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Sunday, 23 March 2003  
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Health Ministry - the sick giant

Recently there has been several adverse comments about the medical profession, particularly regarding those in the government sector.

Working in the Health Department for the past 25 years, I wish to make the following observations on happenings in this Ministry.

Though this Ministry was always a "sick giant", conditions became worse after 1987 with the establishment of the provincial setup. Prior to that medical officers who opted for administrative duties started at the bottom of the ladder and gradually moved up according to seniority, serving in several districts, before coming to the Ministry. The experience they gained was immense.

With the creation of Provincial Councils, mere DMOS and MOHS became Provincial Directors overnight. Within a few years they moved to the Ministry.

All of them had administrative experience in only one province and most of these initial appointments were political. By the mid nineties and thereafter several holding high posts in the Ministry were those who had catapulted into these posts. Even some Directors of various programs have absolutely no administrative experience. That is why these programs have had no impact.

Ministry administrators, due to lack of experience and being political appointees are unable to deal properly with trade unions, some of which have political clout. Trade unions who do not have political support invariably take a beating. There are doctors in the ministry who are misfits, because they are someone's favourites. Some are even trainees, but they are the ones who advise highups. Some doctors have even held posts meant for SLAS officers. Though there is a rule that doctors cannot go abroad more than thrice a year, certain administrators invariably break this rule even taking over trips meant for outstation doctors.

Various ruses are adopted by certain favourites who even get international organizations to sponsor them for conferences so that they could meet their offspring. Some are even taking their spouses abroad thanks to these organizations and drug firms.

The Ministry recently highlighted in the press the number of consultants and medical officers, who were detected by their flying squad engaging in private practice within working hours and the action taken by the minister. Have any medical officers at the centre been found guilty of flouting administrative regulations? No. Two Presidential Commissions, mostly composed of doctors have submitted their reports. The only action taken has been to increase the number of medical directors in the Ministry.

The sick giant needs a thorough clean up. The clean up should start first at the Ministry.

An Outstation Consultant

Food for thought

A controversy seems to be raging among nutritionists, dieticians, doctors of medicines, doctors of philosophy and laymen over some food items suitable for certain ailments. I am not an expert in any of these fields or any other field for that matter and depend solely on the guidance of the experts in the area of food and nutrition.

Man and all other animals depend on plants or other animals which depend on plants for their sustenance. There is not a single food item of plant or animal origin which could be labelled as ideal for humans except perhaps the mother's milk during the first few months of a baby's life. In rare instances even the mother's milk may not agree with her baby. Rice seed contains the nutrients needed for the growth and development of the rice seedling. Similarly cashew or other nuts contain the nutrients needed for the growth and development of their seedlings. It is the same with eggs. The flesh of animals contain proteins, fats minerals and other nutrients to serve the various needs of the respective animals. Cow's milk meets the nutritional needs of the calf.

Although these items are not produced specifically to meet our nutritional needs we have been using them as food for ages. There is a story among rural folk about a native doctor who visited a market to buy vegetables. He found that a vegetable good for phlegm was not good for bile. What was good for bile was not good for windy complaints or phlegm and so on. Ultimately he has come back only with a snake gourd (pathola). if he visits a market these days he is sure to come back empty handed because now even Pathola is loaded with pesticides.

This story reveals a fundamental truth about food items. Any food item would contain a number of chemicals, sometimes running even to hundreds. Many of them are integral parts of the plant or animal and perform some specific functions. There are others which are not needed for the organism but have entered its body from the environment through air, water or food. In the course of production, processing and storage of food, man himself adds pesticides, antibiotics, hormones, preservatives and various other chemicals. Even under natural conditions, without any interference from man, the chemical composition of plants and animals we use as food could vary from place to place, season to season and organism to organism even in the same locality.

With the nutritional wisdom developed mostly through trial and error during thousands of years of man's existence he has learnt to select the food items that are palatable and appear to be safe. In recent years with the advancement of food science, biochemistry, human physiology and other allied subjects scientists are augmenting this knowledge base.

However, we have to accept the fact that it is humanly impossible to do a complete analysis of all the food items that we commonly consume and test how each of them interacts with each individual when taken as food. Each is unique and food for one could be poison for another. The body of every organism whether man, animal or plant is perpetually in a state of flux and as such what is good for an individual at one time could be harmful to him at another time. It could also interact with other food items taken by him and produce undesirable results. We could understand this situation if we go through the literature of medicinal drugs such as an antibiotic or a steroid. Even if it is a single chemical substance. When we read its possible side effects, contra-indications and interaction with other drugs we feel rather nervous to take it.

Through long experience man has learnt to avoid food items which are identified as causing undesirable effects. He also has learnt to remove undesirable effects of some food items during their preparation. But it is not easy for him to identify the long term harmful effects of some food items when taken regularly or in combination with other items. It is not easy even for the scientists to do it due to the vast number of variables in any selected human sample.

