Features
Rise in leprosy cases calls for early detection and awareness
by Randima Attygalle
“I often talk about leprosy in terms of a motorcycle. The front wheel represents curing the disease and the rear wheel symbolizes ending discrimination. Only when both wheels are turning at the same time will we make progress toward our destination of a leprosy-free world,” remarked Yohei Sasakawa, WHO Goodwill Ambassador for Leprosy Elimination marking this year’s World Leprosy Day on January 31.
Sasakawa further noted that, ‘persons affected by leprosy continue to face discrimination, reinforced in some countries by outdated laws that make leprosy grounds for divorce, prevent people with the disease from participating in public life or place other restrictions on their activities.’ Women and children are particularly vulnerable to the social and economic consequences of the disease.
Although today a curable disease, leprosy was one of the most dreaded age-old diseases dating back to some of the oldest civilizations. It had ostracized those inflicted with it by their families and communities. Though many may think that leprosy is now a disease of the past, millions of people, according to the World Health Organization, still live with some form of a leprosy-induced disability.
As of 2019, Ant-Leprosy Campaign of Sri Lanka (ALC) records 1,660 new leprosy cases in the country, of which 38% is found in the Western Province. Among the new cases are 181 (10.9%) child cases and 679 (40.9%) female cases. Late presentations of 455 cases (27.4%) are also recorded. Annually, around 2,000 cases are diagnosed locally.
“We have been observing a rise in leprosy cases in the country over the past few years, notably in the Western Province,” says the Director of the Anti-Leprosy Campaign (ALC), Dr. Champa Aluthweera. The increase in case detection as well as lack of awareness about leprosy, have contributed to this, she says.
The Central Leprosy Clinic functioning under the ALC is located at Room number 12 at the National Hospital. This walk-in clinic provides comprehensive care including diagnosis, management, skin smear testing, physiotherapy services, counseling services and wound care. Patients are provided with needed splints and gutters, specially made shoes, ulcer care kits etc. The clinic is open on all five week days, headed by a Consultant Dermatologist. In addition to the central clinic, 91 District clinics also provide services.
Despite these facilities, difficulties in sustaining momentum and diagnostic interests among clinicians and delay in identifying patients still remains to be addressed, says Dr. Aluthweera. “The collaboration between the health sector and the non-health sector stakeholders remains minimal. The ownership of the situation at the regional level too remains very low,” says the physician who goes on to cite inadequate facilities at dermatology clinics to identify and treat patients, lack of counseling services and inadequate research conducted about the disease and transmission as other bottlenecks. “Advocacy and increased social awareness using all kinds of media including social media is urgent,” adds the ALC’s Director.
Also known as ‘Hansen’s disease’, leprosy is a chronic, progressive infection caused by the bacteria Mycobacterium leprae. A highly contagious disease, leprosy is transmitted via droplets from the nose and mouth. The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract, and the eyes. The skin symptoms of the disease include discoloured patches of skin, usually flat, that may be numb and look faded (lighter than the skin around), growths (nodules) on the skin, thick, stiff or dry skin, painless ulcers on the soles of feet, painless swelling or lumps on the face or earlobes and loss of eyebrows or eyelashes. Other symptoms include nosebleeds and stuffy nose. Leprosy symptoms could however mimic other skin conditions such as Diabetes Mellitus and Pityriasis Versicolar, locally known as aluham. Hence, proper investigation is required to rule out the condition.
Untreated leprosy can cause progressive and permanent damage to the skin, nerves, limbs, and eyes. The symptoms could occur within a year and in certain cases it may take as long as 20 years or even more for them to occur. Leprosy, is curable with multidrug therapy (MDT) today. “Despite this, the disease is fed by social stigma which needs to be dispelled,” says the physician who urges the public to seek early intervention through the facilities at state hospitals.
The Leprosy Hospital in Hendala built by the Dutch in 1708, then called the ‘Leper Asylum’ is one of the oldest of its kind in South Asia. The facility which almost fell into antiquity has been revived, says the ALC’s Director. “The hospital admits patients who cannot take the required drug treatment at home due to lack of family support. Residential care is still provided to them in Hendala.”
