ways and means of tackling the national health crisis. Parliament continues to meet, and it, we reckon, is the best forum for matters of national importance to be discussed and decisions thereon to be taken. After all, that is what those in the current Opposition demanded when the last general election was postponed for months on end due to the pandemic. They even demanded that the dissolved Parliament be re-convened to help solve the health crisis. A new Parliament was elected in August 2020, but the country’s problems have not been solved. So, the question is whether there is any need for an all-party conference, which, in our book, will end up being a political circus. The leaders of the political parties worthy of the name are in Parliament and have the ear of the Prime Minister. The President also visits Parliament and they can meet him there, if they care to.

Most political powwows are NATO (No-Action-Talk-Only) events, where politicians who have got talking hind legs off a donkey down to a fine art display their oratorical skills to the point of queasiness. It may be recalled that nothing came of such gatherings even in the aftermath of the worst ever natural disaster that shook the country—the Boxing Day tsunami (2004). So, why waste time on talkathons?

There are however several other ways in which the main political parties and their leaders can help the public in this hour of crisis. They receive colossal amounts of funds for elections, and, as is public knowledge, only a small portion of them is spent on electioneering, and the balance simply disappears. The last parliamentary polls were held less than a year ago, and the main political parties that are making a public display of their concern for the public should contribute a part of their surplus campaign funds to the fight against the pandemic. They can help look after the needy.

Hospitals and quarantine centres require manpower, the demand for which is increasing, and it is not fair to overtax the military personnel, who are rendering a commendable service. Frontline health workers are also exhausted due to the increasing caseloads. Will the patriotic political party leaders and their backers volunteer to do whatever they can at these health institutions under severe strain? Having talked the talk, shouldn’t they now walk the walk?

If political parties can make their leaders and rank and file behave responsibly, that will be the greatest service they can render. They should also prevail on their supporters to follow the Covid-19 protocol strictly and help stop the spread of the pandemic.

 

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Editorial

Stop playing blame game, heed expert advice

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Wednesday 12th May, 2021

There is a lot of brouhaha over the government’s claim that it influenced the World Health Organization (WHO) decision to approve the emergency use of China’s Sinopharm vaccine; the WHO is reported to have denied this claim. Government propagandists cannot resist the temptation to perform foot-in-the-mouth stunts that embarrass their masters beyond measure. However, the real issue is not how the WHO approval was granted for Sinopharm, or any other vaccine for that matter. The issues that warrant public attention are whether enough vaccine stocks will be available; how effective the jabs will be against the new variants of coronavirus, and how to face the socio-economic issues caused by the pandemic.

Thankfully, some vaccine stocks are arriving here while the pandemic transmission and death toll are increasing steadily although there is a shortage of AstraZeneca vaccine for booster doses. Inoculation is a prerequisite for beating the virus, and given the ever-worsening health crisis, one does not have the luxury of picking and choosing vaccines, especially in respect of the first dose. If the people (as well as the government) had behaved responsibly during the recent festive season, they would have been able to wait until the arrival of the vaccines of their choice. On the other hand, all Covid-19 vaccines currently in use have been found to be highly effective in preventing severe disease and hospitalisation although their efficacy rates are said to vary.

The WHO says everyone has to get the Covid-19 jab fast, and the world must strive to attain global herd immunity through vaccination as soon as possible if the transmission of the virus is to be curbed. WHO lead scientist Dr. Maria Van Kerkhove has, in the weekly epidemiological update, said, “We do not have anything to suggest that our diagnostics or therapeutics and our vaccines don’t work.” This may be some good news in these troubled times, but the situation is far from rosy. One should not lose sight of the fact that Dr. Kerkhove, on Monday, announced that the WHO had changed its classification of the B.1.617 coronavirus variant first found in India last October from a ‘variant of interest’ to a ‘variant of concern’; it has already spread to several countries including Sri Lanka and is wreaking havoc.

Some scientists are of the view that certain coronavirus variants may have the potential to evade antibodies induced by natural infection or vaccination. This, however, does not mean that one should not get inoculated. Instead, one ought to realise that one should not lower one’s guard simply because of the ongoing vaccine rollouts. Nothing should be left to chance in fighting the virus. One should bear in mind WHO chief scientist Dr. Soumya Swaminathan’s wise counsel as regards India.

Dr. Swaminathan is reported to have said that the Indian variant is not vaccine resistant, but India has to depend on its tried and tested public health and social measures to curtail the transmission of the pandemic in addition to boosting its national vaccination drive. This, we believe, is applicable to Sri Lanka as well. Hence, measures such as the ban on interprovincial travel are welcome albeit long overdue. The government has apparently begun to take expert opinion seriously. If such travel restrictions had been imposed during the recent April holidays, the transmission of the virus could have been reduced to a manageable level.

Head of the National Operations Centre for Prevention of COVID-19 Outbreak and Army Commander, Gen. Shavendra Silva, has warned that unless the pandemic situation improves, district borders too will have to be closed. Chances are that far more stringent measures will have to be adopted unless the public fully cooperates with the health authorities to bring the pandemic under control and prevent the projected death rates from becoming a reality. The Association of Medical Specialists (AMS) has already urged President Gotabaya Rajapaksa to impose ‘lockdowns’ at the district level with immediate effect.

The country is in the current predicament because both the government and the public acted irresponsibly. They have to stop blaming each other for the explosive spread of the pandemic they have jointly brought about, share the blame and act responsibly. There is no other way out.

 

 

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