Opinion
‘Vaccines Do Not Save Lives: Vaccinations Save Lives’
Dr B. J. C. Perera
MBBS (Cey), DCH(Cey), DCH(Eng), MD(Paed), MRCP(UK), FRCP(Edin), FRCP(Lon), FRCPCH(UK), FSLCPaed, FCCP, Hony FRCPCH(UK), Hony. FCGP(SL)
Specialist Consultant Paediatrician
Please allow me to start with a bombshell. Long years ago, as a very young Medical Student, I absolutely hated paediatrics. Of course, it was not a matter of hating children; I loved and adored them, including a whole lot of my nephews and nieces. What I hated was just the subject of Paediatrics which dealt with caring for sick children. I was most definitely convinced that it was the very last thing that I would want to choose as a professional career.
The real reason for my intense dislike of Paediatrics was the heart-breaking spectacle of the number of children who died and were sometimes even maimed for life by certain diseases. As a young Medical Student of around 20 years of age, this writer was horrified by the number of bodies of innocent children being wheeled out of the Wards of The Lady Ridgeway Hospital for Children, an institution where he was schooled in the many aspects of Paediatric Healthcare. That was an initiation into Paediatrics by a veritable baptism by fire.
What killed and maimed those children was a plethora of infectious diseases. You name it, we had it in Ceylon, as our Motherland was then known. The killers were Tuberculosis, Tetanus, Diphtheria, Polio, Whooping Cough, Measles, Mumps, Rubella, Bacterial Meningitis, Japanese Encephalitis, Viral Hepatitis, Bacterial pneumonia etc; just to mention a few. In the latter part of the 1960s, the under-5-year mortality rate was around 80 per 1,000 live births. In technical terminology, it implies that out of 1,000 babies born during that period, 80 did not live up to the age of 5 years. It was one of the highest rates in the world.
Then when I qualified as a doctor in 1970, through many a force of circumstances, destiny compelled me to work as an Intern Medical Officer in Paediatrics for six months and then as a Medical Officer in the Out Patient Department (OPD) of the Lady Ridgeway Hospital for Children for one year. It meant that I was exposed to pure paediatrics for one and a half years, totally on the trot.
That is where I realised a home truth. True enough some children died, but Paediatric Healthcare also saved a whole lot of even very sick children and gave back to society humans who would live for another 60 to 70 years as citizens of our Motherland. It quite forcefully induced me to take an about turn, a paradigm swing of 180 degrees, into a professional career in Paediatrics. The rest of course, as many would say, is history.
Fast forward 50 years or so to the present time. Our under-5-year mortality rate in 2022 was under 7 per 1,000 live births; yes, down to single digits. Now then, please mark my words, a reduction of this rate from 80 in the 1960s to under 7 in 2022 is just what dreams are made of. It is almost too good to be true but in stark reality, it is God’s own truth. We have achieved the impossible, and on that score, we have even raced ahead of many countries in our region of the world.
Remember the list of killers that I gave earlier on in this article? More than NINETY FIVE PER CENT of them are not there anymore in Sri Lanka. Among many other things, that by itself is the main reason that we have managed to achieve the impossible. Many of those young child killers have been totally banished from our shores. As just a shining example, the last time we saw a confirmed case of polio was in November 1993., yes, three decades ago. As a Medical Student and as a young junior doctor, this author has seen three epidemics of polio which killed and maimed for life, scores of children including infants.
How we have dealt lethal blows to these killers is through the use of vaccines that protect our children from these infective assassins. The Sri Lankan Ministry of Health Expanded Programme of Immunisation (EPI) has been held up as a beacon of excellence even in the developed world. Our country boasts of over 95 per cent, perhaps around even 99 per cent, coverage of all children against these killer diseases through the EPI. We have seen parents queuing up for hours to get their children vaccinated. They have made it one of their sacred duties to attend to all vaccinations of their children. This author has seen the parents braving even the vile orders of an insurgent group in 1988/1989 civil disturbances in Kurunegala to bring their children in droves from far and wide to our Immunisation Clinic, to get them vaccinated at the right times. The only functioning vaccination clinic for the entire region was our one in General Hospital, Kurunegala. There were hundreds of children being brought. We did not disappoint a single one of those parents. We vaccinated the entire lot. I felt that we owe it to them for their resilience.
