Connect with us

Features

Safe blood: keeping the nation’s heart beating

Published

on

World Blood Donor Day falls tomorrow under the banner, ‘Give blood and keep the world-beating’.

Sri Lankan blood donors have put the country on the world map as one of the very few countries which has achieved a 100% voluntary, unremunerated blood donor base. This is the realization of the National Blood Transfusion Service’s (NBTS) vision of becoming a ‘unique model for the world securing quality assured blood services through a nationally coordinated system.’ NBTS is the only autonomous state run blood transfusion service in South Asia to be conferred a WHO Collaborating Centre which has emerged a regional centre of excellence today. NBTS is also a member of the two leading international bodies- International Society of Blood Transfusion (ISBT) and the Asian Association of Transfusion Medicine (AATM). This ‘lifeline’ of our health sector continues to offer a new lease of life to many despite challenging times.

by Randima Attygalle

The first major incident of blood transfusion in the country took place in 1959 when surgery was performed on the late Prime Minister S.W.R.D Bandaranaike who was shot. The public awareness on blood transfusion was made following this unfortunate incident when as appeal was made to the public to donate blood for the late Premier’s surgery. Back then the Blood Bank was only a single room located near the surgical unit of the General Hospital Colombo (present National Hospital of Sri Lanka). In 1960 it was shifted to the building opposite the Faculty of Medicine. It was an era of using sterilized glass bottles for collection which were reused by the service. A donor was paid ten rupees per donation and the blood was screened only for malaria and syphilis. In 1962 the first regional blood bank was established at the General Hospital, Galle. Today the National Blood Centre is headquartered in Narahenpita consisting of 105 hospitals affiliated to 25 cluster centres.

The centrally coordinated national blood transfusion service with its 105 affiliated blood banks across the country stands above many regional counterparts with their ‘fragmented systems’. This is aligned with the WHO recommendation that ‘all activities related to blood collection, testing, processing, storage and distribution be coordinated at the national level through effective organization and integrated blood supply networks.’ Unlike a system where blood is collected in fragments or in isolation, a nationally managed mechanism such as ours not only prevents blood wastage but also assures safety, quality and equitable access to all, says Director, NBTS, Dr. Lakshman Edirisinghe. Blood, which has a shelf life, needs to be managed, maximizing the availability to the patients’ need and assuring minimal wastage. While the international standard for blood wastage is about 5%, NBTS maintains a level even below that on most occasions which is significant.

NBTS also adheres to ‘Hemovigilance’ which is a set of surveillance procedures covering the entire transfusion chain from the collection of blood and its components to the follow up of its recipients, intended to collect and access information on unexpected or undesirable effects resulting from the therapeutic use of labile blood products. “A mismatched blood transfusion could be fatal. Hemovigilance help assure optimum quality and safety with minimum mishaps,” explains Dr. Edirisinghe.

The ‘crisis situation’ which the NBTS ran into prior to Vesak Poya last month, when the stocks were very low, (due to travel restrictions), was reversed within a few days thanks to the donors who responded to the appeal says the NBTS Director. The local annual requirement is around 450,000 units of blood out of which the daily requirement is around 1,000 to 1,200 RCC (red cell concentrates) units. NBTS strives to assure a national repository level of 12,000 to 13,000 RCC stock. “A RCC stock of about 12,000 units is required and during the pandemic surges these stocks came down drastically due to affected collection which is far below the numbers of continued patient issues. However, thanks to the donors who quickly responded to our appeal, we managed to completely reverse the situation,” notes Dr. Edirisinghe. The challenge now is to control the blood collection just adequate to satisfy the current demand, minimizing wastage as the shelf-life of RCCs is 35 to 42 days, he says. “In addition, there is a daily need of platelets; about 450 units at present. Since they cannot be stored for more than five to six days, blood collections should be maintained at least every two to three days. Thus the usual pattern of organizing mobile blood campaigns during week-ends and public holidays should be strengthened with week day collections, especially with in-house donations on appointment basis with the on-line donor pre-registration system of the National Blood Transfusion Service website.” (www.nbts.health)

Nearly 120 million units of blood are donated globally every year according to the WHO. Blood transfusions are needed for a wide range of health conditions including anaemia, complications during pregnancy and childbirth, severe trauma due to accidents, and surgical procedures. They are also regularly used for patients with conditions such as thalassaemia and for blood components to treat bleeding conditions associated with many diseases. The baseline requirement for blood transfusion has now taken a new dimension points out Dr. Edirisinghe. While road accidents, routine and emergency surgeries require the highest volume of blood transfusions, even during a lockdown or with travel restrictions a baseline requirement of 800 RCC units needs to be maintained for thalassaemia and cancer patients whose life expectancy is now extended. Blood transfusions are also needed for those with Chronic Kidney Disease (CKD) today.

