SLMANEWS
Contents
THE OFFICIAL NEWSPAPER OF THE SRI LANKA MEDICAL ASSOCIATION
December 2012 Volume 05 Issue 12
President’s Note Dear SLMA members, colleagues, friends As we come to the end of the year it is a time to reflect. We wanted to create more visibility for SLMA this year. That was achieved with SLMA embracing electronic media. The SLMA became a house hold name. We wanted to increase participation at SLMA events. This was evident in every event - for example, the 125th Anniversary International Medical Congress, with over 1000 participants was by far the most well attended medical conference ever to be held in Sri Lanka. We wanted to raise funds for the SLMA to improve the quality of our events. We succeeded in raising nearly Rs. 40 million. We wanted to increase our membership. 592 new life members joined the association this year - a record number for any year. SLMA’s success this year was because we worked as a team and accommodated the wishes of everyone. I wish to thank all those who contributed in one way or another to make every one of our events a success. I wish each and every one of you a Merry Christmas and a Happy New Year. May you live long! Thank you. On behalf of the council of the SLMA,
Page No.
Orations and Endowment Lecture
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Ergonomics is Everywhere!
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Ethics Review Committee of SLMA Gets Its Own Office
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Quality and Safety in Health Care
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Past President of SLMA Dr Nihal Perera Dr Lakshman Ranasinghe
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Showcasing Rajarata Reasearch
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SLMA Membership in International Medical Associations
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Avissawella Clinical Society
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Healthfest - Creating a Demand for Healthier Lifestyles and Giving the Options for Lifestyle Change
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Shun/quit Smoking, Says Medical Fraternity in Unison
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SLMA Press Release Supporting Mandating Pictorial Health Warnings Covering 80 per cent of the Front and Back of Tobacco Packs
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Medical Dance 2012
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Economics of Health Care
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Medical Dance - A Short History
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Highlights of the Medical Dance
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SLMANEWS
December, 2012
Notice Board Presidential Induction – 2013 12 January 2013, 6.00 pm onwards at HNB Towers
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December, 2012
Orations and Endowment Lecture 22 September 2012 Sir Nicholas Attygalle Oration Inflammatory Bowel Disease: The Current Status in Sri Lanka Prof Janaka de Silva MBBS, MD, DPhil (Oxon.), FRCP, FCCP, FNAS (SL), FRACP (Hon) Senior Professor and Chair of Medicine, Faculty of Medicine, University of Kelaniya
9 November 2012 EM Wijerama Endowment Lecture Research and Beyond Professor Sanath P Lamabadusuriya MBE MBBS(Cey), PhD(Lond), DSc(Ruhuna), FRCP(Lond), FRCP(Edin), FRCP(Glasg), FRCPCH (Eng), FCCP(SL), FSLCP (SL), FSLGP (SL), DCH (Eng) Emeritus Professor of Paediatrics, University of Colombo
Prof. Janaka de Silva
Prof. Sanath P Lamabadusuriya
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10 November 2012 Sir Marcus Fernando Oration Controlling iodine deficiency disorders in Sri Lanka Dr Renuka Jayatissa MBBS, MSc, MD Consultant Medical Nutritionist, Head, Department of Nutrition, Medical Research Institute, Colombo 7 December 2012 Murugesar Sinnetamby Oration The medically compli-
cated pregnancy – the Sri Lankan perspective Professor Chandrika N Wijeyaratne M.B.B.S. D.M (Col), M.D (Med), FCCP. FRCP (London) Professor in Reproductive Medicine, Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Colombo, Honorary Consultant Physician and Endocrinologist, De Soysa Hospital for Women.
Dr Renuka Jayatissa
Prof. Chandrika N Wijeyaratne
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December, 2012
Ergonomics is Everywhere! Media Briefing on Ergonomics Ergonomics (or human factors) is the scientific discipline concerned with the understanding of interactions among humans and other elements of a system, and the profession that applies theory, principles, data and methods to design in order to optimize human well-being and overall system performance (The International Ergonomics Association). Ergonomics involves all aspects of life and work to suit the environmental parameters to human body and cognitive aspects. A multitude of disciplines e.g. psychology, engineering, industrial design, graphic design, statistics, operations research and anthropometry contributes to the ergonomics and human factors. Even the healthcare field is not spared. A crucial stake lies with the healthcare professionals to promote and apply ergonomics in the health sector. The Sri Lanka Medical Association (SLMA) established an Expert Committee on Ergonomics (SLMAECE) with the objective of promoting ergonomics to medical community, general public and in healthcare settings. The foremost strategy in inculcating an ergonomic culture in a country is making all stakeholders and general public aware of the evolving discipline. A media briefing
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Prof Vajira Dissanayake addressing the media briefing
SLMA-ECE Consultant Community Physician and the Chairperson Dr Kapila Jayaratne
was conducted recently to introduce the discipline of ergonomics and to disseminate the information on its implications on the general public by SLMA-ECE. More than 25 media personnel from 15 print and electronic media stations participated at the briefing.
Media has a big role to play SLMA President, Prof. Vajira Dissanayake, welcomed the participating media personnel and explained the role of media in health promotion. He described the rationale of establishing an expert
committee under the umbrella of SLMA. SLMA ECE will function as the hub in promoting ergonomics in healthcare sector. He requested media to engage more in disseminating health messages to the general public. Contd. on page 8
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December, 2012 Contd.from page 6
Ergonomics... The foremost strategy in inculcating an ergonomic culture in a country is making all stakeholders and general public aware of the evolving discipline. A media briefing was conducted recently to introduce the discipline of ergonomics and to disseminate the information on its implications on the general public by SLMA-ECE.
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Ergonomics is the ‘fit’ between the user, equipment and their environments Introducing the field of ergonomics, SLMA-ECE Consultant Community Physician and Chairperson Dr Kapila Jayaratne detailed definitions and scope of the field. He presented objectives of ECE to the media personnel; • To map and collate evidence in ergonomics and health consequences • To synthesize and disseminate new knowledge on ergonomics • To advocate healthcare and other stakeholders in relevant sectors on issues related to ergonomics • To interface with national and provincial health professionals and other stakeholders (eg. other government bodies, INGOs) as appropriate to generate funds and to facilitate the implementation and adoption of ergonomic initiatives • To initiate and sustain activities both at national and sub-national level to expand ergonomics in health and relevant fields He further elaborated that considering the numerous areas in the healthcare sector which warrant ergonomic interventions, a health-led concerted effort is essential to further expand ergonomics in Sri Lanka. The significance and applicability of ergonomics to healthcare professionals have been endorsed by the Sri Lanka Medical Association, and SLMA-ECE will take the lead role in promoting ergonomics in Sri Lanka. Dr. Jayaratne described recent advances in technology and also the negative effects of mismatched ergonomics. Many areas
are covered under ergonomics but SLMA-ECE will focus on priority areas such as child ergonomics, occupational health, computer ergonomics etc. He invited media personnel to join in hands to promote ergonomics and improve the health of a nation.
Most of the ergonomic solutions can be done using our common sense
Consultant Paediatrician Prof Manouri Senanayke
SLMA-ECE Media Coordinator Dr Jayaruwan Bandara
SLMA-ECE Media Coordinator Dr. Jayaruwan Bandara, emphasized the need to acknowledge the people about “ergonomics”. He said the media has a big role to perform. It should be a collaborative effort and all the stakeholders should take the responsibility to educate the public and familiarize the objectives of ergonomics and its applications. As doctors and experts on the subject, healthcare professionals can provide the knowledge. The task for the media is to convey these messages to the public in an attractive and palatable manner. Dr. Jayaruwan described several strategies that could be adopted in conveying the information to the lay people. He appreciated the media personnel as eye openers of decision makers in this country. He expected the kind hearted support towards this great effort.
