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Friday, March 30, 2018

The Hand that Rocks the Cradle.

By Rohini Anandaraja

The world has ceased to be a secure place to live in, least of all to bring up future generations.
Children are the most vulnerable in societies, and the effects of poverty, environmental degradation and violence compound their vulnerability. How can we as adults  mitigate and reverse these trends, and give future generations the best environments to thrive in?

If one looks back through history, or the pasts of antisocial elements, it becomes apparent that most, if not all, have suffered neglect, injustice, violence, or other trauma in their young lives.
It follows that, if these can be eliminated and  children are brought up in secure and loving environments from the very beginning, brought up to respect others, and to protect their environments, we could hope to make the world a safer place for future generations.

Women bring children into this world, and are closest to, and spend the most time with them in their formative years. Though a mother by her very nature is caring towards her offspring, other factors such as inadequate basic physical / environmental needs, postpartum hormonal imbalances, inadequate partner / other family support ,and other life stresses can impair her ability to optimally care for and nurture her young.

If it is possible to have a solid framework for supporting the welfare of all mothers in whatever area of need, it might be possible, not merely to ensure the innate caring and nurturing a mother is capable of, and give her the best chance to mentor her children and bring up a mentally and physically healthy generation of educated men and women.

Simplistic as it may sound, this may be where the focus now needs to be, where high level politics, legal systems and religions have failed to ensure a peaceful world.

New mothers however cannot be expected to engineer this alone at a time when she not only has to cope with her own emotional, hormonal and physical needs, but also needs to care for her totally dependent newborn. She needs support from those around her.

Historically this support has been forthcoming from extended family when community living has been the norm.
In this day of nuclear families  this support has to come from the spouse. It follows that the spouse has to be educated as well, on the Importance of the support  needed, and  to participate fully in the provision of the safe and loving  environment needed for optimum raring of the young.

It is accepted that significant moulding of character occurs in the first three years of life. Hence education has to commence in the earliest years of childhood for both genders. Each person in the family has to be educated from their earliest days, to behave with kindness, compassion, respect, and with integrity at all times, treating everyone as they themselves would like to be treated, so it becomes ingrained, and becomes second nature as they grow up.

Children learn from what they are exposed to! No amount of lecturing  teaches them better than what they see adults do! Hence they need to be in an environment where kindness and respect prevails, and be made to understand that violence and bullying are not options and cannot be tolerated. They need to grow up with gender and race equality, and be taught to safeguard their environments.

It doesn't seem adequate to leave this education to teachers in schools. By the time they attend Preschool,or kindergarten it is already late. By this time children need to have learnt which behaviours are acceptable, how to socialize courteously and kindly. They need to be equipped to negotiate the social world of other kids, negotiate disagreements peacefully, to deal with apparent injustices, eg of one pupil seeming to be favoured! and be able to regulate their own actions in the absence of parental intervention when away from home - a huge task for a young child. It shows how important what they see and learn at home in their early years becomes.

As well as feeling safe physically, they should be able to share their innermost fears, in a home where support and accurate information is available, with reassurance that kindness and good behaviour are valued ahead of academia and performance.

It most often befalls the mother to provide this safe haven and guidance to the children at this young age, and whatever support she can be provided with to fulfill this important role cannot but carve a path to a better world.

I do not pretend to have a simple solution to the problems of the world today, but if as adults we can help achieve these goals in our own little communities in our own little corners of the earth, even by supporting available networks, we can at least hope to make some positive change, so that by our inaction we do not let our children and our world be destroyed.

The hand that rocks the cradle has the key to the child's world at a time when he/she is most receptive, with opportunity to fashion their psyche and behaviour in favorable ways, so they grow up to be caring, responsible citizens, able to safeguard their future in a safer world for all.

Needless to say, the attendant issues to making this a reality are many. Dealing with poverty, ensuring education for all women globally, promoting gender/race equality etc all need to be addressed, and unless we keep these in mind and act, the problems will continue.

This is not an aim for superiority of one gender over another, to favour one gender over another, or to sideline the important role fathers play in bringing up children, but to highlight the role incumbent on mothers to play in the home, as guardians of these young minds - a role often overlooked and undervalued. It is so men and women can work, not in competition, but in supportive partnerships, to bring up generations of caring and responsible men and women to ensure a safer and better world for all.

Too long have we relied on government agencies, law enforcement agencies, religious groups, corrections facilities to ensure a safe world, which they have failed to deliver. Let us start from the beginning, and give the hand that rocks the cradle the support and education it needs to bring about a new mindset for a safer world.

The hand that rocks the cradle needs a hand. Let us all do our part.

Friday, March 23, 2018

Advances in Technology: a Gift or a Curse?

By Srianee (Bunter) Fernando Dias

Recently, my washing machine, which was just over the warranty period, decided to call it quits.  It turned out that the electronic controls were defective and replacing them would have cost close to the price of a new machine.  So I decided to purchase a new washing machine, lamenting the fact that things are far more complicated than they need to be.  My previous washing machine had lasted about 20 years and was still working when I sold my home.  That machine had no electronic controls, but a simple knob which had to be turned to set the cycle.  Why do washing machines have to have fancy, complicated electronics?