Realizing a base of 100% voluntary unremunerated donors has enabled us to do away with replacement donors. “The ‘giving culture’ of our nation has undoubtedly played a significant role apart from other contributory factors such as having repetitive blood donors and a centrally coordinated system in place,” remarks Dr. Edirisinghe. Regular donors, is an international indicator in blood transfusion which enables quality assured blood. As the WHO notes, ‘an adequate and reliable supply of safe blood can be assured by a stable base of regular, voluntary, unpaid blood donors. These donors are also the safest group of donors as the prevalence of blood-borne infections is lowest among this group.’

Once blood is collected, samples are screened for diseases which are transmitted by blood. Regular donors Dr. Edirisinghe explains, can help improve the safety of donations. Moreover, regular donors very often become organizers of blood donation campaigns which is a bonus factor he says. In addition to the usual screening process, an additional screening tool is now in place to assess donors of the COVID risk. “Those who have either COVID-like or influenza like symptoms, people coming from households with COVID positive patients, those whose PCR or antigen test results are pending are not eligible to become donors. People who have returned from foreign countries in the last three months or those who hope to travel out of the country in the next three months are also not eligible to donate blood,” says the NBTS Director who urges all donors to be responsible and transparent in their disclosure of information.

Despite these temporary limitations, COVID patients, after 28 days from complete recovery are eligible to donate blood, provided they fulfill other criteria. “COVID is not proven so far as to be transmitted through blood or a blood product, therefore those who have recovered have no restrictions in donating blood. In fact, plasma, a blood component prepared from a blood donation is a treatment modality for some COVID patients, which is now underway at NBTS,” explains the physician.

Certain criteria needs to be fulfilled to qualify as a blood donor. A donor needs to be between 18 and 60 years with a hemoglobin level of more than 12.5 g/dL. They should also be free of any non-communicable disease (NCD) including high blood pressure, cardiac disease and cancer. Insulin-dependent diabetic patients also disqualify as donors. “Those with NCDs are disqualified not because their blood is of inferior quality, but because there is a health risk for them when physiological changes occur due to sudden volume depletion in their blood levels following a donation,” explains Dr. Edirisinghe. People with HIV or any other sexually transmitted diseases including Syphilis and those who have ever had Hepatitis B and C are disqualified to be donors. People who have tattooed themselves are also disqualified to donate blood for a year since it involves needle-piercing.

The enthusiasm of the young blood donors (between 18 and 25) is very heartening remarks the physician who encourages the young population of the country to be healthy, free from NCDs as only the healthy can become regular blood donors. He also dispels several myths surrounding blood donation. “Donating blood can make a person obese, it makes the immune system weak and vegetarians cannot donate blood are some of the common myths which need to be debunked. A healthy person can also donate blood up to three times per year (with intervals of four months).”

Thanking all donors who have contributed to the success story of NBTS of the country, its Director encourages regular donors and first-timers to make use of the pre-booking system which was introduced via the NBTS hotline (011-5332153/011-5332154) and the NBTS website (http://nbts.health) during the lockdown as means of mitigating overcrowding during the pandemic. Pre- booking (as opposed to standard walk-in donations) helps NBTS to arrange for donors to visit a centre close to their home or workplace during this pandemic sparing them of the hassle of visiting its headquarters.



Continue Reading
Click to comment

Leave a Reply

Your email address will not be published. Required fields are marked *

Features

Rebuilding the country requires consultation

Published

on

A positive feature of the government that is emerging is its responsiveness to public opinion. The manner in which it has been responding to the furore over the Grade 6 English Reader, in which a weblink to a gay dating site was inserted, has been constructive. Government leaders have taken pains to explain the mishap and reassure everyone concerned that it was not meant to be there and would be removed. They have been meeting religious prelates, educationists and community leaders. In a context where public trust in institutions has been badly eroded over many years, such responsiveness matters. It signals that the government sees itself as accountable to society, including to parents, teachers, and those concerned about the values transmitted through the school system.

This incident also appears to have strengthened unity within the government. The attempt by some opposition politicians and gender misogynists to pin responsibility for this lapse on Prime Minister Dr Harini Amarasuriya, who is also the Minister of Education, has prompted other senior members of the government to come to her defence. This is contrary to speculation that the powerful JVP component of the government is unhappy with the prime minister. More importantly, it demonstrates an understanding within the government that individual ministers should not be scapegoated for systemic shortcomings. Effective governance depends on collective responsibility and solidarity within the leadership, especially during moments of public controversy.