Consultant Paediatrician Prof. Manouri Senanayke said that designing ergonomic solutions for children is especially challenging considering their anthropometrics and as a result the need to accommodate their current size and capabilities. Children are always changing. They are not small adults. Unlike adults who are at a steady state once they have reached adulthood, children grow throughout their childhood. Child Ergonomics is simply creating everything that a child uses suitable to his body parameters. All the relevant factors should be considered when creating a child friendly atmosphere. Although children of the same age may differ vastly from each other in size, strength, cognitive development and emotional maturity, these could be accomplished with simple techniques. “Promoting child ergonomics will have long term effects on children and most of the things can be done using our common sense," Consultant Pediatrician Professor Manori Senanayake, reiterated. Contd. on page 10
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December, 2012 Contd.from page 8
Ergonomics... limitations to prevent occupational hazards. Thereby we can improve the economy of the country, at a time it is mostly wanted" Dr Arnold added. Prof. Manouri Senanayake, (From Left) Dr Mahendra Arnold and Dr Kapila Jayaratne answering the queries
Some participants at media briefing
A workplace without occupational hazards
Consultant Community Physician, Dr. Mahendra Arnold speaking on Occupational Health
Speaking on Occupational Health, Consultant Community Physician, Dr Mahendra Arnold said that annually 2.2 million people die every year from occupational accidents and diseases globally. Around 160 million fall ill for shorter or longer periods from work-related causes. The total cost of such accidents and ill health have been estimated at four per cent of the world’s gross domestic product. Ergonomics is one of the main occupational hazards which contribute to the work related ill health.
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In Sri Lanka not much empathies is paid to workers health. Ergonomic hazards are not mitigated and health problems due to poor ergonomics are not recognized and grossly under-reported. A large number of workers suffer from musculoskeletal problems due to poor ergonomically designed work stations, tools, equipment and work practices. It is important that workers as well as management made aware of ergonomic hazards and through the participation of all sectors and through a stepwise approach ergonomic hazards could be mitigated with a minimal cost. "Poorly designed and incompatible working environments results in reduced efficiency, deficits in productivity, financial losses, increased medical claims, and permanent disability. The ultimate goal of ergonomics is to design the workplace so that it accommodates the variety of human capabilities and
Computer ergonomics provides solutions to multiple problems
Bio-informatics Specialist Dr Nishan Siriwardane
- Bio-informatics Specialist Dr Nishan Siriwardane Sri Lanka is making steady a progress towards eliminating digital divide and helping the Internet and other ICTs transforming society, improving educational and economic benefits to the majority of Sri Lankans. A large section of population from preschoolers to senior citizens use multitude of computers including more traditional desktop computers to other hand held devices such as laptops; tablet PCs smart phones to improve their day to day work requirements. Knowledge on computer ergonomics and its application can benefit users to reap the true potential of technological advancements without harming their health. New software has been created to indicate the excessive use of the computer and therefore improve the health of the workers. Contd. on page 12
It should be a collaborative effort and all the stakeholders should take the responsibility to educate the public and familiarize the objectives of ergonomics and its applications. As doctors and experts on the subject, healthcare professionals can provide the knowledge. The task for the media is to convey these messages to the public in an attractive and palatable manner. - Dr Jayaruwan Bandara
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December, 2012
Contd.from page 10
Ergonomics... Ethics Review Committee of SLMA Gets Its Own Office
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he office of the Ethics Review Committee of the SLMA was declared open by SLMA Ethics Review Committee Chairperson Prof. Anoja Fernando on 7 September 2012.
SLMAECE will facilitate implementation of computer ergonomics principles in near future by establishing guidelines and recommendations for the healthy use of ICT tools. SLMA-ECE Convener Dr Chamaine De Silva, coordinated the media briefing.
The Outcome As a result of the SLMAECE media briefing,
many articles appeared in both Sinhala and English print media. Ada, Silumina, Lankadeepa, Tharunaya, Rejina, Daily Mirror, The Nation, Daily News and Thinakaran newspapers published news on the ergonomics. The ARTV, Swarnawahini and Rupavahini carried news items and featured programs on ergonomics.
Print Media
Electronic Media
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Quality and Safety in Health Care
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Many view quality health care as the overarching umbrella under which patient safety resides. Quality has been conventionally defined as an optimal balance between possibilities realized and a framework of norms and values. This conceptual definition reflects the fact that quality is an abstraction and does not exists as a discrete entity. - Additional Secretary to the Ministry of Health, Dr Palitha Maheepala
Pre-Congress Symposium on Quality and Safety in Health Care was organised as a part of the Foundation Sessions of the SLMA on 9 November 2012 in collaboration with the Directorate for Health Care Quality and Safety, Ministry of Health. The Chief Guest at the Inauguration of the Symposium was Additional Secretary to the Ministry of Health Dr Palitha Maheepala. Ministry of Health, Deputy Director General Medical Services, Dr Lakshmi Somatunga was the Guest of Honour. The other speakers at the sessions were Sri Lanka, WHO Country Office, Consultant, Dr Sarath Samarage, who spoke on “Quality and Safety in Health Care: The WHO Perspective”; Wattala, Hemas Hospital, General Manager/Medical Director, Dr Samnthi De Silva, who spoke on “Quality and Safety in Health Care: A Private Sector Perspective”; Lady Ridgeway Hospital, Director, Dr A H Ratnasiri who spoke on
“Patient Safety Programme Initiative – Case Study from LRH”; Dr Mihirini Amarapathy who spoke on “Patient Safety in a Tertiary Care Hospital”; Rathnapura Provincial General Hospital, Acting Deputy Director, Dr S. Raj Kumar who spoke on “Organisational Culture of Castle Street Hospital for Women and its association with patient safety management.”; Elpitiya Base Hospital, Medical Unit, Senior Medical Officer, Dr L. K. Hirimuthugoda, who spoke on “Impact of an intervention to improve clinic attendance through follow up phone calls to Non-communicable Disease clinic patients”; Walasmulla Divisional Hospital, Director, Dr J. P. Ranasinghe, who spoke on “Responsiveness in the Medical Wards of the General Hospital Matara”. The meeting ended with a summing up by Ministry of Health Directorate for Health Care Quality and Safety, Director, Dr S. Sridharan, who summarised the “Lessons Learned from the Symposium”. Extracts from the keynote
address given by the Chief Guest, Ministry of Health, Additional Secretary, who is presently the Health Services Director General Dr Palith Maheepala, are reproduced below: “I am always delighted to be here and I am particularly delighted to be here today to speak a few words on a subject which is close to my heart, quality and safety in patient care services. We are meeting today in a place noted for quality in medical education and professional development and we are meeting at a time of change and challenge. Mr President, High technologic, industrialized medicine transformed the nature of diseases and its treatment in 20th century. The evolution from an emphasis on vitamin deficiencies and infectious disease to technological driven chronic disease management has been accompanied by the rise of a cost pressured and time pressured highly distributed complex system. Contd. on page 16
Dr. Palitha Maheepala (Left) and Dr. Lakshmi Somatunga making their addresses at the Inauguration of the Symposium
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December, 2012 Contd.from page 14