Many of us use e-mail, WhatsApp, Facebook, Twitter, text messaging, and video-chatting apps, and those of you who are reading this are communicating with friends on the Blog.  It is wonderful to be able to communicate this way, but I am convinced that we need to be judicious in our use of technology.  If one spends all day sitting at the computer, or staring into the phone, when does one make time to take a walk and breathe some fresh air?  Think about all those aging muscles which need to be moved and strengthened frequently.  Sit around all day and your muscles will turn to Jell-O!

We all know of young people who get hooked on video games and play without paying attention to food and drink.  I believe that deaths have been reported in South Korea.
It is definitely a generational thing that we in our eighth decade are intimidated by these fast-developing technologies, whereas toddlers are instinctively able to use the touch screen of their parents’ iPad and watch their favorite movie or TV show.  It is very easy to keep a small child mesmerized and occupied with an electronic device, as opposed to other optionsthat require more effort on the part of the parents.

A few days ago when I was out with my family, I was delighted when I saw my 5- and 6-year-old grandnieces playing a version of “Rock, Paper, Scissors” instead of burying their heads in a smartphone.  They were having so much fun giggling over this version which was called “Lady, Hunter, Lion!”  A few months earlier, I had attended a celebration of a friend’s birthday, during which her grandsons barely said hello to the guests and instead spent all their time with their noses close to their smartphones.

My daughter has imposed a “no-device policy” every weekend in her home.  The whole family (including the parents!) sets aside their computers and other devices for six hours every Saturday and Sunday.  If there is homework to be done on the computer, the kids are required to do it in the living room or dining room where the parents can keep an eye on the screen.  I’m happy that some effort is being made in my family to control the use of these addictive devices.

I may be one of the minority who is not enamored with GPS guidance while driving.  I’d rather check my route ahead of time (yes, I do use Google Maps or MapQuest), print the directions, and sometimes even memorize them before setting out on my journey.  I rely on landmarks and visual clues and really dislike a phantom voice telling me when to turn right or left.  Perhaps I’ve always disliked backseat drivers!  I know that the GPS routes are not always the shortest or the best.  I have a sneaking suspicion that relying on all this external technical assistance  with directions is leading to the atrophy of some part our brains which keeps us oriented in time and space!

In the field of medicine, technological advances made in the last few years have been quite phenomenal.  But with reliance on technology, are we losing some of our clinical skills? There has been much discussion on this topic in the current medical literature.  Because certain tests are available, doctors are often compelled to order them, even though there may be simpler clinical assessments available to reach the same diagnosis.  There are exceptions, of course.  The interventional radiologists perform heroic procedures with minimal invasion.  In the past these procedures may have required opening the skull, chest or abdomen, adding weeks to the patient’s recovery time.  Nowadays they are done as outpatient procedures, by passing slender instruments through veins or arteries.

Communication using the internet has been a boon to many.  Older individuals who may be housebound are able to communicate with friends and family using e-mail and text messaging.  I have observed that older folk who complain that they are lonely are the ones who have not bothered to learn to use a computer and basic e-mailing.  Those who have overcome this hurdle have found that they are no longer isolated.

In the last few days and weeks, we have been made aware of the hazards of using the Internet.  Facebook users have been disillusioned.  Those who believed that the information they were sharing on Facebook was for their friends and family only, have now found out that their data has been mined by other companies for nefarious purposes.  Elections have been manipulated, conspiracy theories have spread far and wide, and the list keeps growing.  It is imperative that we be extracautious when using the latest technological developments.  It is a bit like driving a powerful sports car downhill on a steep, mountainous road with numerous hairpin bends.  One has to know how to shift those gears.  Unless you are James Bond, you may crash and burn.

Sunday, March 18, 2018

Stephen Hawking.(8.1.42 to 15.3.2018)

by Zita Subasinghe Perera

Picture taken by Hubble telescope shows the furthest galaxies ever photographed.
Every speck is a galaxy and some of them billions of years old.

Stephen Hawking the most respected British scientist of modern times died on the 15th of March 2018 at the age of 76. He was confined to a wheel chair for most of his adult life. He spoke through a computerised voice system in an American accent. His name that has been heard in relation to cosmology and Theoretical Physics.He was the Director of Research at the Centre for Theoretical Cosmology at the University of Cambridge. Both his parents were graduates from Oxford even though they did not come from ‘elite’ families. Their son Stephen was born 300 years to the day Galileo was born. They obviously believed in good education and their son Stephen was a graduate of the University College, Oxford. He was not a highly keen student and spent a lot of time in the College boat club. But he got a first class there and went to Cambridge. But even there he did not find enough to satisfy his interest in Cosmology and fell into a depression. he obtained his PHD degree in applied mathematics and theoretical physics, specialising in general relativity and cosmology, in March 1966. He met Jane Wilde during his time at Cambridge and a few months later he was diagnosed as suffering from Motor Neurone Disease (MND) and given 2 years before he would become completely disabled. He refused to be discouraged. At this stage Jane’s presence was crucial to his determination to overcome all obstacles and he obtained his PhD in Applied Maths and Theoretical Physics.

He was inspired by Roger Penrose’s theories of singularity and black holes. Simply stated, a black hole is the ‘empty space’ (to us!) left after the death of a star. But Penrose and Hawkins believed otherwise. Hawkins in fact postulated a radiation from the centre of a black hole and it is called Hawking’s radiation. During his undergraduate years in the early ‘60s and later his graduate years he cooperated with fellow scientists in the description of many cosmic phenomena. He received many prizes and awards. His first book was The Large Scale Structure of Space-Time, written in collaboration with fellow scientist George Ellis in 1971.

