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Native medicine and its place today

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By Dr. Sarath Gamini De Silva

Much discussion and controversies have arisen today as the world is trying to find a remedy for the pandemic ravaging mankind. As allopathic (Western) medicine found no acceptable cure for the illness so far, vaccines are being introduced at a rapid pace seeming to be effective in preventing the disease. Due to the desperate situation, time taken for developing such vaccines and their use in human beings has been shortened to a fraction of what we have known hitherto. Thus, long term harmful effects, though we are reassured to be minimal, are yet to be seen. With new more virulent strains of the virus already appearing in the UK, how effective the vaccines would be in the long term is anybody’s guess.

To fill the gap in the availability of scientifically verified treatment, many Ayurvedic or native medicines (also called traditional or alternative medicines) have come to the fore. Almost every week a person with questionable credentials comes up with a decoction claiming to be based on an ancient formula brought down the generations secretly in ola manuscripts. They are appealing to the patriotic sentiments of the people expecting them to accept these out of respect for tradition. Sudarshani paanaya, Dhammika peniya are among the foremost. The claims of their origins from divine sources or being brought down from the Himalayas have added to the mystique. As a more recent example we remember how the leaves and the latex of Papaya were promoted for treating dengue fever, later found to be of no use.

In my childhood, I swallowed gallons of kottamalli with or without ginger and katuwelbatu as a remedy for fevers, common colds and the likes. Venivelgeta was added to prevent tetanus after an injury. During school holidays we were given aralu to “cleanse” the bowels to survive the next school term! Epsom salt (savinda lunu) was added to make the induced diarrhoea more profuse and hence to make the treatment more effective. Later on, I spared my own children the agony of going through that treatment. We have heard about various treatments given to prevent rabies after a dog bite, the success proven if the victim did not get the fatal illness after eating pork. Similarly, deaths after snake bites were supposed to be prevented by various forms of native treatment.

There is a scientific explanation for many of these so-called successes. With a very few exceptions most viral infections are self-limiting. A “drug’ given during the illness, whether allopathic or traditional, makes the patient feel comfortable, but the duration of the illness itself is not generally shortened nor complications made less likely. As for tetanus, a majority of wounds will not anyway lead to serious infection. Most snake bites are harmless needing no treatment; so are dog bites. These are a few examples where no one can claim success for their medication as the patients would have recovered anyway without any intervention. There are risks when people overlook well proven vaccines for the prevention of rabies, tetanus and other illnesses or antitoxins for snake bites and resort to traditional medicine.

Almost all the medications used by native physicians are of natural origin. Roots, yams, barks and leaves are the sources. Unfortunately, with the advance of scientific method little or no attempt has been made to isolate the effective chemical compounds in them. Hence in decoctions like kasayas, multiple plant derivatives have to be boiled together in a cumbersome procedure producing a bitter unpalatable drink. Fortunately, some preparations like paspanguwa, peyawa and samahan are available in sachets, which we still take for symptomatic relief showing our faith in native medication. Likewise, some Western medicines are of plant origin where the active ingredient has been isolated and produced in a palatable tablet form. Some original plant compounds are now manufactured in laboratories to increase the volume of production.

It was identified many years ago that some commonly available plants had blood sugar lowering properties. They are recommended by some for use by the diabetic patients. However, one is not aware of any attempts to isolate the active compounds and make them commercially available. It is the duty of governments, and the ministry in charge of traditional medicine, to facilitate and encourage research into finding active ingredients in traditional medicine.

The situation is even worse when non communicable diseases (NCDs) are considered. Illnesses like heart diseases, high blood pressure, diabetes or arthritis are cases in point. We are still unraveling the exact causation of these illnesses. In such diseases, giving immediate symptomatic relief and the prevention of well-known debilitating or life-threatening long term complications are mandatory. The allopathic drugs have been tested and tried over a long period of time in scientific analysis and well controlled clinical trials to prove that they are effective in treating the illnesses as well as having minimal side effects. Many chemicals, molecules and compounds which started off in laboratories with this process had to be abandoned due to such undesirable effects or lack of effectiveness. Whether any traditional medicine has been subjected to such intensive study is not known. It should be stressed that no “trial and error” method is acceptable when dealing with human life!