Quality and Safety... Risk and harm to patients from medical management itself has arguably become one of the biggest unintended consequences of this transformation. Ladies and Gentlemen, Anecdotal evidence suggests that history of quality dates back to 13th century and product inspections has been introduced in industries to ensure quality in 1750’s. However, some suggest ancient philosophers such as Aristotle and Plato contemplated quality and its attributes. Statistical process control has been introduced as a method of quality assurance in production industries, in 1920’s and in 1970’s the concept of total quality management has been introduced which later developed to ISO 9000. Many view quality health care as the overarching umbrella under which patient safety resides. Quality has been conventionally defined as an optimal balance between possibilities realized and a framework of norms and values. This conceptual definition reflects the fact that quality is an abstraction and does not exists as a discrete entity. The safety movement in healthcare however can be described has been dormant for many decades with explosive interest and growth beginning in mid-1990’s. Although first do no harm has always been a pri-
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mary guiding principle for physician there are many legal, cultural, logistic, other barriers to obtain in honest appraisal of the extent preventable patient injuries and doing something about understanding gain. Preventable harm due to medical management has been a constant if infrequent, topic in major medical journals throughout 20th century. Hippocratic Oath contemplate a conventional framework of safety as I quote ‘I will prescribe regimes for the good of my patients according to my ability and my judgment and do no harm to anyone’ close quote. Mr President, In November 1999 the institute of medicine America publish a landmark report entitled ‘to a err is human building a safer health system’, the report estimated that between 44,000 to 98,000 patients die preventable death annually in hospitals in the USA with many fold more suffering injuries. The Institute of Medicine report estimated that total national cost for adverse events are between 38 to 50 billion US$ annually. Safety incidences are estimated to cost the NHS UK around 2 billion pounds a year with a further one billion pounds attributed to health care acquired infections. It had been noted 5per cent to 15per cent of hospital admissions are due to health care acquired infections and 5 million such events taking place
in Europe alone. Further, it has been estimated that in some countries 70per cent of patients’ medication has errors. WHO estimated that there are 234 million surgical procedures done annually over the globe and out of which 7 million become complications and 1 million deaths as a result. WHO further revealed that more than 70per cent injections given in primary healthcare institutions are unnecessary. Lessons in approaches to patient safety have been learn from the aviation and nuclear power industries which have developed sophisticated risk reduction and reporting system to learn from mistakes or near misses. Patient safety initiations in the UK date from 2000 with the publication of a department of health report ‘an organization with memory’ which highlighted the need to learn from things that go wrong and the British government established the national patient safety agency in 2001. Since then, there had been many initiatives taken forward by ministries of health in their respective countries to ensure patient safety and quality with the notion that healthcare professionals, organizations and patients should get involved in building such culture of safety in healthcare provision. Sri Lankan Ministry of Health too had taken initiatives in quality assurance way back in 1990’s under the leadership of Dr Reggie
Perera, DDGHS – MS. This programme was revamp in year 2000 with the extensive support of the WHO and the World Bank by Dr Karandagoda and me. We were able to persuade many hospital directors to implement the concepts of 5 ‘S’, Kaizen, and total quality management and also was able to persuade the World Bank to put up a building for the quality secretariat. Now I am proud to note that we have directorate of quality and safety located in this new building, heading the quality assurance programme in the Ministry of Health. Professor James Reson stated I quote ‘only a system approach will create a safer health care culture because it is easier to change the conditions people work in than change human action’ close quote. I am sure, Mr President, that you and your membership will share your wealth of knowledge and your infinite wisdom for the betterment of human society.
High technologic, industrialized medicine transformed the nature of diseases and its treatment in the 20th century.
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Past Presidents of SLMA
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1989
Dr Nihal Perera MBBS (Cey), Dip.Bact. (Manch), PhD (London)
he induction of the President was by Dr Nihal Perera at the SLFI, followed by the Presidential address on the theme ‘To teach is our responsibility’. The Chief Guest at the Annual Sessions in March was the Vice Chancellor of Colombo – Prof G L Peiris whose eloquence held the medical profession with
great impression. 1989 was a dismal year for Sri Lanka because of the insurrection. We saw burning human bodies on the roadside on our way to the Provincial Sessions in Kurunegala. Some social activities were on a low key that year. Representing Sri Lanka at the Commonwealth Medical Association as a Regional President, it was a
privilege to host their International Sessions on AIDS at the Oberoi. Our Guest, Madam Renuka Herath, the Minister of Health was impressed with Dr Dorothy Black’s speech on the World Wide horrors of AIDS. The Minister declared, though in a whisper that it was her moment of awareness of an emerging problem for Sri Lanka.
1984
Dr Lakshman Ranasinghe MBBS (Cey), DCH (RCP Lon & RCS Eng), FRCP(Edin), FCGP(SL), FCCP(SL), FCPaed(SL)
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he President commenced stewardship of the SLMA Council on 23rd October, 1984 by having the silver scroll used for important ceremonial documents re-plated, and, by presenting a framed hand - painting in colour, autographed by the painter, from the Philippines, to the Council; this was displayed in the headquarters for several years. Prof. Wilfred Perera too had our Silver Mace re-plated. The portrait of the late Prof. N D W Lionel was placed on the wall at the entrance to the Lionel Memorial Auditorium. The Council decided that election of the President Elect would run concurrently with that of each new President, and not the end of the President’s Term of Office, as in the past. The President opined that the most important criterion for selecting the President Elect should be
his / her contributions, in service and academically, over the years, for the SLMA, which was unanimously approved by the Council. The President was inducted on 14th December, at which his Address was on ‘Musings Relating to Skin Diseases’, in which he clarified developments from ancient Ayurveda to modern medicine, including terminology. The Council nominated the President to serve on the Cosmetics, Devises and Drugs (statutory) Authority. Electric Fans were installed in the new auditorium in 1984. In March, the longest Annual Sessions in the 97 - year history of the SLMA was held, with 448 registered participants. The President of Sri Lanka was the Chief Guest, and, a ‘Limited Edition’ copy of the ‘Snake Bite’ Number of the CMJ, was presented to His Excellency. A symposium on Herpes Simplex was
conducted. The SLMA Oration on ‘Alcohol Dependence Syndrome in North Western Sri Lanka’ was delivered by Dr. E. C. M. Waas. For the first Time in the History of the SLMA, a General Practitioner delivered the most prestigious oration of the SLMA. Dr. Ben Selvadurai delivered the S C Paul Oration on: ‘Surgical Management of Pituitary Tumours’. A Guest Lecture from the Kandy Society of Medicine on ‘Ano-Rectal Problems’, and, a workshop on ‘Narcotics and Drug Dependence’ were held,- both for the first time. Contd. on page 19
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December, 2012
Showcasing Rajarata Research
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he Joint Symposium Organised by the Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka and the Sri Lanka Medical Association was held on 14 December 2012, from 9.00 am to 2.30 pm at the SLMA Auditorium, 6 Wijerama Mawatha, Colombo 7. The symposium was aimed at showcasing the achievements of the Staff and Researchers at the Rajarata University who were working in a resource poor setting. The symposium began by singing the national anthem followed by lighting the oil lamp. President SLMA Prof. Vajira H. W. Dissanayake welcomed everyone. He thanked Prof.