It has been said that vaccines save lives. However, the title of this article “Vaccines do not save lives: Vaccinations save lives” is taken from a scholarly article written by an erudite academic Walter Orenstein, published in the prestigious journal Human Vaccines and Immunotherapeutics, in 2019. It implies that it does not matter whether we have loads of vaccines against even as many bugs as possible but if the vaccines are not administered then the vaccines cannot save lives.
Now, I come to the real crux of this article of mine. Just a few days ago, there was a media frenzy about a four-month-old baby who died a day after her vaccination. As has been rightly pointed out by the authorities, there is no scientific evidence, sans any doubt whatsoever, to link the death directly to the vaccine.
However, as has been ever so succinctly pointed out by the editorial in The Island Newspaper on 19th July 2023, “This, we believe, is a timely warning, which must not go unheeded, for there occur certain situations where logical reasoning and sound judgement desert most Sri Lankans, who have also earned notoriety for mass hysteria, which leads to irrational behaviour. In spite of its admirably high literacy rate, Sri Lanka is no stranger to groupthink, frequent breakdowns of critical thinking and the people’s strong reliance on social dynamics, shared beliefs, etc., disseminated via social media.”
The real worry for us who care for the health needs of children is the potential aftermath of all this adverse publicity, on our National Immunisation Programme. This is especially so, in the light of many allegations being made on the deaths caused by the administration of reportedly sub-standard drugs that have been imported into the country by our Ministry of Health. Woe be unto it, there is a real possibility of a blanket avoidance of all vaccines that are given to children.
This is a fervent plea to all parents. Please do not jeopardise the future of the children of our land by responding to unfounded allegations and by being hesitant to vaccinate children. I do not think that very many have seen the unbelievable misery that was caused by these infectious diseases that this author has had the misfortune to witness. I would give anything in the world to prevent our getting back into that abyss of despair which was the norm five to six decades ago.
All of us owe it to our nation to ensure that the highest coverage of all EPI vaccines is maintained at present as well as into the future too. Such an investment in health is the least that we owe ourselves, as a nation.
Opinion
‘Outpost of Empire’
Review
by Colleen Figg, Editor
and Reviewer – Amazon, New Voices Publishing
“Fernando echoes Macbeth with the line, “There is judgment here.” It captures the question running through the novel: can anyone participate in corruption and remain untouched by it? Beneath this satire is a dark story about power and the danger of believing, that someone else will always pay the price.”
Shavindra Fernando’s Outpost of Empire is a political novel set in the fictional country of Lackadasia. At its heart is a strong idea: an exploration of world politics, terrorism and the ways in which powerful countries manipulate smaller ones. Fernando is clearly writing about political issues that matter deeply to him.
The names immediately establish the book’s satirical character. Lackadasia, Burgherbugaria and the various Klowns suggest a world in which the people and places are exaggerated, but the issues beneath the exaggeration are recognisable. The playful language allows Fernando to approach terrorism, religious conflict and political corruption from an unusual angle.
Henry Stockwell is a central character: an ambassador who arrives in Lackadasia presenting himself as a friend of the country. He believes he understands how power works and treats the country, its politicians and its people as pawns on his personal chessboard. In his arrogance, he never doubts that he controls events rather than being controlled by them. This confidence makes him a compelling figure and in him, we explore the workings of political influence and the potential traps contained therein.
As the story develops, Fernando reveals a political world where causes are adopted when they are useful, people are exploited and discarded, and the truth becomes whatever those in power need it to be. Ordinary people suffer the consequences of decisions made far beyond their reach or knowledge, while those making those decisions continue to justify their actions. Even the people who help keep this world running may not be as important or as safe as they imagine.
Stockwell brings this idea into focus. He recognises corruption in others and willingly takes part in it himself, yet he cannot see that he might also suffer its consequences. Ultimately, he thinks his position will keep him safe. He is intelligent enough to understand the game, but not insightful enough to grasp the limits of his place within it. This blindness gives the novel a strong sense of irony.
