SLMAnews-2012-12

President’s Note

Contents

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Prof. Vajira H.W. DissanayakePresident,Sri Lanka Medical Assosiation,No.06, Wijerama Mawatha,Colombo 07, Sri Lanka

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 ex-ample, 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 Christ-mas and a Happy New Year.May you live long!

Thank you. On behalf of the council of the SLMA,

Page No.

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December 2012 Volume 05 Issue 12

SLMANEWSTHE OFFICIAL NEWSPAPER OF THE SRI LANKA MEDICAL ASSOCIATION

Orations and Endowment Lecture 4

Ergonomics is Everywhere! 6

Ethics Review Committee of SLMA Gets Its Own Office 12

Quality and Safety in Health Care 14

Past President of SLMA 17 Dr Nihal Perera Dr Lakshman Ranasinghe

Showcasing Rajarata Reasearch 18

SLMA Membership in International Medical Associations 18

Avissawella Clinical Society 19

Healthfest - Creating a Demand for Healthier Lifestyles and Giving the Options for Lifestyle Change 20

Shun/quit Smoking, Says Medical Fraternity in Unison 22

SLMA Press Release Supporting Mandating Pictorial Health Warnings Covering 80 per cent of the Front and Back of Tobacco Packs 23

Medical Dance 2012 24-25

Economics of Health Care 28

Medical Dance - A Short History 32

Highlights of the Medical Dance 33

December, 2012 SLMANEWS

2

Notice Board

Presidential Induction – 2013

12 January 2013, 6.00 pm onwards at HNB Towers


4

22 September 2012Sir Nicholas Attygalle

OrationInflammatory 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, Fac-ulty of Medicine, Univer-sity of Kelaniya

9 November 2012EM Wijerama Endow-

ment LectureResearch and BeyondProfessor Sanath P

Lamabadusuriya MBEMBBS(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

10 November 2012Sir Marcus Fernando

OrationControlling iodine

deficiency disorders in Sri Lanka

Dr Renuka JayatissaMBBS, MSc, MDConsultant Medical Nu-

tritionist, Head, Depart-ment of Nutrition, Medi-cal Research Institute, Colombo

7 December 2012Murugesar Sinnet-

amby 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 Reproduc-tive Medicine, Depart-ment of Obstetrics and Gynaecology, Faculty of Medicine, University of Colombo, Honorary Con-sultant Physician and En-docrinologist, De Soysa Hospital for Women.

Prof. Janaka de Silva

Prof. Chandrika N Wijeyaratne

Dr Renuka Jayatissa

Orations and Endowment Lecture

Prof. Sanath P Lamabadusuriya


6

Media Briefing on Ergonomics

Ergonomics (or human factors) is the scientific discipline concerned with the understanding of in-teractions among humans and other elements of a system, and the profession that applies theory, prin-ciples, data and meth-ods to design in order to optimize human well-being and overall system perfor-mance (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, opera-tions research and anthro-pometry contributes to the ergonomics and human factors. Even the health-care field is not spared. A crucial stake lies with the healthcare professionals to promote and apply ergo-nomics in the health sector.

The Sri Lanka Medical Association (SLMA) estab-lished an Expert Commit-tee on Ergonomics (SLMA-ECE) with the objective of promoting ergonomics to medical community, gen-eral public and in health-care 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

was conducted recently to introduce the discipline of ergonomics and to dissemi-nate 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 participat-ing 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 ergonom-ics in healthcare sector. He requested media to engage more in disseminating health messages to the general public.

Ergonomics is Everywhere!

Contd. on page 8

Prof Vajira Dissanayake addressing the media briefing

SLMA-ECE Consultant Community Physician and the Chairperson Dr Kapila Jayaratne


8

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 de-tailed definitions and scope of the field. He presented objectives of ECE to the media personnel;• Tomapandcollateevidenceinergo-

nomicsandhealthconsequences• Tosynthesizeanddisseminatenew

knowledgeonergonomics• Toadvocatehealthcareandother

stakeholdersinrelevantsectorsonissuesrelatedtoergonomics

• Tointerfacewithnationalandprovincialhealthprofessionalsandotherstakeholders(eg.othergovern-mentbodies,INGOs)asappropriatetogeneratefundsandtofacilitatetheimplementationandadoptionofergonomicinitiatives

• Toinitiateandsustainactivitiesbothatnationalandsub-nationalleveltoexpandergonomicsinhealthandrelevantfieldsHe further elaborated that

considering the numer-ous areas in the health-care sector which warrant ergonomic interventions, a health-led concerted effort is essential to fur-ther expand ergonomics in Sri Lanka. The signifi-cance 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 tech-nology and also the nega-tive effects of mismatched ergonomics. Many areas

are covered under ergo-nomics but SLMA-ECE will focus on priority areas such as child ergonom-ics, occupational health, computer ergonomics etc. He invited media personnel to join in hands to promote ergonomics and improve the health of a nation.

