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Public health officials smother SARS-Cov-2 epidemic

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By A. Bystander

Public health officials have done it again: they have smothered the severe acute respiratory syndrome coronavirus 2 before it took more lives and disabled even more economic activity. This is not the first time that they have got the better of deadly and disabling pathogens. Perhaps the closest parallel is their campaign against malaria, which rampaged over most of Sri Lanka during the 1930s and early the first part of the 1940s. Then there was no WHO or OXFAM. It was then, as now, an achievement of local public health officials: PHIs, nurses, lab technician, ambulance drivers and of course the physicians. Who would dare assess the contribution each group against that of another? It is true that the anti-malaria campaign gained a powerful weapon, when DDT spraying was introduced in the 1940s. Its use was strictly limited later because of its disastrous ill effects on the environment. Not enough has been written about this heroic story. There is some account in Dr. S.A.Meegama’s recent book as there was in Dr. N. K. Sarkar’s Ph.D. thesis. I have not read Dr.Uragoda’s writings; it is most likely that he dwelt on this subject as I recall him holding forth on it. Dr.W.G.Wickremasinghe, the first Ceylonese Director of Medical And Sanitary Services (DM&SS, as was then called) wrote a booklet, an autobiography of sorts, privately distributed (I have lost my copy.), in which he described the work he did with PHIs when he was MOH of the Kalutara district. They went from house to house destroying breeding places for mosquitoes and advising people about ways of avoiding the spread of malaria. It is this remarkable dedication of public health officials and the better distribution of food, irrespective of purchasing power in the hands of consumers coupled with a better distribution of rural hospitals, that helped Ceylon to stand out in the health conditions of its people as the war (1939-45) ended. The rising standards of living and literacy, especially of women, all contributed in their own time.

Infant mortality rates dropped sharply as the malaria epidemic abated. Maternal mortality rates fell similarly with the opening of rural hospitals. Consequently, the average expectation of life at birth shot up. Sustaining all these successes was better nutrition, assured by government schemes to distribute essential commodities evenly among all people under a ration scheme and subsided prices. Japan had invaded South East Asia and the Japanese warships were present on the high seas. We were a British colony and Britain had a deep commitment to Ceylon as Singapore fell to the Japanese. It was important that they had a peaceful country from which they could operate. The people had to be kept reasonably satisfied. But food supplies became scarce. They introduced a scheme of rationing essential food supplies and fuel supplies. The colonial government appointed highly competent civilian as the Competent Authority who oversaw all this work. To do so the government introduced a rationing scheme, which ensured the supply to irrespective of high purchasing power. Each adult was entitled to a kilogram of rice, 2 kilos in the event he did hard labour, some flour, some sugar and some kerosene oil. It is this assured supply that built healthier children in those years who grew up to go to school and university and reasonably long life. (I am one of them.). In England and Wales, the lowest infant mortality rates were registered 1911-1921 because of food rationing during those years of horrible war.

In a paper that Amartya Sen wrote in 1981 in the Bulletin of the Oxford Institute Economics and Statistics he identified five poor countries which stood out on a scatter map relating GDP per capita and infant mortality rates (or average expectation of life at birth). Cota Rica, Cuba, Korea, Sri Lanka and Vietnam, though poor sported rates of infant mortality matching those of OECD countries. The secret of success lay in the fairly even distribution of food and outstanding public health policies. Costa Rica had no army and the money wasted on starched uniforms, polished brass and jack boots went into primary education and public health. Cuba under Fidel Castro spent heavily on primary education and public health. Their public health officers still work in many parts of Africa. I have mentioned some of the policies in colonial Ceylon. The free education scheme launched by Kannanangara and teaching in indigenous languages introduced by Jayawardena and Nalliah supplemented that to make the younger population more literate. There was a pronounced emphasis on primary health care in contrast to curative care of more complex sicknesses. Graduates in medicine and surgery that came out of the new faculty of medicine carried with them not only sophisticated understanding sicknesses but also an admirable commitment to common people. Professional who come here from neighbouring countries to participate in conferences in education and health express wonderment that teachers in government schools regularly teach in schools and that doctors regularly come to work in rural hospitals. It is that commitment of well trained and skilled men (and now women) that helped to hold back the epidemic, thus preventing the curative branch from being overwhelmed by the simultaneous large inflows of sick people. Of the 2,900 or so infected, some 900 were sailors from the Navy who were young and in robust health and the risk of them falling acutely ill was very small. As we do not know the age structure of those others who fell ill, one cannot assess the probability of their proceeding to being acutely need requiring breathing help. I am sure that in time an epidemiologist will look at the figures analytically.

Of course, one must not forget that the bhikkhu sangha recited the ratana sutta interminably to keep off the epidemic as had been done in Vaishali in the time of the Buddha.

