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Yes indeed, Hippocrates is turning in his grave

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My mind time travelled thirty-seven years to the auditorium, Rahula College, Matara. Being one of the two surgeons at the Base Hospital I was a man in demand whom the service receivers respected. My good lady and I were seated in the VIP row of seats and when the curtain raised there was a man hanging from a lamp post in an ill lit left hand corner of the stage. The narrator was late the H.A.Perera and in his inimitable style and signature voice loudly exclaimed “this man hanging here was the last honest man in the country”. The stage play was Maghatha. This was a satirical play depicting the hight of corruption and lawlessness prevailing at the time.

Sri Lanka even at this moment of time is not any better. There will come a time when honesty and truthfulness would make one disqualified to continue to live here. The country is full of dishonest people. Finding an honest man might well prove an exercise that would put Kisa Gothamie in the shade.

It was Monday the 7th November 2022, a public holiday and I had to visit the NHSL,Colombo to see a man who is a distant relative of ours but more importantly a man who did some excellent salvage job for me to make a brand new bathroom screwed up by the previous workmen, up to scratch again. As a result, in a way, I am indebted to him. Having recently had some Deja vu of the thel polim yugaya, I ventured out to bus and walk the trip which I enjoyed very much as the buses were almost empty.

I got to the hospital all right but finding the ward I needed to visit would have been an uphill task if not for an ex-trainee of mine who is at present a top orthopaedic surgeon at the NHSL, whom I met at the Consultants’ lounge. He said “Sir things are very different compared with the time you were a Consultant here. Even after introducing yourself as an ex senior surgeon the response, you receive might embarrass, frustrate, or even anger you. So let me call the ward” and so he did.

It was a medical ward shared between two consultant physicians. There was an air of busyness about the place because they were probably on acute take. Ward had been partitioned into what they called ‘cubicles’ but they were more like solid rectangles or cuboids. Patients of both consultants seemed haphasardly distributed in each ‘cubicle’. Normally in such situations the responsible Physicians name is displayed on the wall at the head end of the bed. No such name boards were visible in this ward. There were three intern house officers on the ward. They knew which cubicle they were responsible for but would definitely have not known the details of patient distribution in the ward. Apparently, the consultants did independent ward rounds but from what I saw those must be reminiscent of the doctor in the house or doctor on the go series. This arrangement is ideal for the two consultants to take every other day off unofficially. I don’t know whether this happens, but I would be very surprised if it didn’t.

My patient’s ordeal exemplifies the degree of confusion that was prevailing amongst the Medical staff of this ward. He is a 51 year old previously healthy teetotaller building supervisor who was suddenly struck down with an acute coronary ailment six weeks ago. Though there has been some delay he eventually had a stent inserted into one of the main arteries of his heart. After a few days in the cardiology unit, he was discharged with a number of tablets and capsules to swallow on a daily basis. All was good till 04 November, when he developed pain under the rib cage radiating to the back of the chest and up between shoulder blades. For all intent and purposes, it was a cardiac (heart) pain and he should have been admitted to the cardiology ward. Not to be. He was bundled into this medical ward. An ECG done on admission had shown some new changes signifying reduced blood supply to a part of the heart with no biochemical evidence of permanent damage to that part of the heart. The biochemical marker of heart muscle damage is Troponin. Hence this condition is called Troponin negative Acute Coronary Syndrome. The medical team in consultation with the cardiology Registrar has started him on anticoagulants (blood thinners). ECG done next mane was normal. Thank goodness for that. Cardiology Registrar never saw the patient physically. Telemedicine at its peak!

Even after my talking to the Consultants personally who promised that a transfer to cardiology would happen, the patient continued to camp in the medical ward for a few more days before being discharged. The scenario made me feel that the Registrars functioned independently of the consultants or communication between senior and junior medical staff was happening only at a very low ebb. Either way it was a dismal state of affairs. I am not sure whether this patient’s management conforms to the accepted norms currently used in the developed world.

My visit was a little over 24 hours after all this had happened. Thanks to my ex-trainee, current Consultant Orthopaedic surgeon, I was greeted well by the doctor at the front desk who passed me on to the doctor my friend and ex-trainee had spoken to over the phone. She and the doctor in charge of the ‘cubicle’ escorted me to my patient. They were two lovely innocent looking girls who seemed trying to find their way around still.

