My Tribute to Sidath Jayanetti

By Nihal D Amerasekera
 

It was with great sadness I received the news of the passing away of yet another friend from our wonderful batch. Sidath Jayanetti joined our batch with the reputation as a fine Rugby player from Royal College, Colombo. He always had a great presence and an air of confidence but had the humility kindness and charm to be liked by everyone who knew him.

My first close contact with him was when we started our clinical work together with Dr Thanabalasunderam in 1964. It was a gruelling 2 months of apprenticeship which brought us all together. The harsh criticism and hard comments never wiped away his broad smile. All through the Rags, Law Medical Match, Block Nights and Colours Nights he was there with us to enjoy the fruits of our labour at Medical College. How time has flown since those happy days of our golden youth.
 

Sidath was superb company, always. His anecdotes and stories of people and places brought us much laughter. His sheer presence radiated happiness. My last contact with him was in London when he attended the Batch Reunion in 1997 with his family. We reminisced and drank to our health. My lasting memory is that broad smile which was Sidath's trade mark. He was a gem in a world of pebbles.

My thoughts are with his family at this hour of grief.

May he attain the ultimate Bliss of Nirvana.

Sidath Jayanetti

I just heard the sad news that yet another member of our batch had passed away. Please see Nalin's e-mail below.

---------- Forwarded message ----------
From: nalin nanayakkara <nalinn@earthlink.net>
Date: Thu, Nov 8, 2012 at 10:19 AM
Subject: Dr Sidath Jayanetti

Friends,

I am informing you with deep regret that Dr Sidath Jayanetti is no more.He passed way in Miami, Florida last night, the victim of a massive stroke.Sidath was my classmate at Royal and at Med College and after I got married we got related, he was my wife's first cousin.At Royal he was a classy Rugby winger, he used to run like the wind to the amazement of all the onlookers.It was just 10 days ago that I sent him two DVD's of our 50th Med School reunion of Sep 2012.He called me back to say that he recognized most everyone there.Sidath was looking forwards to going back to SL in Dec. and we agreed to meet there.Ciest la vie !

Nalin N

Colombo Medical School Alumni Association

Dear Friends,

Everyone agreed that our recent Batch Reunion was a tremendous success. Our batch also had the largest representation at the first ever Mega Reunion of Colombo Medical Graduates held in Colombo some time ago. This gentle reminder is about another important matter.

Sanath Lama and I have already requested you to consider joining the Colombo Medical School Alumni Association (CoMSAA). Some of you have already joined. If you have not done so already, please think about it seriously. I am resending you the information you need.

 

Instructions on how to apply for membership is given in the application form.

Download Application Form

For more information about CoMSAA, please click on:

www.comsaa.org

Thank you.

Lucky

An Interview with Sanath Lamabadusuriya

Interview
(Courtesy official website of the Student Medical Journal of the Faculty of Medicine, University of Colombo).

If you are sure of yourself, stand your ground!

An interview with Professor Sanath P. Lamabadusuriya

Ruwanthi Seneviratne, Manu Wimalachandra, Dakshitha Wickramamsinghe

Introduction

Senior Professor and former chair in Paediatrics and former Dean of the Faculty of Medicine, Colombo, Professor Sanath P. Lamabadusuriya is a well known and much respected medical academic. He has made an immense contribution to teaching, research and the practice of medicine both in Sri Lanka and overseas. He has also been awarded a prestigious MBE by HRH Queen Elizabeth II for his contributions to the field. Here, Prof. “Lama” as he is affectionately known, shares his experiences with our editorial team.

What was the initial period like?

My choice was to specialize in the medical side rather than the surgical side, since surgery never attracted me. I graduated at the top of my batch and so I had the opportunity to get my choice of appointment for internship. I chose the professorial medicine unit for the first 6 months under Professor K. Rajasuriya and for the next 6 months, to the surprise of many, I chose to work under Dr. P.R. Anthonis, as working with the professor of surgery at that time you were more a clerk than anything else. To this date I believe I made the correct choice. Initially the unit had a SHO, but he left during my 2 nd month and I had to take on his role as well. I had a lot of responsibility, which I enjoyed thoroughly.

How did you become an academic?
After my internship, I served at the Chest Hospital, Welisara for a period of nine months. During this time two vacancies were advertised at the Colombo Medical Faculty; Lecturer/Senior Lecturer in Pathology and Lecturer/Senior Lecturer in Paediatrics. I applied for both posts because I always liked the academic setting. The interviews for the post in Pathology were first, and to this date I'm thankful to Prof. Gerry Cooray for not selecting me!