His personal relationships:
Jane Wild was his first girlfriend while at college. As his condition deteriorated he was helped by the support of Jane who he married later. they travelled to the United States several times for conferences and physics-related visits. They had three children, a daughter and two sons, born between 1967 and 1979. The challenges to Jane who had her own career, were tremendous and the relationship between her and Stephen broke down. During his troubled period Stephen had grown close to one of his nurses Elaine Masan and after his divorce in 1995 he married Elaine. But there were many strains on this relationship and it came to an end in 2006. Thereafter Stephen resumed a closer relationship with his first wife Jane and his three children.

He wrote the book ‘A brief History of Time’ in 1988. It was a science-based book bought by more people in history than any other publication known. But many say that they did not read the book to completion. His first wife Jane and daughter Lucy are writers too. Jane’s book ‘Travelling to Infinity- my life with Stephen’ appeared in 2007 and was made into the film ‘The theory of Everything’ in 2012.

What was Stephen’s disability?
It was a slow progressing form of motor neurone disease called Amyotrophic lateral sclerosis (ALS). It gradually paralysed him over his life time. The diagnosis was given in 1961 with a life expectancy of two years but Stephen defied all medical opinions and lived with his disability in a motorised wheel chair with a speaking device and motor control finally carried out by batting of his eye lids which were the only movable parts in his body in the end. But he conducted his scientific life of discovery of the cosmos and unique original phenomena which a man or woman with all motor and sensory faculties would have found impossible. He nearly died a few times. In 1985 after a visit to CERN, at the edge of France and Switzerland, Stephen contracted pneumonia and was on life support. Wife Jane demanded the support to be continued even when she was advised that it is better to withdraw support. in 1986 he received a computer program called the "Equalizer" from the organisation called Words Plus. Stephen claimed that with the use of a computer now he had more words at access than before he lost his voice. Gradually the motorisation was fine tuned to let him use his eye lids and chin movements. Towards the end of his life he had increased difficulty in breathing and succumbed to pneumonia often.

Plans for a trip to space
On 26 April 2007, Hawking flew aboard specially-modified Boeing 727 jet operated by a zero gravity company off the coast of Florida to experience weightlessness. 
Hawking died at his home in Cambridge, England, early in the morning of 14 March 2018, at the age of 76. His family stated that he died peacefully.

Future of Humanity:
In 2006 Hawking posed an open question on the Internet: "In a world that is in chaos politically, socially and environmentally, how can the human race sustain another 100 years?", later clarifying: "I don't know the answer. That is why I asked the question, to get people to think about it, and to be aware of the dangers we now face."

Hawking expressed concern that life on Earth is at risk from a sudden nuclear war, a genetically engineered virus, global warming, or other dangers humans have not yet thought of. Such a planet-wide disaster need not result in human extinction if the human race were to be able to colonise additional planets before the disaster, thought Hawking.

Saturday, March 17, 2018

Srianee (Bunter) is still in town

We entertained Bunter and a few batch friends at our Battaramulla home last Friday.

Monday, March 12, 2018

Creative Spot by Mahendra Gonsalkorale

Dambulu Gale

This perennial Sinhala favourite was first sung by Chitra and PLA Somapala in the mid-1950s. PLA was born in 1921 and was always interested in Music and singing. He joined Radio Ceylon in 1943 as a Sithar player and violinist. He worked with famous musicians such as Ananda Samarakone and in fact, when Ceylon achieved Independence, he played the Sithar at the singing of the National Anthem. He met his future wife Chitra Perera, a female artist during a radio programme in 1946 and became close friends and they got married in 1953. PLA died in 1991 at the age of 70. They have 4 sons, Prasanna, Rohan, Nalin and Chandana Chitral, and one daughter Piyumi. Chandana Chitral "Chitty" is a famous singer and musician too. He has introduced "fusion" (of music cultures) to many songs. His version of Dambulu Gale is unique.

Wednesday, March 7, 2018

The Speedy Virtual Interview Series - Episode 5 - Part 2

(Virtual Interview conducted by Mahendra (Speedy) Gonsalkorale)

March  2018

Professor  Sanath P Lamabadusuriya
Emeritus Professor and Consultant Paediatrician. Colombo, Sri Lanka

Speedy: Welcome again Sanath for the Final Part of the Interview.  We reached the point where you got through Part 1 of the MRCP. Was that the time when you decided to pursue a career in Paediatrics?

Sanath: No, I made my choice for a career in Paediatrics when I got the post of Lecturer in the Department of Paediatrics.

Speedy: I see. And while in that post, you were awarded a Colombo–Plan scholarship?

Sanath: That is correct, and this enabled me to proceed to the UK for post graduate studies for a period of two years.

Speedy: I see. And you told me that about this time you had a most interesting experience prior to leaving for the UK. Could you tell us about it?