They were thorough with the patient’s condition but didn’t seem to know much logistics around it. They didn’t know if an official referral had been made to the cardiologist who performed the index procedure. They perused the notes but couldn’t find one. They didn’t know which of the two consultants was on call. No consultant has visited the ward on Sunday. I was there till past midday on Monday (07) and didn’t see any consultant doing a round. My patient told me no consultant had gone round the ward on the whole of Monday too. Apparently, the young sweet innocent doctor was not that innocent, after all. She had made a long scribble in the notes without asking the patient a single question and without examining him at all. What a country and what a department of health services!

My response to the two young ladies was this. “Doctors, as budding consultants please remember these are the most vulnerable of human beings because they are acutely unwell. It is our duty to do our best for them. Always try to recognise an urgent situation and treat it to prevent it becoming an emergency. Public holidays are public holidays in which microorganisms are still active causing infection, blood clots still form on ulcerated plaques inside arteries causing acute arterial insufficiency in different parts of the body including the heart, blood pressures and sugars still keep going up and down unconcerned and a whole lot of other known and unknown pathological processes still go on unrelenting. Hence, if you are rostered for the weekend or the public holiday, please make sure your services are physically available. When I was here at the NHSL about twenty years ago there used to be a weekend and public holiday roster made by a man called Mr. Gamage without whom the director felt crippled. There were no computers and printers installed. A simple cyclostyling machine did the job. All wards, all consultants all clinical and other departments received a copy each. So, everybody knew who was on call. Every on-call consultant did a full ward round in the morning. If an emergency cropped up with one of his patients (rarely the case) needing a re-operation he did it himself without handing it over to the casualty team. Exotic investigations and high-tech interventions may well be needed but not the bread and butter of patient care. Awareness, availability ability and empathy constitute holistic care. Please don’t hold them back. Shower your patient with all of the above and you would be a great doctor”. They listened to me so intently in pin-drop silence that they looked as if they were devotees listening to a sermon delivered by Ven. Narada Thero of Vajiraramaya in the distant past.

Unlike in my active working days, in this day and age, even consultants get paid for extra duty they perform. They do get paid for working on holidays as well. Those who get paid for work they haven’t done are as guilty as those who wilfully robbed the country to drag us into economic doldrums. Also, crimes can be perpetrated by commission or by omission. Those who hold back their services to the sick, when rostered, commit a grave crime by omission specially if the juniors who have been entrusted the boss’s job miss an urgent situation which later becomes an emergency to which the poor patient succumbs.

This is in stark contrast to the time I was a trainee and then a consultant and a trainer. The second half of my internship in 1973 was with a tough boss but a great obstetrician Dr. D. E. Gunatilleke, who was to become the Professor of Obstetrics and Gynaecology, University of Ceylon, Colombo, the following year. We had a post MRCOG (part l) Registrar (called SHO those days) who came down to the De Soysa Hospital for Women to take up the job from being MOH Atakalampanna, an area in the Ratnapura Health District. He was a gentleman par excellence too. Being an inexperienced trainee, he was very worried about taking the lead so I almost became his equal instead of his intern. He used to talk to the boss through me. This was one of our emergency admission days and we had already done four Caesarean sections for the night when we received a patient transferred from the Base Hospital, Horana with the baby lying crosswise and the mum in labour. Baby’s hand has prolapsed into mum’s vagina. Baby was still alive but in distress. My Registrar the late Dr. Shanthan Perera said, “Machan boss has just returned home after doing the fourth section. I don’t feel confident to call him. Could you please help me with this? I readily obliged as I had a great rapport with my boss. I picked up the phone and spoke to him. “Sir I am awfully sorry to bother you at this ungodly hour especially knowing you have just returned home from hospital. We got this young lady whose second pregnancy has been complicated by her going into labour with a transverse lie of the foetus, hand prolapse and foetal distress. I have resuscitated her with intravenous fluids and intermittent boluses of 50% dextrose. She is on oxygen and an indwelling catheter is showing a good urine output. I have got blood cross matched and the theatre is ready” “Don’t worry Janapriya, I will be there in 10 minutes” Lo and behold he was there in little over five minutes––he lived at Rosemead Place––did a Caesarean section and extracted a healthy baby. It was 5 am and the fifth Caesarean section was done and dusted! Time for a cat nap before the next day starts.

Those were the days. If I fall seriously ill, I will use my time machine and go back in time to be treated by one of those doctors and gentlemen. They had no flashy cars. They had no private practice or indeed extra duty payment or holiday pay. They had no CT and other scanners to help them with diagnostic work up. What they had in plenty were knowledge, skill, empathy and duty consciousness. They were honest, worked very hard and placed patient welfare at the pinnacle. Even a physically diminutive figure like the boss of mine I was referring to, stood head and shoulders above self-conceited big burley medical men of today proudly plying around in expensive top of the order automobiles.

