Features
My 18 week ordeal of double trouble
by Dr. Lakshman Abeyagunawardene
I thought of writing this article in order to share with readers of the Sunday island newspaper, my recent experience as a patient suffering from two illnesses at the same time. I could describe this period as sheer mental agony as I had to bear the social as well as possible medical consequences of illnesses that plagued me over a prolonged period. Writing newspaper articles in my opinion, is one of the best ways in which at least one section of the community can be educated on health issues.
My professional career called for frequent lectures to be given to a wide variety of target audiences ranging from post graduate doctors preparing for examinations in Community Medicine and medical students, to humble village folks like new settlers in Mahaweli areas in the late seventies and early eighties. I always made it a point to emphasize the fact that the occurrence of disease is not only a biological phenomenon but a social one as well, a point that I picked up in my post graduate training and which has got etched in my mind through conviction. Subsequent developments as described later, led to the worst period when I was confined to the guest room in my home as I was not permitted even to climb the stairs that led to my comfortable bedroom upstairs. The move which was to last several weeks, involved shifting many personal items which were indispensable for day to day life.
It all began with a rash on the right side of my face involving the nose, cheek and areas around the eye. Although I suspected Herpes Zoster (commonly called Shingles) particularly because I recalled a bout of chicken pox over 50 years ago, soon after my Internship while working at the Colombo South Hospital. Although it is a self-limiting disease, I decided to seek medical attention because as far as possible, I try to stay away from self treatment except for very minor illnesses. Herpes Zoster is a viral infection that occurs with reactivation of the varicella –zoster virus that had been lying dormant in certain nerves for many years. Symptoms typically start with pain and a rash along the affected path of the nerve, followed two-three days later by a vesicular eruption.
With a 24- hour curfew in force, that weekend happened to be one where all “Channel Centres” were deserted. I therefore decided to go to the Emergency Room (ER) of Sri Jayewardenepura Hospital (SJPH) where the doctor confirmed my diagnosis and prescribed an anti viral drug called Acyclovir, pain killers Gabapentin and Panadeine. I was also referred to the Ophthalmic (Eye) Ward because my right eye seemed to be affected. Fortunately, the Senior Registrar on duty ruled out any involvement of the eye and said that my vision was normal. This was confirmed by the Consultant Ophthalmologist (Eye Surgeon) whom I later channeled as I was very concerned about my eyesight. As always, I diligently took all prescribed drugs but at the end of two weeks, I unfortunately developed Postherpetic Neuralgia (PHN) which is a known complication of Shingles.
I had heard of Post Herpetic Neuralgia (PHN) but never imagined that it was so painful. In general, all pain due to Neuralgia is very painful, difficult to treat and lasts a long time. I realized through experience, what it is like to be the sufferer rather than a doctor treating a patient.
Quite apart from my present illness, I was having spells of dizziness off and on, which I attributed to Gabapentin which is known to cause such side effects. On one such occasion it was so bad that I was about to fall. Fortunately, we were in our bedroom and my wife was at hand to prevent the fall and led me to my bed. My wife was quite helpless in such situations and called my son who lived close by and called for an ambulance. My son and the ambulance arrived almost simultaneously, but as I had not lost consciousness, I was able to explain to the paramedics that I was on Gabapentin and did not need hospitalization. Whether or not the paramedics understood what I said, they withdrew mainly because their patient was a doctor and knew what he was doing!
On a subsequent occasion, I had a syncopal (fainting) attack while I was having breakfast and my wife again had to go through the usual motions of calling my son and the ambulance. This time, I had lost consciousness and when I was back to normal, I myself thought that it could not have been due to the Gabapentin. Therefore, I didn’t resist hospitalization as I previously did. These two episodes clearly showed the importance of family support. I dread to think what a bachelor living alone would have done under such circumstances.
For a number of years, I have been having an irregular pulse. This drew my attention when it continued and my cardiologist referred me to a Cardiologist and Electrophysiologist who put me on what is called a Holter Monitor. After reading the report he said that I have a few extra systoles (ectopic beats) and that accounts for the irregular pulse. He further said that it is normal for some people and I needed no treatment. Mind you, that was about six years ago.