SLMA-ECE Media Co-ordinator Dr. Jayaruwan Bandara, emphasized the need to acknowledge the people about “ergonom-ics”. He said the media has a big role to perform. It should be a collaborative effort and all the stakehold-ers should take the respon-sibility to educate the public and familiarize the objec-tives 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 sev-eral 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.

Most of the ergonomic solutions can be done using our common sense

Consultant Paediatrician Prof. Manouri Senanayke said that designing ergo-nomic solutions for children is especially challenging considering their anthropo-metrics and as a result the need to accommodate their current size and capabili-ties. 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 devel-opment and emotional maturity, these could be accomplished with simple techniques. “Promot-ing child ergonomics will have long term effects on children and most of the things can be done using our common sense," Con-sultant Pediatrician Profes-sor Manori Senanayake, reiterated.

Ergonomics...Contd.from page 6

Contd. on page 10

SLMA-ECE Media Coordinator Dr Jayaruwan Bandara

Consultant Paediatrician Prof Manouri Senanayke

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.


10

A workplace without occupational hazards

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 esti-mated at four per cent of the world’s gross domestic product. Ergonomics is one of the main occupational

hazards which con-tribute to the work related ill health.

In Sri Lanka not much empathies is paid to work-ers health. Ergonomic hazards are not mitigated and health problems due to poor ergonomics are not recognized and grossly under-reported.

A large number of work-ers suffer from muscu-loskeletal 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 ergo-nomic hazards could be mitigated with a minimal cost. "Poorly designed and incompatible working environments results in reduced efficiency, deficits in productivity, financial losses, increased medi-cal claims, and permanent disability. The ultimate goal of ergonomics is to design the workplace so that it accommodates the variety of human capabilities and

limitations to prevent oc-cupational hazards.

Thereby we can improve the economy of the coun-try, at a time it is mostly wanted" Dr Arnold added.

Computer ergonomics provides solutions to multiple problems

- Bio-informatics Specialist Dr Nishan Siriwardane

Sri Lanka is making steady a progress towards eliminating digital divide and helping the Internet and other ICTs transform-ing society, improving educational and economic benefits to the majority of Sri Lankans. A large sec-tion of population from pre-schoolers 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 require-ments. Knowledge on computer ergonomics and its application can ben-efit users to reap the true potential of technological advancements without harming their health. New software has been cre-ated to indicate the exces-sive use of the computer and therefore improve the health of the workers.


Prof. Manouri Senanayake, (From Left) Dr Mahendra Arnold and Dr Kapila Jayaratne answering the queries

Some participants at media briefing Bio-informatics Specialist Dr Nishan Siriwardane

Consultant Community Physician, Dr. Mahendra Arnold speaking on

Occupational Health

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


12

SLMAECE will facilitate implementation of comput-er ergonomics principles in near future by establishing guidelines and recommen-dations for the healthy use of ICT tools.

SLMA-ECE Convener Dr Chamaine De Silva, coordi-nated the media briefing.

The OutcomeAs a result of the SLM-

AECE 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

The 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.

Ethics Review Committee of SLMA Gets Its Own Office


14

A 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 collabo-ration with the Directorate for Health Care Quality and Safety, Ministry of Health.