When I went for interview for the post in Paediatrics, I found that it was chaired by the Vice Chancellor at that time, Mr. Walwin De Silva. Prof. Rajasuriya, Prof. Priyani Soysa and Prof. Chapman were also there; quite a panel! Many in the field of paediatrics had also applied for the post, but one by one they got knocked out. Prof. Soysa asked me why I didn‟t do paediatrics for my internship and my reply was “I did medicine for the first 6 months, so I could not do paediatrics for the 2 nd 6 months”. Of course she knew it was a hollow answer, but this was not known to the non-medical people in the panel. I was selected for the job!

What were your first experiences as an academic?

We as undergraduates never took paediatrics seriously because there were only 2 questions in the clinical medicine paper, and one could easily pass medicine without knowing much paediatrics. Therefore I had not done much reading in paediatrics. Before assuming duties I wanted to read up, but the only book I had was a book by Prof. C.C. De Silva and Mrs. Vishvanathan, meant for mothers!

I assumed duties on the 1st April 1969. In the beginning, I was sharing responsibilities with 2 house officers, and had first on call duty for 3 months.

I received a Colombo Plan scholarship to go to UK to do my MRCP and DCH. The British Council had arranged a course in paediatrics at the Institute of Child Health, but I informed them that I would prefer a job in the National Health Service. I applied and was selected for the post of SHO in neonatal paediatrics at the Whittington Hospital in North London. I was on call every other night, but the salary was 120 pounds, much more than the 72 pounds I would have received from the scholarship! Max Friedman, the Consultant whom I worked with, didn't allow reading notes when presenting cases and this was a training by itself. During this appointment I had to sleep in the unit, if a baby was being ventilated. During this very busy and intensive appointment, I managed to pass the MRCP (London) examination at the first attempt.

I was sent to the UK for a period of two years, but within 6 months, I had finished the exams. I was faced with two options, to work as a registrar and get a better salary, or to get some research experience but to manage with the scholarship money. I had no one to ask for advice, and fortunately decided to get into research and forego the monetary benefits. To this date, I am very happy I made that decision.

I started reading for my PhD in 1972, with Dr. John Harries at the Great Ormond Street Hospital for Children and Institute of Child Health. However, my leave was about to finish in 1973 so I applied for an extension of leave. The dean didn't like the idea but Prof. Soysa backed me and managed to get the leave extended. If they had not, I would not have stopped my PhD to come back, and my career would‟ve taken a different course. I wouldn't have come back to Sri Lanka.

During this period of research I had to fall back to the scholarship allowance of 72 pounds again. I worked for the Southern Relief Service during the weekends and for the 20 hours of work I was paid 30 pounds. I was provided with a chauffer driven radio car and I had to visit patients‟ homes because their GPs were not available. I criss-crossed the London streets innumerable times, visiting homes. I resumed duties at the LRH on 1st January 1975.

People were happy to see me as many were not returning after foreign training, at that time. During the first 3 months I was only entitled to a 3 figure salary, but that was more than enough. I was single, living with my parents, the bus travel cost only 25 cents either way and the lunch was Rs. 1.60, so I had a comfortable life. I brought a bicycle in my sea luggage, but arriving at the LRH in a bath of sweat didn't help my work, so I opted to get a car with a car permit. I thoroughly enjoyed teaching and I got to know the students very closely.

Tell us about your experience at the Galle Medical Faculty.

The Faculty of Medicine, University of Ruhuna, was established in the late 70s and I was chosen for the post of Founder Professor of Paediatrics. One of my biggest achievements there was the Cleft Palate Project, in collaboration with the Great Ormond Street Hospital for Children. The Co-Director of the project was Dr. Michael Mars, Consultant Orthodontist, at the Hospital for Sick Children, Great Ormand Street, London. In addition to the service rendered to the patients, it also had the world‟s largest database on unoperated cleft lip and palate with more than 1000 patients. It was so successful that the BBC even made a film about the project called “When to Mend Faces”. The film was televised in 1992 in a programme titled QED and won an award.

A lady who had seen this documentary was interested in donating £250,000 for a health development project. They contacted me, but I was on sabbatical leave, and the project was awarded to the disability studies unit of the Colombo North Medical Faculty. The money was used to start a diploma course to train speech therapists, and as a direct result, we now have nearly 60 speech therapists in Sri Lanka.

In 1988, during the final few months of my sabbatical leave in Saudi Arabia, many of my friends wrote to me advising me against returning to Sri Lanka as the political situation was unstable. I however, returned, to the surprise of many! I had no personal threats, and I did not go on strike a single day.