This time round when I lost consciousness, to cut a long story short, after the necessary referrals were made, the EEG that my Neurologist ordered showed some changes and my doctors decided that the origins of the changes had nothing to do with my nervous system but that its origins were cardiac (meaning that the origin of the EEG changes could be due to some defective movement of electrical impulses in the heart). So, I went back to my cardiologist who referred me to a Cardiologist and Electrphysiologist. The latter put me on a Holter Monitor again. Based on the history and the new Holter Monitor reading, he recommended a Pacemaker. I readily complied and he implanted a Permanent Pacemaker on September 8. Sutures were removed after about a week and I had to attend a “Programming Session” on September 27. The doctor reported that the surgical wound was clean and that the whole procedure was successful. The implantation of the pacemaker did not bother me at all, but the anxiety of anyone facing a surgical operation was telling on me.
I had to go through the procedure of pacemaker implantation while the pain in my right eye persisted. It was after my fainting episode and pacemaker implantation was recommended that I was debarred from climbing stairs. I was confined to the Guest Room and this is where my agony really started. My wife did not allow me to even go to the living room which was just three steps below. Towards the latter stages, I watched news on the small TV in the kitchen. I had to be satisfied with the laptop computer that my son brought. But it was a far cry from the Desktop I was used to. I missed my weekly shot of an alcoholic drink! I had not taken even a beer since the beginning of June.
I think I had a turnaround in my fortunes after the doctor did the Programming on September 27. It was this doctor’s advice that I strictly followed (more so my wife and son) because there was nothing more the Neurologist who was treating my neuralgic pain could do. The electrophysiologist who did the pacemaker implantation asked me to resume my regular evening walk but advised me not to drive the car till the end of October. When I asked him whether I could take my weekly shot of an alcoholic drink, he jokingly asked me whether it was Single Malt or Scotch. I replied that I take Single Malt , Scotch, Gin, Rum, Vodka, Tequila and even Ceylon Arrack in rotation, depending on availability. More than anything else, I was happy to be back in my bedroom, using my toilet, 52 inch TV in the TV room and the Desktop in my study.
Once the Eye Surgeon said that my vision is intact and the Cardiologist had successfully implanted the Pacemaker, I was free to take some decisions on my own. As I was bothered by the persisting pain in the eye, I went back to using Gabapentin when the eye pain was severe (discontinued since that episode of dizziness). Picking up information from the Internet, I started trying some home remedies like washing my eyes and using a warm compresses frequently. I also started taking a course of Vitamin B Complex and refrained from eating Bananas and Citrus fruits to help in the recovery of damaged nerves. If I continue to recover from the eye pain and the other minor symptoms of PHN, I will not be able to pin point and say that it was one specific intervention named above that was responsible for the turnaround. Being a doctor myself also certainly helped in many instances. However, I had resigned myself to think that recovery from PHN is very, very slow. As I recover slowly from PHN, I painfully realized the plight of many who are affected by Neuralgic pain and continue to suffer.
As a precautionary measure, I still keep away from my mobile phone and the microwave oven. The Pacemaker also restricts my movements of the left arm. I will continue to live with such restrictions for some more time. But I know that I have already seen and experienced the worst of this period of agony.
Features
Humanitarian leadership in a time of war
There has been a rare consensus of opinion in the country that the government’s humanitarian response to the sinking of Iran’s naval ship IRIS Dena was the correct one. The support has spanned the party political spectrum and different sections of society. Social media commentary, statements by political parties and discussion in mainstream media have all largely taken the position that Sri Lanka acted in accordance with humanitarian principles and international law. In a period when public debate in Sri Lanka is often sharply divided, the sense of agreement on this issue is noteworthy and reflects positively on the ethos and culture of a society that cares for those in distress. A similar phenomenon was to be witnessed in the rallying of people of all ethnicities and backgrounds to help those affected by the Ditwah Cyclone in December last year.
