Towards a healthy and productive nation

Health and education are the most important pillars of a country’s standing and progress. Sri Lanka is one of the few developing countries in the world with both free healthcare and education (primary to university) systems. In fact, Sri Lanka’s health and education indices are often on par with those of the developed world. Sri Lanka has also eliminated diseases such as Malaria, which still claim millions of lives elsewhere. This can be attributed to the investments made since Independence in free healthcare and education. Yet, there are many challenges that we face in both sectors.

President Gotabaya Rajapaksa has pledged a total revolution in the health sector. Such an approach is vital to ensure a healthy nation. In his speeches and policy statements made since his swearing in last November, President Rajapaksa has emphasized his commitment to improving and expanding the health sector and also the need for a National Health Policy.

His Vistas of Prosperity and Splendour Policy Document outlines several steps that should be taken to develop the healthcare system, both Western and Ayurveda. Among them are: Steps taken to obtain healthcare services conveniently and without waiting list/ long queues and crowding; Upgrade the National Hospital to international level; Equip and upgrade one selected hospital in each district to a level similar to NHSL; Upgrade all hospitals by providing necessary facilities, physical as well as human resources; Introduce modern diagnosis and treatment facilities i.e. E-Health, Telemedicine; Improve facilities to retain doctors in the country; Establish ISO standards in all public and private healthcare facilities to ensure safe environment for all; Establish a regulatory authority to govern all hospitals, dispensaries, labs, services etc. and maintain accepted standards; Maintain compulsory safe stock levels of essential drugs and supplies.

He also seeks to establish a National indigenous Medical Council and Sri Lanka Medical Ayurveda Council. In addition, he wants to develop a system to register traditional healers (Weda Mahathmayas) as indigenous doctors; Provide necessary facilities to improve Ayurveda hospitals to a standard level, provide preventive care facilities and to provide facilities to Ayurveda physicians; Encourage research on indigenous drugs and treatment facilities and establish mechanism to register the same; Provide facilities to cultivate all medicinal plants, herbal gardens and provide facilities to manufacture and export herbal cosmetic products; Upgrade institute of medicine to a level of Ayurveda University; Steps taken to update Ayurveda Pharmacopeia; Develop a mechanism to cater tourists for Ayurveda, Siddha, homeopathy and other traditional treatment methods. These are all worthy proposals and some are already being implemented.

Coronavirus (COVID-19) crisis

The President, who has shown a hands-on approach to administration, paid a surprise visit to the National Hospital, Colombo, recently where he gained a first-hand experience of the shortcomings in the health sector and the improvements that need to be made. This showed the priority he has given to the health system.

In today’s globalized world, it is very difficult to contain any potential health problem to one country. This was amply demonstrated by the Coronavirus (COVID-19) crisis, which has still not abated. It did not take long for Sri Lanka to get its first COVID-19 patient, albeit a Chinese national who had come from Wuhan, the epicentre of the outbreak.

As soon as the outbreak was reported, President Gotabaya Rajapaksa held a discussion with all the relevant stakeholders in the health and also travel sectors and urged them to take all necessary steps to safeguard our citizens from the viral disease. He directed that all facilities be provided to the Infectious Diseases Hospital in Angoda to contain and treat any affected individuals. It was as a result of this effort that Sri Lankans woke up to the good news that the country’s only confirmed Coronavirus patient, a Chinese national from Wuhan, has made a full recovery and that no other patient has been confirmed as having the disease.

The credit for this good news should go to health authorities and the team at the Infectious Diseases Hospital in Angoda, who worked day and night regardless of the risk to their own lives to handle this crisis. The Medical Research Institute (MRI) which developed a blood test to detect the virus also deserves praise.

But none of this would have been possible without the political leadership and guidance provided by President Gotabaya Rajapaksa, who also directed that arrangements should be made to equip 12 hospitals islandwide to deal with any suspected cases.

All Sri Lankans were worried about the fate of Sri Lankan students and other Sri Lankans residing in Wuhan, the epicentre of the viral outbreak which is now in lockdown. There was a clamour in the media and the society to bring them here as quickly as possible. This is where Sri Lanka’s excellent diplomatic relations with China came into play as Sri Lanka reached out to Chinese authorities to get clearance to land a SriLankan Airlines plane in Wuhan.