Sanath: Yes Speedy, this really happened. In late 1971 (year of the first JVP uprising) I decided to have my palm read by one Dr. Kingsley Goonetilleke, who had an office at Galle Road Ratmalana. At that time I had long hair and a beard. After parking my Triumph Herald car some distance away and wearing a pair of rubber slippers and an unbuttoned shirt, I walked into his premises. After accepting a payment of 10 rupees, he daubed my right palm with India ink, got an imprint on a sheet of white paper and started reading. When he asked for my profession I replied that I am a bank clerk. Then he told me that it could not be true and unless I assisted him, he would not be able to give an accurate reading. When I replied that I was a doctor, he said that I have to be doing something more than treating patients. When I asked him what he meant, he replied that I have to be teaching, doing research or both. (He was “spot on” as I was doing all three as a lecturer).I kept quiet and he went on reading saying that I am due to proceed abroad fairly soon and after a few years that I would return single and get married to a person known to my family. At that time I had never met my future wife Buddhika, He went on to mention that I would become a professor before my 40th birthday. (It was not possible at that time because both PriyaniSoysa and Herbert Aponso were due to retire in the early 90’s). After I returned at the end of 1974, I went through a marriage arranged by my parents. Buddhika’s father and my father were cousins, hailing from the same village called Pahalagoda in Tangalle.

SpeedyThat is quite an amazing story Sanath! Has this influenced your views on palmistry and horoscopes?

Sanath: I do not have fixed ideas about both topics. However, my personal experience which I related just now has swayed me towards being a believer.

Speedy: Quite understandable. This shows how people approach these matters and how personal experience influence belief. Just out of interest, why did you consult this person?

Sanath: My father used to dabble in astrology as an amateur and he had dealings with Kingsley Goonetilleke. That may be the reason why I consulted him. However, the palmist did not ask for my name and he did not know my identity.

Speedy: Cultural influences do play a big role in our belief systems. I quite appreciate that.
And then you went to the UK.

Sanath: Yes, in late December 1971, I boarded a BOAC flight and arrived in London. I was allowed only GBP 2.50 as foreign exchange and spent most of it drinking Scotch whiskey on board. When I arrived at Heathrow, I had only 50 pence in my pocket! I followed a course in Child Health at the Institute of Child Health, University of London, which had been arranged by the British Council. I passed the DCH (London) exam without much difficulty. I was given a monthly allowance of GBP 72.00 and lived in a bed-sitter at 58, Hermiston Avenue. N8. I travelled by bus to the tube station at Finsbury Park and got off at Russell Square.

Speedy: You were just a clinical observer or were you actually doing clinical work?

Sanath: No my scholarship did not give me a clinical position and I was rather bored following this course. I contacted the British Council and informed them that as I wanted practical clinical experience before sitting for the exams, I would like to do a job in the NHS. They told me that I would have to find a job on my own and when I find one, to inform them so that they would stop my monthly allowance. I applied for a few posts and was successful in getting an SHO post in neonatal paediatrics at the Whittington Hospital in North London.

Speedy: This must have given you valuable direct clinical experience.

Sanath: Yes it did and I was also able to save some money and go to France for a short holiday. I went by train to Paris, crossing the English Channel in a hovercraft.

Speedy: I remember doing that journey with Patrick Fernando who is also sadly no more. We crossed the channel by ferry. Please tell us about your stint at Whittington Hospital

Sanath: I started work at Whittington Hospital on the 1st of April 1972 and worked for six months until the end of September 1972. I was on call every other night and when on call worked continuously from 8.00 am to 4.00 pm on the following day. I was provided with free hospital accommodation, subsidised food, free phone calls, free laundry services and free beer in the doctor’s mess! As I did not have to spend for transport I saved a lot of money from my monthly salary of GBP125.00. I purchased a Ford Anglia car for GBP 60.00. During this time I passed the MRCP (Part 11) examination at my first attempt. I also associated closely with SusiriWeerasekera, who was a SHO in orthopaedic surgery at the same hospital.

Speedy: Was it all work while you were in the UK?

Sanath:  Fortunately not Speedy! In the summer of 1972, I went on a driving and camping holiday with Bertram Nanayakkara in his Volkswagen Beetle. We set off from London to Dover and crossed the English Channel to Calais. We drove to Paris and camped in a campsite in the north of Paris. These campsites had all the facilities. Then we drove to Lyon and Interlaken in Switzerland, our next camping site. We visited Geneva, Zurich and Berne and drove to Vienna where we visited two castles (Schonbrunn and Belvedere), and then drove to Munich to see the Olympic village about two weeks before the 1972 Olympic Games. I took over the wheel and I was able to exceed 80 mph, which Bertram could not! On the autobahn, another car overtook us and one of the blacks in that car started gesticulating at us for apparently no reason. We crossed the border at Arnheim in Holland towards twilight and when we returned to the car after the immigration check, we discovered that our camping equipment had disappeared together with the roof rack! Then we realised how I was able to exceed a speed of 80 mph and why the occupants of the car that overtook us, gesticulated (they would have witnessed the roof-rack being blown away). We drove back to a police station in Germany to report our loss so that we could claim insurance. We drove to Amsterdam through Rotterdam and parked our car close to the railway station so that we could attend to our ablutions. We spent the rest of the nights in our car as our finances were exhausted. From Amsterdam, we drove to Brussels, visited the Golden Square, saw the Mannequin Pis and returned to London through Calais and Dover. During the trip Bertram was teasing me about the inexpensive Kodak Instamatic camera I was using with magicubes, in comparison to his much more expensive Canon camera. After the trip, Bertram sheepishly asked for copies of my photographs as his camera had not functioned at all during the entire trip!

Speedy: The exuberance of youth! Bet you couldn’t do that now! What followed the Whittington job? Presumably, your scholarship time was not exhausted?