Sisira Siribaddana for the initiative taken by him to organize the symposium. Prof. Siribaddana in his speech thanked the SLMA for hosting the symposium. The symposium was attended by over 50 people including postgraduate students from the University of Colombo. The quality of presentations made was excellent. There were many examples of research being implemented in practice. The presentations included talks by Dr Faiz Marikkar on “Cell-cell fusion, actin and cancer genetics”; W Kumbukgolla on “Anti-bacterial properties of Tea”; Indika Senevirathne on “Anti-oxidant properties of common yams in Rajarata”; Dr NJ Dahanayake on “Gestation-
al Diabetes in Rajarata”; Dr Suneth Agampodi on “Molecular epidemiology of Leptospirosis in Sri Lanka”; Panduka Mahamithawa on “Anti-Diabetic effect of true Ceylon Cinnamon”; Dr Anjana Silva on “Malsara to Kunakatuwa; taxonomy and venom“; Dr Senaka Pilapitiya on “Subtleties of
complementary and alternative medicine research”; Dr Thilini Agampodi on “Qualitative research informed, maternal and child health”; Dr Kosala Weerakoon on “Paradigms of Rickettsioses in Rajarata?” and Dr Channa Jayasumana on “Sri Lankan agricultural nephropathy”.
SLMA Membership in International Medical Associations The SLMA is a member of the following international associations:
World Medical Association (WMA): http://www. wma.net
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Commonwealth Medical Association (CMA): http://www.thecommonwealth.org/Internal/151924/
Council of Medical Associations in Asia and Oceania (CMAAO): http:// www.cmaao.org/
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Avissawella Clinical Society Annual Sessions 2012
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he Avissawella Clinical Society, established in 1990 is one of the oldest hospital based clinical societies in Sri Lanka. The Sessions have been held jointly with the SLMA almost since its inception and it is a regular feature in the Annual Calendar of the SLMA. This year’s Sessions was held on 15 December 2012 with the participation of over 100 doctors from hospitals in the region. Avissawella Base Hospital Medical Superintendent Dr. Panagoda, who has been associated with the Clinical Society since its inception gave an account of the history at the Inauguration of
Avissawella Clinical Society President Dr Mangala Dissanayake
A section of the Audiance
the Sessions. President of the SLMA Prof. Vajira Dissanayake said that he was happy that the SLMA has been a part of the Annual Sessions every year. President of the Avissawella Clinical Society, Consultant Obstetrician and Gynaecologist, Dr. Mangala Dissanayake thanked the SLMA for their support. The presentations at the sessions included talks by Dr H.T.Wickramasinghe on “Weaning Controversies”; Prof Vajira H. W. Dissanayake on “Genetics in Medical Practice”; Dr. Lasantha Malavige on “Breaking the Ice and Helping Patients with Sexual Problems”; Dr Kanishka Karunarathne on “Cervical Cancer Screening and HPV”; Dr
Piyusha Attapaththu on “Metabolic syndrome and Obesity”; Dr Ananda Wijayawickrama on “Early Diagnosis and Initial management of DHF”; Dr Nissanka Jayawardena on “ Wound Dressing”; Dr Philip G. Veerasingam on “The Golden Mountain”. Dr W.A.S.Vipula Secretary of the Clinical Society proposed the vote of thanks.
Senior Consultant Surgeon Dr Philip G. Veerasingam
Contd.from page 17
Past Presidents... A senior SLMA Past President, Prof. Milroy Paul, wrote to the Editor, CMJ commending the ‘Snake Bite’ CMJ. Although blind by then, his wife had read the contents to him, and, his letter affirmed: ‘when the Editorial was read to me, I saw the snakes!’ Dr. David Warrel, Prof of Medicine in Oxford and Joint Editor of the Oxford Textbook of Medicine at the time, in a personal communication declared that the CMJ ‘Snake Bite Symposium’ Number should be an exemplary precedent to all physicians of Asia. The entire ‘Snake Bite’ Number was
subsequently incorporated in the Index Medicus. The President participated in the Annual Meetings of the Malaysian Medical Association, and the Indian Medical Association. A Joint Meeting was held with the Kandy Society of Medicine, in Colombo, in August. Engraved medals were presented to the academic Presenters. Subsequently, at their Annual Sessions in Kandy, the President was the Guest Speaker on ‘Dermatology in Paediatrics.’ A Joint Meeting was held with the
Matara Clinical Society in November, where 21 Papers were read. In 1996, Lions International District 306A awarded a gold medal and Certificate for “Excellence in Health Care”, at their Annual Convention in the BMICH, to the President, who had Edited the ‘Snake Bite’ Number. The figure in the background of the portrait above is Bodhisatva Avalokithesvara (Natha Devindu), the ancient Patron Divinity for Maha Kushta,- major skin diseases, and, harbinger of Maithri Buddha.
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December, 2012
Healthfest - Creating a Demand for Healthier Lifestyles and Giving the Options for Lifestyle Change A Social responsibility activity of the College of Community Physicians of Sri Lanka By Dr Susie Perera
Healthfest is a day of activity, 'a place to chill out or a family outing'. A day full of activity was used as a public platform to launch the 'Super Eight'. The Public was able to experience some options for a healthier lifestyle. For the first time in Sri Lanka 8 health targets were packaged and given as a message to the public. Super Eight is the brand name given for people to be reminded of the health targets. Healthfest is a concept created by the College of Community Physicians of Sri Lanka and was first held on the 17th of November at the Viharamahadevi Park. The College had been working on this program for nearly one year, advocating to different sectors from the demand as well as the supply side. By demand we mean different target groups in the community including youth, preschoolers, housewives, corporate sector. Empowering these different target groups and ultimately every individual in the society to demand for healthier lifestyles is what we are aiming at through social marketing of the 'Super Eight'. However we recognized
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that creating awareness and giving them just knowledge is not adequate. People must have different options that can replace the unhealthy ones. Our advocacy was also directed in changing the ‘supply’, the catering and beverage sectors were reached and we aimed at getting some of the leading catering and beverage industries to make the initial change.
The chief guest at the Healthfest was HE the President, Mahinda Rajapakse and the Super Eight was launched by His
Excellency. A video presentation which was used to launch Super Eight will be used in the future social marketing campaign.
‘The Super eight’ health targets 1. Maintain your body mass index (BMI) between 18.5- 24.9 (the ideal is 23) 2. Avoid excess salt in food ( Limit salt consumption to one teaspoon of salt per person per day - a 400 g pack of salt should be sufficient for a family of 4 for 20 days) 3. Avoid excess added sugar - i.e. not more than 6 teaspoons of sugar per non-diabetic person per day 4. At least 30 minutes of moderate (e.g. brisk walk, aerobic exercises, cycling) physical activity per day for at least 5 days a week 5. Consume 5 servings of Fruit & Vegetables per day (the recommended amount is 400 gms of Fruit and Vegetables per person per day). Remember variety is good. 6. Limit food with Trans Fats (found in some commercially baked and fried food such as short eats, pastries, cakes and re-heated oil) 7. Give up smoking and Alcohol 8. Maintain your Blood Pressure below 140 /90. Check your blood pressure annually
Presentation of a plaque with Super eight to HIM The president, Mahinda Rajapakse
Brand logo of Super eight
SLMANEWS A life course approach is followed in advocating the Super Eight. This was emphasized as healthfest was a day for all. Most health promotion campaigns although applicable to general population are receptive to those who either have the disease or who have a perception that they are falling into an 'at risk age’. The Healthfest concept is exceptional that it is targeting all and in particular empowering to be healthy. The Healthfest was entrance free to all. At the entrance a small colorful card depicting the Super Eight and opportunity to record three health status indicators namely Body Mass Index (BMI), Blood pressure and Radom blood sugar was given. The picture shows the Hon Minister of Health being shown the card which has
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the Super Eight in English, Sinhala and Tamil. There were several health booths which enabled people to get these health status indicators checked. The day started with the youth component of the Healthfest. A Triathlon was organized by the youth partners which were the Achievers Rotaract club taking the lead with other Rotaractors and the Interactors of Colombo district. The photos show different stages of the Triatholon. Different forms of physical activity were promoted at Healthfest. The public participation in stretching exercises, Yoga, Zumba was encouraged. Whilst professional instructors showed the way the public engagement was facilitated by the young scouts as well as medical students and other health professionals.