A few years later, the chair fell vacant in Colombo, and I returned to Colombo as Professor of Peadiatrics.

How is your teaching experience overseas different to the one in Sri Lanka?

The British students ask questions whenever they are in doubt, whilst our students are very subdued. The foreign students also have a very broad knowledge and are more mature. They may not know the nitty-gritty of paediatrics, but you can have a decent conversation with them on just about any subject. May be it ‟s our “epa” culture; there is no encouragement for anything!

Can you give us some tips about handling children?

Handling children is an art that is developed through experience. The key to it is a conducive

environment and age and gender appropriate toys. The power of toys is amazing!

Any special message to our students?

Spend more time in the wards rather than in the library; because you never know when you might need what you have seen. A x-ray of the chest which had an azygous system I saw as an undergraduate helped me in my MRCP clinicals!

And if you are sure of yourself, stand your ground!

Speedy's Reunion Presentation

“Challenges and  Opportunities in an Ageing Society”

Summary of  Lecture delivered at the 50^th Anniversary Reunion Academic session of the Medical Entrants of 1962 in Sri lanka on the 1^st of September 2012 by  Dr Mahendra Gonsalkorale.

 

The World population is growing rapidly. From an estimated 2.5 billion in 1950, it reached 6.1 billion in 2000 and is projected to grow to 8.2 billion in 2025. It took over 4000 years to reach 2 billion but it will take less than 75 years to quadruple that number. Sri lanka’s current population of just over 20 million will grow to 23 million by 2030. People are also surviving longer at all ages and more and more are achieving old age. Increased life expectancy is a Global phenomenon. Correspondingly, due to decease in fertility rates, there is less than the expected numbers of younger people, and the net result is a change in the age distribution pyramid from the familiar broad based, gradually tapering shape as in the mid 60s and before, to one with a relatively narrower base with a “fat” middle (the older people) and a taller shape (because of the persistence of the very old).
 

 

 The proportion of elderly people in all countries is increasing. From about 4-10% just 50 years ago to 15-20% now and expected to increase to 25-30% in the mid 2000s. In Sri lanka, there are about 1.9 million over the age of 60 (10%) and this is expected to increase to 4.5 million (25%) by 2040. In America, there are currently around 40 million over 65s compared to 23M just 50 years ago. Within the over 60s, there is a massive increase in the very old. The balance between the older and younger is affected and this will have a significant effect on the care of older people and in the financing of pensions.

 

More old people and less (proportionately) young people means

•       More age associated diseases such as  dementia (Alzheimer’s), cardiovascular diseases,

                degenerative neurological disorders, cancer, arthritis and related disorders, chronic        respiratory disease, other chronic diseases.

•       Increase in disability levels in the population

•       Less people to support and care for older people.

•       Large increases in health and social care costs. 

The burden of Dementia is one of the most worrying concerns for the future. The WHO estimates that worldwide, nearly 35.6 million people live with dementia. This is expected to double by 2030 (65.7 million) and more than triple by 2050 (115.4 million). The vast majority of these will be elderly.

Dementia affects people in all countries, with more than half (58%) living in low- and middle-income countries. By 2050, this is likely to rise to more than 70%. The WHO observes that only eight countries worldwide currently have national programmes in place to address dementia.  

This may all sound very negative but there is a more optimistic view to be taken and with greater preparation and anticipation of need, the lives of both the elderly and the young could be enhanced. Older people can have a better quality of life and the young could look forward to a time of fulfilment and relative leisure when they become old. 

Some of the challenges that need to be met are the following. 

(1)    Meeting health, social and housing needs. These are also fuelled by rising expectations, technological advances which are often costly, medical breakthroughs and other factors

(2)    Resourcing  (financial and other)  the demands of an ageing population who consume more resources, with the added factor of a relative decrease  in economically productive young wage earners

(3)    Evolving a society devoid of intergenerational disputes and replete with respect and love - a cohesive, equitable and productive society, with the wisdom and maturity of old age balancing the exuberance of youth. Today’s young are tomorrow’s old, all have a stake. 

These challenges could be met by adopting various measures such as, 

(1)    A major shift in attitudes and perceptions of what it means to progress through life from birth to death, getting rid of the negative image of old age, utilisation of a range of skills and talents of old people set free from the need to pursue active employment, greater involvement in voluntary work, providing support for children and grandchildren.  

