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Safe blood: keeping the nation’s heart beating

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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.



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Amusement ride brought to life on big screen Jungle Cruise

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By Tharishi Hewavithanagamage

Directed by Jaume Collet-Serra from screenplay written by Glenn Ficarra, John Requa, and Michael Green, ‘Jungle Cruise’ is loosely based on Walt Disney’s theme park attraction of the same name. After success of the ‘Pirates of the Caribbean’ franchise, it comes as no surprise that Disney wanted to create another ride-based movie, this time featuring one of its first rides. The riverboat amusement ride was the only attraction to exist in the Adventureland themed section on Disneyland’s opening day in 1955. The live-action riverboat adventure stars Dwayne Johnson, Emily Blunt, Jack Whitehall, Jesse Plemons, and Paul Giamatti.

The film is set in 1916, and follows Dr. Lily Houghton (Emily Blunt) in a fervent search for a mystical tree whose petals known as Tears of the Moon, are said to have healing properties. Her strong belief that she could bring about medical breakthroughs and save numerous lives, prompts her to embark on the adventure of a lifetime, deep into the Amazon rainforest.

With a map in hand, Lily along with her brother McGregor (Jack Whitehall) enlist the help of skipper and swindler Frank Wolff (Dwayne Johnson) to help navigate the vast waters of the rainforest. Coveting the mystical petals for their own goals are Prince Joachim (Jesse Plemons) and a team of 400-year old cursed conquistadors led by Aguirre (Edgar Ramírez). In a race against time, the bad guys and the jungle, Lily must place her trust in Frank if she is to ever reach the tree, but it’s easier said than done.

The latest Disney movie is definitely fun to watch. It’s a classic, and far too predictable, adventure, where a small group of protagonists venture into the unknown. The movie obviously borrows heavily from big screen hits like ‘Indiana Jones’, ‘The Mummy’ franchise, ‘Anacondas: Hunt for the Blood Orchid’ and even the ‘Pirates of the Caribbean’ franchise. This film is a patch-work of tropes.

The two-hour movie also packs a lot, which is precisely why the plot gets murkier as the audiences and protagonists cruise through. The big picture is brimming with smaller side stories which include characters that aren’t essential to the plot and in the end remain forgettable, like Paul Giamatti’s crusty harbormaster Nilo, who unfortunately falls into the margins of the movie. And scenes such as Prince Joachim talking to bees, makes the film utterly nonsensical. However, the strongest points of the movie are seen in the strengthening relationships and character development, which receive just about enough screen time to hold the story together. And while there is no overarching theme for this tale, it handles themes like women empowerment and exoticism.

‘Jungle Cruise’ offers audiences an imaginative look at deeper areas of the Amazon. The titular jungle, Frank’s beloved boat and adorable pet Jaguar Proxima are CGI highlights, whereas most other effects, notably the ragtag supernatural conquistadors, who look like they hung out with Davy Jones for too long, fall flat.

The film also delivers meticulously choreographed action sequences that showcase each individual character’s physical prowess. Everyone gets a chance to throw a punch with good form, not just The Rock. The film also draws in ideas and references from the actual ride. The humor, a courtesy of Frank’s pun-laden jokes is an actual reference to the theme-park attraction. The ride is known for its corny jokes, all delivered by skippers who narrate the adventure to visitors. Everything comes together to make the film a fun-filled experience. It falls short of a strong plot but is driven forward by the performance of the two leads.

An unlikely pair, both Dwayne Johnson and Emily Blunt showcase their stellar acting skills. Blunt brings a strong charisma as an intrepid scholar and adventurer, breaking barriers in ‘a man’s world’ through her role as Dr. Lily Houghton. Blunt expertly navigates the character’s inner nerd and heroine in doing amazing stunts and even takes on Johnson’s muscular self. Johnson pours his heart and soul into his character Frank. At first glance Frank comes across as a rogue character with no depth and mainly supplies humor to the tale, but as the story unfolds Johnson taps into deeper aspects of the character. The Blunt-Johnson pairing oddly makes their banter fun, but the sense of awkwardness can be overwhelmingly uncomfortable in some scenes.

Jack Whitehall’s role as Lily’s not-so-adventurous brother McGregor, is Disney’s latest attempt to introduce a gay character, but fails to leave a deep impression. It also seems like it’s never a good adventure without the nefarious Germans trying to kill everyone, but Jesse Plemons brings more comedic relief than menace to his role as Prince Joachim. The conquistador villain Aguirre played by Edgar Ramírez, remains sidelined and underused.

At the end of the day, ‘Jungle Cruise’ is a fun summer adventure that everyone can enjoy. Although the film doesn’t meet the standards set by their cooler counterpart ‘Pirates of the Caribbean’, ‘Jungle Cruise’ brings its own unique quirkiness that saves it from drowning completely.

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Astrologers suggested he be ordained

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Ven. Hikkaduwe Sri Sumangala Thera

Ven. Hikkaduwe Sri Sumangala Thera was an eminent scholar monk in the nineteenth century. He was the founder of the Vidyodaya Pirivena.