It was Lord Moynihan, a pioneer surgeon who, seeing patients with advanced bladder cancer suffer with excruciating pain due to the cancer invading pelvic nerves said, “Lord, if you want to take me please do not take me through my bladder” I have modified this as per below,

Lord, if you want to take me please don’t torture me through the corridors of the hospitals of Sri Lanka, be it state run or privately owned but simply knock me down with a train, a bus, a lorry or a truck. I will accept it with grace and the drivers will go scot-free too.

Dr. M. M. Janapriya



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Opinion

The policy of Sinhala Only and downgrading of English

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In 1956 a Sri Lankan politician riding a great surge of populism, made a move that, at a stroke, disabled a functioning civil society operating in the English language medium in Sri Lanka. He had thrown the baby out with the bathwater.

It was done to huge, ecstatic public joy and applause at the time but in truth, this action had serious ramifications for the country, the effects have, no doubt, been endlessly mulled over ever since.

However, there is one effect/ aspect that cannot be easily dismissed – the use of legal English of an exact technical quality used for dispensing Jurisprudence (certainty and rational thought). These court certified decisions engendered confidence in law, investment and business not only here but most importantly, among the international business community.

Well qualified, rational men, Judges, thought rationally and impartially through all the aspects of a case in Law brought before them. They were expert in the use of this specialised English, with all its meanings and technicalities – but now, a type of concise English hardly understandable to the casual layman who may casually look through some court proceedings of yesteryear.

They made clear and precise rulings on matters of Sri Lankan Law. These were guiding principles for administrative practice. This body of case law knowledge has been built up over the years before Independence. This was in fact, something extremely valuable for business and everyday life. It brought confidence and trust – essential for conducting business.

English had been developed into a precise tool for analysing and understanding a problem, a matter, or a transaction. Words can have specific meanings, they were not, merely, the play- thing of those producing “fake news”. English words as used at that time, had meaning – they carried weight and meaning – the weight of the law!

Now many progressive countries around the world are embracing English for good economic and cultural reasons, but in complete contrast little Sri Lanka has gone into reverse!

A minority of the Sinhalese population, (the educated ones!) could immediately see at the time the problems that could arise by this move to down-grade English including its high-quality legal determinations. Unfortunately, seemingly, with the downgrading of English came a downgrading of the quality of inter- personal transactions.

A second failure was the failure to improve the “have nots” of the villagers by education. Knowledge and information can be considered a universal right. Leonard Woolf’s book “A village in the Jungle” makes use of this difference in education to prove a point. It makes infinitely good politics to reduce this education gap by education policies that rectify this important disadvantage normal people of Sri Lanka have.

But the yearning of educators to upgrade the education system as a whole, still remains a distant goal. Advanced English spoken language is encouraged individually but not at a state level. It has become an orphaned child. It is the elites that can read the standard classics such as Treasure Island or Sherlock Holmes and enjoy them.

But, perhaps now, with the country in the doldrums, more people will come to reflect on these failures of foresight and policy implementation. Isn’t the doldrums all the proof you need?

by Priyantha Hettige

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Opinion

GOODBYE, DEAR SIR

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It is with deep gratitude and profound sorrow that we remember Mr. K. L. F. Wijedasa, remarkable athletics coach whose influence reached far beyond the track. He passed away on November 4, exactly six months after his 93rd birthday, having led an exemplary and disciplined life that enabled him to enjoy such a long and meaningful innings. To those he trained, he was not only a masterful coach but a mentor, a friend, a steady father figure, and an enduring source of inspiration. His wisdom, kindness, and unwavering belief in every young athlete shaped countless lives, leaving a legacy that will continue to echo in the hearts of all who were fortunate enough to be guided by him.

I was privileged to be one of the many athletes who trained under his watchful eye from the time Mr. Wijedasa began his close association with Royal College in 1974. He was largely responsible for the golden era of athletics at Royal College from 1973 to 1980. In all but one of those years, Royal swept the board at all the leading Track & Field Championships — from the Senior and Junior Tarbat Shields to the Daily News Trophy Relay Carnival. Not only did the school dominate competitions, but it also produced star-class athletes such as sprinter Royce Koelmeyer; sprint and long & triple jump champions Godfrey Fernando and Ravi Waidyalankara; high jumper and pole vaulter Cletus Dep; Olympic 400m runner Chrisantha Ferdinando; sprinters Roshan Fernando and the Indraratne twins, Asela and Athula; and record-breaking high jumper Dr. Dharshana Wijegunasinghe, to name just a few.

