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Navy’s peacetime war against insidious killer

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By Admiral Ravindra C Wijegunaratne

(Retired from Sri Lanka Navy)

Former Chief of Defence Staff

If someone asked me what the senior appointment I really loved most was, my answer would be Chief of Staff of the Sri Lanka Navy (Second-in-Command of the Navy) – CoS. The CoS has all the perks—an official bungalow in Colombo 7, vehicles and staff—that the Commander is entitled to, but does not have the same responsibilities as the Commander. He has all the freedom to travel the length and breadth of the country on inspections of major bases, ships and craft. He does not have to attend all important meetings with VVIPs. Actually, the CoS runs the Navy at the ground level. So, you can work according to your own schedule, of course, with the Commander’s approval.

I served under Admiral Jayantha Perera as his CoS for more than one year. He was happy about my frequent travel to the North and the East and looking into issues at the ground level and in situation.

As the CoS, I attended the funerals of close relatives (child, wife, father or mother) of our officers and sailors. I observed at funerals in North Central Province, where large number of naval personnel come from, parents of most of our young sailors from that part of the country died of kidney failures. A large number of them were middle-aged or in their early 50s. The disease is known as the Chronic Kidney Disease (CKD). It was sad to see the farmers who feed the country contract CKD at a relatively young age, suffer for years and die. The reason is contaminated water they use for drinking and cooking. Scientists and medical experts have cited various reasons—excessive use of fertilizer/pesticides, the contamination of groundwater and tank water—but the real cause is still not known.

The only way to prevent the disease is to make clean water available for drinking and cooking for the people in areas with a high CKD burden. Upon inquiry from Senior Health Ministry officials in 2015, we came to know that there were 30,500 CKD patients in the North Central province alone and the number was on the rise. All the patients had to undergo dialysis regularly.

As the CoS, I discussed the issue with Navy Commander Admiral Perera, and on his instructions, tasked the outstanding Marine Engineering Officer, then Commander MCP Dissanayake (Dissa) with manufacturing a low-cost water purification plant. Dissa was well known for his research and development projects he headed during the war; they were very effective and helped save many lives. He was the Command Engineering Officer in North Central Naval Command, based in Poonawa, Medawachchiya at that time. He proposed the manufacture of an RO plant (Reverse Osmosis water purification plant). The Navy has been using imported RO plants in its large ships for decades and our engineers are adept at repairing them.

The cost of an imported RO plant with a 10-ton (10,000 litres) output a day is approximately Rs. 3.8 million. The installation of an imported plant costs approximately Rs. 5 million. Dissa’s plant cost only Rs 950,000 and the total cost including installation was Rs. 1.4 million.

The problem was funding. Every officer and every sailor contributes Rs. 30 from his/her pay every month to the ‘Social Responsibility Fund’ of the SLN. With approximately 55,000 personnel, the collection is about Rs 1,650,000 a month. We could produce one RO plant per month! Work started immediately. On 11th July 2015, Admiral Perera retired and I was appointed as 20th Commander of the Navy by then President Maithripala Sirisena.

One of my tasks during my visit to North Central Naval Command was to declare open the Navy’s first RO plant on 22nd December 2015 at Kadawath Rabewa, the village of Leading Marine Engineering Mechanic Premaratne. This small village alone had 250 CKD patients.

From that day, I made use of all the fora I attended, both here and abroad, to raise funds for this worthy cause. Funds poured in, from foreigners, Sri Lankans, here and overseas and the business community and we could manufacture at least two plants a month.

Then, President Sirisena ordered the Presidential Task Force on CKD to provide sufficient funds for the Navy’s project. We started a production line in our R and D Project Factory in Welisara under the able guidance of Dissa.

In 2016, we manufactured 344 plants and installed them in various places, especially in schools, temples and churches. 344 plants were manned by 344 trained sailors. Every plant is capable of producing 10,000 litres (10 tons) of clean drinking water daily, and the quality of this water is better than bottled water you drink. That came to 3.44 million litres of clean drinking water per day to public free of charge. Three mobile service teams with vehicles were formed.