The second facility which was set up in Mantivu in the East in 1920 is today cash-strapped and does not function in the same capacity it used to, says Dr. Aluthweera. This, however, needs to be resurrected for wider reach, she adds.
Features
Are rice consumers and farmers victims of current practices?
by Neville Ladduwahetty
One of the subjects President Anura Kumara Dissanayake is responsible for is agriculture. On the other hand, subjects such as food security and health that are related and dependent on agriculture come under the purview of Prime Minister Harini Amarasuriya. Consequently, the production and distribution of agricultural products have a bearing on access to food at affordable prices to ensure not only food security but also on poverty and malnutrition. Thus, responsibility for the welfare and wellbeing of the majority of Sri Lankans depend on the joint efforts of the President and the Prime Minister.
An area that will have a significant bearing on the above is the production and distribution of rice. This topic is addressed in a well-researched article titled “RICE MONOPOLY Continues to Put Farmers and Consumers in Peril” by Prageeth Sampath Karunathilaka (Daily Mirror, Sept 25. 2024). This article confirms that consumers and farmers are victimised not only due to shortages in production but also by the current practices that are permitted to operate with regard to the production and distribution of rice.
RICE PRODUCTION
The aforesaid article says the per capita rice consumption is approximately 125 kg per year. Furthermore, it states that during a conversation the author had with a former Director of Agriculture, K.B. Gunaratne, he had commented that despite the fact that there were variations during COVID, Sri Lanka must produce an additional 2.4 million metric tons annually”.
The argument that Sri Lanka is self-sufficient in rice does not hold water. Therefore, since the current shortfalls have a bearing on market prices which in turn have a bearing on health, poverty and malnutrition, price variations should be avoided. It is therefore imperative that rice production be increased and stocks monitored regularly to ensure that sufficient stocks are available at any time because shortfalls are often the cause to justify increasing market prices.
Increasing paddy production could be achieved either by advanced technologies or by bringing more land under cultivation. Since the latter approach would involve an increase in infrastructure and maintenance costs, it would be more prudent to resort to advanced technologies because human capital and related infrastructure are already available. Furthermore, the former approach is likely to bear not only faster results but also more income to the farmer through increased yields.
CURRENT PRACTICES
The article cited above states: “In the past large-scale paddy mill owners sold rice at Rs. 220 per kilogram, based on the government’s guaranteed price. Meanwhile, smaller mill owners sold the same rice for Rs. 160-175 per kilogram. This allowed large scale mill owners to make a profit of Rs. 60-75 per kilogram of rice. They earned significant profits from paddy purchased at low prices. Although the government set a guaranteed price of Rs. 100 per kilogram of paddy, some large-scale mill owners bought it for as low as Rs. 70-80. It is no secret that purchasing hundreds of thousands of kilos of paddy at low prices and storing it led to massive profits ….
According to the National Institute of Post-Harvest Management, a large-scale mill owner earns at least 4 million in profit per day, which amounts to Rs. 120 million per month … To produce one kilogram of Nadu rice, about 1.5 kilograms of paddy are required”. This is so with other varieties as well. Thus, on average, nearly 2/3 of rice is produced from 1 kilogram of paddy.
“The cost of producing one kilogram of rice, including expenses such as machinery, electricity, labour and distribution is approximately 25 rupees. Given the government’s guaranteed price of 100 rupees per kilogram of paddy, rice can be sold to consumers at 160-175 rupees per kilogram. However, in the current market, a kilogram of rice is sold at 220 rupees”.
With due respect, there appears to be an inaccuracy in the conclusion that “rice can be sold to consumers at 160-175 rupees per kilo”. If as stated in the article cited above, 1.5 kilos of paddy are required to produce 1 kilo of rice and the guaranteed price is Rs. 100 for a kilo of paddy, it means a farmer would need Rs. 150 to produce 1 kilo of rice. To this, if Rs. 25 is added as the cost of production as stated in the article, the bare cost without profit would be Rs. 175. Therefore, the comment that “rice can be sold to the consumer at 160-175 rupees per kilogram” needs to be revisited.