The Chief Guest at the Inauguration of the Sym-posium was Additional Secretary to the Ministry of Health Dr Palitha Ma-heepala. Ministry of Health, Deputy Director General Medical Services, Dr Lak-shmi Somatunga was the Guest of Honour. The other speakers at the sessions were Sri Lanka, WHO Country Office, Consul-tant, 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 “Qual-ity and Safety in Health Care: A Private Sector Perspective”; Lady Ridge-way Hospital, Director, Dr A H Ratnasiri who spoke on

“Patient Safety Programme Initiative – Case Study from LRH”; Dr Mihirini Amarapa-thy who spoke on “Patient Safety in a Tertiary Care Hospital”; Rathnapura Pro-vincial 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 man-agement.”; Elpitiya Base Hospital, Medical Unit, Senior Medical Officer, Dr L. K. Hirimuthugoda, who spoke on “Impact of an in-tervention to improve clinic attendance through follow up phone calls to Non-com-municable Disease clinic patients”; Walasmulla Di-visional 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. Srid-haran, 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 par-ticularly 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 develop-ment 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 cen-tury. 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.

Quality and Safety in Health Care

Dr. Palitha Maheepala (Left) and Dr. Lakshmi Somatunga making their addresses at the Inauguration of the Symposium

Contd. on page 16

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


16

Risk and harm to patients from medical management itself has arguably become one of the biggest unin-tended consequences of this transformation.

Ladies and Gentlemen, Anecdotal evidence sug-gests 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 philoso-phers 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 de-veloped to ISO 9000.

Many view quality health care as the overarching umbrella under which pa-tient safety resides. Quality has been conventionally defined as an optimal bal-ance 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-

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 some-thing about understanding gain. Preventable harm due to medical manage-ment has been a constant if infrequent, topic in major medical journals through-out 20th century. Hippo-cratic Oath contemplate a conventional framework of safety as I quote ‘I will pre-scribe 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 Novem-ber 1999 the institute of medicine America publish a landmark report entitled ‘to a err is human build-ing 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$ annu-ally. 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 infec-tions. 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 surgi-cal procedures done annu-ally 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 unneces-sary.

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 ini-tiations 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 pa-tient safety agency in 2001. Since then, there had been many initiatives taken for-ward by ministries of health in their respective countries to ensure patient safety and quality with the notion that healthcare profession-als, organizations and pa-tients should get involved in building such culture of safety in healthcare provi-sion. Sri Lankan Ministry of Health too had taken initia-tives 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 exten-sive 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 direc-torate of quality and safety located in this new building, heading the quality assur-ance programme in the Ministry of Health. Profes-sor 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 member-ship will share your wealth of knowledge and your infinite wisdom for the bet-terment of human society.

Quality and Safety...Contd.from page 14

High technologic, industrialized

medicine transformed the

nature of diseases and its treatment in the

20th century.

SLMANEWS December, 2012

17

Past Presidents of SLMA

The induction of the President was by Dr Nihal Perera

at the SLFI, followed by the Presidential ad-dress on the theme ‘To teach is our responsibil-ity’.

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 be-cause of the insurrec-tion. 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 Common-wealth Medical Asso-ciation 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 hor-rors of AIDS.

The Minister de-clared, though in a whisper that it was her moment of awareness of an emerging problem for Sri Lanka.

1989 Dr Nihal Perera MBBS (Cey), Dip.Bact.

(Manch), PhD (London)

The President commenced stewardship of the SLMA Council on 23rd October, 1984 by having the silver

scroll used for important ceremo-nial documents re-plated, and, by presenting a framed hand - paint-ing 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 select-ing the President Elect should be

his / her contributions, in service and academically, over the years, for the SLMA, which was unani-mously 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 de-velopments from ancient Ayurveda to modern medicine, including ter-minology. The Council nominated the President to serve on the Cos-metics, Devises and Drugs (statu-tory) 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 reg-istered 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.

1984Dr Lakshman RanasingheMBBS (Cey), DCH (RCP Lon & RCS Eng),

FRCP(Edin), FCGP(SL), FCCP(SL), FCPaed(SL)

Contd. on page 19


18

The Joint Sympo-sium 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 achieve-ments of the Staff and Researchers at the Raja-rata University who were working in a resource poor setting.

The symposium began by singing the national anthem followed by light-ing 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 at-tended by over 50 people including postgraduate stu-dents 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 proper-ties of Tea”; Indika Sen-evirathne 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 alter-native medicine research”; Dr Thilini Agampodi on “Qualitative research in-formed, maternal and child health”; Dr Kosala Weera-koon on “Paradigms of Rickettsioses in Rajarata?” and Dr Channa Jayasuma-na on “Sri Lankan agricul-tural nephropathy”.