(2)    When the retirement age was set years ago, the expectation was that retired people would live on the average about 5 years more before they die according to life expectation at the time. This has changed over the years and at present, retired people can expect to live at least a further 10 years or more. This has major funding implications and current pension arrangements are not sustainable and the concept of retirement needs to be reviewed. The Shakespearean concept of 3 score years and 10 is outmoded and a good model is one of the 3 ages, the first is one of growing up and learning, the second is one of adulthood with employment, marriage and parenthood and the third age is one of gradual withdrawal from active employment with pursuit of leisure. These are blend into each other. 

(3)    Forward planning to meet the demands of a large increase in the number of old people.  

(4)    Change emphasis from a Disease Model to a Preventive model. The aim is to ensure that longevity is matched by a long disability-free period and not by the nightmare scenario of prolonging life by extending the period of disabled life that often precedes death, using the old adage, “add life to years and not years to life”.

 

(5)    Towards this end, the message that for a healthy old age, living a healthy life when you are young has to be promoted. Among suggested measures are :- 

•       control of hypertension,

•       attention to a proper diet, weight control

•       regular mental and physical exercise

•       correction of lipid abnormalities

•       smoking cessation

•       correction of abnormalities of heart rhythm  such as atrial fibrillation

•       Social interventions, e.g., the provision of libraries, heating allowances, free health checks which though needing funding will produce long term savings and benefits.

•       Imaginative housing and home care schemes

•       incentives such as low cost or free recreational facilities and transport for older people  

(6)    Creative use of new technologies e.g., use of telemedicine, smart homes, house robots.  

(7)    Suitable national and international legislation to protect older people. 

(8)    It is also suggested that we need to rethink our attitude to death and prolongation of life. The largest proportion of the total healthcare budget spent per person is at the end of life.

                Death is as inevitable as life and without death, life cannot be sustained. Death is not a                 failure, accept death with dignity and equanimity.  

In conclusion,  

We have to change the way we think about how we live and progress from birth to death.

We have to re-engineer the concept of retirement

We need to devote more resources towards dementia research

We need to fight against ageism, paternalism. We need to get away from the concept of a World for the Young to a World for All.

We need to harness the immense potential of technology and remain optimistic.

 

 

Hooray! Our blog "hits" have just topped 10,000

Hello Viewers,

I am happy to announce that our blog has had 10,000 pageviews as at 29th September, 2012. I started this blog on March 16th, 2011 with the following posting.

Planning for the 50th Anniversary

Hello Everyone!

As we start planning for our 50th Anniversary of entering medical school, I have taken the first steps in developing a simple blog for easier communication. It is primarily for the 1962 entrants to the Colombo Medical Faculty of the University of Ceylon (as it was then known). The blog will carry important news items, pictures, e-mail messages, announcements etc. Please feel free to send in your comments to: colmedgrads1962@gmail.com or direct to my personal e-mail address: adnl1102@gmail.com. We can improve on it as we go on and gather momentum.

In 18 months, we have had 10,000 "hits".

Lakshman Abeyagunawardene (Lucky)

The College of Community Physicians of Sri Lanka honours Lakshman Abeyagunawardene

When I started this blog in March 2011, it was primarily meant to be a part of the build-up towards the 50^th Anniversary Reunion that we successfully concluded earlier this month. Whenever possible, I have also highlighted noteworthy achievements of our batch colleagues since then. This is what I have recorded so far.

1.      Sanath Lamabadusuriya – SLMA President 2011.

2.      Chirasri Mallawaratchi Jayaweera Bandara - Dr. P. Sivasubramaniam Memorial Oration 2011.

3.      Pramilla Kannangara Senanayake – Founder of Educate a Child Trust (EACT).

4.      Mahendra Gonsalkorale – Prof. S.R. Kottegoda Memorial Oration 2011.

5.      Suriyakanthi Karunaratne Amarasekara and Chirasri Mallawarchchi Jayaweera Bandara – among recipients of SLMA  ‘Outstanding Health Professional’ Awards to mark International Women’s Day 2012.

6.      N. D. Amerasekara – Recipient of a special plaque awarded by his old school Wesley College in September 2012 for his services as Editor of the school website ˜Double Blue Internationalâ”.

7.      Lareef Idroos – Re-elected President of the Sri Lanka Medical Association of North America, West Coast in March 2012. He was first elected to the post in February 2010.

I am now pleased to share the news that I was admitted as a Fellow of the College of Community Physicians of Sri Lanka at the Inauguration of its Annual Scientific Sessions on Thursday 20^th September 2012. This is in recognition of services rendered to Public Health/Community Medicine.

 

 

Accepting the award from the President of the College Dr. Vinya Ariyaratne. 

 

The following Citation was read by Dr. Santhushya Fernando.