Sanath: Yes, I had I had plenty of time left, as I had obtained both DCH (London) and MRCP (UK) within six months of arrival. After completing that, I had one of two choices; either I could apply for a registrar’s post in the NHS and earn more money or revert back to the scholarship allowance and pursue research.

Speedy: I know what you decided but what drove you to pursue the research option?

Sanath: As I was single I had no one close to advise me. But I chose the research option because I was already an academic and involved in a bit or research before I arrived in London. (Fortunately, I opted for the latter and this happened to be one of the most important decisions I have made in my life). My position was as a research fellow in paediatric gastroenterology at the Institute of Child Health, London. My supervisor was John Harries who was a Senior Lecturer. Others in the department were Professor Otto Wolff, June Lloyd (who later became a Baroness), Audrey Fosbrooke and David Muller.

Speedy: Could you please talk about your research experience?

Sanath: My first research project was to assess the usefulness of the Xylose Tolerance Test as a screening test for coeliac disease. My findings were different to the hitherto published work as I found it too unreliable to be used as a screening test. Subsequently, other studies proved that I was correct. Later I got on to bile salts; to find the effects of unconjugated bile salts and mixtures of bile salts and lipids on the small intestinal function and structure. The experimental model was the Wistar rat. I sacrificed well over 700 rats for my research. I had to obtain an animal licence from the Home Office to carry out the dissections. I used to present my research findings at meetings of the Paediatric Research Society, Medical Research Society and the European Society for Paediatric Gastroenterology, in different centres in England as well as in Helsinki and Verona.

Speedy: Great stuff! Did this research lead to a research Degree?

Sanath: Not unless I registered for one. In fact, after a few months my supervisor inquired from me whether I would like to register for a research degree and if so a minimum of two years was required. As I had started research on the 1st of September 1972, I needed an extension of leave as I came on two years leave which would be over at the end of 1973. I applied for an extension and with great difficulty, I was able to obtain an extension of one year.

Speedy: Was this a paid job or purely Honorary?

Sanath: This was Honorary and I had to revert back to my scholarship allowance. During this time I had reverted back to my bed-sitter at Hermiston Avenue and was stretched for finances. Fortunately, PramillaSenanayake introduced me to the Southern Relief Service based in Crystal Palace which was a locum service for GPs on leave. I was provided with a chauffeur-driven radio car to visit patients in their homes. I was paid GBP 1.50 per hour and worked from 9.00 am to 7.00 pm, on Saturdays and Sundays. I earned GBP 30.00 per weekend to supplement my scholarship allowance. (I worked really hard, seven days of the week, without a break.)

Speedy: That must have been really tough but it must have also been a life saver! You must be very grateful to Pram.

Sanath: Indeed I was.

Speedy: Did you do more trips to Europe?

Sanath: In the summer of 1973 I went to the Scandinavian countries on another driving and camping trip with Bertram. We sailed from Harwich to Hamburg and visited Copenhagen, Malmo, Jonkoping, Stockholm, Oslo and back to Copenhagen, Hamburg and Harwich. Both these trips to the continent were really enjoyable and we used a book called “Europe on 5 dollars a day” which was quite handy.

Speedy: And back to work! How long did it take you to complete your PhD?

Sanath: I obtained the PhD (London) after 2 years and 3 months of research and returned home at the end of 1974, after completing the study leave. I was the first clinician to obtain a research degree in Sri Lanka.

Speedy: The first Sri Lankan Clinician to obtain a Research Degree! I wasn’t aware of that. Congratulations!

Sanath: Thanks Speedy.

Speedy: As you said, you came back to Sri Lanka. Were you tempted to stay on in the UK?

Sanath Speedy, the country was going through difficult times; however, I was keen on returning so that I could be with my parents who were both quite old by then.

Speedy: That is a very honest and frank answer. Tell us now about what you did after returning to Sri Lanka.

Sanath: Soon after I returned, I won the George Wickramasuriya prize which was awarded for research in paediatrics and obstetrics and gynaecology; I shared the prize with Professor S.S Ratnam from Singapore. I resumed work at LRH and Colombo Medical Faculty for a monthly salary of Rs.900.00. There was no private practice but the income was sufficient to lead a comfortable life as I was single and living in Wellawatte with my parents. As it took one year for me to get a car permit, I travelled by bus to LRH and the bus fare was 25 cents. I had lunch in the Senior Common Room which cost Rs. 1.60. On two days of the week, rice was not available and we ate manioc, sweet potato or string hoppers (during Mrs Sirimavo Bandaranaike’s regime). When the sea baggage arrived, it included a bicycle and I cycled to work.

Speedy: This was a time of great political change in Sri Lanka. Can you give us the background on which new Medical Faculties sprung up?

Sanath: During this time, some opposition members of parliament made speeches in parliament saying that if and when they come to power, they would abolish standardisation at the University entrance examination. When JRJ romped to power in 1977, they had to honour their promises. When standardisation was abolished, it was found that relatively more Tamil students would be entering the two medical faculties. As this was politically not acceptable, more Sinhala students had to be admitted. Then it was found that the number of slots available in Colombo and Peradeniya were insufficient to accommodate the increased intake. In 1978 two new Faculties of Medicine were created in Ruhuna and Jaffna. When the posts were advertised I applied for Ruhuna and was selected (I was the only applicant).