Showcasing Rajarata Research

World Medical Associa-tion (WMA): http://www.wma.net

Commonwealth Medical Associa-tion (CMA): http://www.thecommon-wealth.org/Internal/151924/

Council of Medical Associations in Asia and Oceania (CMAAO): http://www.cmaao.org/

SLMA Membership in International Medical AssociationsThe SLMA is a member of the following international associations:


19

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 Colom-bo, in August. Engraved medals were presented to the academic Present-ers. 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 dis-eases, and, harbinger of Maithri Buddha.

Past Presidents...Contd.from page 17

The 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 par-ticipation of over 100 doctors from hospitals in the region. Avissawella Base Hospital Medical Superinten-dent Dr. Panagoda, who has been associated with the Clinical Society since its inception gave an account of the history at the Inauguration of

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 Obstetri-cian and Gynaecologist, Dr. Mangala Dissanayake thanked the SLMA for their support.

The presentations at the ses-sions included talks by Dr H.T.Wickramasinghe on “Weaning Controversies”; Prof Vajira H. W. Dissanayake on “Genetics in Medi-cal Practice”; Dr. Lasantha Malavige on “Breaking the Ice and Helping Patients with Sexual Problems”; Dr Kanishka Karunarathne on “Cervi-cal 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. Veerasin-gam on “The Golden Mountain”. Dr W.A.S.Vipula Secretary of the Clinical Society proposed the vote of thanks.

Avissawella Clinical SocietyAnnual Sessions 2012

Avissawella Clinical Society President Dr Mangala Dissanayake

A section of the Audiance

Senior Consultant Surgeon Dr Philip G. Veerasingam


20

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 Pub-lic was able to experience some options for a health-ier 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 Novem-ber at the Viharamahadevi Park. The College had been working on this pro-gram for nearly one year, advocating to different sec-tors from the demand as well as the supply side.

By demand we mean dif-ferent target groups in the community including youth, preschoolers, housewives, corporate sector. Em-powering these different target groups and ulti-mately 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

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.

‘TheSupereight’healthtargets

1.Maintainyourbodymassindex(BMI)between18.5-24.9(theidealis23)

2.Avoidexcesssaltinfood(Limitsaltconsumptiontooneteaspoonofsaltperpersonperday-a400gpackofsaltshouldbesufficientforafamilyof4for20days)

3.Avoidexcessaddedsugar-i.e.notmorethan6teaspoonsofsugarpernon-diabeticpersonperday

4.Atleast30minutesofmoderate(e.g.briskwalk,aerobicexercises,cycling)physicalactivityperdayforatleast5daysaweek

5.Consume5servingsofFruit&Vegetablesperday(therecom-mendedamountis400gmsofFruitandVegetablesperpersonperday).Remembervarietyisgood.

6.LimitfoodwithTransFats(foundinsomecommerciallybakedandfriedfoodsuchasshorteats,pastries,cakesandre-heatedoil)

7.GiveupsmokingandAlcohol8.MaintainyourBloodPressurebelow

140/90.Checkyourbloodpressureannually

The chief guest at the Healthfest was HE the President, Mahinda Ra-japakse and the Super Eight was launched by His

Excellency. A video pre-sentation which was used to launch Super Eight will be used in the future social marketing campaign.

Healthfest - Creating a Demand for Healthier Lifestyles and Giving the Options for Lifestyle ChangeA Social responsibility activity of the College of Community Physicians of Sri Lanka

Presentation of a plaque with Super eight to HIM The president, Ma-hinda Rajapakse

Brand logo of Super eight


21

A life course approach is followed in advocating the Super Eight. This was emphasized as healthfest was a day for all. Most health promotion cam-paigns 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

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 Inter-actors of Colombo district. The photos show different stages of the Triatholon.

Different forms of physi-cal 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.

HE the President inspects preparation of Healthy Koththu

HE The president at the launch of the Super Eight

Contd. on page 26

Hon Minister of Health being shown the card which has the Super Eight in English, Sinhala and Tamil

Volunteers at the Healthfest

Secretary to the Ministry of Health Dr Nihal Jayathilaka and Additional Secretary (Public health) accompanies the Deputy Minister of Health at Healthfest

Hon. Minister of health examining the variety of local fruits available at the supermarket stall


22

By KumuDini HettiaracHcHi

The medical fra-ternity 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. Va-jira H.W. Dissanayake, with the SLMA taking the lead in this campaign and garner-ing the unstinting support of all doctors’ and dentists’ colleges in Sri Lanka as well as the Government Medi-cal Officers’ Association (GMOA).