The satirical approach gives Fernando room to criticise political hypocrisy without turning the novel into a direct political argument. By using fictional countries and exaggerated names, he creates some distance from specific governments and events while still making the larger targets of the book clear. The humour does not take away from the seriousness of the subject; instead, it makes the cruelty and self-interest beneath the political performance stand out more sharply.
Near the end, Fernando echoes Macbeth with the line, “There is judgment here.” It captures the question running through the novel: can anyone participate in corruption and remain untouched by it? Beneath this satire is a dark story about power and the danger of believing that someone else will always pay the price.
I came away feeling that Outpost of Empire is a valuable and thought-provoking book, particularly in today’s political and social climate. It has a distinctive voice, and the questions it raises about power, responsibility and foreign interference remain relevant far beyond the fictional borders of Lackadasia.
About the Author
Shavindra Fernando has worked as a reporter. He read English & Classics at the University of Peradeniya in Sri Lanka, and took International Relations & Ethnic Politics as a Reuter Fellow at the University of Oxford in England. The Vague Poetess (1999)was his first novel.
Opinion
Speaker’s dilemma
The Opposition, in its wisdom (or perhaps stupidity), has submitted yet another No-Confidence Motion (NCM) against the Speaker of Parliament. Perhaps it hopes to score some brownie points in the eyes of the public, which is hardly indifferent to such developments. Yet, knowing full well that the motion is unlikely to succeed, the exercise may well prove futile — akin to banging one’s head against a solid rock.
Nevertheless, the nearly fifty allegations levelled against the Speaker, whether justified or mere mudslinging, cannot simply be brushed aside. Such allegations may well have a bearing on the individual concerned, particularly where it matters most — his conscience — and few would dispute that possibility.
From a protocol standpoint, the Speaker occupies one of the highest positions in the country, ranking third in the hierarchy of state. He consequently belongs to the uppermost echelons of public life, with acquaintances and associates extending across a wide spectrum of society, including diplomats and other distinguished personalities. Such a position carries with it not merely prestige and privilege, but also an onerous responsibility to uphold the dignity and integrity of the office.
As the guardian of Parliament, the Speaker is expected to maintain standards of conduct, impartiality and discipline that are beyond reproach.
Whether the allegations are justifiable or not may be of little consequence to members of the ruling party, who will undoubtedly defend their colleague to the hilt. Nevertheless, the stigma arising from such allegations may prove difficult to erase, particularly in the eyes of his family, close associates and, ultimately, the voters who placed their trust in him. Of course, it is common knowledge that politics can be a dirty game and that, as Lord Acton famously observed, “power tends to corrupt, and absolute power corrupts absolutely.”
Yet, nothing could be more devastating than a person losing his own soul in the process. On the one hand, stepping down could be construed as an admission of responsibility for the allegations levelled against him. On the other, allowing the No-Confidence Motion (NCM) to proceed could expose him to further public scrutiny and potentially inflict lasting damage on his character, dignity and reputation. Thus, he finds himself caught between two unenviable choices, each carrying consequences that may extend far beyond the immediate political fallout.
The Speaker is therefore confronted with a classic Hobson’s choice, with neither option likely to be without consequences. After all, in politics, there are no permanent friends or enemies—only permanent interests.
WILLIAM
Opinion
How long can Sri Lanka remain silent on its demographic crisis?
I write this with a sense of profound disappointment, rather than as a critic of the government or any individual public official. For several months, I have been drawing public attention to what I consider one of the most serious long-term challenges facing Sri Lanka—the country’s rapidly changing demographic structure, declining fertility, population ageing and the consequent contraction of the working-age population.
I have written several articles on this subject, believing that informed public discussion could encourage policymakers, academics and relevant institutions to examine the issue before its consequences become irreversible. I went a further step by addressing a detailed letter to the President on 28 August 2026, seeking consideration of a National Demographic Action Plan.
That letter was not merely an expression of concern. It contained practical proposals: long-term demographic projections, assessment of the consequences for labour supply and productivity, examination of declining fertility and delayed family formation, reassessment of education and employment policies, consideration of migration, and the establishment of continuous demographic monitoring.
I deliberately addressed the matter to the highest level because demographic change is not the responsibility of one ministry. It cuts across Finance and Planning, Education, Labour, Health, Higher Education, migration, social protection and national human-resource planning.