Speedy: We shall discuss your family at a later point but suffice to say at this point that you married Buddhika, who is sadly no more with us, in February 1976.

Sanath; Yes, I did and we had a very happy time together till she passed away in November 2013.

Speedy: We were all saddened to learn of her illness and your loss.

Sanath: Thanks Speedy. We have to accept these inevitabilities in life and just do our best to get on with it.

Speedy: A courageous and realistic attitude. Let us get back to the next stage in your life.

Sanath:  In 1979 when Buddhika was granted her Post Graduate study leave, I took sabbatical leave and assumed duties as locum Consultant Paediatrician at Pilgrim Hospital , Boston, Lincolnshire and Buddhika joined me later. When my leave was over in November 1979, I returned home. I assumed duties at Ruhuna on the 1st of September 1980 as the Founder Professor(Palmist KG’s second prediction was proved correct because when I assumed duties in Ruhuna, I was 37 years old).

Speedy: Sanath, you have achieved a lot in your long and illustrious career. Is it possible to single out any project which gave you the most satisfaction?  

Sanath: My most satisfying professional project is the Sri Lankan Cleft-Lip and Palate Project of which I was the co-director together with Dr Michael Mars, who was a Senior Registrar in Orthodontics at the Hospital for Sick Children, Great Ormond Street, London. When I was in Galle, in 1982, Michael contacted me and invited me to join in a research project. There was a controversy in the West about the restricted growth of the middle third of the face (maxilla) in patients who had been operated at the conventional time for a cleft palate. The dilemma was whether it was due to an intrinsic bone defect or iatrogenic, due to surgery. To resolve the issue a population of patients was required who were born with such defects and who had not received surgical treatment, at the conventional time. As such patients were not found in the West, he wished to know whether such patients are found in Sri Lanka and if so whether I would like to participate in a project to resolve the issue.. As I sent a positive reply he visited Karapitiya on a pilot trip with a maxillo-facial surgeon, David James. I collected about 30 such patients of different ages. They took plenty of photographs, dental casts and lateral X-rays of the skull using a cephalostat. They wished to come again. My reply was that they are welcome but if they come again the patients also should benefit. Michael inquired from me what facilities could be provided for surgery. As the hospital at Karapitiya was not built as yet only the one at Mahamodera was available. I told him that I could provide a theatre table, lamp, oxygen cylinders and nothing else. Later he managed to raise funds and arrived with a surgical team which comprised of plastic surgeons, anaesthetists, ENT surgeons, orthodontists, speech therapists, theatre nurses, dental nurses and a paediatrician. They were from the UK and Norway. About 30 crates of equipment were airlifted containing surgical equipment, anaesthetic equipment, drugs, IV fluids, theatre boots, gloves, gowns, dressings etc.

Speedy: This shows how determined you are when you pursue something close to your heart. How did you set about recruiting patients?

Sanath: I managed to collect hundreds of patients from all over the country by advertising through the media.They were prioritised and only patients with un-operated cleft lips and/or palates were selected. Many investigations such as dental casts, speech recordings, photographs, nasendoscopies,  psychometric assessments, audiometry etc. were performed. Medical students acted as interpreters. Surgery was performed during the night as that that was the only time a theatre was available at Mahamodera. Over the years there were three surgical expeditions, each visit for two weeks and over 700 patients underwent successful surgery without a single mortality. There were several other visits for follow-up. Although the country was going through a civil war the recall rate was high from all over the country. The project resulted in many research degrees, scientific papers, lectures, orations etc. It also created the largest data base in the world for un-operated cleft lips and palates.The final verdict was that the poor growth of the maxilla was due to the timing and quality of surgery. As a result of these findings, the cleft palate services in the UK were re-organised.

Speedy: Did it receive a lot of publicity?

Sanath:  There was a lot of publicity in the local media. The BBC made a film of the project titled “When to Mend Faces” and it was telecast on Channel 4 of British TV and Rupavahini. This film won an award as well. After viewing the film an anonymous person donated GBP 200,000.00 to develop speech therapy services in Sri Lanka. At that time we had only one speech therapist and she was in the private sector. As a result of this donation a diploma course for speech therapy was set up in the University of Kelaniya and currently, there are over 70 speech therapists distributed all over Sri Lanka. In recognition of my contribution to the project, Her Majesty Queen Elizabeth 11 conferred an MBE to me in 1992. Currently, I am the only Sri Lankan domiciled in Sri Lanka to receive a Royal Honour.

Speedy: A stunning achievementYour MBE was well deserved. I am not aware of any in our Batch who figured in the Honours list although two of my classmates at Royal received Honours. One was TissaJayasekera who received an OBE and the other was DeepalLiyanage (known as Dai now) who received an MBE.

Sanath:  Both of them are domiciled in the UK. I remember Deepal. His brother Sunil was a boxer and a Rheumatologist. He was senior to us. TissaJayasekera was a Rugby colours man.

Speedy: When did you become Professor of Paediatrics in Colombo?

Sanath: After PriyaniSoysa’s retirement, I assumed duties as the Professor in September 1991. (Again I was the only applicant) The Colombo Medical faculty changed its curriculum drastically getting rid of the 2nd and 3rd MBBS examinations and replacing these with modules and streams. I was appointed as the Chairman of the Clinical Stream for the new curriculum. Ten members of the academic staff, including me, visited the University of New South Wales to undergo training for this major step. I changed the evaluation process in paediatrics by giving 40% of the final mark for continuous assessment (done in a very objective manner) during the Final Year Professorial appointment and holding the clinical examination at the end of the appointment. The students were very pleased with the change.