STRATEGY for the IMMEDIATE
What is evident from the foregoing is that the higher the guaranteed price for paddy, the greater is the benefit to the farmer because of increased income. On the other hand, high guaranteed prices for paddy results in high prices for the consumer. What is demonstrated above is that with a guaranteed price of Rs. 100 for paddy, the price to the consumer has to be close to Rs. 200 and above. Another fact demonstrated is that a high guaranteed price to the Farmer and an affordable price to the consumer is an incompatible proposition. Consequently, the challenge is how the farmer could earn a worthwhile income while ensuring that the consumer has access to rice at an affordable price.
A fact that influences this challenge is the availability of paddy surpluses soon after each harvest. The large-scale millers have financial capacities and infrastructural resources to buy large stocks following each harvest at low prices and store the paddy. Consequently, farmers are at their mercy. Such advantages are not available to small and medium scale Mill owners. However, the Agriculture Department reports that it is “set to provide a maximum loan amount of Rs. 50 million rupees for small and medium scale rice mill owners and maximum loan amount of Rs. 25 million rupees for paddy storers and collectors through state and private banks…” (Dept. of Agriculture Report).
An alternative proposed by All Ceylon Farmers’ Federation (ACFF) Convener Namal Karunaratne speaking to The Sunday Morning (June 25, 2023) is “that prices could be reduced if production cost was reduced… For instance, to reduce production costs, farmers’ equipment and gear need to be freed from taxes. Fertiliser prices need to be reduced. If production costs are reduced to about Rs. 60 a kilo of paddy can be sold for Rs. 80-90. The responsibility for this is in the hands of the government.”
Similar concepts have been in operation since 2000 by The Farm Storage Facility Loan Program (FSFL) of the US Department of Agriculture. FSFL provides low-interest financing so producers can build or upgrade permanent and portable storage facilities and equipment. Eligible commodities include grains, oilseeds, peanuts, pulse crops, hay, hemp, honey, renewable biomass commodities, fruits and vegetables, floriculture, hops, maple sap, maple syrup, milk, cheese, yogurt, butter, eggs, meat/poultry (unprocessed), rye and aquaculture. Eligible facility types include grain bins, hay barns, bulk tanks, and facilities for cold storage.
Drying and handling and storage equipment is also eligible, including storage and handling trucks. Eligible facilities and equipment may be new or used, permanently affixed or portable. Since its inception in May 2000, more than 33,000 loans have been issued for on-farm storage, increasing storage capacity by 900 million bushels.
FSFL is an excellent financing programme for on-farm storage and handling for small and mid-sized farms, and for new farmers. Loan terms vary from 3 to 12 years. The maximum loan amount for storage facilities is $500,000. The maximum loan amount for storage and handling trucks is $100,000. In 2016 FSA introduced a new loan category, the microloan, for loans with an aggregate balance up to $50,000. Microloans offer a 5 percent down-payment requirement, compared to a 15 percent down-payment for a regular FSFL, and waive the regular three-year production history requirement.
CONCLUSION
The clear objective of any government has been to ensure a healthy income to the paddy farmer and rice at an affordable price to the Consumer. Achieving such an objective means improving the welfare and wellbeing of nearly a third of the population who are engaged in production and improving the health of the whole nation with an impact on poverty.
A variety of opinions and proposals have been expressed and explored over the years to realize the objective stated above. Most of them involve the intervention of the Government in one way or another. For instance, one way is for the Government to control 10% of paddy production to stabilize production and to provide financial benefits in one form or another to reduce costs.
One form of financial assistance considered has been to provide loans to establish small and medium scale Mills and storage facilities throughout the country; a strategy adopted by the US Department of Agriculture. Another form has been to subsidize fertilizer and other inputs required in the production of paddy. Yet another is to establish guaranteed prices for paddy; a strategy that favours the Farmer but not the Consumer, as stated above.
