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Mental health: From commoner to Royal

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By Sunil Dharmabandhu

I read with keen interest the most illuminating article by Randima Attygalle citing profusely Dr. Neil Fernando on his major contributions in the development and improvement of psychiatric services in Sri Lanka. I wish to share with The Island’s international readership a perspective from personal experiences, as an adolescent, when tragedy struck our family with the sudden news that my brother, eldest in the family, Nimal, was found dead in his bedsitter in North London in July 1963. He was only 22. It was in the form of a telegram delivered by an officer from the Department of Immigration and Emigration. Fortunately, my mother had gone to meet my father at the Colombo Municipal Council to keep an appointment with a consultant for her. The officer kindly drove me to the CMC where I handed the telegram to my father. His face just dropped with complete shock. In the meantime, my mother was walking back home from the Moratuwa Railway Station when she heard some people already talking aloud about the sudden death of my brother, who went abroad for further education. It was not until she was near home that the penny dropped that something was drastically wrong somewhere, still refusing to believe it had anything to do with her family. But, as she entered through the gate, she realised, to her utter shock, that she was entering a funeral house! She just collapsed on the cement floor. The doctor was called in, who gave Diazepam intramuscularly.It was almost a month before my brother’s ashes were received, making it the longest funeral, to my knowledge! Well, my father never went back to work since he suffered a serious nervous breakdown! He was only 54 at the time. My mother recovered, gaining strength to pull herself through, to look after the family somehow. Unable to cope, my father ended up in Angoda, as it was known then. A colleague and a close friend provided yeoman’s service to us, else the outcome would have been entirely different, with losing my beloved father too in the aftermath!He had found out that there was precious little time left before my father was to come under a compulsory detention order, of the then very primitive mental health legislation, which would deny my mother the right to have him discharged or even transferred to Mulleriyawa Sanatorium! As luck would have it, he was transferred in the nick of time, to our great relief, enabling us to make daily visits, during his recovery process.It was indeed a watershed in our family’s destiny! My ambition to study medicine, despite gaining admission to Royal College, was the next casualty. There was an urgent need for me to seek employment, to keep the home fires burning. I joined the Bank of Ceylon, my two sisters too boosted the family finances through their respective employment.However, after my father made a complete recovery, fed up with an office job, I left for the UK to train as a psychiatric nurse in Wales, where I met my Welsh wife-to-be. We got my parents over twice and again, my mother after the demise of my father at the age of 82. I continued with my career ending up as a visiting Mental Health Act Commissioner appointed by the then Home Secretary, Jacqui Smith which required me to visit patients detained in hospitals, under the provisions of the Mental Health Act of 1983, and scrutinise their documentation. It was a rewarding and satisfying job, I recall.

Britain’s Royal Family was thrust into a national debate about mental illness today after it was revealed that not just two but five of Queen Elizabeth’s cousins were hidden away in a mental hospital on the same day 46 years ago. Newspapers delved at length into previous cases of royal mental illness and one mental-care expert urged the queen to visit her relatives, four are alive, to bring the issue of mental health into the open.

Britain’s latest royal ‘scandal’ began with the banner headline ‘Queen’s Cousin Locked in Madhouse’ in the tabloid Sun. An accompanying photograph showed a wrinkled and bedraggled old woman staring out blankly. Other tabloids were quick to follow up, revealing that two of Queen Elizabeth’s first cousins and three second cousins were all brought to a Victorian-era mental hospital in the heart of the Surrey countryside, south of London, on the same day in 1941.

All five belonged to the Bowes-Lyon family of Queen Mother Elizabeth, who at 87 is frequently referred to as the “nation’s favourite grandmother.” The two first cousins were listed as dead in the 1963 edition of ‘Burke’s Peerage’, a guide to the British aristocracy, even though one is alive and the second died only last year. The three second cousins are also still alive. Genealogists said all five may have shared a genetic flaw passed by the 21st Baron Clinton, and not the Royal Family. Leading genealogist Hugh Peskett said: “If five female cousins all have one mental problem, it’s pretty obvious the cause is genetic…The great relief is that the genes are obviously in the Clinton family and not in the Royal Family. It is clearly a Clinton family gene which is wrong, rather than that of the Bowes-Lyon family.”