Speedy: You became more involved with Medical Education and was elected Dean in 2002. How did this come about? Did you have some ideas which you wanted to put into practice?

Sanath: I was elected as the Dean for a three-year term of office. I was contested by Rezvie Sherriff whom I beat very comfortably. During this time I made a professional visit to Bhutan and agreed to admit about five Bhutanese students per year. Each student had to pay a course fee of USD 10,000.00 per year, which was paid by the WHO. Since then many Bhutanese students have graduated from our medical faculties. I also trained a Bhutanese paediatrician. I am very proud to say that there wasn’t a single strike by the students, academic or non-academic staff during my tenure of office.

Speedy: Keeping focused on Medical Training, how did you become involved in the Post Graduate Institute of Medicine (PGIM)?

Sanath: The predecessor to the PGIM was the Institute of Post Graduate Medicine (IPGM) whose Director was Professor KN Seneviratne. I was appointed as the Secretary to the Board of Study (BoS) in paediatrics. Later the IPGM was abolished and the PGIM replaced it. I was a member of the BoS in paediatrics from its inception until I was appointed as its Chairman in 1991 when I returned to Colombo. I was the chief examiner for both the DCH and MD examinations. I continued in that position until I retired in 2008. I brought in many reforms in the training programme and was instrumental in creating sub-specialities. I was a member of the Board of Management of the PGIM for many years in the 1980s, 1990s and until 2008.

Speedy: These were all groundbreaking initiatives. You also held many positions in various medical associations. Just to mention a few, you were the President of the Galle Medical Association in 1990- 1991 and the President of the Sri Lanka Paediatric Association in 1993 and President of the SLMA in 2011. You were a member of the Sri Lanka Medical Council for many years. You became the country representative of the South Asian Paediatric Association and culminating as the President of the Asia Pacific Paediatric Association (APPA) from 2007 to 2010. These are notable achievements.

Sanath: Thank you. Yes, I felt greatly honoured. You mentioned the APPA, and the academic sessions of APPA were held in Colombo at the BMICH in 2007, during the war. However it was very well attended. I served in the Standing Committee of the International Paediatric Association (IPA) for many years. I was honoured as “Outstanding Paediatrician of Asia” by APPA in 1997, when the sessions were held in Hong Kong. When I was President of APPA I was invited to deliver Guest Lectures in several member countries of the region. Just to complete my International profile, I was awarded many short-term WHO fellowships and was a member of several WHO committees. I was a member of the WHO Immunisation Practices Advisory Committee (IPAC), based in Geneva, for three years and currently am a member of the International Technical Advisory Group (ITAG) based in New Delhi.

Speedy: And in 1989 you were awarded a prize for Social Paediatrics jointly by the WHO and International Paediatric Association (IPA). What was the nature of this award?

Sanath: This was a travelling fellowship worth USD 10,000.00 and I spent two months in the Chinese University of Hong Kong and one month in the Chulalonkorn University in Bangkok, Thailand.

Speedy: Sanath, there is one more thing which brought you a lot of Media attention. I am referring to the Professor PriyaniSoysa Medical Malpractice case. If you don’t want to discuss that please let it go.

Sanath: Speedy, I am quite happy to discuss it. Let me outline the case. In May 1992 I was contacted by my former RC classmate Shibly Aziz, to take over the care of the daughter of a colleague of his, RienzieArsecularatne, both of whom were State Counsel in the AG’s department. SuhaniArsecularatne was warded at Nawaloka Hospital, under the care of Prof. PS. She was being treated for rheumatic chorea for over a month by PS. I disagreed with the diagnosis as I detected that Suhani had very brisk knee jerks in addition to the choreiform movements. As I suspected a brain tumour, I requested for a CT scan of the brain, which revealed a brain stem glioma, which proved to be inoperable. After Suhani passed away a few months later, Rienzie filed a case against Priyani and was found guilty in the District Court but was acquitted in the Appeals Court on a technical issue. This was a landmark case in the annals of legal history in Sri Lanka and received very wide publicity in the media. I gathered that this case is quoted very often during lectures for law students, both in the Law Faculty as well as at Law College.

Speedy: Sanath, we know a lot about you now but as I indicated earlier, would you mind telling us something about your own family, about your wife and your children?

Sanath: I am happy to do so. Of course, I am proud of my professional achievements but I am even more proud of my own family. As I already indicated, I married my wife Buddhika, in February 1976 at the Holiday Inn Hotel in Colombo. Our batch-mate JanakaWijetunga was the best man. Buddhika was a Peradeniya graduate. At that time only 75 guests could be invited and only a wedding cake and a soft drink could be served. However, at the home-coming held at my home in Wellawatte plenty of friends and relations were invited and plenty of food and drinks were served. Buddhika returned home after obtaining the MRCP (UK) and was appointed as OPD physician at Karapitiya. Later she assumed duties as Visiting Physician, Homagama Hospital and retired as OPD physician, National Hospital. She was a very kind hearted individual who helped many relatives who were less well off. She was also very spiritual minded and attended dhamma talks and participated in many meditation retreats. She accompanied me on my numerous trips abroad. Unfortunately, she was diagnosed to have ovarian cancer in November 2011 and survived only for two more years.