Royal had won the Senior & Junior Tarbats as well as the Relay Carnival in 1973 by a whisker and was looking for a top-class coach to mould an exceptionally talented group of athletes for 1974 and beyond. This was when Mr. Wijedasa entered the scene, beginning a lifelong relationship with the athletes of Royal College from 1974 to 1987. He received excellent support from the then Principal, late Mr. L. D. H. Pieris; Vice Principal, late Mr. E. C. Gunesekera; and Masters-in-Charge Mr. Dharmasena, Mr. M. D. R. Senanayake, and Mr. V. A. B. Samarakone, with whom he maintained a strong and respectful rapport throughout his tenure.

An old boy of several schools — beginning at Kandegoda Sinhala Mixed School in his hometown, moving on to Dharmasoka Vidyalaya, Ambalangoda, Moratu Vidyalaya, and finally Ananda College — he excelled in both sports and studies. He later graduated in Geography, from the University of Peradeniya. During his undergraduate days, he distinguished himself as a sprinter, establishing a new National Record in the 100 metres in 1955. Beyond academics and sports, Mr. Wijedasa also demonstrated remarkable talent in drama.

Though proudly an Anandian, he became equally a Royalist through his deep association with Royal’s athletics from the 1970s. So strong was this bond that he eventually admitted his only son, Duminda, to Royal College. The hallmark of Mr. Wijedasa was his tireless dedication and immense patience as a mentor. Endurance and power training were among his strengths —disciplines that stood many of us in good stead long after we left school.

More than champions on the track, it is the individuals we became in later life that bear true testimony to his loving guidance. Such was his simplicity and warmth that we could visit him and his beloved wife, Ransiri, without appointment. Even long after our school days, we remained in close touch. Those living overseas never failed to visit him whenever they returned to Sri Lanka. These visits were filled with fond reminiscences of our sporting days, discussions on world affairs, and joyful moments of singing old Sinhala songs that he treasured.

It was only fitting, therefore, that on his last birthday on May 4 this year, the Old Royalists’ Athletic Club (ORAC) honoured him with a biography highlighting his immense contribution to athletics at Royal. I was deeply privileged to co-author this book together with Asoka Rodrigo, another old boy of the school.

Royal, however, was not the first school he coached. After joining the tutorial staff of his alma mater following graduation, he naturally coached Ananda College before moving on to Holy Family Convent, Bambalapitiya — where he first met the “love of his life,” Ransiri, a gifted and versatile sportswoman. She was not only a national champion in athletics but also a top netballer and basketball player in the 1960s. After his long and illustrious stint at Royal College, he went on to coach at schools such as Visakha Vidyalaya and Belvoir International.

The school arena was not his only forte. Mr. Wijedasa also produced several top national athletes, including D. K. Podimahattaya, Vijitha Wijesekera, Lionel Karunasena, Ransiri Serasinghe, Kosala Sahabandu, Gregory de Silva, Sunil Gunawardena, Prasad Perera, K. G. Badra, Surangani de Silva, Nandika de Silva, Chrisantha Ferdinando, Tamara Padmini, and Anula Costa. Apart from coaching, he was an efficient administrator as Director of Physical Education at the University of Colombo and held several senior positions in national sporting bodies. He served as President of the Amateur Athletic Association of Sri Lanka in 1994 and was also a founder and later President of the Ceylonese Track & Field Club. He served with distinction as a national selector, starter, judge, and highly qualified timekeeper.

The crowning joy of his life was seeing his legacy continue through his children and grandchildren. His son, Duminda, was a prominent athlete at Royal and later a National Squash player in the 1990s. In his later years, Mr. Wijedasa took great pride in seeing his granddaughter, Tejani, become a reputed throwing champion at Bishop’s College, where she currently serves as Games Captain. Her younger brother, too, is a promising athlete.

He is survived by his beloved wife, Ransiri, with whom he shared 57 years of a happy and devoted marriage, and by their two children, Duminda and Puranya. Duminda, married to Debbie, resides in Brisbane, Australia, with their two daughters, Deandra and Tennille. Puranya, married to Ruvindu, is blessed with three children — Madhuke, Tejani, and Dharishta.

Though he has left this world, the values he instilled, the lives he shaped, and the spirit he ignited on countless tracks and fields will live on forever — etched in the hearts of generations who were privileged to call him Sir (Coach).