During our school days we were told that meat, fish, eggs, butter and milk should be in our diet regularly and that food items of plant origin are poor cousins because they lack some essential amino-acids and vitamins or something to that effect. Later on we were told that animal fats are saturated fats and are not good because they contribute to hypertension, heart diseases and bowel cancer. The virtues of unsaturated fats and oils of plant origin were highlighted. Then it was the ratio between HDL and LDL that was important. Coconut oil was accused as the biggest culprit responsible for the high incidence of cardiovascular diseases in the country.

Then we were made to understand that coconut is not the villain after all and it is OK when taken in moderation. Any way the debate is continuing. We are also told that vegetables such as tomatoes and carrots are good to prevent cancer because they have something called antioxidants which fight free radicals which are responsible for causing cancer and other diseases. That tea decreases the absorption of iron in the diet and the fibre in vegetables is very good to prevent bowel cancer and to reduce the absorption of fats into the body.

Anyway we have to admit the fact that food science, so to say, is still in its infancy. Lots of things about food and nutrition still remain to be discovered. With all these pronouncements we are somewhat in a state of confusion. In this scenario what can we, the ordinary citizens do? It looks as if where our diet, is concerned the best policy to follow till these controversies are resolved is to believe in the two sayings "Variety is the spice of life" and "Too much of anything is good for nothing". Eat anything and everything in moderation but not the samething every time. Have as many varieties of food items as practically possible. It might be good to have variety in the methods of food preparation as well. This should help to reduce deficiency diseases and other nutrition related ailments.

The importance of variety in our diet was highlighted in Sri Lankan homes during the Sinhala New Year celebrations in the past. An important item in the traditional New Year lunch was the Hath Maaluwa (The seven in one curry) consisting of seven types of food items including green leaves, nuts and yams.

G. Dharmawardhana, 
Kotte

Unethical advertising

It was interesting to listen to Dr. Pertchuk on the above topic at the Lionel wendt Auditorium on Saturday 22 February.

Unethical advertising, he went on to explain, was unfair advertising in the eyes of the public, especially because the majority of the advertising was targeted at children.

I recall a recent advertisement by the advertisers explaining to the public that cricket matches would not be possible if not for advertising - or a statement to this effect.

The good doctor was also of the view (and we endorse this wholeheartedly) that parents and educators should be responsible to inform the children who are at the receiving end of advertising that they certainly do not need to be gullible for every scrap thrown their way.

Certainly this is true with some children. If an educator or a parent says that processed foods aren't healthy for consumption as a daily diet or that certain drinks should not be the norm, they do listen and conform to this. for the past 5-6 years we have done this successfully with parents who support this trend. We do not need a generation of future citizens suffering from unknown diseases.It is time for parents and educators with healthy attitudes to promote healthy eating styles and not give-in to advertising that will cause serious health damage to our future generation. As an early childhood educator I practise this in the schools I visit.

Dr. Pertchuk went on to state that all schools in Sri Lanka would do well to emulate a subject known as Media Literacy with exposure on advertising.

Shanthi Wijesinghe, 
President - Association of Montessori Directresses.

Treasure hunters

The newspapers recently reported that 10 treasure hunters (two of them in robes) had gone to the Tissawa Raja Maha Viharaya with necessary tools and equipment to treasure hunt, but the timely intervention of the police had thwarted such action and the entire group had been remanded.

This is only just another instance of vandals going on the rampage and destroying valuable archaeological sites. I personally know this historically important Tissawa Raja Maha Viharaya at Katupotha in the Kurunegala District and also its chief priest Rev M. Siddhatta Thera who is also the Chief Sangha Nayaka Thera of the North Western Province.

Though holding such a high post, as a person this chief priest is very simple and unassuming and always ready to help anyone known or unknown who seeks help. In fact one of these vandals had visited the temple a few days prior to this incident and had a discussion with the chief priest on the historically important nature of this temple. However this chief priest or anyone else for that matter, is helpless in a situation where vandals come in the night to destroy archaeological sites and rob priceless items.

Cannot the Department of Archaeology help such institutions with a plan to safeguard at least what is left and still not vandalized ? After all it is the bounden duty of the State to look after the nation's historically important sites and preserve them for prosperity.

M.G. Gunetileke, 
Nugegoda

Discharge for army deserters

As an old soldier I am astounded by the news item that the army and the government have decided to grant discharges to Army deserters, some 58,000 of them, and legitimise their discharge from the service. One wonders what the logic behind this thinking is. These are people who, on their own free will and volition, joined the army to "serve the country". They were fully aware of the conditions and the rules and regulations of the service. Instead of conforming to the regulations, they deserted for their convenience.

The army and the Ministry of Defence, failing over the years to implement the rules for their arrest, now resort to the simple expedient of discharging them from the service, once again contravening the law for dealing with deserters. The government is violating the law of the land.

One wonders whether the Ministry of Defence has given due consideration, in depth, to this matter before making this decision. Undoubtedly, the simplest thing to do is to discharge the deserters and get over the headache. But, what about the long term implications for discipline in the Services and the country as a whole ? Will desertion cease to be an offence in the armed services in the future ? Will other offenders - murderers, rapists, arsonists, gang robbers, etc, - all be similarly given honourable discharges and be free to carry on their activities ?.