The Queen Mother has been a patron of Mencap, a charity dealing with the mentally handicapped, for the last 25 years, and newspapers were quick to absolve her of any personal responsibility. When she discovered her nieces were alive five years ago, she sent them money and presents, they reported. Newspapers also examined previous cases of royal mental illness, from George III at the end of the 18th Century to two cases of mental illness and handicaps among royal children in the early years of the 20th Century.

One was Prince John, the youngest of George V’s six children. He was mentally impaired and epileptic and died at 14. The other was Prince Albert, son of Edward VII, who died at 28 and was described in one newspaper today as “an oddball and a dunce.”

“Madness, illegitimacy and divorce are the three skeletons that rattle loudest in the royal cupboard,” Alan Hamilton wrote in the Times under the headline “Royalty’s Unspoken Fear.” Despite vast improvements, psychiatric services remain under funded in UK to keep up with increasing demands and inevitable lengthy queues. Sadly, it is too late for some. Heads Together is a mental health initiative, spearheaded by The Royal Foundation of The Duke and Duchess of Cambridge, which combines a campaign to tackle stigma and change the conversation on mental health with fundraising for a series of innovative new mental health services.

Led by the Duke and Duchess of Cambridge and Prince Harry, Heads Together unites eight mental health charities, including Mind. Since May 2016, Heads Together has encouraged millions of people to have important conversations about mental health. Money raised by Heads Together is now supporting innovative projects to tackle mental health challenges.

This includes a £2 million fund to create digital tools for young people seeking help online, regarding their mental health, and new programmes to support mental health in schools, workplaces and the defence community.

(The writer is a retired MHC Visiting Commissioner, UK)



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Opinion

Cosmic Egg, Jealousy and Rhetoric

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Remarks I made (The Island, 12 Oct) on Upul Wijayawardhana’s article on Astronomy, Astrology, Cosmology, etc., in The Island  of 07 October, weren’t at all meant to be ‘snide’ or derogatory as he wrongly alleges in his 15 October The Island article! I just would have liked him to delve somewhat deeper into the subjects he referred to in his article’s title, without fanning out tongue-in-cheek (his phrase) in various directions anecdotally. He listed scientists doing excellent work both at home and abroad, throwing in vignettes too from their lives. This is inspiring, of course, and cause for much pride; but it would have been more useful if he had included, even briefly, some specific findings from their work that had a bearing on his article’s title.

I am sorry I did not ‘expand’ more on the ‘cosmic-egg’ as, he says, he had wished. Far finer heads are grappling with it with little or no success; its understanding could well be even outside the confines of science as we know it. My purpose was to point out that the Big-Bang couldn’t have been the start of it all, as casually accepted by some. Let’s be happy anyway that the ‘cosmic-egg’ did  ‘expand’ by itself to make the Universe – even without my help!

 In his  15 October article again in a familiar vein, he asks in his title,  ‘Jealousy: is it in our genes?’  As before, he then wavers away to give detailed accounts of some scientists doing excellent work abroad, and of Yohani, the successful young singer, and exhorts us, I assume, not to be jealous of them. Message taken; thanks!

To return to his rhetorical title, if jealousy is indeed in our genes no DNA sequence has been found for it as yet, but fingers are always crossed!

Let’s not scoff at it overmuch either; jealousy’s quite human; and harmless too – but only if indulged in extremely lightly and in passing; it could even prompt initiative and creativity!