The continuing important role of the prime minister in the government is evident in her meetings with international dignitaries and also in addressing the general public. Last week she chaired the inaugural meeting of the Presidential Task Force to Rebuild Sri Lanka in the aftermath of Cyclone Ditwah. The composition of the task force once again reflects the responsiveness of the government to public opinion. Unlike previous mechanisms set up by governments, which were either all male or without ethnic minority representation, this one includes both, and also includes civil society representation. Decision-making bodies in which there is diversity are more likely to command public legitimacy.

Task Force

The Presidential Task Force to Rebuild Sri Lanka overlooks eight committees to manage different aspects of the recovery, each headed by a sector minister. These committees will focus on Needs Assessment, Restoration of Public Infrastructure, Housing, Local Economies and Livelihoods, Social Infrastructure, Finance and Funding, Data and Information Systems, and Public Communication. This structure appears comprehensive and well designed. However, experience from post-disaster reconstruction in countries such as Indonesia and Sri Lanka after the 2004 tsunami suggests that institutional design alone does not guarantee success. What matters equally is how far these committees engage with those on the ground and remain open to feedback that may complicate, slow down, or even challenge initial plans.

An option that the task force might wish to consider is to develop a linkage with civil society groups with expertise in the areas that the task force is expected to work. The CSO Collective for Emergency Relief has set up several committees that could be linked to the committees supervised by the task force. Such linkages would not weaken the government’s authority but strengthen it by grounding policy in lived realities. Recent findings emphasise the idea of “co-production”, where state and society jointly shape solutions in which sustainable outcomes often emerge when communities are treated not as passive beneficiaries but as partners in problem-solving.

Cyclone Ditwah destroyed more than physical infrastructure. It also destroyed communities. Some were swallowed by landslides and floods, while many others will need to be moved from their homes as they live in areas vulnerable to future disasters. The trauma of displacement is not merely material but social and psychological. Moving communities to new locations requires careful planning. It is not simply a matter of providing people with houses. They need to be relocated to locations and in a manner that permits communities to live together and to have livelihoods. This will require consultation with those who are displaced. Post-disaster evaluations have acknowledged that relocation schemes imposed without community consent often fail, leading to abandonment of new settlements or the emergence of new forms of marginalisation. Even today, abandoned tsunami housing is to be seen in various places that were affected by the 2004 tsunami.

Malaiyaha Tamils

The large-scale reconstruction that needs to take place in parts of the country most severely affected by Cyclone Ditwah also brings an opportunity to deal with the special problems of the Malaiyaha Tamil population. These are people of recent Indian origin who were unjustly treated at the time of Independence and denied rights of citizenship such as land ownership and the vote. This has been a festering problem and a blot on the conscience of the country. The need to resettle people living in those parts of the hill country which are vulnerable to landslides is an opportunity to do justice by the Malaiyaha Tamil community. Technocratic solutions such as high-rise apartments or English-style townhouses that have or are being contemplated may be cost-effective, but may also be culturally inappropriate and socially disruptive. The task is not simply to build houses but to rebuild communities.

The resettlement of people who have lost their homes and communities requires consultation with them. In the same manner, the education reform programme, of which the textbook controversy is only a small part, too needs to be discussed with concerned stakeholders including school teachers and university faculty. Opening up for discussion does not mean giving up one’s own position or values. Rather, it means recognising that better solutions emerge when different perspectives are heard and negotiated. Consultation takes time and can be frustrating, particularly in contexts of crisis where pressure for quick results is intense. However, solutions developed with stakeholder participation are more resilient and less costly in the long run.

Rebuilding after Cyclone Ditwah, addressing historical injustices faced by the Malaiyaha Tamil community, advancing education reform, changing the electoral system to hold provincial elections without further delay and other challenges facing the government, including national reconciliation, all require dialogue across differences and patience with disagreement. Opening up for discussion is not to give up on one’s own position or values, but to listen, to learn, and to arrive at solutions that have wider acceptance. Consultation needs to be treated as an investment in sustainability and legitimacy and not as an obstacle to rapid decisionmaking. Addressing the problems together, especially engagement with affected parties and those who work with them, offers the best chance of rebuilding not only physical infrastructure but also trust between the government and people in the year ahead.