Giving out a strong mes-sage about the deadly effects of smoking on dif-ferent 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 Practi-tioners of Sri Lanka; the As-sociation of Pulmonologists of Sri Lanka; the College of Psychiatrists of Sri Lanka; the Sri Lanka College of

Haematologists; the College of Forensic

Pathologists of Sri Lanka; the College of Community Dentistry of Sri Lanka; the Sri Lanka Dental Associa-tion; 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. Dissanay-ake, explaining that people were being struck down by heart disease, stroke, dia-betes, cancer, chronic lung diseases etc.

Some of the underly-ing causes of NCDs are bad habits, one of which is smoking. Smoking is an im-portant risk factor we need to deal with.

People should quit smok-ing, for not only is the smok-er affected but all those around him as well because they become passive smok-ers, he said. Awareness is of paramount importance and a message should be sent out through the packets themselves about the con-sequences 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

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 Febru-ary 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 con-sequences of smoking.

Shun/quit Smoking, Says Med-ical Fraternity in Unison

Full backing for pictorial warning on packets of cigarettes

Panel of medical experts. Pic by Athula Devapriya

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,


23

SLMA Press Release Supporting Mandating Pictorial Health Warnings Covering 80 per cent of the Front and Back of Tobacco Packs

Over 60 per cent, of deaths world-wide are due to non-communi-cable diseases (NCD).

The four main NCDs are cardio-vascular diseases, cancers, dia-betes and chronic lung diseases. Nearly 80 per cent of non-commu-nicable disease deaths occurred in low- and middle-income coun-tries. 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 – cardio-vascular 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 ex-posed 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 hos-pital with chronic tobacco related diseases. Money spent on pur-chasing tobacco and expenditure incurred in obtaining treatment, in addition to forgone income from losing work is a substantial con-tributor to poverty. Each of these deaths and the other consequenc-es are preventable.

Many countries have imple-mented evidence based measures to reduce tobacco use. One of the

important measures undertaken to educate smokers of the harms of tobacco use is mandating picto-rial health warnings on tobacco products. Other measures include discontinuation of all forms of advertising, sponsorships and pro-motions, increasing the taxes on tobacco to reduce affordability and banning smoking in public places.

The National Authority on Tobac-co 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 super-markets. 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 de-clare toxic substances contained in cigarettes, in each pack. This measure will substantially contrib-ute in addressing the enormous health, social and economic harms caused by tobacco, which is detrimental to the wellbeing of the people and will undermine devel-opment 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 tobacco-related diseases each day.

The following colleges and asso-ciations attended the conference:SriLankaMedicalAssociationSriLankaDentalAssociationGovernmentMedicalOfficersAssociationCollegeofPsychiatristsSriLankaCollegeofOncologists;SriLankaCollegeofPaediatriciansCeylonCollegeofPhysiciansCollegeofCommunityPhysiciansCollegeofGeneralPractitionersofSriLankaAssociationofPulmonologistsofSriLankaCollegeofPsychiatristsofSriLankaSriLankaCollegeofHaematologistsCollegeofForensicPathologistsofSriLankaCollegeofCommunityDentistryofSriLankaCollegeofMedicalAdministratorsTheNationalInstituteofMentalHealth

The Medical Dance, the most prestigious and the oldest Dance in Sri Lanka, still continu-ing 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

morning to the music of Friends in Har-mony 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 perfor-mance 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 profes-sion – Surgeons, Physicians, Obstetri-cian and Gynaecologists, Paediatricians, Neurologists, Pulmonologists, Radiolo-gists, 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. Ev-eryone appreciated the kind gesture by Dr. Ruvaiz Haniffa - the SLMA treasurer, who gave back the prize he won, an

Medical Dance 2012

24


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. Ev-eryone appreciated the kind gesture by Dr. Ruvaiz Haniffa - the SLMA treasurer, who gave back the prize he won, an

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.

Medical Dance 2012

25



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 ar-ranged in a natural setting and people were enjoying the environs and could re-lax 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. How-ever 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-

ket economy that prevails. Some principles that could be adopted were shared and we expect that a lead-ing Supermarket will show-case 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.