The events that led to this situation unfolded with dramatic speed. In the early hours before sunrise the Dina made a distress call. The ship was one of three Iranian naval vessels that had taken part in a naval gathering organised by India in which more than 70 countries had participated, including Sri Lanka. Naval gatherings of this nature are intended to foster professional exchange, confidence building and goodwill between navies. They are also governed by strict protocols regarding armaments and conduct.
When the exhibition ended open war between the United States and Iran had not yet broken out. The three Iranian ships that participated in the exhibition left the Indian port and headed into international waters on their journey back home. Under the protocol governing such gatherings ships may not be equipped with offensive armaments. This left them particularly vulnerable once the regional situation changed dramatically, though the US Indo-Pacific Command insists the ship was armed. The sudden outbreak of war between the United States and Iran would have alerted the Iranian ships that they were sailing into danger. According to reports, they sought safe harbour and requested docking in Sri Lanka’s ports but before the Sri Lankan government could respond the Dena was fatally hit by a torpedo.
International Law
The sinking of the Dena occurred just outside Sri Lanka’s territorial waters. Whatever decision the Sri Lankan government made at this time was bound to be fraught with consequence. The war that is currently being fought in the Middle East is a no-holds-barred one in which more than 15 countries have come under attack. Now the sinking of the Dena so close to Sri Lanka’s maritime boundary has meant that the war has come to the very shores of the country. In times of war emotions run high on all sides and perceptions of friend and enemy can easily become distorted. Parties involved in the conflict tend to gravitate to the position that “those who are not with us are against us.” Such a mindset leaves little room for neutrality or humanitarian discretion.
In such situations countries that are not directly involved in the conflict may wish to remain outside it by avoiding engagement. Foreign Minister Vijitha Herath informed the international media that Sri Lanka’s response to the present crisis was rooted in humanitarian principles, international law and the United Nations. The Convention on the Law of the Sea (UNCLOS) which was adopted 1982 provides the legal framework governing maritime conduct and obliges states to render assistance to persons in distress at sea. In terms of UNCLOS, countries are required to render help to anyone facing danger in maritime waters regardless of nationality or the circumstances that led to the emergency. Sri Lanka’s response to the distress call therefore reflects both humanitarianism and adherence to international law.
Within a short period of receiving the distress message from the stricken Iranian warship the Sri Lankan government sent its navy to the rescue. They rescued more than thirty Iranian sailors who had survived the attack and were struggling in the water. The rescue operation also brought to Sri Lanka the bodies of those who had perished when their ship sank. The scale of the humanitarian challenge is significant. Sri Lanka now has custody of more than eighty bodies of sailors who lost their lives in the sinking of the Dena. In addition, a second Iranian naval ship IRINS Bushehr with more than two hundred sailors has come under Sri Lanka’s protection. The government therefore finds itself responsible for survivors but also for the dignified treatment of the bodies of the dead Iranian sailors.
Sri Lanka’s decision to render aid based on humanitarian principles, not political allegiance, reinforces the importance of a rules-based international order for all countries. Reliance on international law is particularly important for small countries like Sri Lanka that lack the power to defend themselves against larger actors. For such countries a rules-based international order provides at least a measure of protection by ensuring that all states operate within a framework of agreed norms. Sri Lanka itself has played a notable role in promoting such norms. In 1971 the United Nations General Assembly adopted a resolution declaring the Indian Ocean a Zone of Peace. The initiative for this proposal came from Sri Lanka, which argued that the Indian Ocean should be protected from great power rivalry and militarisation.
Moral Beacon
Unfortunately, the current global climate suggests that the rules-based order is barely operative. Conflicts in different parts of the world have increasingly shown disregard for the norms and institutions that were created in the aftermath of the Second World War to regulate international behaviour. In such circumstances it becomes even more important for smaller countries to demonstrate their commitment to international law and to convert the bigger countries to adopt more humane and universal thinking. The humanitarian response to the Iranian sailors therefore needs to be seen in this wider context. By acting swiftly to rescue those in distress and by affirming that its actions are guided by international law, Sri Lanka has enhanced its reputation as a small country that values peace, humane values, cooperation and the rule of law. It would be a relief to the Sri Lankan government that earlier communications that the US government was urging Sri Lanka not to repatriate the Iranian sailors has been modified to the US publicly acknowledging the applicability of international law to what Sri Lanka does.