 

by Jehan Perera

Continue Reading

Features

PSTA: Terrorism without terror continues

Published

on

When the government appointed a committee, led by Rienzie Arsekularatne, Senior President’s Counsel, to draft a new law to replace the Prevention of Terrorism Act (PTA), as promised by the ruling NPP, the writer, in an article published in this journal in July 2025, expressed optimism that, given Arsekularatne’s experience in criminal justice, he would be able to address issues from the perspectives of the State, criminal justice, human rights, suspects, accused, activists, and victims. The draft Protection of the State from Terrorism Act (PSTA), produced by the Committee, has been sharply criticised by individuals and organisations who expected a better outcome that aligns with modern criminal justice and human rights principles.

This article is limited to a discussion of the definition of terrorism. As the writer explained previously, the dangers of an overly broad definition go beyond conviction and increased punishment. Special laws on terrorism allow deviations from standard laws in areas such as preventive detention, arrest, administrative detention, restrictions on judicial decisions regarding bail, lengthy pre-trial detention, the use of confessions, superadded punishments, such as confiscation of property and cancellation of professional licences, banning organisations, and restrictions on publications, among others. The misuse of such laws is not uncommon. Drastic legislation, such as the PTA and emergency regulations, although intended to be used to curb intense violence and deal with emergencies, has been exploited to suppress political opposition.

 

International Standards

The writer’s basic premise is that, for an act to come within the definition of terrorism, it must either involve “terror” or a “state of intense or overwhelming fear” or be committed to achieve an objective of an individual or organisation that uses “terror” or a “state of intense or overwhelming fear” to realise its aims. The UN General Assembly has accepted that the threshold for a possible general offence of terrorism is the provocation of “a state of terror” (Resolution 60/43). The Parliamentary Assembly of the Council of Europe has taken a similar view, using the phrase “to create a climate of terror.”

In his 2023 report on the implementation of the UN Global Counter-Terrorism Strategy, the Secretary-General warned that vague and overly broad definitions of terrorism in domestic law, often lacking adequate safeguards, violate the principle of legality under international human rights law. He noted that such laws lead to heavy-handed, ineffective, and counterproductive counter-terrorism practices and are frequently misused to target civil society actors and human rights defenders by labelling them as terrorists to obstruct their work.

The United Nations Office on Drugs and Crime (UNODC) has stressed in its Handbook on Criminal Justice Responses to Terrorism that definitions of terrorist acts must use precise and unambiguous language, narrowly define punishable conduct and clearly distinguish it from non-punishable behaviour or offences subject to other penalties. The handbook was developed over several months by a team of international experts, including the writer, and was finalised at a workshop in Vienna.

 

Anti-Terrorism Bill, 2023

A five-member Bench of the Supreme Court that examined the Anti-Terrorism Bill, 2023, agreed with the petitioners that the definition of terrorism in the Bill was too broad and infringed Article 12(1) of the Constitution, and recommended that an exemption (“carve out”) similar to that used in New Zealand under which “the fact that a person engages in any protest, advocacy, or dissent, or engages in any strike, lockout, or other industrial action, is not, by itself, a sufficient basis for inferring that the person” committed the wrongful acts that would otherwise constitute terrorism.

While recognising the Court’s finding that the definition was too broad, the writer argued, in his previous article, that the political, administrative, and law enforcement cultures of the country concerned are crucial factors to consider. Countries such as New Zealand are well ahead of developing nations, where the risk of misuse is higher, and, therefore, definitions should be narrower, with broader and more precise exemptions. How such a “carve out” would play out in practice is uncertain.

In the Supreme Court, it was submitted that for an act to constitute an offence, under a special law on terrorism, there must be terror unleashed in the commission of the act, or it must be carried out in pursuance of the object of an organisation that uses terror to achieve its objectives. In general, only acts that aim at creating “terror” or a “state of intense or overwhelming fear” should come under the definition of terrorism. There can be terrorism-related acts without violence, for example, when a member of an extremist organisation remotely sabotages an electronic, automated or computerised system in pursuance of the organisation’s goal. But when the same act is committed by, say, a whizz-kid without such a connection, that would be illegal and should be punished, but not under a special law on terrorism. In its determination of the Bill, the Court did not address this submission.

 

PSTA Proposal

Proposed section 3(1) of the PSTA reads:

Any person who, intentionally or knowingly, commits any act which causes a consequence specified in subsection (2), for the purpose of-

(a) provoking a state of terror;

(b) intimidating the public or any section of the public;

(c) compelling the Government of Sri Lanka, or any other Government, or an international organisation, to do or to abstain from doing any act; or

(d) propagating war, or violating territorial integrity or infringing the sovereignty of Sri Lanka or any other sovereign country, commits the offence of terrorism.