26

Healthfest...Contd.from page 21

Different stages of the Triatholon

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


27

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 Agri-culture too partnered the College of Community physicians to give a health emphasis to the national drive of 'Api Wawamu - rata nagamu', which is 'Api

wawamu - Poshanaya Wadamu'. We promoted at least 5 types of fruit and vegetable trees to be planted in home gardens.

We gave a recommen-dation 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 Agricul-ture department on planting

techniques sans pesticides and artificial manuring.

Various other stalls of-fering different healthier options were available at Healthfest. From Fitness machines to the impor-tance of foot massage, from experiments with coconut based products, to a supermarket that show-cased its future potential to provide local fruits, to catering agencies that were willing to offer healthier

snacks in their outlets in fu-ture and a range of bever-ages 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 add-ed color to the event. They expressed their opinion on Super Eight.

Different forms of physical activity were promoted at Healthfest Some events at the pre-school program

Contd. on page 30


28

By FatHima carDer

The Sri Lanka Medical As-sociation has focused its attention on discussing the economics and other broad-

er 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 Require-ments in the Sri Lankan Health Sec-tor”.

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 Ac-counts” 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 Senevi-rathne.

The Symposium on “Human Resources Requirements in the Sri Lankan Health Sector” Chaired by: Dr C. Thurairajah and Prof. Saroj Jayasinghe consisted of four presen-tations: “Current Human Resources in the Government Health Sector and Future Projections” by Ministry of Health, Development and Planning Unit, Management, Director (Plan-ning), 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

General (Education, Research and Training) Dr Sunil De Alwis, “Hu-man Resources Requirements in the Private Sector” by Private Health Ser-vices 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 com-mittee under the Chairmanship of Dr Palitha Abeykoon, ably assisted

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 Col-lege 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.

Economics of Health Care

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 Chair-person Dr Palitha Anbeykoon and College

of Medical Administrators President Dr Nick Jayasuriya chairing the session.

Ministry of Health Additional Secretary Dr Palitha Maheepala delivering his address


The main focus of the seminar was to find ways and means of address-ing 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 con-sultant Dr Palitha Abeykoon posed the question, ‘What makes a health system ‘good?’ Explaining, he said that it will mean different things to dif-ferent 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 ha-rassed 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 work-ing, a pressure group will be lobbying for kidney transplants and a newspa-per will be looking for a good story.

The three main objectives of man-aging a health system should encom-pass providing a service, respond-ing 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

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 popu-lation 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, addi-tional secretary to the Ministry of Health, Dr Palitha Mahipala, said that health is the responsibility of the individual and not the govern-ment. “The free health system was introduced in the 1930s. In 1920, Sri Lanka had the worst health in-dicators 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.

29

Contd. on page 31

A section of the audience showing representatives from both the public and private sectors

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.


30

Healthfest...Contd.from page 27

The College member-ship 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 empow-ered and for that they need healthier options.

The College of Community physicians of Sri Lanka to-gether with the support of the Ministry of Health and the National Nutrition Sec-retariat of the Presidential Secretariat will be taking Super Eight the brand of eight health targets forward as a national en-deavor of addressing Non communicable diseases in Sri Lanka.

Street drama

Popular Singer Nirosha Virajini comments on super 8

Dayasiri Jayawardena meets HE the President at Healthfest

About the writer Dr Susie Perera is

the President of the College of Community Physicians

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.


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 coun-tries. 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 eco-nomics is healthcare, with compara-tive studies from other countries were also made by University of Kelaniya, Faculty of Medicine, senior lecturer, Dr Anuradhini Kasthuriratne and Insti-tute for Health Policy executive direc-tor 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 expen-diture, Sri Lanka’s health outcomes were probably the best in the world.

The organisers were urged to con-tinue to conduct similar seminars so as not to lose sight of a good initia-tive, which some panellists and par-ticipants felt need to be taken forward to maximise the available financial resources in order to provide the best services to patients, cost effectively.

Economics...Contd.from page 29

“A binding requirement of the Framework is picto-rial 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 San-thushya Fernando of the College of Community Phy-sicians said they included increasing the ‘price’ of cigarettes through high tax-es; prohibition of smoking in certain ‘places’ such as hospitals, public vehicles, public places, hotel rooms, workplaces and eleva-tors; prohibition of sale of cigarettes in certain ‘places’ such as public places; and

limiting the ‘promotion’ of cigarettes through advertis-ing and packaging.