There are many anecdotal stories of malignant disease being cured by native medicine. In almost all these instances people have resorted to alternative medicine when allopathic treatment has failed to prevent the progress of the disease. In these instances, after some period of apparent improvement, the disease inexorably gets worse. Even without any treatment, many chronic illnesses are known to subside spontaneously. Alterations in the immunity of the individual may be a factor. Whether any form of treatment can claim credit for such “cures” is questionable. It has become the vogue to undertake extreme dietary changes and other forms of life style modification to alter the course of chronic diseases including malignancies.

People had total faith in native medicine and occult sciences in the olden days as there was no alternative remedy available. Stories about the times of King Ravana and the physician king Buddhadasa are legendary and would have played an important role at that time. But when more established scientifically proven allopathic medicine is available for many illnesses, quoting ancient unverified stories will not help. No one will ever think of going back to horse-drawn carriages because the fuel powered cars cause environmental pollution!

The merits of native medicine are further diminished by their “adulteration” with allopathic drugs alleged to be practiced by native physicians. It is widely suspected that syrups, gulis, etc., actually contain allopathic drugs powdered and reconstituted. Many Ayurveda and related study courses now include some teaching in allopathic medicine and pharmacology. Some traditional physicians prescribe antibiotics and pain killers to gullible public who are naïve enough to believe that they are trained in both systems of medicine! It is well known that a large number of native physicians take allopathic medicine for their own illnesses like hypertension and diabetes. How some such physicians publicly advise against the use of drugs for diabetes like insulin and metformin is deplorable. Over the years these drugs have been proven without doubt to improve the disease and prevent long term complications.

Many herbal products imported mostly from Asian countries currently do not require registration by the drug regulatory authorities. These are costly and are often of no proven benefit. They are commonly prescribed even by doctors registered in allopathic medicine. They should be brought under regulatory control without further delay.

The media play a big role in promoting unproven medications, both traditional and allopathic, spreading harmful misinformation. Politicians seem to take refuge in them when their action or inaction disappoint the public who are looking up to them to control the current pandemic. It is deplorable how they mislead the people by openly ingesting such decoctions. Obviously, they will not be held accountable if unforeseen toxic effects occur in those who swallow it. Those responsible have put the cart before the horse, by asking the experts to decide on the issue after they have already appeared to openly recommend the decoction to the people. The short term substantial financial benefits to those who peddle unproven medications is an incentive to continue hoodwinking the gullible public. The risk of such falsely reassured people ignoring effective public health guidance is worrying.

While showing scenes where alcohol is consumed or there is tobacco smoking, the television screens show a legend to say that these habits are harmful to health. Likewise, it should be mandatory that when questionable medication is shown or advertised, a legend to say that these claims are unproven could rectify the issue to some extent. Ideally, electronic media and other news organisations should have their own advisors on health matters, who can clarify issues before giving publicity to such products. This is especially so at a time when health programs are said to be very popular among viewers

This article is written in good faith to overcome the epidemic of misinformation which is as harmful as the pandemic itself. Coming from a physician trained in allopathic medicine who has much faith in the symptomatic relief given by them, it is not intended to discredit the native forms of treatment or their practitioners. Over thousands of years native medicines were the only form of treatment available to help the people survive illness. More properly conducted research is the urgent need to make the system relevant to today’s needs. However, being ignorant enough to get stuck in history and tradition would ensure that the nation will continue to stagnate without progress. Issues have been logically discussed in the hope that people will be informed enough to see things as they are.



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Sinharaja world heritage

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Conservation Outlook Assessment: Significant Concern

By Professor Emeritus Nimal Gunatilleke

Continued from Yesterday

 