He was born in the village of Hettigoda in Hikkaduwa on 20-01-1827.

As was the Sinhala custom, his horoscope was cast by an eminent astrologer who predicted that the child was under the evil influence of the planets and that he will have a life of misfortune, with a suggestion that he be ordained. The parents then consulted several other eminent astrologers who too, made similar predictions.

(As later events proved, the predictions happened to be from those who had not properly mastered the science of astrology, or due to the inaccurate time of birth recorded).

As per the predictions, his parents then decided to ordain him. With that in view, he was given only a temple-oriented education, with no formal schooling.

When he was about 14 years old, preparations were made to ordain him at an auspicious time. But, as the auspicious time was fast approaching, he was found missing.

After he was found, he told his father not to ordain him and bring the Buddha Sasana into disrepute, as his astrological predictions were adverse.

However, he was ordained later as Hikkaduwe Sri Sumangala Thera, of his own volition.

Nobody ever thought, at the time, that he would one day be a scholar of great repute.

The following year, he sojourned at the Mapalagama Temple, in the Galle District during the Vas Season (rainy season) with his preceptor Mobotuwana Revatha Thera and several other monks.

This young Sumangala Samanera (novice) endeared himself to the devotees, with his disciplined demeanour and with his sermons, based on the Jathaka stories (stories of the former lives of the Buddha). One such devotee – John Cornelis Abeywardena, an English scholar (an ancestor of the present day Galle politician Vajira Abeywardena) volunteered to teach English to this young inspiring preacher.

It was a time when some bhikkhus were engaged in native medical treatment. And Sumangala Thera, then still a novice, was to answer this question as to whether the bhikkhus could engage in such a practice.

He construed that it was harmless to treat the hapless, destitute patients, friends or relations, provided it was not for any material gain and that it was not a serious violation of the Vinaya rules.

While travelling by train, one day, this Samanera met a group of pilgrims from Siam (now Thailand), coming down south, after a pilgrimage to Anuradhapura.

The pilgrims knew only their Siam language and the Pali language, resulting in they being cut off from the local populace.

One of them, half-heartedly spoke to this Samanera in the Pali lanugage. It was then that he realised that he was spaking to a Pali scholar. This resulted in exchange of views between the two of them.

Later he continued with his higher learning under several reputed venerable preceptors and also authored several valuable books.

During the Vas Season, in that year 1858, he sojourned at the Bogahawatta Temple, in Galle, and commenced publishing a newspaper for Buddhists named “Lanka Loka”.

He was a close friend of Col. Henry Steele Olcott, who arrived in Ceylon in the year 1880.

During those colonial days, the first class compartments in trains were more or less reserved for the white masters. Quite often, these compartments were seen going empty, except for one or two of them, while the second and third classes were crammed. Though some Sri Lankans had the means to travel first class, they didn’t have the courage to do so. There were others who did not care a damn for the white skins and unhestatingly travelled first class.

One day Sumangala Nayaka Thera was travelling to Kandy and entered a first class compartment, occupied by two high- spirited Englishmen.

With characteristic arrogance they subjected the Nayaka Thera to a barrage of vulger comments and rude insults.

“This old fellow has, by mistake, got into this compartment” one of them said.

“No, this is not a mistake. He is purposely, fraudulently, travelling first class with a third class ticket.”

“Shall we hand him over to the Railway Authorities?” asked the other.

The Thera gazed at them silently with a benign smile on his face.

At Polgahawela, the train was shunted into a siding, for the train carrying Sir Arthur Gordon, Governor of Ceylon, who was returning to Colombo, after a holiday, was due at any moment.

The train arrived and the Governor’s special compartment drew up right alongside the one occupied by the venerable monk. Glancing out of the window, the Governor saw Sumangala Thera and a smile of pure pleasure shone on the Governor’s face. For he and the learned monk were close friends. Scholars both, they visited each other quite often and spent many hours in erudite discussion.

“My dear High Priest! Fancy meeting you like this!” said Sir Gordon, opening the door of his compartment and walking into the one occupied by the Thera. They were engaged in a lively conversation, in English, and the train was 11 minutes late.

With the Governor’s departure, the two louts now crestfallen and repentant at their boorish behaviour, profusely apologised to the Thera.

With a smile on his face, the Thera, accepted their apologies with a brief exhortation. Thereafter they were engaged in a lovely conservation till the journey’s end.

Once there was a clash between some Buddhists who went in a procession and some Catholics at Maggona, resulting in the death of a Catholic.

As a sequel, a Buddhist named Seeman Fernando was sentenced to death. On representations made by the Nayaka Thera to the Governor, Seeman Fernando was released.

One day, a group of pilgrims that also included some members of the Cambodian Royal Family, went to Kandy with the Nayaka Thera for an exposition of the Tooth Relic.

It was a non-event as no prior intimation had been made to the Dalada Maligawa authorities in time.