Concerned old soldier

The other side of liberated children

I write with reference to an article title on " Parents should be more supportive" by Umangi de Mel featured in the Magazine section of the Sunday Observer of 23rd February.

The writer has based her report on the views expressed by Ahimsa Hasith Silva and Maria Bernadine in an interview with them at a farewell party, and has shed light only on one side of the life of young people, leaving the other side in total darkness.

Maria's expectation that parents should be approachable by their children even to the extent of discussing sex, is certain to be met with total rejection by many parents however much they are swayed by western culture. We live in a land which has a culture dating back to thousands of years where traditional values are still treasured, though steadily declining due to the heavy western influence. Her views may be endorsed by those who grab western culture blindly with both hands and take a headlong fall into an abyss of immorality, with scant disregard for their parents.

We see more and more people in this country getting themselves carried away by western influence which has gobbled up simply everything in life that one can think of. This has heavily induced the lifestyles of so many to lose their identity completely, alienating them with their families. Many of the tidal waves instrumental in effecting this change seem to come from the West, especially America, a country where traditional values are non-existent due to its population being made up of different races of people migrated there from all over the world and their cultures and social values being neutralized in the process of mass social integration into a new nation. There is no necessity for us to follow this trend and lose our social values and traditions which distinguish us from other nations to be unique with a sense of pride.

When considered overall, children in far eastern countries will have some degree of respect for elders, unlike their counterparts in the western hemisphere, where parents are treated as friends. Our traditions and upbringing would not provide grounds for us to treat our elders with scant respect and expect them to behave as friends at all times. A child can freely talk to his or her parents as friends on a multitude of topics but not on everything. There are certain taboos still in force, especially those relating to sex, which parents find uncomfortable to discuss with their children in an overt manner as done with their friends. Our parents have yet a long way to go to get even with their western counterparts in discussing sex with their children.

Maria seems to be worried mainly about her inability to speak openly about sex with her parents, and she needs parents to be changed with the times and allow greater freedom for their children. If such a change comes over in this country, with all the parents changing their attitude towards their children with an open policy of sex, what we can expect is further degradation of a nation already losing its cultural values at an alarming rate.

Maril Gunawardene, 
Talangama.

Political rallies or public nuisance ?

On Monday (10th) early morning most of the house wives of Colombo and suburbs were busy on their telephones - not gossiping on Ashvariya Rai's latest boy friend, nor on the important Indian-Lankan cricket match, but on the safety of their children going to school that day. This was the result of the early morning news about a political rally organized by two main parties taking place in the heart of Colombo. The police on their part was ready with anti-riot squads with latest technology to combat the trouble makers if the rally got out of control and violence broke up.

This news item sent shivers up the spines of most caring parents whose thoughts were on the safety of their kids. We have seen in the past that innocent by-passers and by-standers getting hurt very badly and victimised, including school children and old people as well. In view of the bad past experience most parents decided not to send their children to school on this day to avoid any unpleasant experience and heart ache. Some school van owners also decided to take a day off as they thought of the safety of their vehicles.

Bold and obstinate parents who sent their children to schools, were in for a rude shock when some schools closed at 12 noon without any notice. They had to rush to schools from their offices/homes to pick up their children as the public transport system was not functioning as usual.

Some office girls also decided to take "french leave" to avoid unnecessary problems and hardship in getting back home. Some decided to go home half day on the pretext of sickness. There was a lull in the traffic in the morning inwards to the city on all major roads, as most of the people who had important work on this day postponed their work. Generally, the public avoided coming to Colombo and the few who came to Colombo too made a hasty retreat by 11 am.

Most private buses towards Colombo after 12 noon were off the roads. Government offices worked on a go-slow and lethargic mood in the morning. Morning session was devoted to discuss pros of the rally. Some radicals vanished from their seats by 11 am, and ran to the closest down town pubs, to have some "dutch courage" to boost up their morale to attend the rally.

Most affected was the private sector. They had to carry on with their work in spite of all these hardships. The turn out of office female staff was low and the man-hours wasted on the roads, meetings and deadlines missed, were some major disasters which affected the daily routine of the highly productive private sector.

The result of the rally was utter confusion and disorder - students lost a school-day, people could not attend to their normal work, and government departments worked half-day. Private sector was greatly affected. Most shop keepers put up their shutters and thereby loss of turnover. The city of Colombo was almost deserted, as if people expected some aliens to invade Colombo.

What a chaos and loss of productivity / man-hours, just because of a political rally. This is not the first time it happened, every time there was a rally, we heard the same sad story - public nuisance.

Public rallies are of course a public necessity, but it should not be a public nuisance to the general public. To avoid all these problems and loss of productivity in future, the government and the police should take immediate measures not to give permission to hold rallies on week days. This should be a Saturday or Sunday picnic activity, so that the participants could attend in their own time without disturbing the productivity and without being a public nuisance.

Ariyasumithra Wijeyaratne, 
Piliyandala

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