Speedy: Yes, when we learnt about it, we felt a lot of sadness.

Sanath: Thank you Speedy. I had a lot of support from family and friends for which I will always be grateful. We had three lovely children who are all doing well I am happy to say.

Speedy: What is your spiritual side Sanath? Are you religious? What makes you tick?

Sanath: I am not the temple-going type and I don’t believe in rituals. I feel that by doing an honest job of work very diligently, one acquires merit.

Speedy: Thank you very much. I hope it wasn’t an intrusion! Do tell us about your children

Sanath: Not at all. Regarding my children, our elder son Shamin was born in November 1976. He attended Richmond College, Galle and later Ananda College, Colombo where he represented the school in chess and badminton. He later entered the Colombo Medical Faculty and captained the University chess team and was awarded colours. After graduation, he specialized in rheumatology and is currently working at the National Hospital. He is also very spiritually minded and attends dhamma talks frequently.

Speedy: Taken after the mother!

Sanath: Indeed. Our second son Harshan was born in January 1979. He attended Richmond College, St, Thomas’ (Mt. Lavinia) and Royal College. He did not like the way he was taught and we had doubts whether he would enter a university. We purchased a coconut estate in Weerapokuna so that one day he would be able to live off the land.(By the way, as yet, Harshan has not visited the estate!)  However, there was a dramatic change in his career when I went to England with my family on sabbatical leave in March 1996. He used to play scrabble in school and represented Royal College at scrabble as well as the country. In England, he participated in numerous tournaments and won many awards. He was invited to appear on the popular Channel 4 TV programme, Countdown and became the runner-up. Later he won the British National Scrabble title and represented his adopted country as well. He attended Stenning Grammar School and obtained five A’s at the London A level examination. Later he entered Cambridge University and moved to Oxford for the clinical studies. Currently, he is working as a consultant paediatrician in Swindon Hospital. He married Michelle Gunasekera in 2011 and became a father last November. Last year he became runner-up at both the World Scrabble championship and British national championship after resuming playing scrabble after an absence of many years. Michelle is a registrar in nephrology in Oxford.

Speedy: I recall Harshan’s Scrabble achievement and in fact, there is a post on our Blog about it from Lucky on 27th August 2017. I find it fascinating to listen to how your son changed over the years.

Sanath: Yes, it was a great relief when he became more keen on his studies. My daughter Dilusha was born in January 1983 and studied at Ladies College and VisakhaVidyalaya. She graduated from the Colombo Medical Faculty, topping the batch with a first-class scoring 4 out of 5 distinctions at the final MBBS examination and winning eleven gold medals. She easily outshone her father who also topped his batch but obtained only 2 out of 3 distinctions and a second class at the final examination.

Speedy: Wow! That is an amazing record. You must take some credit for it Sanath, I am sure genes had something to do with it!

Sanath: I don’t know about that!  She married Upul Wickramarachchi and is currently in Norwich on postgraduate study leave. Upul is a research fellow in cardiology in Norwich. Dilusha delivered a son (my first grandchild) in June last year.

Speedy: Sanath, what have you done since retirement from your post? 

Sanath: My children have advised me to enjoy life by travelling. I embarked on an Alaskan cruise in August 2016 and a Baltic cruise in August 2017, both of which I enjoyed very much. As the Rajarata Medical Faculty is short of staff, I volunteered to teach there and was appointed as a Visiting Professor in April 2015. I visit Anuradhapura, Monday to Friday alternate weeks. The students are very appreciative of my decision as they are aware that I turned down three invitations from SAITM, to join it. (Logistically and financially,I would have been better off at SAITM) Last year the Vice-Chancellor of the Sabaragamuwa University, Professor Sunil Shantha, invited me to be the consultant for the establishment of a Medical Faculty in Sabaragamuwa. This faculty would be located in Ratnapura and 75 students would be admitted this year. Currently, I am the Chairman of the Meththa Rehabilitation Foundation which was founded by Dr B. Panagamuwa. I am also the Chairman of the Board of Trustees of the Children’s Convalescent Home in Thalagolla, which was founded by Professor C.C. de Silva in the early 1950s.

Speedy: Sanath, you mentioned the Meththa Foundation. You are probably aware of the fact that the SLMDA (Sri Lankan Medical and Dental Association in the UK), of which I am an active member, strongly support Meththa and we have raised considerable sums of money for it. Dr BandaraPanagamuwa who leads Meththa is a member of the SLMDA.

Sanath:  Yes, I am aware of that and welcome your support wholeheartedly.

Speedy: With your long and distinguished career which is by no means over, have you got any advice for young doctors who are just embarking on a career?

Sanath:  I always advise the students to spend more time in the wards rather than in the library, so as to acquire clinical skills, which I did as a student. As I am totally against strikes, at every opportunity, I advise them against strikes as it is the poor people who suffer during GMOA strikes.

Speedy: That is very good advice. Well, Sanath, we have travelled far together in our two interviews and now I like to conclude this virtual interview. Your story is also one that covers a period common to all of us who graduated about the same time and has rekindled so many pleasant memories. What you have achieved is something we are all very proud of. It has been an immense pleasure to journey through your life and I wish to thank you for agreeing to feature in the Speedy Interview and wish you all the best for the rest of your journey.

Sanath: Thank You. It has been a pleasure and privilege.