Hon Minister of Health being shown the card which has the Super Eight in English, Sinhala and Tamil
Volunteers at the Healthfest
Contd. on page 26
Secretary to the Ministry of Health Dr Nihal Jayathilaka and Additional Secretary (Public health) accompanies the Deputy Minister of Health at Healthfest
HE The president at the launch of the Super Eight
Hon. Minister of health examining the variety of local fruits available at the supermarket stall HE the President inspects preparation of Healthy Koththu
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SLMANEWS
December, 2012
Shun/quit Smoking, Says Medical Fraternity in Unison Full backing for pictorial warning on packets of cigarettes By Kumudini Hettiarachchi
T
he medical fraternity threw its full force behind the Government recently, reiterating in one voice that “smoking kills” and there is a need to alert people to the deadly risks through pictorial warnings on the packets of cigarettes. “People should quit smoking. There is no other alternative,” underscored Sri Lanka Medical Association (SLMA) President Prof. Vajira H.W. Dissanayake, with the SLMA taking the lead in this campaign and garnering the unstinting support of all doctors’ and dentists’ colleges in Sri Lanka as well as the Government Medical Officers’ Association (GMOA). Giving out a strong message about the deadly effects of smoking on different health aspects were the SLMA’s Committee on Tobacco and Alcohol; the Sri Lanka College of Oncologists; the Sri Lanka College of Paediatricians; the Ceylon College of Physicians; the College of Community Physicians; the College of General Practitioners of Sri Lanka; the Association of Pulmonologists of Sri Lanka; the College of Psychiatrists of Sri Lanka; the Sri Lanka College of Haematologists; the College of Forensic
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Pathologists of Sri Lanka; the College of Community Dentistry of Sri Lanka; the Sri Lanka Dental Association; the College of Medical Administrators; and the National Institute of Mental Health. “Non-communicable diseases (NCDs) are spreading faster than ever before and for a developing country such as Sri Lanka, the population affected by NCDs is unbearable,” pointed out Prof. Dissanayake, explaining that people were being struck down by heart disease, stroke, diabetes, cancer, chronic lung diseases etc. Some of the underlying causes of NCDs are bad habits, one of which is smoking. Smoking is an important risk factor we need to deal with. People should quit smoking, for not only is the smoker affected but all those around him as well because they become passive smokers, he said. Awareness is of paramount importance and a message should be sent out through the packets themselves about the consequences of smoking, like many other countries do, according to him. “Packets of cigarettes should be used as a medium of education.” About 50 people die each day due to tobacco, was the terrible data given by Dr Narada Waranasuriya, the head of the SLMA’s
Panel of medical experts. Pic by Athula Devapriya
Committee on Tobacco and Alcohol, with the number of people dying each year in Sri Lanka due to tobacco being estimated between 12,000 and 20,000. Pointing out that tobacco use had reached epidemic proportions worldwide; he said that on the positive side Sri Lanka was among the more than 170 parties who embraced the World Health Organization’s Framework Convention on Tobacco Control introduced in February 2005. Sri Lanka was the fourth country in the world to ratify this international convention, which mandates the use of large and clear warnings on the drastic consequences of smoking. Contd. on page 31
People should quit smoking, for not only is the smoker affected but all those around him as well because they become passive smokers - Prof. Vajira H.W. Dissanayake,
SLMANEWS
December, 2012
SLMA Press Release Supporting Mandating Pictorial Health Warnings Covering 80 per cent of the Front and Back of Tobacco Packs
O
ver 60 per cent, of deaths world-wide are due to non-communicable diseases (NCD). The four main NCDs are cardiovascular diseases, cancers, diabetes and chronic lung diseases. Nearly 80 per cent of non-communicable disease deaths occurred in low- and middle-income countries. The four main risk factors identified for these deaths are tobacco, alcohol, unhealthy diet and lack of physical activity. Tobacco is a leading cause of three of the main NCDs – cardiovascular diseases, cancers and chronic lung diseases. Tobacco use is considered to be one of the biggest threats to public health that the world has ever faced. It is responsible for 6 million deaths each year worldwide. Of these, 600,000 are non-smokers exposed to second-hand smoke. One in two of current users will eventually die of a tobacco-related disease In Sri Lanka, the number of people dying each year due to tobacco has been estimated to be between 12,000 and 20,000. In addition to deaths alone, there are a large number admitted to hospital with chronic tobacco related diseases. Money spent on purchasing tobacco and expenditure incurred in obtaining treatment, in addition to forgone income from losing work is a substantial contributor to poverty. Each of these deaths and the other consequences are preventable. Many countries have implemented evidence based measures to reduce tobacco use. One of the
important measures undertaken to educate smokers of the harms of tobacco use is mandating pictorial health warnings on tobacco products. Other measures include discontinuation of all forms of advertising, sponsorships and promotions, increasing the taxes on tobacco to reduce affordability and banning smoking in public places. The National Authority on Tobacco and Alcohol Act No 27 of 2006, which is one of the most important acts enacted in this country to improve the health and well-being of the people aims to reduce the enormous health, economic and social harms of tobacco. This Act mandates that health warnings to appear on tobacco packages to be prescribed by the Minister of Health. Large, clear pictorial health warnings increases quitting, and more importantly, prevent children and young people from taking up smoking; Larger the warning, larger the impact. It also makes it difficult for the tobacco industry to display cigarette packs attractively at sales points, including supermarkets. Around 50 countries in Europe, North and South America, Asia, and Africa have already implemented this measure despite dogged opposition by the tobacco industry. The international response to the epidemic has been decisive. The international convention, The WHO Framework Convention on Tobacco Control entered into force in February 2005. Since then, it has become one of the most widely embraced treaties in the history of the United Nations with
more than 170 parties. Sri Lanka was the fourth country in the world to ratify this. Mandating large and clear warnings is one of the measures that this treaty binds its parties to. Therefore, we fully support the initiative undertaken by the Minister of Health to mandate pictorial health warnings covering 80per cent of the front and back of the tobacco packs, and to declare toxic substances contained in cigarettes, in each pack. This measure will substantially contribute in addressing the enormous health, social and economic harms caused by tobacco, which is detrimental to the wellbeing of the people and will undermine development initiatives undertaken by the government of Sri Lanka. We also hope that this measure will be implemented without delay as new tobacco users are recruited each day, and people die from tobaccorelated diseases each day. The following colleges and associations attended the conference: Sri Lanka Medical Association Sri Lanka Dental Association Government Medical Officers Association College of Psychiatrists Sri Lanka College of Oncologists; Sri Lanka College of Paediatricians Ceylon College of Physicians College of Community Physicians College of General Practitioners of Sri Lanka Association of Pulmonologists of Sri Lanka College of Psychiatrists of Sri Lanka Sri Lanka College of Haematologists College of Forensic Pathologists of Sri Lanka College of Community Dentistry of Sri Lanka College of Medical Administrators The National Institute of Mental Health
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SLMA
December, 2012
Medical Dance 20 T he Medical Dance, the most prestigious and the oldest Dance in Sri Lanka, still continuing to this day from the 1930s, was held on 8 December 2012 at the Oak Room of the Cinnamon Grand in Grand Style. The guests started arriving at 8.30 pm and mingled around for cocktails. The doors opened at 9.15 pm and the Dance was opened around 9.45 pm with the President and Dr. Mrs. Dissanayake taking the floor followed by members of the Dance Committee together with their spouses. The guests Danced to their heart’s content till 3.00 am in the
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morning to the music of Friends in Harmony and Flame. The sit down dinner was welcomed by all guests, as it gave them an opportunity dance between courses. 3D video mapping, a Jewellery show by Vogue, a Latin dance performance by Footwork, and a belly dance performance by Kreshula all added colour to make the dance an event to remember for a long time. The guests, nearly 300 in all, consisted of a cross section of the medical profession – Surgeons, Physicians, Obstetrician and Gynaecologists, Paediatricians, Neurologists, Pulmonologists, Radiologists, Anaesthesiologists, Ophthalmolo-
gists, Medical Administrators, and many other specialists and non specialists – they were all there together with their guests from the accounting, legal, and many other professions. Some doctors had even travelled from the UK, USA and Australia. There were prices and surprises with gift vouchers ranging from dinner for two in five star hotels to weekends in holiday resorts to airline tickets to many destinations on offer. So the raffle tickets were sold out in quick time. Everyone appreciated the kind gesture by Dr. Ruvaiz Haniffa - the SLMA treasurer, who gave back the prize he won, an
ANEWS
December, 2012
012
y
airline ticket, to be drawn again. It was redrawn and given to a new winner. The lucky winner of the business card draw by the platinum sponsors BMW got the chance to take away a BMW 5 series car home with a full tank of fuel for a week. The Dance was organised by the Dance Committee with President Prof. Vajira H. W. Dissanayake, Honorary Secretary Dr. Lasantha Malavige –; Dr. Dennis and Mrs. Chrissy Aloysius; and Dr. Preethi Wijegoonewardena assisted by Ms. Jayarani Thennakoon and Mr. M Rajasingham sharing the bulk of the organising work.