The country’s own experience of internal conflict has shaped public consciousness in important ways. Sri Lanka endured a violent internal war that lasted nearly three decades. During that period questions relating to the treatment of combatants, the protection of civilians, missing persons and accountability became central issues. As a result, Sri Lankans today are familiar with the provisions of international law that deal with war crimes, the treatment of wounded or disabled combatants and the fate of those who go missing in conflict. The country continues to host an international presence in the form of UN agencies and the ICRC that work with the government on humanitarian and post conflict issues. The government needs to apply the same principled commitment of humanitarianism and the rule of law to the unresolved issues from Sri Lanka’s own civil war, including accountability and reconciliation.
By affirming humanitarian principles and acting accordingly towards the Iranian sailors and their ship Sri Lanka has become a moral beacon for peace and goodwill in a world that often appears to be moving in the opposite direction. At a time when geopolitical rivalries are intensifying and humanitarian norms are frequently ignored, such actions carry symbolic significance. The credibility of Sri Lanka’s moral stance abroad will be further enhanced by its ability to uphold similar principles at home. Sri Lanka continues to grapple with unresolved issues arising from its own internal conflict including questions of accountability, justice, reparations and reconciliation. It has a duty not only to its own citizens, but also to suffering humanity everywhere. Addressing its own internal issues sincerely will strengthen Sri Lanka’s moral standing in the international community and help it to be a force for a new and better world.
BY Jehan Perera
Features
Language: The symbolic expression of thought
It was Henry Sweet, the English phonetician and language scholar, who said, “Language may be defined as the expression of thought by means of speech sounds“. In today’s context, where language extends beyond spoken sounds to written text, and even into signs, it is best to generalise more and express that language is the “symbolic expression of thought“. The opposite is also true: without the ability to think, there will not be a proper development of the ability to express in a language, as seen in individuals with intellectual disability.
Viewing language as the symbolic expression of thought is a philosophical way to look at early childhood education. It suggests that language is not just about learning words; it is about a child learning that one thing, be it a sound, a scribble, or a gesture, can represent something else, such as an object, a feeling, or an idea. It facilitates the ever-so-important understanding of the given occurrence rather than committing it purely to memory. In the world of a 0–5-year-old, this “symbolic leap” of understanding is the single most important cognitive milestone.
Of course, learning a language or even more than one language is absolutely crucial for education. Here is how that viewpoint fits into early life education:
1. From Concrete to Abstract
Infants live in a “concrete” world: if they cannot see it or touch it, it does not exist. Early education helps them to move toward symbolic thought. When a toddler realises that the sound “ball” stands for that round, bouncy thing in the corner, they have decoded a symbol. Teachers and parents need to facilitate this by connecting physical objects to labels constantly. This is why “Show and Tell” is a staple of early education, as it gently compels the child to use symbols, words or actions to describe a tangible object to others, who might not even see it clearly.
2. The Multi-Modal Nature of Symbols
Because language is “symbolic,” it does not matter how exactly it is expressed. The human brain treats spoken words, written text, and sign language with similar neural machinery.
Many educators advocate the use of “Baby Signs” (simple gestures) before a child can speak. This is powerful because it proves the child has the thought (e.g., “I am hungry”) and can use a symbol like putting the hand to the mouth, before their vocal cords are physically ready to produce the word denoting hunger.
Writing is the most abstract symbol of all: it is a squiggle written on a page, representing a sound, which represents an idea or a thought. Early childhood education prepares children for this by encouraging “emergent writing” (scribbling), even where a child proudly points to a messy circle that the child has drawn and says, “This says ‘I love Mommy’.”
3. Symbolic Play (The Dress Rehearsal)
As recognised in many quarters, play is where this theory comes to life. Between ages 2 and 3, children enter the Symbolic Play stage. Often, there is object substitution, as when a child picks up a banana and holds it to his or her ear like a telephone. In effect, this is a massive intellectual achievement. The child is mentally “decoupling” the object from its physical reality and assigning it a symbolic meaning. In early education, we need to encourage this because if a child can use a block as a “car,” they are developing the mental flexibility required to later understand that the letter “C” stands for the sound of “K” as well.