None of these options have proved satisfactory, as far as achieving the desired objectives are concerned. The reason perhaps is because strategies proposed are from the perspectives of the Farmer or the Consumer and not from a holistic perspective of both. Therefore, the strong recommendation is that a Forensic Audit is conducted to ascertain the most effective strategy or strategies to meet the interests of both Farmer and Consumer.
However, what is needed in the immediate term is for the Government to engage with the large-scale mill owners and the representatives of the All Ceylon Farmers’ Federation to establish a sustainable compromise arrangement that serves the interests of both the Farmer and Consumer because at the end of the day, their interests affect the wellbeing, health and food security of the whole nation, the responsibility for which rests jointly with the President and the Prime Minister.
Features
Hope for future; Heads need be cautious
Many good things have been happening; the best is that in all Sri Lankans, barring opposing political parties and politicians, hope has been rekindled after decades of gloom and doom. We trust, admire and have full confidence in the President and the Prime Minister. Cass does not need to spell these out and give reasons.
Beware the bullet
Open letters have been penned and seen in the public sphere as how things should be done. Personally, Cass believes no pontificating nor even advice is needed. President Anura Kumara Dissanayake and his advisors, and Dr Harini Amarasuriya know what they have to do, how best to do these, and they will deliver, for the greater benefit of the country and its people. Already things are greatly improved like food items getting cheaper.
Cass always wondered why eggs and onions were imported from India, Bangladesh and Pakistan when we can produce our own, and if there occurred a shortfall, we just had to tide over that hiccup and use less or no eggs and onion. Then she was told of the import mafias – unscrupulous persons making personal profits at the expense of the country and us The People. The authorities, under the new dispensation which is honest and wise and true to the country will stop import of inessentials. That will give a boost to local producers. So, enjoy it!!
One matter Cass wanted to write an open letter to the two Heads was to please be careful; employ high security; cut down on moving around freely. They have to be very cautious. The entire country’s future now depends on these two: the Prez and PM. This is no exaggeration. Murderers, willing now to kill for perhaps a mere Rs 2,000, float around looking for their kind of work. Someone corrected Cass when she said this. Stupid, a murderer can be hired for a shot of arrack, so low is the morale of some and so rampant are sharpshooters ready to be hired.
The two Big Ones must constantly keep in mind that there are politicians in kapati suits who do not have an ounce, nay, an atom of conscience. The hunger for power, envy, need to avenge being defeated are so great that for the sake of just himself, he will order the murder of someone, even though it will shatter the entire country and send it plunging down a gorge worse than the bankruptcy they caused. Also, a strong motive pushes them forward to order a killing – their being open to exposure now that previous crimes are to be re-investigated, and more closely.
Remember Lasantha W was brutally, horrendously murdered just because he was writing about an act of suspected corruption. Even more tragic was the torture and murder of ruggerite Wassim Thajudeen since he cocked a snook at powerful sons and was, it is said, due to a dispute about a sports team. Those who were suspected of commissioning the murders and the murderers themselves are still free and around. Nothing was proven in these cases so what Cass says here is almost hearsay, but fingers pointed then and still do so. Murder simply cannot be overlooked.
Advice given by elders when we complained of a theft of something of ours was: Why do you accommodate temptation? Why are you not careful about your possessions? Do not keep them lying around, inviting theft. Now that Cass is the older person and allowed to advise: please, increase the security around our Head of State and Head of Government. It was wonderful seeing the President Elect let himself out of his car and walk unescorted by security personnel to take his oaths as Head of State. He needs to change his stance; and Harini as well. They need very secure, foolproof protection. They must also cut out walk-abouts.
Work ethic
Iridescent, luminous is the message conveyed by the true story of the son who reported for work in the skies while his father was taking oaths as the Prez of the Democratic Socialist Republic of Sri Lanka. His reply to his peers who asked him why he was not among the VVIPs at this momentous event is said to have been: “I let my father do his job and I like to do my job.”