 IVOR TITTAWELLA

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Opinion

President must match his words with deeds

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President Gotabaya Rajapaksa accompanied by Army Commander General Shavendra Silva for the Army Day celebrations at Saliyapura

We were pleased to read the recent speech delivered at the 72nd anniversary of the Gajaba Regiment by President Gotabaya Rajapaksa, in which he admitted about the voter disillusionment in his government. We are aware that the government had to contend with unprecedented issues on account of the Covid epidemic, and had to give priority in seeking solutions to the challenges by imposing restrictions to the economic and social activities; while channelling limited resources to medical supplies and social service facilities.

If the President is prepared to review and turn a new page for the improvement of the country, one should expect the President to rehash the decision-making procedure of the Government. The voters are of the view that some of the crucial steps adopted, were either introduced or implemented in some instances, without recognising the impact on the country’s sovereignty and security.

As an initial step, the President should consider appointing a National Planning Committee with nationalist-minded experts, to work on a programme to tackle key economic issues and management of nationally important strategic centres for the next four years. Without proceeding ahead haphazardly and creating crisis situations, once such decisions are adopted, if the government can adhere to a plan with a nationalist vision, it will be acceptable to the voters who elected the President. Such a plan should also investigate the country’s priorities, future stability, resources, and national security. The implementation should be transparent and accountable.

Let us examine some of the issues which were tackled without a proper plan, which resulted in causing frustration and disappointment among the voters and the public. The method of overseeing the pricing and supply of commodities, such as sugar, rice, garlic, gas cylinders, etc was atrocious, which brought untold hardships to the consumer and to the producers. The complete mismanagement must be admitted by the government, and a more rational formula will have to be adopted, if the plan is to take the country systematically forward. It is necessary to exercise detailed examination of the supply chain, the storage facilities, and the Government outlets, to get rid of the unconscionable profiteers awaiting to fleece the consumers and marginalise the public organisations, which are established to protect the consumers. Once a rational decision is taken, the government should pursue the implementation with determination; rather than surrender to the dictates of the unscrupulous middlemen who hold onto the stocks, causing loss of confidence of the public.

A crucial area which needs urgent review is how to regulate luxury and semi-luxury imports, which consumes a considerable amount of foreign exchange earned by export of goods and services, including the foreign remittances of Sri Lankan workers. At least as a short term measure, the free trade introduced by JRJ about 40 years ago, should be re-examined and suitable qualitative controls should be introduced, to curb the outflow of foreign exchange for non-essential goods.

The President’s holistic decision on the banning of chemical fertiliser is, indeed, a step in the right direction, which will bring expected results in the improvement in soil and water quality and the general health of the masses. However, such a crucial decision was not followed professionally to ascertain the availability of other nutrients, and enough supply of compost fertiliser to apply in the following growing season. The unscientific method of managing the subject gave opportunities to many to engage in public agitation against this holistic decision.

It was, indeed, ironic to hear the slogans mouthed by ‘farmers’ of 2021 demanding chemical fertiliser, whereas their fathers were demonstrating in 1970s decrying the government’s and the officials’ dictates to replace bio-fertilizers with chemical fertiliser to ‘usher in thegreen revolution ‘. It is the wish of the majority of the population to get rid of the vicious cycle of poisoning, resulting from the use of chemical fertiliser, and we would request the government to take the required steps in the right direction to implement the laudable decision effectively and efficiently.

We need a clear and dedicated policy in relation to our international relations. We must always be nonaligned in our dealings with the big powers who are engaged in a global power game.

We should know the friendly nations who stood by Sri Lanka when it waged war with Tamil Tiger terrorists and subsequently at UNHCR, and about the other countries which attempted to crucify Sri Lanka for defeating the world’s most brutal terrorist organisation. Their attempts to continue persecuting Sri Lanka will naturally weaken the Sri Lankan state, and at all times Sri Lanka should express her rejection of such vicious attempts, and should bring these facts at bi-lateral discussions and multilateral conferences.