 

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Opinion

The care of good dentists

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I experienced an agonizing toothache for the first time in my right-hand upper jaw. On bringing it under control with native medicines, a couple of colleagues at my work place stressed me to see a dentist who could prevent any recurrence, and recommended a highly proficient doctor by the name Rini Mathew attached to a popular medical centre in Riyadh. After nearly five-days-wait I was successful in getting an appointment to consult her.

This highly pleasant lady doctor from Kerala, India, after seeing the set of teeth in my right-hand upper jaw recommended for a root canaling and requested to return in two-weeks-time. Having not undergone any sort of surgery in my whole life, I was a little confused as to what to expect. As I arrived prepared for the repair work on my teeth, the good lady told me to my pleasant surprise that I don’t need any further treatment for the moment and if I get the toothache back again to come and see her. I thanked God and praised her for her being frank and honest.

The history of dentistry records Hesy-Re, an Egyptian scribe, who lived around 2600 BC is recognized as the first dental practitioner. In ancient Greece, Hippocrates and Aristotle wrote about dentistry, specifically about treating decaying teeth, but it wasn’t until 1530 that the first book entirely devoted to dentistry – The Little Medicinal Book for all kinds of diseases and infirmities of the Teeth – was published.

You don’t want to feel like just another item on your dentist’s to-do list. The best dentists, like whom I consulted, have a way of letting their patients know they care about them personally. They are interested in their patient’s lives and are eager to become a part of their general care team. The best dentist always gives you the care that you deserve.

 

S. H. MOULANA

 

 

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Opinion

The Age of Animal Ministries

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The call by the government’s backbench MP Mr. Dilan Perera to be made the Rilav/Vanduru Amathi, or the Minister for Monkeys, in the Pohottuva Realm, certainly leads to plenty of interest.

This must do with the various divisions and breakup tasks that have been given to both Cabinet and State Ministers, in the current play of governance, by the Gotabaya strategies. 

The call for a Rilav Ministry may have come after the Minister for Coconuts, Arundika Fernando, tried to climb a coconut palm, in his estate, at Dankotuwa, and hold a press conference to tell the people about the shortage of coconuts and the cause of the high price of this essential food item. One was surprised that he did not blame the coconut price hike on the 19A to the Constitution, and give any assurance that the coming 20A will bring the nut prices to within the people’s reach. Such nutty thinking is possible from politicos today.

What was also interesting is how he did this climb, halfway to coconut heights, with some modern climbing gear, having nothing to do with the traditional coconut tree climbers, who used their feet and hands to move much higher, and also walk on ropes from tree to tree for coconut plucking and toddy tapping. He must be following the new thinking of the Rajavasala on Digital Development to raise this country to new heights of Rajapaksa Success.

Let’s get back to the hopeful Rilav Amathi – the Monkey Minister Dilan Perera. The dictionary meaning of ‘Rilava”, that comes from the Vaanarayas, is those who take the forest products. This certainly has much relevance to the huge forest destruction taking place today, with the clear political blessings of the Rajapaksa realm. It is the crooked, or rilav, thinking of the Pohottu politicians that is causing this huge destruction of nature, bringing disaster to the environment. Is it the hope of Mr. Dilan Perera that he would be put in charge of this chronicle of destruction, becoming the political gatherer of profitable forests products, and giving free forest land to the political catchers of 20A fondness?

Or, is he thinking of the romantic legends of the monkey Hanuman, that had so much to do with Rama and Sita, and brought so much of forest land from India and dumped in several parts of this country, giving much of the ayurvedic medicine to this day. Is the Pohottuva Dilan thinking of becoming the Phohottu Hanuman, to bring in new legends of politically powerful romances that will soon be part of the Hanuman Keli or Monkey Games of the Power Players? His recent defence of the 20A, against the 19A that he voted for, gives a good indication of the Rilav and Vanduru thinking that is the stuff of Pohottu politics.

 There is also a good opportunity for the call for a Nari/Hival Amathi, or Fox Minister, in this government. Why not have one of these foxy politicians, with their delight in political long-jumping, who have plenty of nari-thinking in their systems, as the new Nari-Hival Amathi. He or she will make some quick decisions on how the ‘Nari Tharjanaya’, the Fox Threat in the Kalutara, and now Horana areas, can be tackled; giving the Cabinet Minister of Health time to keep thinking of matters other than public health, and more on the political health of those who are in the bandwagon of power politics. 

A Nari-Hival Amathi will be one whose hoots will be heard loud and clear in support of 20A, and one who would have gladly hooted in support of both the 18A and 19A, and is ready to raise both hands, and even one’s legs, for the 20A.

There are other animals who can have Cabinet or State portfolios in this politics of backward evolution. Why not have a Buffalo, or Meeharak Amathi? This could be a Pohottuva activist who will promise to give a good price to the curd made from buffalo milk, and also tell the public how much they can benefit by lying for hours in the mud found near their homes, without looking for government jobs or contracts for services that can only be given to the Pohottu catchers.