That ethos was much with us older persons when we were in careers: hardly took leave, especially medical staff and teachers, (not government teachers who were often non-caring of kids in their charge); we worked a full day. Cass remembers going to her place of work the day after her husband was cremated. Shocked looks. You could have taken a week off. But why? I did all I had to do and now I am ready to carry on my job. She remembers as the Education Officer in a professional association finding students taking very long over an assignment they had to submit before final results. Why have you taken so long to complete the research and submit your paper? My father died? When? A year ago. So, you are in deep mourning all this time, unable to do what you have to do! That is the general trend in this lotus eating country of ours.
Back to work
This malaise has ceased. Goodness gracious! A woman reports that she visited the income tax office in the past week. A department which had earned the wrath of the public for sending them from pillar to post. But to her utter surprise and delight her work was attended to, pronto, and she was treated politely.
Cass had a report to get about a piece of land. Her agent went a number of times to two offices concerned and spent many hours, but the document was not signed. The person authorised to sign the document had gone to political meetings, he said. The agent told her the officer expected jarava – oiling palms. Post September 23, Cass told her agent that now he would get the completed document handed over to him the moment he went in!
Demise of the vehicle parades
A vendor on Thurstan Road opposite Royal and Thurstan Colleges told a friend that normally a large number of armed forces’ vehicles driven by uniformed personnel would stop in front of where he was to drop boys studying at Royal. But no longer since September 23!
Monday late news reported that 107 vehicles, all luxury, were allocated to Presidential advisors, secretaries et al by ex Prez Ranil W. So very many advisors when he was a man who decided matters often on his own? What did Rosy Senanayake advise him on, pray? Sartorial elegance? This is just one institution and the cost borne by us, citizens, in maintaining them a favoured bod could cruise all over in a public paid for vehicle? Deeply shocking!
Dr Harini Amerasuriya’s views
Cass listened to an interview conducted before the presidential elections by Kishani Alanki of Conversations with Dr Harini Amarasuriya where she was asked what she stood for if the NPP won the presidency. Cass’ heart got lighter, hopes kept rising and pride was born within as Dr H A outlined strategies she would promote. She first made clear the ideology of the NPP and its inception – the National People’s Power or Jathika Jana Balawegaya, established in 2019, is a socialist political alliance led by the Janatha Vimukthi Peramuna, consisting of 21 political parties.
Dr H A’s main areas of interest are education, women’s and children’s concerns and of course bringing equality among all in the island, particularly concentrating on erasing the divide between the haves and the marginalized. She was questioned about the low representation of women in Parliament and how she fared, with the majority of her co-MPs being male. She smiled broadly! She said she fared well but there were instances when behaviour toward other women MPs was below par (Cass’ words).
Encouraging it was to hear that in her interaction with women in various spheres of employment and economic status, she found so many willing to give of their ability to improve the condition of the people of the land. Yes, Cass agrees wholesale with the move: give a woman a job and she will do it well, with full commitment and effort. Corruption and its temptation are so much less in women, Cass boldly affirms.
So, unlike on previous Fridays, with Cass’ dismal mood infusing her Cry with acid and suppressed frustration, she now looks to the future with hope and enthusiasm.
Features
Pathfinder Foundations launches Sinhala Translation of ‘The India Way: Strategies for an Uncertain World”
The Sinhala translation of ‘The India Way: Strategies for an Uncertain World’ by Dr. S. Jaishankar, Minister of External Affairs of the Government of India, will be launched in Colombo today. The decade from the 2008 Global Financial Crisis to the 2020 Coronavirus pandemic has significantly transformed the world order. In The India Way’, Dr. S. Jaishankar analyses these challenges and proposes possible policy responses. He places this thinking in the context of history and tradition, appropriate for a civilizational power that seeks to reclaim its place on the world stage.
The Sinhala translation of the book ‘The India Way’ is a publication by the Pathfinder Foundation translated by Ajith Perakum Jayasinghe.
The original publication was undertaken by Delhi-based Harper Collins Publishers India Private Limited, from whom Pathfinder Foundation obtained the license to translate the work into Sinhalese language and print for distribution free of charge.
The book is available free of charge for public libraries and libraries of all universities in the country by contacting pm@Pathfinderfoundation.org or 011 425 9952-3.
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