India, our neighbour, is leaving no stone unturned until we have PCs and with all powers. Most of the Sri Lankans do not want PCs, an additional tier of administration at a cost of colossal expenditure and with practically no benefits. At a time when Sri Lankans are required to tighten their belts and manage expenditure, the Government must convey to India that all issues can be managed under the present unitary system of Government. Sri Lanka should be noticeably clear on this issue to enable Sri Lanka-India international relationship to prosper. Sri Lanka should also continue bi-lateral discussions with India regarding oil tanks in Trinco, as to how these can be used for the economic development of the country, assuring that Sri Lanka will not allow any other country to have any control over the strategically important Trincomalee harbour. Recently an Indian writer has stated that India does not bother to understand her neighbouring countries, and decides on inter-state policies without considering the expectations of her neighbours. Imposing PCs on Sri Lanka and insistence on the implementation of the failed proposal emanated from the Indian centralised foreign policy machinery, which in this instance primarily addressed the aspirations of the Tamil Nadu agitators, who were expressing their support for the separatists in Sri Lanka. India’s strategy was to kill two birds with one stone, and executed its policy of proposing PCs to weaken the central government of Sri Lanka, while appeasing the extremists in Tamil Nadu to divert their attention from their own struggle for a separatist racist state in India. Sri Lanka should be firm in rejecting the Indian formula to destabilize the country, and continue to address the common issues faced by ordinary people in Sri Lanka, including the minorities living in the periphery.

The mandate given by the public clearly stated that the proportional representation system should be changed, and all future elections should be held according to the number of electorates, and members should represent the electorates based on the percentage of votes gained by the candidates. All who investigated into the system introduced by JRJ were of the view that the system breeds corruption and bribery, while precluding the visible representation of an electorate.

The President recently invited the expatriate Tamil groups, presumably as an effort to improve reconciliation of Sinhala and Tamil views and expectations. Such discussions should be based on specific conditions that the participants do not support separatism in Sri Lanka, and they accept a unitary Sri Lanka. Otherwise, such discussions will only provide opportunities to reopen the subject of traditional homelands, pushing the country back to the unenviable 1990s.

RANJITH SOYSA

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Opinion

Gamble of Provincial Council elections at this time

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By Jehan Perera

There are indications that the government is planning to conduct Provincial Council elections in the early part of next year.  It is reported that the cash-strapped government will be providing parliamentarians, who are in charge of district development, with Rs 100 million each to engage in development activities in their electorates.  In addition, former members of Provincial Councils, and local government authority members will also be entitled to substantial monetary resources to do likewise.  If these large sums of money are made available to politicians to spend prior to the election, they could contribute to the thinking that the government is investing in development for better times, ahead despite the hardships of the present. But the cost of this gamble which will include printing money could be high, so there must be other motivations.

The present situation on the ground is hardly propitious to the conduct of elections.  The economy is in deep trouble with foreign exchange reserves threatening to be negative if scheduled foreign loans are repaid on time unless there is a fresh infusion of foreign loans.   Among the several reasons why foreign exchange is scarce is that the government is keeping the foreign exchange rate artificially low instead of letting market forces determine the price.  This is no different from the price controls that the government attempted to place on rice which led to hoarding and artificial scarcities notwithstanding the declaration of a state of emergency to deal with the hoarders.  If the government relaxes the exchange rate it is likely that the foreign exchange rate, will soar and prices of imports will soar likewise, adding to the inflation in the country.

Some of the present day economic problems are beyond the control of the government to resolve. These would include the loss of economic production due to the months of lockdown that followed the rise in Covid spread.  The contribution of the tourism industry to the economy has been much diminished due to the closure of the country’s airports to prevent infection spread from abroad.  However, some of the economic setbacks have been self-inflicted.  The biggest one is the implementation of the chemical-free agriculture policy on a scale that has no precedent in any other country in the world.  Even the most economically advanced countries, such as Germany, where there is a  high demand for organic food, has only devoted around 10 percent of its agricultural land to chemical-free agriculture. And Switzerland, known as one of the cleanest countries in the world, recently rejected the banning of pesticides at a referendum as voters felt it was impractical.