25
SLMANEWS
December, 2012 Contd.from page 21
Healthfest... The Healthfest showcased the importance of early introduction to lifestyle modification. Preschool teachers were trained and involved in a full days program. Parents too were able to observe how these changes were introduced from awareness to skill building and interactive play. The Healthfest was arranged in a natural setting and people were enjoying the environs and could relax under trees on a sunny day. They were also able to indulge in different types of food and beverages and there was nothing missed. High sugar carbonated drinks were avoided. However the option was given to people to choose the desired sugar level from no added sugar drinks to those where sugar could be added to taste. Leading catering agencies that took part had turned out new healthier food with added fiber and less oil snacks. Street drama conducted by the Colombo Faculty of Medicine gave a message on super eight and also provided entertainment Street drama conducted by the Colombo Faculty of Medicine gave a message on super eight and also provided entertainment. There is a growing super market culture in Sri Lanka. The college was interested in working with a supermarket that could exhibit best practices in promoting Super Eight within the open mar-
26
Different stages of the Triatholon
ket economy that prevails. Some principles that could be adopted were shared and we expect that a leading Supermarket will showcase these best practices in the future for others to follow. A wider availability of variety of local fruits is also envisaged. The picture shows the Hon. Minister of health examining the variety of local fruits available at the supermarket stall which collects them directly from the local farmers. Dialog axiata who was our principal sponsor launched a facility to check BMI.
Hon. Minister of Health promotes safe water as the best drink
Minister of Agriculture, Deputy Minister of Health and the Secretary Health at the Healthfest
SLMANEWS Those who have Dialog mobile phones will be able to check BMI by dialing #771*264#. Dialog will also be displaying important health messages which are also related to Super Eight as missed call alerts. The Ministry of Agriculture too partnered the College of Community physicians to give a health emphasis to the national drive of 'Api Wawamu - rata nagamu', which is 'Api
December, 2012
wawamu - Poshanaya Wadamu'. We promoted at least 5 types of fruit and vegetable trees to be planted in home gardens. We gave a recommendation for the following varieties. Lime, banana, papaw, passion fruit, beans (long, winged, broad), katuru murunga, . The plants were available for sale. Demonstrations were conducted by the Agriculture department on planting
Different forms of physical activity were promoted at Healthfest
techniques sans pesticides and artificial manuring. Various other stalls offering different healthier options were available at Healthfest. From Fitness machines to the importance of foot massage, from experiments with coconut based products, to a supermarket that showcased its future potential to provide local fruits, to catering agencies that were willing to offer healthier
snacks in their outlets in future and a range of beverages that were healthier. The changes did not in any way create a vacuum of choice and it was clear that people can lead an interesting life whilst opting for healthier choices. Celebrities and other public figures who attended added color to the event. They expressed their opinion on Super Eight. Contd. on page 30
Some events at the pre-school program
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SLMANEWS
December, 2012
Economics of Health Care By Fathima Carder
T
he Sri Lanka Medical Association has focused its attention on discussing the economics and other broader issues related to health care such as human resources development. These began with two symposia at the 125th Anniversary International Medical Congress. They were on “Financing Health Care in Sri Lanka” and on “Human Resources Requirements in the Sri Lankan Health Sector”. The Symposium on “Financing Health Care in Sri Lanka” chaired by Prof. S. P. Lamabadusuriya and Dr B. J. C. Perera consisted of three presentations: “Sri Lanka Health Accounts” by Institute of Health Policy, Fellow and Director Dr Ravi Ranan Eliya, “Healthcare Costs and Equity” by University of Colombo, Faculty of Medicine, Department of Clinical Medicine, Professor in Medicine, Prof. Saroj Jayasinghe “The Science and Economics of Drug Discovery in the 21st Century” by UK, University College London, Royal Free Hospital and Centre for Immunodeficiency, Department of Clinical Immunology, Consultant in Clinical Immunology and Allergy, Dr Suranjith Senevirathne. The Symposium on “Human Resources Requirements in the Sri Lankan Health Sector” Chaired by: Dr C. Thurairajah and Prof. Saroj Jayasinghe consisted of four presentations: “Current Human Resources in the Government Health Sector and Future Projections” by Ministry of Health, Development and Planning Unit, Management, Director (Planning), Dr Champika Wickramasinghe, “Development of Human Resources for Health in the Government Health Sector” by Ministry of Health, Education, Research and Training Unit, Deputy Director
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Panellists at the symposium on “Financing Health Care in Sri Lanka”
Panelists at the symposium on “Human Resources Requirements in the Sri Lankan Health Sector”
SLMA Health Management Committee Chairperson Dr Palitha Anbeykoon and College of Medical Administrators President Dr Nick Jayasuriya chairing the session.
General (Education, Research and Training) Dr Sunil De Alwis, “Human Resources Requirements in the Private Sector” by Private Health Services Regulatory Council, Member, Dr Amal Harsha de Silva and “Human Resources Requirements – the Views of the Private Sector” by Durdans Group of Hospitals, Senior Manager, Dr Vibash Wijeratna, representing the Large Hospital Groups. The Health Management committee under the Chairmanship of Dr Palitha Abeykoon, ably assisted
Ministry of Health Additional Secretary Dr Palitha Maheepala delivering his address
by Dr Ruvaiz Haniffa is taking this discussion to the wider medical and professional community through a series of symposium. The first of these symposia on “Economics of Healthcare in Sri Lanka” organised by the Sri Lanka Medical Association (SLMA) in collaboration with the College of Medical Administrators of Sri Lanka on ‘Economics of Healthcare in Sri Lanka’ was held on November 21, at the Lionel Memorial Auditorium, of the SLMA, in Colombo 7.