The next morning, the Thera was walking leisurely along the Nuwara Wewa, when Governor Gordon, who was going in a horse drawn chariot saw the Nayaka Thera and after greeting him indulged in a lively conversation. When he told him about the non-event of the exposition of the tooth relic the previous day, the Governor took immediate steps for a special exposition, directing the Government Agent to make the necessary arrangements.

In the year 1873, he founded the Vidyodaya Pirivena – a seat of Buddhist higher learning. It was his greatest service to Buddhism.

When the permit to have a perahera was first introduced at the turn of this centry, the Nayaka Thera, as Head of Vidyodaya, sought permission to hold the annual perahera of the Pirivena. Permission was at first refused, but mysteriously granted a few days later.

Despite the refusal, the Nayaka Thera had gone ahead with the arrangements to hold the perahera, and when a senior police officer on horseback brought the permit personally to the High Priest, he contemptuously rejected it and sent the officer away.

This incident was reported to the I.G.P. who, in turn, reported it to the Governor of the colony of Ceylon.

The Governor, a close friend and admirer of Ven. Hikkaduwe Sri Sumangala Thera, sent his Maha Mudliyar, Sir Solomon Dias Bandaranaike, as his personal emissary, to respectfully request the learned scholar monk to come to Queen’s House to discuss the matter, as His Excellency feared that the act of the Nayaka Thera would be an undersirable precedent.

“I refused to accept the police permit for this reason,” the Nayaka Thera, told the Governor. “When I first asked for permission to hold the perahera, permission was refused. A few days later, permission was granted. This indicates that permits are given, not according to any law, but at the whims and fancies of police personnel, which is all wrong. That is why I refused the permit that was given on second thoughts. The freedom to practise the Buddhist religion and its rites have been guaranteed in the Kandyan Convention, and I shall be grateful if you and your minions will kindly remember that.”

The chastened Governor was profuse in his apologies to the outspoken scholar monk.

The Nayaka Thera was taken ill on the 21st April 1911 and passed away on the 29th (about 110 years ago).

Perhaps he would never have envisaged, that his much cherished Vidyodaya Pirivena would be no more on a tidal wave, in the years to come.

 

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Talented and versatile

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Shareefa Thahir is not only popular, as a radio personality, but she also has a big following on social media. Each time she uploads a new photo, or an event where she is in the spotlight, the ‘likes’ and ‘comments’ keep soaring. Shareefa does the scene at the Sri Lanka Broadcasting Corporation (Radio Sri Lanka – 97.4 and 97.6) as an English announcer, and news reader, and she is also a freelance TV presenter, and news anchor, on Rupavahini.

Had a chat with this talented, and versatile, young lady, and this is how it all went…

1. How would you describe yourself?

In just a few words, I would say a simple, easy-going person. And, my friends would certainly endorse that.

2. If you could change one thing about yourself, what would it be?

I love myself, and I accept whatever laws I may have. So, obviously, there’s nothing that I would want to change in myself.

3. If you could change one thing about your family, what would it be?

Absolutely nothing because they are amazing…just the way they are (and that hit by Bruno Mars ‘Just The way You Are’ came to mind when you asked me this question!)

4. School?

Melbourne International, and Gateway College. I was the captain of my house and participated in athletics – track events, etc.

5. Happiest moment?

Oh, I will never forget the day I won the Raigam Award for my work on television.

6. What is your idea of perfect happiness?

Accept yourself and enjoy the tiny things in life.

7. Are you religious?

I believe in God, but I don’t think you should go about announcing it. I stay true to my heart.

8. Are you superstitious?

A little …..stitious! Hahaha! Just kidding – not at all!

9. Your ideal guy?

Someone who accepts me for who I am, and who is supportive in my journey…like I would be in his.

10. Which living person do you most admire?

I would say Jennifer Lopez, for the simple reason that she is still very energetic, and active, for her age (52), keeps herself in good shape, and still has a huge fan base.

11. Which is your most treasured possession?

Yes, I would say my talent.

12. If you were marooned on a desert island, who would you like as your companion?

My best friend as I would certainly need someone to chat with! Hahaha!

13. Your most embarrassing moment?

Saying ‘good morning’ to viewers on an evening live show!

14. Done anything daring?

Not yet. I wonder when I would get that opportunity to do something…real daring, like, let’s say, climbing Mount Everest!

15. Your ideal vacation?

A life without social media, in Greece, enjoying the beauty of nature.

16. What kind of music are you into?

Oh, I can go on and on about this; it depends on my mood. I love alternate rock, mostly, but I enjoy reggae, and pop, too.

17. Favourite radio station?

SLBC’s Radio Sri Lanka.

18. Favourite TV station?

Channel Eye (for obvious reasons).

19 What would you like to be born as in your next life?

Myself…again.

20. Any major plans for the future?

I’m hoping to start a new venture. However, I’m keeping my fingers crossed, as right now the scene is pretty dicey, with this virus being so unpredictable.

 

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