NIRAJ DE MEL, Athletics Captain of Royal College 1976

Deputy Chairman, Old Royalists’ Athletics Club (ORAC)

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Opinion

Why Sri Lanka needs a National Budget Performance and Evaluation Office

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President Dissanayake presenting Budget 2026 in Parliament

Sri Lanka is now grappling with the aftermath of the one of the gravest natural disasters in recent memory, as Cyclone Ditwah and the associated weather system continue to bring relentless rain, flash floods, and landslides across the country.

In view of the severe disaster situation, Speaker Jagath Wickramaratne had to amend the schedule for the Committee Stage debates on Budget 2026, which was subsequently passed by Parliament. There have been various interpretations of Budget 2026 by economists, the business community, academics, and civil society. Some analyses draw on economic expertise, others reflect social understanding, while certain groups read the budget through political ideology. But with the country now trying to manage a humanitarian and economic emergency, it is clear that fragmented interpretations will not suffice. This is a moment when Sri Lanka needs a unified, responsible, and collective “national reading” of the budget—one that rises above personal or political positions and focuses on safeguarding citizens, restoring stability, and guiding the nation toward recovery.

Budget 2026 is unique for several reasons. To understand it properly, we must “read” it through the lens of Sri Lanka’s current economic realities as well as the fiscal consolidation pathway outlined under the International Monetary Fund programme. Some argue that this Budget reflects a liberal policy orientation, citing several key allocations that support this view: strong investment in human capital, an infrastructure-led growth strategy, targeted support for private enterprise and MSMEs, and an emphasis on fiscal discipline and transparency.

Anyway, it can be argued that it is still too early to categorise the 2026 budget as a fully liberal budget approach, especially when considering the structural realities that continue to shape Sri Lanka’s economy. Still some sectors in Sri Lanka restricted private-sector space, with state dominance. And also, we can witness a weak performance-based management system with no strong KPI-linked monitoring or institutional performance cells. Moreover, the country still maintains a broad subsidy orientation, where extensive welfare transfers may constrain productivity unless they shift toward targeted and time-bound mechanisms. Even though we can see improved tax administration in the recent past, there is a need to have proper tax rationalisation, requiring significant simplification to become broad-based and globally competitive. These factors collectively indicate that, despite certain reform signals, it may be premature to label Budget 2026 as fully liberal in nature.

Overall, Sri Lanka needs to have proper monitoring mechanisms for the budget. Even if it is a liberal type, development, or any type of budget, we need to see how we can have a budget monitoring system.

Establishing a National Budget Performance and Evaluation Office

Whatever the budgets presented during the last seven decades, the implementation of budget proposals can always be mostly considered as around 30-50 %. Sri Lanka needs to have proper budget monitoring mechanisms. This is not only important for the budget but also for all other activities in Sri Lanka. Most of the countries in the world have this, and we can learn many best practices from them.

Establishing a National Budget Performance and Evaluation Office is essential for strengthening Sri Lanka’s fiscal governance and ensuring that public spending delivers measurable value. Such an office would provide an independent, data-driven mechanism to track budget implementation, monitor programme outcomes, and evaluate whether ministries achieve their intended results. Drawing from global best practices—including India’s PFMS-enabled monitoring and OECD programme-based budgeting frameworks—the office would develop clear KPIs, performance scorecards, and annual evaluation reports linked to national priorities. By integrating financial data, output metrics, and policy outcomes, this institution would enable evidence-based decision-making, improve budget credibility, reduce wastage, and foster greater transparency and accountability across the public sector. Ultimately, this would help shift Sri Lanka’s budgeting process from input-focused allocations toward performance-oriented results.

There is an urgent need for a paradigm shift in Sri Lanka’s economy, where export diversification, strengthened governance, and institutional efficiency become essential pillars of reform. Establishing a National Budget Performance and Evaluation Office is a critical step that can help the country address many long-standing challenges related to governance, fiscal discipline, and evidence-based decision-making. Such an institution would create the mechanisms required for transparency, accountability, and performance-focused budgeting. Ultimately, for Sri Lanka to gain greater global recognition and move toward a more stable, credible economic future, every stakeholder must be equipped with the right knowledge, tools, and systems that support disciplined financial management and a respected national identity.

(The writer is a Professor in Management Studies, Open University of Sri Lanka and you can reach Professor Abeysekera at nabey@ou.ac.lk)

by Prof. Nalin Abeysekera ✍️

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