SLMANEWS The main focus of the seminar was to find ways and means of addressing the pressing issues with regard to costs in the health sector and to make the maximum and best use of the resources available so as to provide the best possible service to the patient. Speaking on the occasion, SLMA president, Prof. Vajira Dissanayake said that this is a timely symposium to make the healthcare community aware of the need to channel money where it is needed. “When one makes a treatment decision, it is a decision based on finance, and therefore the decision should be one that will be of benefit to the patient,” he said. Making a presentation at the seminar, SLMA, Health Management Committee, chairman and WHO consultant Dr Palitha Abeykoon posed the question, ‘What makes a health system ‘good?’ Explaining, he said that it will mean different things to different bodies within the health sector and others connected. For example, the Ministry of Health will defend the budget, the Ministry of Finance will try to balance the many claims made on the government’s purse, the harassed secretary will be trying to avert another strike, a troubled hospital director will try to find more beds, a doctor or nurse may have run out of antibiotics while a mother with a sick child will find the hospital is not working, a pressure group will be lobbying for kidney transplants and a newspaper will be looking for a good story. The three main objectives of managing a health system should encompass providing a service, responding to expectations from patients and fair financing which means one should not go bankrupt on account of being ill. “Fortunately, healthcare in Sri Lanka is considered a low cost service with good results. Sri Lanka’s welfare system has placed health at the centre more than 60 years ago. There has been a public/private mix is primary healthcare – 55per cent of outpatient care is provided by the
December, 2012
A section of the audience showing representatives from both the public and private sectors
private sector while 90per cent of indoor care is provided by the public sector,” said Dr Abeykoon. Sri Lanka’s expenditure on health is low and out of pocket expenditure is high compared to other countries, it was revealed. While Sri Lanka is now a lower middle income country, up from being a low income country, the country is also one of the fastest aging countries in South Asia. Focusing on the relationship between health and wealth, Dr Abeykoon said that the two main points are – (1) Keeping a population healthy reduces the cost to the health service, and (2) A healthy population increases productivity. He added that private practice is a saving grace for many doctors since their salaries are not that high. On the other hand, in the health sector in the outstations, there aren’t sufficient specialised surgeons to attend to patients. Addressing the seminar, additional secretary to the Ministry of Health, Dr Palitha Mahipala, said that health is the responsibility of the individual and not the government. “The free health system was introduced in the 1930s. In 1920, Sri Lanka had the worst health indicators and today, it had the best health indicators in the region. The life expectancy of the male is 71 years while that of the female is 78 years.
Sri Lanka’s expenditure on health is low and out of pocket expenditure is high compared to other countries, it was revealed. While Sri Lanka is now a lower middle income country, up from being a low income country, the country is also one of the fastest aging countries in South Asia.
Contd. on page 31
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SLMANEWS
December, 2012
Contd.from page 27
Healthfest... The Healthfest was arranged in a natural setting and people were enjoying the environs and could relax under trees on a sunny day. They were also able to indulge in different types of food and beverages and there was nothing missed. High sugar carbonated drinks were avoided.
The College membership is of view that such a dialogue on Super Eight is essential in a social marketing campaign that is aimed at empowering people with health targets for them to reach and sustain. The Healthfest is the initial event that launched Super Eight. The concept is important for others to follow when creating social events portraying healthier lifestyles. The underlying emphasis being that just awareness is not enough. People must be empowered and for that they need healthier options.
The College of Community physicians of Sri Lanka together with the support of the Ministry of Health and the National Nutrition Secretariat of the Presidential Secretariat will be taking Super Eight the brand of eight health targets forward as a national endeavor of addressing Non communicable diseases in Sri Lanka.
About the writer Dr Susie Perera is the President of the College of Community Physicians
Popular Singer Nirosha Virajini comments on super 8
Street drama
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Dayasiri Jayawardena meets HE the President at Healthfest
SLMANEWS
December, 2012
Contd.from page 29
Economics... People have access to health with a health care facility being available within a three kilometre radius of any ones location. Maternal mortality has come down to very low levels and in fact is on par with developed countries. It is also the best in the region,” he added. Certain issues were highlighted – patients who buy certain over the counter drugs like paracetemol and stock them for a long period of time while there are patients who, having being prescribed medication for high blood pressure, will after some time stop taking the tablets thinking that they are better and hence there is
no further need to continue. In such situations, what they do is wrong - in not continuing with the prescribed drugs and at the same time wasting valuable drugs as they throw what is still left over after a while, which is a waste. Presentations to address the economics is healthcare, with comparative studies from other countries were also made by University of Kelaniya, Faculty of Medicine, senior lecturer, Dr Anuradhini Kasthuriratne and Institute for Health Policy executive director and Fellow Dr Ravi Rannan-Eliya. An important point highlighted by Dr Ravi Rannan-Eliya was the fact that
as countries become more and more affluent, healthcare is delivered more and more by the public sector rather than the private sector. He pointed out that it is a common myth that it was the other way around. It was also pointed out that per unit of expenditure, Sri Lanka’s health outcomes were probably the best in the world. The organisers were urged to continue to conduct similar seminars so as not to lose sight of a good initiative, which some panellists and participants felt need to be taken forward to maximise the available financial resources in order to provide the best services to patients, cost effectively.
Contd.from page 22
Shun/quit Smoking... “A binding requirement of the Framework is pictorial warnings,” said Dr Warnasuriya, stressing that there is evidence-based, scientific findings that prove beyond doubt that such warnings help to curb smoking. He said that the tobacco industry resorted to various insidious methods to engulf innocent children in a haze of cigarette smoke. Referring to the 4 Ps of tobacco control, Dr Santhushya Fernando of the College of Community Physicians said they included increasing the ‘price’ of cigarettes through high taxes; prohibition of smoking in certain ‘places’ such as hospitals, public vehicles, public places, hotel rooms, workplaces and elevators; prohibition of sale of cigarettes in certain ‘places’ such as public places; and
limiting the ‘promotion’ of cigarettes through advertising and packaging. To reduce the attractiveness and appeal of tobacco products to consumers, particularly young people, the College of Community Physicians was specific that graphic warnings must cover at least 75per cent of the front of the packet of cigarettes while a warning statement, graphic and explanatory message must cover 90per cent of the back of the packet. Dr Fernando said that the tobacco industry uses various methods to promote this deadly habit. “They make it look like fun and they even invade sports,” she said recalling the “China: Olympics special”. All the diseases which come about due to smoking were listed by those present and the list was
very long. Meanwhile, an SLMA media release said that tobacco is the leading cause of three of the main NCDs – cardiovascular diseases, cancers and chronic lung diseases, and is considered to be one of the “biggest threats” to public health that the world has ever faced. “It is responsible for six million deaths each year worldwide, of which 600,000 are non-smokers exposed to second-hand smoke. One in two of current users will eventually die of a tobacco-related disease,” the release said, adding that “an important measure undertaken to educate smokers of the harms of tobacco use is pictorial health warnings on tobacco products. Other measures include discontinuation of all forms of
advertising, sponsorships and promotions, increasing taxes on tobacco to reduce affordability and banning smoking in public areas.” Large, clear pictorial health warnings increase quitting of smoking and more importantly prevent children and young people from taking up smoking. Larger the warning, the larger the impact, it added.