4. Language as a Tool for “Internal Thought”
Perhaps the most fascinating fit is the work of psychologist Lev Vygotsky, who argued that language eventually turns inward to become private speech. Have you ever seen a 4-year-old talking to himself or herself while building a toy tower? “No, the big one goes here….. the red one goes here…. steady… there.” That is a form of self-regulation. Educators encourage this “thinking out loudly.” It is the way children use the symbol system of language to organise their own thoughts and solve problems. Eventually, this speech becomes silent as “inner thought.”
Finally, there is the charming thought of the feasibility of conversing with very young children in two or even three or more languages. In Sri Lanka, the three main languages are Sinhala, Tamil and English. There are questions asked as to whether it is OK to talk to little ones in all three languages or even in two, so that they would learn?
According to scientific authorities, the short, clear and unequivocal answer to that query is that not only is it “OK”, it is also a significant cognitive gift to a child.
In a trilingual environment like Sri Lanka, many parents worry that multiple languages will “confuse” a child or cause a “speech delay.” However, modern neuroscience has debunked these myths. The infant brain is perfectly capable of building three or even more separate “lexicons” (vocabularies) simultaneously.
Here is how the “symbolic expression of thought” works in a multilingual brain and how we can manage it effectively.
a). The “Multiple Labels” Phenomenon
In a monolingual home, a child learns one symbol for an object. For example, take the word “Apple.” In a Sri Lankan trilingual home, the child learns three symbols for that same thought:
* Apple (English)
* Apal
(Sinhala – ඇපල්)
* Appil
(Tamil – ஆப்பிள்)
Because the trilingual child learns that one “thought” can be expressed by multiple “symbols,” the child’s brain becomes more flexible. This is why bilingual and trilingual children often score higher on tasks involving “executive function”, meaning the ability to switch focus and solve complex problems.
b). Is there a “Delay”?
(The Common Myth)
One might notice that a child in a trilingual home may start to speak slightly later than a monolingual peer, or they might have a smaller vocabulary in each language at age two.
However, if one adds up the total number of words they know across all three languages, they are usually ahead of monolingual children. By age five, they typically catch up in all languages and possess a much more “plastic” and adaptable brain.
c). Strategies for Success: How to Do It?
To help the child’s brain organise these three symbol systems, it helps to have some “consistency.” Here are the two most effective methods:
* One Person, One Language (OPOL), the so-called “gold standard” for multilingual families.
Amma
speaks only Sinhala, while the Father speaks only English, and the Grandparents or Nanny speak only Tamil. The child learns to associate a specific language with a specific person. Their brain creates a “map”: “When I talk to Amma, I use these sounds; when I talk to Thaththa, I use those,” etc.
*
Situational/Contextual Learning. If the parents speak all three, one could divide languages by “environment”: English at the dinner table, Sinhala during play and bath time and Tamil when visiting relatives or at the market.
These, of course, need NOT be very rigid rules, but general guidance, applied judiciously and ever-so-kindly.
d). “Code-Mixing” is Normal
We need not be alarmed if a 3-year-old says something like: “Ammi, I want that palam (fruit).” This is called Code-Mixing. It is NOT a sign of confusion; it is a sign of efficiency. The child’s brain is searching for the quickest way to express a thought and grabs the most “available” word from their three language cupboards. As they get older, perhaps around age 4 or 5, they will naturally learn to separate them perfectly.
e). The “Sri Lankan Advantage”
Growing up trilingual in Sri Lanka provides a massive social and cognitive advantage.
For a start, there will be Cultural Empathy. Language actually carries culture. A child who speaks Sinhala, Tamil, and English can navigate all social spheres of the country quite effortlessly.
In addition, there are the benefits of a Phonetic Range. Sinhala and Tamil have many sounds that do not exist in English (and even vice versa). Learning these as a child wires the ears to hear and reproduce almost any human sound, making it much easier to learn more languages (like French or Japanese) later in life.