The consequences listed in sub-section (2) include: death; hurt; hostage-taking; abduction or kidnapping; serious damage to any place of public use, any public property, any public or private transportation system or any infrastructure facility or environment; robbery, extortion or theft of public or private property; serious risk to the health and safety of the public or a section of the public; serious obstruction or damage to, or interference with, any electronic or automated or computerised system or network or cyber environment of domains assigned to, or websites registered with such domains assigned to Sri Lanka; destruction of, or serious damage to, religious or cultural property; serious obstruction or damage to, or interference with any electronic, analogue, digital or other wire-linked or wireless transmission system, including signal transmission and any other frequency-based transmission system; without lawful authority, importing, exporting, manufacturing, collecting, obtaining, supplying, trafficking, possessing or using firearms, offensive weapons, ammunition, explosives, articles or things used in the manufacture of explosives or combustible or corrosive substances and biological, chemical, electric, electronic or nuclear weapons, other nuclear explosive devices, nuclear material, radioactive substances, or radiation-emitting devices.

Under section 3(5), “any person who commits an act which constitutes an offence under the nine international treaties on terrorism, ratified by Sri Lanka, also commits the offence of terrorism.” No one would contest that.

The New Zealand “carve-out” is found in sub-section (4): “The fact that a person engages in any protest, advocacy or dissent or engages in any strike, lockout or other industrial action, is not by itself a sufficient basis for inferring that such person (a) commits or attempts, abets, conspires, or prepares to commit the act with the intention or knowledge specified in subsection (1); or (b) is intending to cause or knowingly causes an outcome specified in subsection (2).”

While the Arsekularatne Committee has proposed, including the New Zealand “carve out”, it has ignored a crucial qualification in section 5(2) of that country’s Terrorism Suppression Act, that for an act to be considered a terrorist act, it must be carried out for one or more purposes that are or include advancing “an ideological, political, or religious cause”, with the intention of either intimidating a population or coercing or forcing a government or an international organisation to do or abstain from doing any act.

When the Committee was appointed, the Human Rights Commission of Sri Lanka opined that any new offence with respect to “terrorism” should contain a specific and narrow definition of terrorism, such as the following: “Any person who by the use of force or violence unlawfully targets the civilian population or a segment of the civilian population with the intent to spread fear among such population or segment thereof in furtherance of a political, ideological, or religious cause commits the offence of terrorism”.

The writer submits that, rather than bringing in the requirement of “a political, ideological, or religious cause”, it would be prudent to qualify proposed section 3(1) by the requirement that only acts that aim at creating “terror” or a “state of intense or overwhelming fear” or are carried out to achieve a goal of an individual or organisation that employs “terror” or a “state of intense or overwhelming fear” to attain its objectives should come under the definition of terrorism. Such a threshold is recognised internationally; no “carve out” is then needed, and the concerns of the Human Rights Commission would also be addressed.

 

by Dr. Jayampathy Wickramaratne
President’s Counsel

Continue Reading

Features

ROCK meets REGGAE 2026

Published

on

JAYASRI: From Vienna, Austria

We generally have in our midst the famous JAYASRI twins, Rohitha and Rohan, who are based in Austria but make it a point to entertain their fans in Sri Lanka on a regular basis.

Well, rock and reggae fans get ready for a major happening on 28th February (Oops, a special day where I’m concerned!) as the much-awaited ROCK meets REGGAE event booms into action at the Nelum Pokuna outdoor theatre.

It was seven years ago, in 2019, that the last ROCK meets REGGAE concert was held in Colombo, and then the Covid scene cropped up.

Chitral Somapala with BLACK MAJESTY

This year’s event will feature our rock star Chitral Somapala with the Australian Rock+Metal band BLACK MAJESTY, and the reggae twins Rohitha and Rohan Jayalath with the original JAYASRI – the full band, with seven members from Vienna, Austria.

According to Rohitha, the JAYASRI outfit is enthusiastically looking forward to entertaining music lovers here with their brand of music.

Their playlist for 28th February will consist of the songs they do at festivals in Europe, as well as originals, and also English and Sinhala hits, and selected covers.

Says Rohitha: “We have put up a great team, here in Sri Lanka, to give this event an international setting and maintain high standards, and this will be a great experience for our Sri Lankan music lovers … not only for Rock and Reggae fans. Yes, there will be some opening acts, and many surprises, as well.”

Rohitha, Chitral and Rohan: Big scene at ROCK meets REGGAE

Rohitha and Rohan also conveyed their love and festive blessings to everyone in Sri Lanka, stating “This Christmas was different as our country faced a catastrophic situation and, indeed, it’s a great time to help and share the real love of Jesus Christ by helping the poor, the needy and the homeless people. Let’s RISE UP as a great nation in 2026.”

Continue Reading

Trending