Reproduced with Permission from the Sunday Times of 9 December 2012 http://www.sundaytimes.lk/121209/ news/shunquitsmoking-says-medical-fraternity-inunison-24062.html
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SLMANEWS
December, 2012
Medical Dance A Short History
T
he first Medical Dance was organized by an informal group of enthusiastic doctors and medical students in the 1930s. Its history is lost in the mists of time: there are no official records, as the Dance did not have a formal institutional base. It was much later that the national association – the Sri Lanka Medical Association (SLMA)– became involved in its organisation. Dr. P. R. Anthonis, the most senior of the Past Presidents of the SLMA, who is today 95 years old, recalls that when he was a medical student in the 1930s Dr. E. P. de Silva and others were organizers of this prestigious Dance. At that time it was one of the highlights of the social calendar in our country, being held annually at the Galle Face Hotel. There were few large hotels in the country at that time and like all such events was a formal affair and expensive to attend. A rigorous dress code for both ladies and gentlemen was enforced: anyone not in Formal Dress (black dinner jacket and black bow tie for the men and the ladies clad in sarees with the ‘saree pota’ usually draped over the head or a ball gown)
32
were turned away at the door and only admitted if they returned properly clad. Tickets were difficult to come by. Dr Shelton Wijetillaka, a Senior Past President of the SLMA, recalls that when he was a medical student in the 1940s the dance was still prestigious and the rules were laid down by the original organizers continued to be in force. Many famous medical people were involved in organizing the Medical Dance during these early years and included Drs Cyril Fernando, Aloy Fernando, Laddie Fernando, Bubsy Mendis, Willie Ratnavale, Shelton Cabraal, David Jayamana, L. P. D. Gunawardene and Douglas Flamer Caldera. In the latter part of 1950s the dance went into slow decline, with poor participation. The stalwarts who had organized the Dance over the years and kept it lively and vibrant had either passed away or were no longer active. In addition the economy of the country had taken a downturn. This was when Dr E. H. Mirando stepped in and made a significant change. On the 17th of July 1959 he moved a resolution at a meeting of the SLMA to take over the organisation of the Medical Dance. The reso-
lution was adopted with the proviso that it would be open to all members of the medical profession and their guests. It was thus that the SLMA became the organisers of this dance. Within a short time the dance was rejuvenated and once again became an important social event for the profession. Those who attended the dance in 1964 at the Hotel Taprobane will recall that we had to book 2 floors of the hotel—the demand for tickets was so heavy. The venue for the dance was the Galle Face Hotel for over a quarter of a century. Later it moved to the Grand Oriental Hotel, or Hotel Taprobane as it was subsequently renamed, for a short period; the Samudra Hotel at the site of the present Taj Samudra Hotel on one occasion and since 1975 to date the Hotel Lanka Oberoi, now renamed the Colombo Plaza. The history of the Dance is not without its lighter moments. The Cabaret was a regular feature with dancers in various stages of undress – both planned and unplanned: on one occasion there was an unexpected bonus when the sunflower hiding the left breast of one dancer fell off in mid-performance! Contd. on page 36
Within a short time the dance was rejuvenated and once again became an important social event for the profession. Those who attended the dance in 1964 at the Hotel Taprobane will recall that we had to book 2 floors of the hotel— the demand for tickets was so heavy. The venue for the dance was the Galle Face Hotel for over a quarter of a century.
SLMANEWS
December, 2012
Highlights of the Medical Dance
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SLMANEWS
December, 2012
Contd.from page 32
Medical Dance... At the Samudra Hotel Dance it was noticed that the belly dancer was pregnant – some belly dance that was! On another occasion a senior member went on stage and sang ‘NAMO NAMO MATHA’ and the Dance ended abruptly at 2 am. The later nineteen eighties saw the country in a war situation. It was considered in bad taste to hold the Dance and for many years there was no Medical Dance. It was revived in 1992.
Compiled by Dennis Aloysius and Malik Fernando in November 2005 Having served as one of the Social Activities Secretaries or as a member of the Dance Committee from 1994, the year of Presidency of Dr JB Peiris, I think it appropriate to take up the narrative where Dennis and Malik left. Sadly Dr P R Anthonis and Dr Shelton Wijetillake are no longer with us. I do remember Dr Wijetillake being a very active and enthusiastic member of the Dance Committee. He did not consider it intruding to go from table to table selling raffle tickets at the dance. Unfortunately the dance was not held annually since 1992. In 1995 when Dr Lucian Jayasuriya was the President (I was one of the Social Activities Secretaries at that time) the dance
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was cancelled by a Council decision following a bomb blast in Colombo. Many of us were involved in treating the horrendous casualties, and we did not have the heart to go ahead with the dance. Most of the arrangements had already been made and we even had to forfeit a percentage of the advance booking fee for the Hotel. In 1999 during the Presidency of Prof Nimal Senanayaka, the dance was in progress when a bomb blast occurred at the Colombo Town Hall. You may recall that the President of our country Chandrika Kumaranatunge was injured at that time. Several of our members left the dance floor and rushed to Nawaloka Hospital where the casualties were admitted, to offer their services. In the year 2000 during the Presidency of Dr Kumar Weerasekera, the dance was cancelled as there were many acts of terrorism in and around Colombo, and the Council thought that it was not prudent for medical professionals to hold a major social event. Since then the Dance was held annually till the year 2006. It is noteworthy that many Presidents who were non dancers themselves, Dr S Ramachandran, Dr D N Athukorala, Prof. Anoja Fernando, Prof. A H Sherrifdean, to name a few had no hesitation in keeping up the grand traditions of the SLMA. The Medical Dance has been resurrected this year
by our current President Prof. Sanath Lamabadusuriya after a lapse of 4 years. It augers well for the future that this event has already been included in the calendar of events for the year 2012. I do hope the trend will continue.
Compiled by Suriyakanthie Amarasekera in November 2011 The Dance Committee 2012 takes on where Suri left.....from the next page The Medical Dance held on 9 December 2011 was a grand success. Around 180 guests danced through the night to the music of Summerset and Outburst brining back memories of the Medical Dance of years gone by. The Dance Committee led by Drs Suriyakanthi Amarasekera and Gamini Walgampaya fine-tuned the whole occasion to everyone’s delight. The sit down dinner was much appreciated. The guest got more than value for their money with no less than 11 airline tickets and dozens of other prizes given away.
Complied by the Dance Committee in December 2012
The Dance Committee led by Drs Suriyakanthi Amarasekera and Gamini Walgampaya fine-tuned the whole occasion to everyone’s delight. The sit down dinner was much appreciated. The guest got more than value for their money with no less than 11 airline tickets and dozens of other prizes given away.
Our focus is on patient safety and quality first “ Asiri Heart Centre is committed to providing excellent patient care, efficiently and at a reasonable cost. Asiri Heart Centre has become a leader in the treatment and
prevention of cardiac diseases. Our superior clinical outcomes are
accompanied by our outstanding service quality. This reflects the calibre of our highly trained physicians, continuous training and improvement strategies, use of latest
technology,
and
adherence
to
evidence
Superior service at Asiri Heart No. 21, Kirimandala Mawatha, Colombo 05. Tel : 011 4524400 / 011 2368407 / 011 2368408 Fax : 011 4524451 / 011 4527311 E-mail : info@asiri.lk Web : www.asiri.lk
based
cardiac
”
care.