I opened the RO plant at the Kebithigollewa Madya Maha Vidyalaya on 16 June 2016, exactly 10 years after LTTE claymore mine attack that killed 60 civilians, who travelled in a bus in Kebithigollewa. Addressing the children, who gathered in the hall, where the victims’ bodies had been kept, I said, “Our armed forces will ensure your safety. What happened 10 years back will not occur in the future. You’ll have a great responsibility to study hard now without any fear. We will fight this deadly disease of CKD with the help of our expertise. Dear children, please bring empty bottles when you come to school. Drink and carry home safe drinking water from the RO plant we have installed. Give this water to your siblings, parents, relatives and friends”. I saw tears of happiness, especially in the eyes of GCE Advanced Level students.

The schoolchildren usually carry drinking water from home to school, but the children in the North Central Province carry safe drinking water home from school! Bravo to Navy’s research engineers. Bravo Zulu, Dissa.

I am happy that the safe drinking water project I initiated has continued under successive Navy Commanders who have evinced a keen interest in it. We have installed more than 760 RO plants in the North and North Central Provinces. I thank the Navy and all those who have contributed to this worthy cause. The project is on, and many more people will benefit from it.

An expert in CKD/CKDu treatment process, Dr Asanga Waruna Ranasinghe, in his research article, The Incidence, prevalence and trends of Chronic Kidney Disease (CKD) and Chronic Kidney Disease of uncertain aetiology (CKDu) in North Central Province of Sri Lanka : an analysis of 30,566 patients’ on page six, refers to a decrease in the number of CKD patients. He says it is probably due to the availability of safe drinking water.

Do not forget the Navy is a silent force. No one notice what they do. Today, more than 760 plants produce 7.6 million litres of safe drinking water free to the public. The Navy went a few steps further, manufacturing two medical RO plants required for dialysis machines in Colombo and Kandy General Hospitals.

The Navy also manufactured mobile RO plant installed in a truck fur use in disaster situations.

As a result, the spreading of CKD has been controlled and most of North Central Province children want to join the Navy Engineering branch.

Some history teachers in the North Central Province have compared the Navy to King Mahasen’s Army. King Mahasen, who ruled Sri Lanka from 277 to 304 AD, constructed 16 large tanks or wewas. He was deified following the construction of the Minneriya tank and for giving water to needy people.

If our Navy is compared to King Mahasen’s Army for providing more than 7.6 million litres of clean drinking water to people daily, I compare our Engineering Officer, Captain (E) MCP Dissanayake as Commander Meghavannabaya, King’s main advisor and Chief Engineer.

 



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India and China opting to make positive impact in Ukraine

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Ukrainian troops ride atop an armoured vehicle on a road in the eastern Donetsk region

In what could be considered the most thought provoking development to date in the global politics growing out of the Russian invasion of Ukraine, China and India have called on Russia and Ukraine to go for a negotiated solution to the crisis. Of particular importance is Chinese Foreign Minister Wang Yi’s pronouncement to the effect that the parties need to ‘keep the crisis from spilling over and affecting developing countries.’

Elaborating on this policy position, Wang Yi was quoted saying: ‘China supports all efforts conducive to a peaceful resolution of the Ukraine crisis. The fundamental solution is to address the legitimate security concerns of all parties and build a balanced, effective and sustainable security architecture.’

As pointed out by some commentators, this stance by China is indeed a far cry from the unconditional support extended to Russia by China in all matters of vital importance to the former. In other words, it is a comedown of sorts from the ‘all weather friendship’ that was seen as binding the countries.

As explicit as the Chinese Foreign Minister on this question was India’s Foreign Minister Subrahmanyam Jaishankar. He said: ‘As the Ukraine conflict continues to rage, we are often asked whose side we are on. Our answer, each time, is straight and honest – India is on the side of peace and will remain firmly there. We are on the side that calls for dialogue and diplomacy as the only way out.’

Hard ground realities and economic pressures that are extending well beyond the Eastern European theatre could be considered as compelling China and India to adopt this policy stance on the Ukraine crisis. It is plain to see, for instance, that the Russian invasion is meeting stubborn Ukrainian military resistance which is rendering the invasion a highly costly exercise for Moscow.