Again, the credit should go to the President for using his good offices to make this happen. In fact, Sri Lanka became only the fourth country (after the US, UK/EU and Japan) to evacuate its citizens from locked-down Wuhan. Thus 33 persons (students and their family members) who were stranded in Wuhan city were successfully brought back to the country amidst thorough quarantine measures. SriLankan Airlines flight UL1423, consisting of 16 specially trained crew members, landed at the Mattala Rajapaksa International Airport. The entire nation will be indebted to SriLankan Airlines and their crew who undertook to this mission. In fact, President Gotabaya Rajapaksa held a special reception for the SriLankan Airlines crew who performed this heroic mission and described them as an example to the entire country.

One cannot forget the role played by the Army and the Air Force which worked behind the scenes to facilitate this entire operation. The Army built a fully self-contained quarantine facility at their sprawling Diyatalawa base in just one week to accommodate the students and family members, where they will be kept under observation for 14 days. Diyatalawa has been chosen because the area often has the same weather patterns as Wuhan. Again, President Rajapaksa was in close contact with the Army top brass over these arrangements.

The Air Force’s Chemical, Biological, Radiological, Nuclear and Explosives (CBRNE) unit, set up in 2016 to handle war related destructions and victims of such incidents, trained the SriLankan Airlines crew in the necessary procedures. The CBRNE has also taken steps to completely decontaminate the persons who entered Sri Lanka from Wuhan. Measures were also taken to completely decontaminate the SriLankan Airbus.

Intelligence apparatus

President Gotabaya Rajapaksa has stressed that the existence of a CBRNE unit is essential in the context of emerging threats to national security (The Police also has a similar unit). There is a real possibility of non-state actors such as terror groups getting their hands on biological or chemical agents of destruction. Hence the President’s emphasis on revamping our intelligence apparatus to take on the dangers posed by such developments. HAZMAT (Hazardous Materials) suits and gas masks must be part and parcel of the Security Forces and Police arsenal.

But we are not completely out of the woods yet. The World Health Organisation (WHO) has declared the Coronavirus as a “Global Health Emergency†while the first death of a Coronavirus patient outside China was reported from the Philippines and later from Japan and France. This is why the President has instructed that it is essential to redouble our efforts to contain the spread of the virus.

Going forward, this must serve as a lesson for all stakeholders to face any health emergency. Under the President’s astute leadership, the health authorities are handling this crisis admirably. But we must identify any shortcomings in the handling of this challenge and modify the responses accordingly. That will help us whether any such storm in the future.

But healthcare does not just mean developing hospitals and other healthcare facilities. It is a much broader picture. For example, correct lifestyle choices and diets can help us avoid many Non-Communicable Diseases (NCDs), which have become a major problem. Hence the President’s idea of encouraging the production of food free of pesticides and chemicals, by increasing the use of organic fertilizer for agriculture. “We must prepare plans to encourage Sri Lanka’s entire agriculture sector to shift to using only organic fertilizer within the next decade. Increasing domestic production of organic fertilizer should be included in these plans.â€

He has also plans to promote: healthy meals free of agro chemicals and additives; production of organic food; proper eating habits at all ages; a healthy environment by preventing pollution of air, water, soil through a sustainable environment policy.

The training of medical personnel is also an important step. As the President said in his address to Parliament on January 3 “we look forward to upgrading teacher training schools and nursing schools to degree awarding level. The shortage of trained graduate teachers continues to be a problem in the education sector. Further, by upgrading the existing 3-year diploma programme in Nursing into a 4-year degree, and by improving the English knowledge of nurses, we will create opportunities for them to even seek work abroad by providing services that meet international quality standardsâ€.

Health is a vast sector that has no real boundaries in the modern world. It is also a sector replete with new and emerging challenges as the COVID-19 episode has shown us. President Gotabaya Rajapaksa has grasped the importance of having a healthy nation for the country’s development, for no other sector can be developed if the people and the workforce are not healthy. The entire nation must rally round his efforts to develop the health sector to the latest international standards.