Yet, after sending that registered letter, I have not even received an acknowledgement.
This is what troubles me most. I fully appreciate that government has numerous urgent problems to address. Economic recovery, disaster management, employment, education and many other immediate concerns understandably demand attention. But demographic change is different. It operates slowly, almost silently, while steadily narrowing the choices available to future governments.
By the time the shortage of workers, accelerated ageing, increased dependency and the economic consequences of very low fertility become impossible to ignore, remedial action may be enormously more difficult and expensive. What is equally disappointing is the apparent silence of the institutions that should be at the centre of this discussion.
The latest Census has provided the country with an invaluable body of demographic evidence. My own published work has attempted to connect those findings with national development, productivity, education, employment and human-resource planning. On the top of these endeavours, I have seen voluminous articles written by Professor Manori Weerathunga, of the Population Department of the Colombo University, President Population Association of Sri Lanka, and Director Centre for Ageing Studies of University of Colombo. Yet I have seen little evidence of a visible national policy response from the relevant planning and statistical authorities.
Given the multiplicity of the roles and the credentials she possesses, I would strongly urge her to take the bull by the horns and formulate a draft national demographic policy with the expertise of the demographic scientists. This task cannot be delegated to the SLAS or Planning panjandrums. The government should seriously think why the thinktanks are abdicating their mandatory responsibilities and playing a passive role when the country is confronted with burning issues. Are there any sinister plans by disgruntled senior officers to derail the development plans is the question that begs an answer? Alternatively, the government should seriously enlist the support of the IMF or the World Bank, before the demographic bomb explodes!
Are we treating the Census merely as a statistical exercise, rather than as an early-warning the system for national planning? This question deserves a public answer.
I went even further by writing on “Educational Delays, Biological Clock and Sri Lanka’s Fertility Crisis.” My purpose was not to blame the education authorities. I sought to draw attention to the possibility that prolonged delays in university education, examinations, admissions and graduation may interact with delayed family formation and the biological realities of childbearing. I had hoped that this would stimulate examination by the Education sector and other relevant stakeholders.
Unfortunately, I have yet to see any meaningful response. My concern is therefore not whether my own articles have been acknowledged. That is completely irrelevant. The issue is whether the substantive national questions raised in those articles are being examined by anyone in authority.
A citizen who spends considerable time studying a national problem, writing about it publicly and then submitting a constructive proposal to Government should not necessarily expect agreement. But surely an acknowledgement—or better still, a response indicating that the matter is being examined—is not too much to expect.
There is also another dimension which I recently highlighted in discussing Sri Lanka’s transition from an “Age of Longevity” towards an “Age of Experience”. Sri Lanka is simultaneously facing a shrinking younger workforce and an expanding reservoir of older citizens possessing decades of professional and institutional experience.
The demographic challenge, therefore, should not be viewed only through the lenses of pensions, healthcare and elderly care. The country must also ask how the accumulated knowledge, expertise and institutional memory of its experienced citizens can be mobilised for national development.
This is precisely why I find the present silence so difficult to understand. I have no personal or political agenda. I have spent decades working in human resources, productivity and management specialist, and I have chosen in the later stage of my professional life to devote my writing to contemporary national issues which I believe deserve national attention.
Perhaps my concerns are misplaced. Perhaps the government already has a comprehensive demographic strategy under preparation. The relevant institutions have already initiated studies that are not yet public.
If that is the case, I would be delighted to be proved wrong. But if no such comprehensive process exists, then I respectfully ask: how much longer can Sri Lanka afford to remain silent?
The demographic clock does not stop while governments deliberate.
My appeal is therefore not for recognition of my efforts. It is for recognition of the problem. I hope the relevant authorities will prove that the silence I have encountered is not indifference, but merely the silence before meaningful action.
Sri Lanka cannot afford to discover, ten or twenty years from now, that the warnings were visible, the evidence was available, the proposals were made—and nobody acted.
The time to respond to the demographic crisis is now, while choices still remain.
Over to you, the President, the Prime Minister, the Minister of Finance and National Planning, Vice Chancellor of Colombo, Director General of Census and Statistics.
Athula Ranasinghe
Productivity Specialist and Management Consultant
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