Despite the initiation of some desperate measures by the Putin regime, such as the partial mobilization of Russia’s citizenry for the war effort and the holding of ‘referendums’ in territory seized from Ukraine in an effort to legitimize Russia’s hold on it, the invasion could be considered as having all but stalled. On the other hand, the Ukrainian resistance seems to be having ample resolve and morale. Bolstered by recently supplied sophisticated Western weaponry, it has more than taken the fight back to the Russian invaders.

Evidently, then, Russia’s war effort is not going according to plan. However, the human costs, in particular, for both main sides to the conflict are prohibitive. Ukraine civilians are being subjected to a bloodletting that civilized sections the world over are recoiling from in horror. They could be said to be at the receiving end of state-inspired barbarism.

On the other hand, the majority of Russian civilians ought to be seeing themselves as nothing less than cannon fodder in Russian strongman Putin’s efforts to resurrect the defunct Soviet empire, now that they are being forcibly conscripted into an apparently futile war effort.

All this and more, ‘on the ground’, is clearly evident to both the friends and foes of Russia. They are likely to be of the view that the senseless war ought to be brought to a close.

On the other hand, to a greater or lesser degree, all countries are currently experiencing the adverse economic effects of the war. As is known, the Ukraine invasion is a principal cause for the worldwide rise in food and energy prices. If stagflation is fast spreading in the world and the more vulnerable sections among citizenries are sinking further into poverty and disempowerment it is, to a considerable extent, due to the Russian invasion of Ukraine and its ill effects.

China and India, two of the foremost economic powers of the South, ought to be fully alert to these realities. Among other things, they know for certain that there could be no economic growth for them and the world amid mounting material hardships and the steady impoverishment of people.

To re-state a fundamental axiom in classical economics, there could be no demand for goods and services if people lack the power to purchase, which comes from money in hand. And without the exercising of demand the production of goods and services comes to a grinding halt. That is, economies crumble. This is happening in the South right now.

The inference is inescapable from the foregoing that the invasion of Ukraine must end and that needs to be achieved by political means since a continuation of armed hostilities would only beget more war and its ill-consequences. Accordingly, China and India would prefer to have a negotiated solution to the Ukraine crisis.

A peek at recent growth trends in India and China would disclose the extent to which these economies have been dependent on the growing prosperity of their upper and middle classes to nourish their material fortunes. A report published in this newspaper on September 21, 2022 said, among other things, that by 2026, India’s dollar millionaires are expected to double. During the 2021- 2026 period China’s dollar millionaires are expected to grow by 97 per cent. It is these classes that have been keeping their economies ticking in recent decades by virtue of their growing purchasing power. Their purchasing power has steadily translated into a strong indigenous manufacturing base, among other things.

It does not follow from the foregoing that economic equity is a very strong point of India and China. That would necessitate a steady trickling down of wealth to the economically lower classes but we would certainly be having growth and that has been happening markedly in India and China.

Likewise, the prosperity of their neighbours as well as that of the rest of the world contributes positively towards the growth stories of India and China. While India and China have been interacting positively in the economic field over the decades on the basis of their increasing economic power and thereby gaining mutually, it will be to their advantage to ensure that their neighbours too advance towards economic wellbeing.

This accounts for the ready extension by India and China of economic assistance to Sri Lanka in its current woes. Indeed, India and China would extend their largesse to other countries in the region in their hour of need as well because the growth successes of these economic giants are predicated upon the prosperity of their neighbours, among other factors. In the absence of a degree of economic prosperity, these smaller neighbours could not expect to interact effectively in the economic sphere with India and China and gain significantly by it.

Accordingly, it will be in the national interest of India and China to call on Russia and Ukraine to go for a negotiated settlement. If the conflict is thus ended it will not only benefit India and China but the rest of the world as well, considering that the conflict is exerting widespread economic ill-effects.

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‘Use heart for every heart’

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World Heart Day 2022

By Dr.Mohan Jayatilake
Consultant Cardiologist
Former President of Sri Lanka Heart Association

The theme of World Heart Day 2022 is “USE HEART FOR EVERY HEART”. The World Heart Federation has created this day to raise awareness about Cardiovascular Diseases (CVD).

Every year, on September 29th, people all over the world celebrate Heart Day as a way to draw attention to cardiovascular illnesses, their management as well as the worldwide toll they take on society. World Heart Day was created in the year 2000 to inform people around the globe that Heart diseases and Stroke are the world’s leading cause of death, claiming 17.9 million lives every year. According to WHO statistics, 82% of deaths occurring in low and middle-income countries are due to lack of resources.