Water diverted from Ampanagala reservoir to Muruthawela will be used to meet the irrigation deficit of Muruthawela and Kirama Oya systems and the balance will be transferred to Chandrika Wewa, through existing LB canal of Muruthawela scheme up to 13.8 km and a new canal of 17.0 km. After that, the water requirement of Hambantota harbour is to be transferred to Ridiyagama tank through the Walawe river and Liyangasthota anicuit. However, due to the extreme length of the diversion through the three-river basins of Nilwala, Kirama Ara and Urubokka Oya, it will lead to a massive conveyance losses of the diverted water while on the way to the Walawe basin. Furthermore, enormous costs associated with its construction, a failure to fully realise the intended outcomes due to a shortage of water budget will simply be a burden that Sri Lanka cannot afford with her current economic condition, according to Eng. Prema Hettiarachchi. It may be worth recording that the water ingress into the grouted tunnel of the Uma Oya near Ella has still not been fully repaired, even though the Uma Oya project is nearing completion. An expensive lesson to be learnt on the nature of the weathered geological structure, lineaments and implementing its unexpected and costly mitigatory measures which will eventually to be paid back by this and future generations of tax payers of this country.

According to the Irrigation Department web site postings, Mahaweli Consultancy Bureau has initiated the Environment Impact Assessment (EIA), but due to the unavailability of concurrence of the Forest Department, revised TOR has not been issued by the CEA. Therefore, due to the unavailability of updated TOR, the EIA study has been delayed.

Environmentally, the most contentious issue highlighted in the news media is the proposed construction of a RCC dam at Madugeta to build a reservoir for which around 79 ha of forested (and some agricultural) lands in Sinharaja and a portion of prisine riverine forest in Dellawa would be inundated. On the Sinharaja side of the proposed Madugeta reservoir (right abutment) at present there are home gardens and small-scale tea plantations in addition to good riverine forests. In contrast however, proportionately a larger area of luxuriant forest of Dellawa, which is a part of the new ‘Sinharaja Rain Forest Complex’ would go under the chain saw for this reservoir construction (left abutment). The Geo-engineering report of May 2019 on GNDP has revised the siting of the dam to a more favourable location with supposedly reduced impacts but they forewarn that the three core-drilling along the proposed dam axis that had to be temporarily abandoned due to protests made by the villagers, need to be completed to confirm the geological suitability for the dam site.

 

Are there any Environment-Friendly Alternative Options?

As an alternative site for a dam on Gin Ganga, Eng. Nandasoma Atukorale (Specialist Engineer [Hydropower]) has proposed a location at the confluence of Mahadola with Gin Ganga at the village of Mederipitiya, way back in 2006. According to him, the riverbed at this site is 261 masl and have a catchment area of 132 km2. He proposes the construction of a 35 m high concrete gravity type dam that would form a reservoir with a storage capacity of 65 million cu.m and a potential discharge of 320 million cu.m of water annually which could divert 293 million cu. m of water to the SE Dry Zone. Most importantly, this region passes through a relatively narrow section of the river which is ideally suited for a dam according to him. However, geological suitability and socio-economic impacts of local communities need to be investigated, beforehand.

Quite interestingly, Eng. Athukorale claims that ‘although it is not economically very attractive, another 200 million cu.m of water could be diverted to the Nilwala basin by constructing a dam across Gin Ganga at the downstream of the confluence with Dellawa Dola at the village of Madugeta, with an 8000 m long tunnel which could be considered at a later stage provided further water shortages are experienced in the area’.

 

Now that the proposed Madugeta reservoir is receiving heavy criticisms from the environmental front, wonder whether Mederipitiya option proposed by Eng. Athukorale could be revisited for the diversion of Gin-Nilwala river water to the SE Dry Zone.

In a research paper titled ‘Comparison of Alternative Proposals for Domestic and Industrial Water Supply for Hambantota Industrial Development Zone’ Eng. Prema Hettiarachchi makes a comparison among three irrigation projects Kukule Ganga, Gin-Nilwala and Wey Ganga to convey water from the SW wet zone to SE dry zone.

She proposes yet another option that is probably still on the drawing boards to be considered which is the Wey Ganga diversion in Ratnapura District. According to her, this could meet the industrial and drinking water requirement (154 MCM + drinking water) of Hambantota metropolitan area at a significantly lower cost and with less damage to the environment. Further, there is a possibility of augmenting this scheme by diverting a part of Kalu Ganga catchment at a later stage.