To reduce the attractive-ness 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 warn-ing statement, graphic and explanatory message must cover 90per cent of the back of the packet.

Dr Fernando said that the tobacco industry uses vari-ous 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 smok-ing 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 cur-rent 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 discon-tinuation 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.

Shun/quit Smoking...Contd.from page 22

Reproduced with Permission from the Sunday Times of 9 December 2012

http://www.sun-daytimes.lk/121209/news/shunquit-smoking-says-med-ical-fraternity-in-unison-24062.html

31


32

The first Medi-cal Dance was organized by an

informal group of en-thusiastic 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 Asso-ciation (SLMA)– became involved in its organisa-tion.

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 Sil-va and others were orga-nizers of this prestigious Dance. At that time it was one of the highlights of the social calendar in our country, being held an-nually 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)

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 presti-gious 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 Fer-nando, Aloy Fernando, Laddie Fernando, Bubsy Mendis, Willie Ratnavale, Shelton Cabraal, David Jayamana, L. P. D. Gu-nawardene and Douglas Flamer Caldera.

In the latter part of 1950s the dance went into slow decline, with poor participation. The stalwarts who had orga-nized 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 coun-try 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 profes-sion 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 re-named, 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 un-planned: on one occasion there was an unexpected bonus when the sunflow-er hiding the left breast of one dancer fell off in mid-performance!

Medical Dance A Short History

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.


33

Highlights of the Medical Dance

Improved anthropometric measurement

Improved biochemical data

Improved appetite

Improved total calorie intake

Health For Life

Appeton Wellness 60+The Ideal Food for Geriatrics

of geriatrics tested displayed Improved Nutritional Status*

CLINICALLYPROVEN

FO

R G E R I AT R I C S

FOR GERIATRICSAppeton Wellness 60+ is a special food formulated with essential nutrients

based on the biological needs of the elderly. It is clinically proven that 100% of geriatrics tested responded well to Appeton Wellness 60+.*

Every elderly respondent who took Appeton Wellness 60+ steadily improved his / her Body Mass Index (BMI) over 12 weeks*.

Time (weeks)

-3

-4

-2

-1

0

1

2

3

00 week

0.9

6 weeks

-1.1

2.3

12 weeks

-2.8

Changes of mean BMI (%)

Intervention Control

* Clinically Proven Endorsement is referenced in ‘Effect of Nourishing Formula (Appeton Wellness 60+) Supplementation on the Nutritional Status, Functional Performance, Cognitive Function and Quality of Life of Malnourished Elderly in Old Folks Home’. Study conducted by Dr Zahara and team at the Department of Nutrition & Dietetics, Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia.

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At the Samudra Hotel Dance it was noticed that the belly dancer was preg-nant – some belly dance that was! On another occa-sion a senior member went on stage and sang ‘NAMO NAMO MATHA’ and the Dance ended abruptly at 2 am.

The later nineteen eight-ies saw the country in a war situation. It was con-sidered in bad taste to hold the Dance and for many years there was no Medi-cal Dance. It was revived in 1992.

Compiled by Dennis Aloysius and Malik Fernando in November 2005

Having served as one of the Social Activities Sec-retaries or as a member of the Dance Committee from 1994, the year of Presiden-cy 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

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 Presi-dent of our country Chan-drika Kumaranatunge was injured at that time. Several of our members left the dance floor and rushed to Nawaloka Hospital where the casualties were admit-ted, 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 terror-ism in and around Colom-bo, 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 them-selves, Dr S Ramachan-dran, Dr D N Athukorala, Prof. Anoja Fernando, Prof. A H Sherrifdean, to name a few had no hesitation in keeping up the grand tradi-tions of the SLMA.

The Medical Dance has been resurrected this year

by our current President Prof. Sanath Lamabadu-suriya 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 every-one’s delight. The sit down dinner was much appreci-ated. 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

Medical Dance...Contd.from page 32

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.

36

”

“ 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 based cardiac care.

Our focus is on patient safety and quality first

Superior service at Asiri HeartNo. 21, Kirimandala Mawatha, Colombo 05.

Tel : 011 4524400 / 011 2368407 / 011 2368408Fax : 011 4524451 / 011 4527311E-mail : [email protected] Web : www.asiri.lk

SLMAnews-2012-12

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