Dr. Lakshman Abeyagunawardene was born in Hikkaduwa on October 22^nd, 1941 at the height of the Second World War. He was educated at Ananda College, Colombo, and passed the University Entrance examination held in December 1960. Having entered the Science Faculty of the University of Ceylon to follow the 1^st MB course in June 1961 when such course was conducted for the last time, he was then admitted to the Colombo Medical Faculty the following year in June 1962. Dr. Abeyagunawardene graduated with the MBBS degree in March 1967. Following his Internship at the General Hospital, Colombo South, he worked in the clinical field for two years before opting voluntarily for a career in public health long before being called up for mandatory service as a Medical Officer of Health. Starting as an MOH at Matara in 1970, he later joined the Health Education Bureau (HEB) of the Ministry of Health before leaving for the United States on a World Health Organization (WHO) Fellowship in March 1974.

He specialised in public health and health education and obtained the degree of Master of Public Health (MPH) from the University of California, Berkeley, USA in 1975. On his return, Dr. Abeyagunawardene continued his service in the HEB as a Health Education Specialist. In 1986, he was certified as a consultant in community medicine by the Post Graduate Institute of Medicine (PGIM) following conferment of the degree of Doctor of Medicine (MD) in community medicine (by research) by the University of Colombo.

While serving the Health Education Bureau of the Ministry of Health, Dr. Abeyagunawardene was in charge of the Community Health Education sub unit and in later years, the Training sub unit as well. In that capacity, he directed the highly successful Family Health Education Action Programme mobilising village level volunteers for health action throughout the length and breadth of the country. Apart from his involvement in his own research studies, Dr. Abeyagunawardene has supervised research projects and dissertations of MD and M SC candidates of the PGIM. Dr. Abeyagunawardene has the distinction of coordinating the M SC course in Health Education when the PGIM doors were thrown open to non- medical and non-dental health professionals. He has also served as a member of the Board of Study in Community Medicine of the PGIM over an extensive period until he left government service in 1990.

Having served the Government of Sri Lanka for 23 years, he opted for early retirement to join the United Nations Children’s Fund (UNICEF) in 1990. As a National Professional Officer in UNICEF, Colombo, he continued to work closely with his national counterparts, notably the Health Education Bureau. Apart from other duties, Dr. Abeyagunawardene was responsible for the planning, implementation and evaluation of UNICEF-funded mass media programmes to promote oral rehydration therapy, iodised salt, child immunisation, and breastfeeding under the Baby Friendly Hospitals Initiative.

Dr. Abeyagunawardene has also served the World Health Organisation (WHO) and the Commonwealth Secretariat of London as a short term consultant with assignments in Indonesia and Malaysia. In 1998, he retired prematurely from the UN to emigrate to the United States where he served the South Carolina Department of Health and Environmental Control as a Health Education Specialist for a further period of ten years before final retirement in January 2009. The South Carolina Department of Health and Environmental Control recognised Dr. Abeyagunawardene’s services when he was presented with the Award for Excellence in 2006 for his contribution in the state’s highly successful Childhood Lead Poisoning Prevention Programme.

Dr. Abeyagunawardene joined the Sri Lanka Association of Community Medicine as a life member soon after he opted for a career in Public Health in 1970, and later served as a Committee Member. With the establishment of the College of Community Physicians of Sri Lanka, he continued to serve as a Council member until he left the country in 1997. He has also served as a Council Member of the Sri Lanka Medical Association (SLMA) for several years.

Dr. Abeyagunawardene has many publications to his credit and has been a regular presenter of scientific papers at the annual sessions of the Sri Lanka Medical Association and the Sri Lanka College of Community Physicians. He won the P.H. Wilson Peiris Memorial Award at the 99^th Anniversary Academic Sessions of the SLMA in 1986 for his paper entitled “Factors Influencing the Defaulter Rate of Leprosy Patients in a Hyperendemic Region in Sri Lanka”. A paper entitled “Mobilising Mass Media for Health” which outlined an evaluation of the HEB’s very first series of media seminars was published in the prestigious international health journal “World Health Forum” of the WHO in 1988. Dr. Abeyagunawardene published his Memoirs in 2009 with his book entitled “From Hikkaduwa to the Carolinas – Memoirs of a Reluctant Expatriate”. Dr. Abeyagunawardene returned to Sri Lanka on a permanent basis in 2009 and straightaway involved himself in CCP activities by sharing his US experience in childhood lead poisoning and prevention with the general membership at the College’s scientific sessions in 2010. Dr. Abeyagunawardene now lives in Battaramulla with his wife Mangala. They have a son and daughter and three grandchildren.