As an abiding thought, it is the considered opinion of the author that a trilingual Sri Lanka will go a long way towards the goals and display of racial harmony, respect for different ethnic groups, and unrivalled national coordination in our beautiful Motherland. Then it would become a utopian heaven, where all people, as just Sri Lankans, can live in admirable concordant synchrony, rather than as splintered clusters divided by ethnicity, language and culture.
A Helpful Summary Checklist for Parents
* Do Not Drop a Language:
If you stop speaking Tamil because you are worried about English, the child loses that “neural real estate.” Keep all three languages going.
* High-Quality Input:
Do not just use “commands” (Eat! Sleep!). Use the Parentese and Serve and Return methods (mentioned in an earlier article) in all the languages.
* Employ Patience:
If the little one mixes up some words, just model the right words and gently correct the sentence and present it to the child like a suggestion, without scolding or finding fault with him or her. The child will then learn effortlessly and without resentment or shame.
by Dr b. J. C. Perera
MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paediatrics), 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
Features
SIMPSON’S … set to carve a distinct sonic identity
It is, indeed, encouraging to see our local artistes working on new formats, where their music is concerned.
Variety is the spice of life, they say, and I do agree, especially when it comes to music.
Blending modern synth textures, ambient layers and soulful undertones, the group SIMPSON’S is set to carve a distinct sonic identity within Sri Lanka’s contemporary music landscape.
Their vision, they say, is not simply to produce songs, but to create emotional atmospheres – experiences that elevate, energise and resonate, both locally and beyond.
This four-piece outfit came into the scene, less than two years ago, and they are already making waves with their debut single ‘Balaporottuwak’ (Hope).
The song, I’m told, marks the beginning of a new sound, and at the forefront of ‘Balaporottuwak’ is the group’s lead vocalist and guitarist, Ryo Hera, who brings a rich cultural heritage to the stage.
As a professional Kandyan Wes dancer, Ryo’s commanding presence and textured vocals bring a distinct energy to the band’s sound.
‘Balaporottuwak’

Ryo Hera: Vocals for ‘Balaporottuwak’
is more than just a debut single – it’s a declaration of intent. The band is merging tradition and modernity, power and subtlety, to create a sound that’s both authentic and innovative.
With this song, SIMPSON’S is inviting listeners to join them on an evolving musical journey, one that’s built on vision and creativity.
The recording process for ‘Balaporottuwak’ was organic and instinctive, with the band shaping the song through live studio sessions.
Dileepa Liyanage, the keyboardist and composer, is the principal sound mind behind SIMPSON’S.
With experience spanning background scores, commercial projects, cinematic themes and jingles across multiple genres, Dileepa brings structural finesse and atmospheric depth to the band’s arrangements.
He described the recording process of ‘Balaporottuwak’ as organic and instinctive: “When Ryo Hera opens his voice, it becomes effortless to shape it into any musical colour. The tone naturally adapts.”
The band’s lineup includes Buddhima Chalanu on bass, and Savidya Yasaru on drums, and, together, they create a sound that’s not just a reflection of their individual talents, but a collective vision.

Dileepa Liyanage: Brings
structural finesse and
atmospheric depth to the
band’s arrangements
What sets SIMPSON’S apart is their decision to keep the production in-house – mixing and mastering the song themselves. This allows them to maintain their unique sound and artistic autonomy.
“We work as a family and each member is given the freedom to work out his music on the instruments he handles and then, in the studio, we put everything together,” said Dileepa, adding that their goal is to release an album, made up of Sinhala and English songs.
Steering this creative core is manager Mangala Samarajeewa, whose early career included managing various international artistes. His guidance has positioned SIMPSON’S not merely as a performing unit, but as a carefully envisioned project – one aimed at expanding Sri Lanka’s contemporary music vocabulary.
SIMPSON’S are quite active in the scene here, performing, on a regular basis, at popular venues in Colombo, and down south, as well.
They are also seen, and heard, on Spotify, TikTok, Apple Music, iTunes, and Deezer.
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