The Tamil Tigers were defeated more than a decade ago. But the politics of today is still seething with tiger threats to national unity. With what is happening to the leopards in this country, there is certainly a cause for a pohottu backbencher to ask for a Kotiya or Diviya portfolio. This can be a pohottu player who have the stripes of corruption on one’s body, with plenty of experience of grabbing the land of others, whether paddy fields or plantations, with the twisted politics of power, whether from the UNP, SLFP, UPFA or the Yahapalana travesty. A Koti Amathi will be roaring away, and leaping with great success on grabbing the property of other people, for the rising cause of Pohottu Balaya, the future power Dual Citizens, especially of the Washington-Medamulana alliance.

It is not likely that there will be any calls for a Bull or Cow – Harak Amathi – especially after the reigning silence over the plan to stop the slaughter of cattle. There are plenty of bulls in the huge pack on the government side, at Diyawanna Oya, we hear and also see their ‘gon talk’ and ‘harak keliya’ in the parliament so often today. They will be happy that cattle slaughter will remain a reality here, with no moves for the rise of a vegan society, which is certainly not the substance of the real Rajavasala thinking, with complete absence of kindness to animals.

There are many more animal or species ministries that can be offered to build up this Rajavasala Sathva Kattiya, once the 20A is passed, and the ministries can flow from the Rajapaksa pen. There is much space for more than one serpent or Sarpa Amathi – who will spread themselves all over the country, and crawl around and strike down with venom those who dare talk of the disasters that lie ahead post 20A. There can be many cockroach and mosquito ministers, too, who will help spread the Covid 20 — that can be far more dangerous than today’s Covid-19.

Let’s give a bow to the Age of Animal Ministries or Sathva Amathya Yugaya. 

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Opinion

Where is Sajith’s leadership?

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By Dr UPUL WIJAYAWARDHANA

The Leader of the opposition is a vital link in democracy and, as the name implies, is expected to give leadership. Unfortunately, the behaviour of Sajith Premadasa is casting doubts as to whether he is giving that leadership.

Even when he challenged Ranil for the leadership of the UNP, he was happy to put up a fight for some time and then give up. His disappearance into the wilderness after losing the presidential election and issuing a statement that he would devote the rest of his life to looking after leopards, perplexed many. Egged on by a coterie of Ranil-haters, he split the UNP but still wanted to grab the HQ of the party, an aspiration he quickly gave up after the last general election, probably because the UNP did unexpectedly bad.

There is no doubt that the biggest challenge he faces is opposing the introduction of the 20th amendment. If the ugly scenes in the parliament, when 20A was tabled, on 22nd September is anything to go by, many would be in for disappointment. “The ongoing campaign against 20A is characterised by a severe trust deficit, which the Opposition has failed to overcome.”: This forewarning in the editorial “Diyawanna Post Office” (The Island, 22 September) seems to ring true. I greatly doubt the opposition enhanced its image with this behaviour and the contempt of the voters towards Members of Parliament surely would increase.

What was displayed was not leadership but gang-leadership. Instead of obeying the rulings of the Speaker and forging a strong opposition in a democratic manner, what we saw was rowdy behaviour. To add insult to injury, they were demanding the cameras be aimed at them, so that the whole country could witness their rowdiness!

I too am against some aspects of 20A, like removing the limitation of Cabinet size and letting dual citizenship holders enter parliament, but have done so by just means; having voiced them through this newspaper.

In addition, Sajith failed miserably as a leader when he did not take any action against the national list MP Harin Fernando, who made a totally unsubstantiated allegation against Malcolm Cardinal Ranjith. He told the Presidential Commission of Inquiry investigating the Easter Sunday attacks that the Cardinal shifted the Sunday Mass to Saturday as he was aware of the terrorist attack. As a catholic himself, Harin should have verified facts before he made such a serious accusation. In spite of having had to admit his folly to the commission, on his way out, Harin made sarcastic remarks to journalists. It is impossible even to speculate what earthly purpose these insults are meant to serve. If it is to regain the support of the Buddhist voters, it certainly is an exercise in futility as most Sri Lankans hold Malcolm Cardinal Ranjith in high esteem for his exemplary leadership following the Easter Sunday attacks.

Sajith should have taken immediate action, as this is a repeat offence; having taken Harin to the Cardinal for an apology on the previous occasion. Instead, he said in high-brow Sinhala “abhyantara kathikawathaka yedenewa”, meaning an internal conversation is taking place. Sajith seems to be under the impression that using serious sounding words would satisfy the masses and solves problems.

Unfortunately, Sajith’s lack of leadership qualities are becoming more obvious by the day. Perhaps, there is a chance for Ruwan Wijewardena, if he plays his cards right!

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