Together with members of the World Heart Federation, we need to spread the news that at least 80% of premature deaths, from heart disease and stroke, could be avoided if the main risk factors, heavy smoking, unhealthy diet, reduced physical activity, and alcoholism, are controlled.

Increased high blood pressure, increased blood sugar levels, being obese, or overweight, are all side effects of living a bad lifestyle that may harm your heart.

The world was battling the Covid-19 pandemic for the last two years. Unfortunately, patients, with CVD, are more vulnerable and have become high risk groups. Heart patients are susceptible to get a more severe form of Covid-19 infection which could make matters worse.

National activities such as public talks, cardiovascular screening, walks, runs, concerts or sporting events are organised worldwide by members and partners of World Heart Federation.

Global leaders have recognised the urgency to give priority to prevention and control of heart diseases with other non-communicable diseases (NCD) which include cancer, diabetics and chronic lung diseases.

This year also, according to the theme, we ask people to take charge of their home’s heart health by taking steps to reduce the burden of the following risks:

Stop smoking

Stop smoking to improve your own and your children’s heart health.

Cigarette smokers are 2-4 times more prone to get heart disease and strokes, than non-smokers. Stopping smoking dramatically reduces the risk of heart disease, strokes and deaths.

A Few steps for successful cessation

Find your reason – strong motivation will help.

Line up support in advance – medical assistance

Lean on your loved ones

Find new ways to relax/unwind – stress can make a person fall back to smoking. Music, meditation, yoga or any other activity will help to alleviate stress.

Try and try again

– you only need to try again and again to achieve your target, even though you are unsuccessful in your first attempt.

Avoid alcohol and other triggers.

Physical exercise always helps to alleviate stress and avoid triggers of smoking.

Healthy diet at home

Unhealthy diet is at the root of many health issues, especially obesity, diabetics and CVD. Rapid urbanisation, changing lifestyles and easy accessibility of fast foods have made our dietary patterns unhealthy. Following are some healthy food patterns:

Limit saturated and trans fats

Limit salt

Limit sugar

Plenty of fruits and vegetables

At least five portions of fruits and vegetables per day should be a norm of your dietary habits. You should opt for low fat milk and dairy products.

Animal products, mainly beef, pork, poultry with skin, mutton, lard, butter, cheese carry a lot of saturated fat. Trans fats are contained in baked, processed and fried food items, certain margarines and spreads. In order to cut down saturated and trans fats, consume lean meats, poultry without skin, low fat dairy products, fish and nuts. Vegetable oils should be in moderation.

Regular Exercises

It is recommended that adults should do at least 150 minutes of moderate intensity physical activity or at least 75 minutes of high intensity physical activity per week.

Families should limit the amount of time spent in front of TV to less than two hours per day.

Exercise should be a regular part of your life. Due to the Covid pandemic, public exercise facilities are closed and most of the time movement of people is restricted. Therefore, home-based exercises were adopted to make exercises an enjoyable task.

Lose Weight

The world is now facing visible epidemic of obesity. It not only adversely affects your cardiovascular health, but also can affect your mental well-being.

The ways to lose weight effectively,

Do not skip meals – it will make you hungrier and go for more snacks.

Plenty of fruits and vegetables

Get active

– exercise burns off excess calories.

Use a smaller plate – eating smaller portions definitely reduces weight.

Do not ban foods

– you can enjoy an occasional treat otherwise you crave them more.

Cut down on alcohol

– it can make you gain weight.

Manage Stress

Psychological health and well-being can affect your cardiovascular health. Regular exercise, practising relaxation, being with your family and friends sometimes, adequate sleep, various hobbies, and maintaining positive attitudes towards life.

Know your numbers

Visit your doctor or healthcare professional.

Know your blood pressure which is one of the risk factors for CVD. Check regularly and take steps to control it including salt intake, exercises and medication.

Know your cholesterol – high cholesterol is another major risk factor for CVD. It should be checked regularly and controlled with dietary measures and medication.

Know your blood sugar – diabetics, conditions with high blood sugar levels multiply CVD risk. Diet control and medication required to control it.