Eng. Hettiarachchi further states that ‘by comparing the workload, it could be estimated to be nearly one third that of the Gin-Nilwala diversion. The Wey Ganga diversion can be carried out at a significantly lower cost by local agencies. That can also address the water scarcity of Hambantota metropolitan area including the requirements of international harbour and proposed industrial development zone with the relatively less environmental damage which is a major issue with respect to large scale projects. Construction period will also be less since the workload is less and can be carried out by the local agencies’.

What I have strived to show with this detailed irrigation engineering information available on public domain in the form of research publications, is that the Madugeta reservoir option is not the only one available for taking water from the wet zone rivers to the SE Dry Zone which is indeed a legitimate requirement for agricultural and industrial development of that region.

Pre-feasibility studies have been conducted on these options since 1968 and a considerable wealth of technical information is already available with the Irrigation Department. Apparently, according to knowledgeable irrigation engineers, there are more environmentally friendly, and cost-effective options with greater assurance of water conveyance to the SE Dry Zone available for consideration. It is often the case that during pre-feasibility studies of these large engineering projects, environmental concerns are given the least priority. Steady supply of water during extreme drought events which are becoming more frequent depends very much on the nature of the vegetation cover of the watershed area. These environmental aspects need to be critically evaluated before such costly projects are designed. As an example, although, the major engineering work of the Uma Oya project has been almost completed, its cost-effectiveness is yet to be seen with a denuded watershed, a potential of heavy soil erosion on top of the unexpected heavy expenditure on tunnel boring and other engineering works.

Biologically speaking, the Dellawa Forest Reserve is an integral part of Sinharaja Rain Forest Complex representing the pristine climax forest vegetation of SE wet lowlands and provide a vital connectivity link to adjoining Diyadawa forest of equal significance via the remains of Dombagoda forest. Therefore, clearing a riverine strip of this forest for the construction of Madugeta Reservoir would lead to an irreparable and irreplaceable damage to its characteristic riverine/flood plain forest vegetation.

On the other hand, pledging a reforestation initiative of a much larger area with Hevea rubber as a compensatory measure proposed by the political administration is totally unacceptable. Preserving intact forests in protected areas has no substitutes or replacements. Furthermore, the Natural Heritage Wilderness Area act and the binding articles of the UNESCO Convention on Protection of the World Cultural and Natural Heritage to which Sri Lanka is a signatory, clearly state that causing direct or indirect damage to a natural heritage is legally not permissible.

In summary, the Sinharaja World Heritage Site is already in a state whose biological values are threatened and/or are showing signs of deterioration and significant additional conservation measures have been recommended to restore these values over the medium and long term. Adding more threats like the construction of reservoirs inside protected areas at this stage would inevitably downgrade the values further to a ‘critical conservation outlook’ which is not what the citizenry of Sri Lanka and the world at large would acknowledge as ‘sustainable development’.

The author of this article is a member of the National Sustainable Development Council of Sri Lanka and he thanks Dr Jagath Gunathilaka of Peradeniya University for providing the geotechnical information described herein. The author can be contacted at .)

 

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US seeking way out of Afghan killing field

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As the Biden administration makes its initial moves to extricate the US’ remaining security forces personnel from Afghanistan, it would do well to ponder on former US President John F. Kennedy’s insightful comment on foreign policy: ‘Domestic policy can only defeat us; foreign policy can kill us.’ This is a rare nugget on the nature of foreign policy.

Considering the high costs, human and economic, a country could incur as a result of blundering on its foreign policy front, Kennedy could be said to have spoken for all countries. However, there is no denying that the comment is particularly applicable to expansionist powers or ‘hegemonic’ states.

Sensible opinion is likely to be of the view that the US decision on quitting Afghanistan should have come very much earlier; may be a couple of years after its bloody misadventure in the conflict and war-ridden country. Considering the terribly high human costs in particular the US’ 20 long years in Afghanistan have incurred, the US could be said to have committed one of its worst foreign policy blunders, overshadowing in severity the blood-letting incurred by the super power in Vietnam. However, in both theatres, the consequences for the US have been of unbearable magnitude.

The US death toll speaks for itself. At the time of writing more than 2,300 US security forces personnel have been killed and over 20,000 injured in Afghanistan. Reports indicate that over 450 Britons have died in the same quagmire along with hundreds of similar personnel from numerous other nationalities. Apparently, it took an exceptionally long period of time for the US to realize that Afghanistan for it was a lost cause.