SINGLEMINDED COMMITMENT

The government has so far shown a singular commitment to going ahead with the decision to have chemical-free agriculture.  There has been some concession to big business interests such as in the case of the tea industry. Some of the necessary chemical inputs for fertiliser are being permitted. However, this is an exception and the general rule that agriculture should take place without chemical inputs continues to prevail.   So far there has not been flexibility shown with the farming community who are coming out publicly in protest as they are seeing their harvests being reduced.  These protests are taking place in all parts of the country and in some areas the small farmers have not been planting crops fearing that the yield will be too small. The government has offered compensation but, given the financial crisis it is in, this is unlikely to materialise in the short term.

 The government’s present policy on organic agriculture appears to be following a military logic that sees the objective clearly and goes for it at all costs. One of the key features of democratic governance is that consultations take place with those whose interests are bound up with issues prior to the implementation of change.  These consultations need to take place at multiple levels over a period of time if the decision being made is likely to have major consequences.  Further it is not sufficient to practice tokenism in consultations.  Often consultations take place but the views generated are not heeded.  Those who consult sometimes appear to be listening but do not really listen nor are they willing to change their preconceived attitudes and plans.  The essence of democratic government is to be responsive to public opinion, and to educate public opinion on new measures that need to be taken in the larger interests of society.

 On the positive side, and to the credit of the government, it is providing space for public protests against its policies.  Speaking in New York at the UN General Assembly, President Gotabaya Rajapaksa said he had instructed the police not to use batons and violence to break up peaceful protests.  Restraint has been shown in the case of the three-month long strike by government school teachers who continue to be paid their salaries while doing no work.  There were initial signs of harsh restraint when Covid control laws were used to detain some of the teachers who were leading the protests.  At this time these strong arm methods of control have stopped.  Unfortunately, however, the problems that the organic farming problems and teachers’ strike pose show no signs of being resolved through compromise.

 MULTIPLE MOTIVATIONS

There may be multiple motivations in holding Provincial Council elections at the present time.  These elections are already three years overdue.  The previous government failed to conduct the elections fearing that a bad performance would send a negative message to people who were already moving away from it. They changed the election law to make it more difficult to hold elections again. However, unlike the previous government, the present government leadership is made of sterner stuff when it comes to holding elections and winning them. It appears to be planning new strategies to regain the upper hand.  The 2022 budget which is to be presented to Parliament later this month will offer the government an opportunity to address the immediate concerns of voters at least in the short term. They may also see elections at this juncture as being helpful to ensure political authority and benefits for its second tier of leaders who will be satisfied with them at the moment.

 There is also speculation that the government’s sudden decision to conduct Provincial Council elections is the result of pressure from the Indian government. It is notable that the government’s announcement was made shortly after the visit to Sri Lanka of India’s Foreign Secretary, Harsh Vardhan Shringla.  At his meeting with President Gotabaya Rajapaksa he had reiterated India’s position regarding the need to fully implement the 13th Amendment and to hold the Provincial Council elections at the earliest. During his visit the Indian Foreign Secretary had also urged the Tamil political parties not to look to India for a solution to their problems but to discuss the issues that trouble them and resolve them in dialogue with the Sri Lankan government.

 In this context, the decision of the government to go ahead with Provincial Councial elections is the silver lining to the grey clouds that overhang the country.  It is an indication that President Gotabaya Rajapaksa is being consistent with the pledges he made in New York at the UN General Assembly.  The holding of Provincial Council elections, even in the present disadvantageous political situation that the government is in gives a positive message that the President is not neglecting his promises to the international community with regard to the reconciliation process. Addressing the root causes of the war and bringing reconciliation between the communities needs to be the number one priority of any government.  The provincial council system as presently constituted is in need of improvement, both in terms of the distribution of powers and resources, but it is the way forward if the ethnic and religious minorities are to feel they are a part of governance structures of the country, and hence co-architects of a shared future in which there is national reconciliation.

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