Know your warning signs

Recognising symptoms of CVD can help you survive because earlier the treatment better the chances of survival.

Chest pain of tightening or burning in nature with pain radiating down the upper limbs or to the neck or back associated with sweating and nausea is the typical presentation of heart attacks. Sometimes heart burn or burning tummy pain could be due to a heart attack rather than gastritis or indigestion.

Sudden weakness of limbs, slurring of speech, mouth deviation or double vision could be due to a stroke. Knowing these symptoms and seeking medical assistance allow you to get treatment early and prevent complications which can be life threatening most of the time.

Take your medicine regularly and correctly

If you are already diagnosed with a heart disease or stroke, taking your medication, without fail, will reduce the chances of getting another attack of stroke or heart disease

Measures during pandemic

The Covid-19 pandemic has created havoc, globally. People with CVD fall into very high risk category.

Therefore it is important to,

Continue your medication uninterruptedly

Follow medical advice

Continue exercise and balance diet.

Maintain your social network and

Do not hesitate to take vaccination.

By doing the household steps, mentioned above, you and your family can reduce the burden of heart diseases.

Breastfeeding and lifelong health

Breastfeeding is the best form of nutrition for newborn and infants, according to WHO. Increasing public awareness is important. Infants who are breastfed tend to have lower cholesterol and blood pressure as well as lower rates of overweight and obesity all of which improve cardiac health.

Both undernourished and over nourished, early in life, can increase the risk for developing CVD. Evidence suggests that children who are undernourished while in the uterus and at childbirth bear a higher CVD risk later in life.

Maternal obesity during pregnancy has been associated with obesity in children which also increases the risk of developing CVD in life.

As always, our emphasis will be on improving heart health across all nations in adult male and female, as well as children.

By adopting lifestyle changes, people all over the world can have longer and better lives through the prevention and control of heart disease and strokes.

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Doctors…taking a break

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When we think of doctors, what comes to mind is medicine, patients, etc., and that’s only natural as doctors are our saviours…when we are ill.

We would hardly associate doctors with entertainment, and that’s where most of us are wrong.

I’ve been to a couple of concerts where these men of medicine have excelled, on stage, as entertainers, and some of them, I would say, are super-duper.

Yes, the Annual Sri Lanka Medical Association Doctors’ Concert is a much-looked-forward to musical extravaganza where the doctors, and their families, are provided the unique opportunity to showcase their talents, in performing arts.

It is usually held on the final day of the Annual Scientific Congress of the Sri Lanka Medical Association (SLMA), and it’s all happening this Saturday, October 1st, at the Lotus Room of the BMICH.

Says Dr. B.J.C.Perera, Senior Consultant Paediatrician:

“It is a common belief that medical doctors are a sombre set of people who are mainly involved in looking after people with illnesses. True enough, they do perform that ever so immensely important task in society, and such a mission is by no means to be taken lightly, in view of its tremendous significance. Healing the sick is certainly a noble task and many of them are renowned performers, as well as experts in their own chosen specialties of the profession.

“However, it may come as a surprise to many that several of these medical men, and women, have other talents – musical, acting, drama, etc. There are very many extremely gifted performers of real class amongst our medical men, and women. In recognition of this, the SLMA has provided an opportunity for these artistic men, and women, to showcase their talents, and flair, in the performing arts, at the glittering SLMA Doctors’ Concert.

“This is a much-anticipated opportunity for members of the medical profession, and their family members, to put their hair down and forget medicine, at least for an evening. The Doctors’ Concert was started many years ago as a rather informal event and it has a most proud tradition of being staged annually, for quite a few decades, in the history of the SLMA.

“A dedicated band, consisting mainly of doctors, first played at the concert, in 2014. This was in the Committee Room 1, currently the Lotus Room, of the BMICH. They performed on a small stage done for them on a side.

“The continuing progress of the event was due to the untiring efforts of that absolute virtuoso in music, a drummer himself, Dr. Christo Fernando. He left no stone unturned to make the event a resounding success, from 2014 onwards.”

This Saturday, October 1st, we will not see doctors, in their usual uniforms (Coats and Scrubs), stethoscopes, or anything connected with medicine, but entertainment, at its best…on stage!

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