The lesson that the US and other expansionist powers ought to come to grips with is that it would not be an ‘easy ride’ for them in the complex conflict and war zones of the South. The ground realities in these theatres are of mind-boggling complexity and Afghanistan drives this point home with notable harshness. Power projection in South-west Asia and persistence with its ‘war on terror’ were among the apparent prime objectives of the US in Afghanistan as well as in Iraq but what the US did not evidently take into consideration before these military involvements were the internal political realities of these countries that are not at all amenable to simplistic analyses and policy prescriptions.

The Soviets ought to have come to grips with some features of the treacherous political terrain presented by Afghanistan in the late eighties but their principal preoccupations were related more to the compulsions of the Cold War. Simply put, the Soviets were bent on preserving the ‘satellite’ status of Afghanistan and their war effort was aimed at this in the main. Preparing Afghanistan for democracy was not even least among the Soviet Union’s concerns, of course.

However, the same does not apply to the US. The latter helped the Mujaheddin in the task of getting rid of the Soviet presence in Afghanistan but its aim was also to have a US-friendly regime in Kabul that would be a veritable bridgehead of US power and influence in the region on a continuous basis. In other words, the US expected the regime which replaced the Soviets to be pro-Western and essentially democracy-friendly. The US did not in any way bargain to have in Afghanistan Islamic fundamentalist regimes whose political philosophies were the anti-thesis of democracy as perceived in the US and practised by it.

However, the Islamic fundamentalist Taliban regime which eventually came to power in the mid-nineties in Afghanistan, once the Soviets withdrew, defied all Western expectations. As is known, the Taliban was not only repressive and undemocratic but was staunchly opposed to everything Western. There were no hopes of the Taliban working towards Western interests. Besides, the US did not expect to see in Afghanistan a country dangerously divided on ethnic, tribal and religious lines. The problems of Afghanistan have been compounded over the years by the coming together of the Taliban and the Al-Qaeda and these groups have world wide Islamic fundamentalist links.

It has been the aim of the US to have in Kabul religiously moderate, pro-democratic regimes but as developments have proved over the past few decades these administrations have not been in a position to hold out against the Taliban. In fact, it is the Taliban that is veritably at the helm of power in Afghanistan currently and years of futile attempts at trying to contain the Taliban have brought home to the US and its allies that they have no choice but to talk to the Taliban in order to secure some respite to effect ‘an honourable exit’ from the bloodied land. This is where matters stand at present.

However, as pointed out by commentators, it is the Afghan civilian population that has suffered most in the decades-long blood-letting in the country. Conservative estimates put the number of Afghan security forces personnel killed in Afghanistan at around 60,000 to date and the number of civilians killed at double that figure.

Accordingly, the Afghan people would be left to face an uncertain and highly risk-riddled future when the last of the US security forces personnel and their allies leave Afghanistan in September this year. The country would be left to its own devices and considering that the Taliban will likely be the dominant formation in the country and not its legitimate government, the lot of Afghan civilians is bound to be heart-rending.

There is plenty to ponder on for the US and other democratic countries in the agonies of Afghanistan. One lesson that offers itself is that not all countries of the South are ‘ready for democracy’. This applies to very many countries of the South that already claim to be democracies in the Western sense. Southern ‘democratic’ polities defy easy analysis and categorization in consideration of the multitude of identity markers they present along with the legitimacy that they have achieved in the eyes of their states and populations. What we have are dangerously volatile states riddled with contradictions. Relating to them will prove to be highly problematic for the rest of the world.

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The Soul

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The Soul (also known as Ji hun) is based on the sci-fi novel ‘Soul Transfer’, written by Jiang Bo in 2012. The novel was widely popular and inspired director Cheng Wei-Hao to adapt the tale into a movie. The story is about a married couple who are determined to uncover the truth behind strange activities in their community. According to the official synopsis for the film from Netflix, while investigating the death of a businessman, a prosecutor and his wife uncover occult secrets as they face their own life-and-death dilemma. The film stars Chang Chen, Janine Chang and Christopher Lee among others.

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