Tuesday, July 07, 2009

Our clan does not have a knowledge that goes beyond the law of nature

A speech by Dambane Gunawardane summarized by R Meepitiye Seelarathane thero

Associated with the green vegetation and wild animals, the life style of veddhas was an independent one. Traditional wealth of knowledge and culture of Veddahs, who were born, bred and dead in jungles were built on the shaping of the nature. However, with the time being, as a result of so called development, progress and deforestation, homelands and cultural practices of indigenous people have been subject to drastic changes. Very recently, the academic staff and students of the department of language and cultural education of the Sri Jayewardenepura University visited Dambana with a view to studying the nature of the current veddha tribe and their association with the nature. This is a summary of the speech of Dambane Gunawardane. The original article in sinhala was prepared by Rev. Meepitiye Seelarathane thero. This appeared in the newspaper “Lanka” on 10 May 2009. We translate this to English and republish for the benefit of non sinhala speaking readers to enhance their wisdom from that of the indigenous communities such as veddha tribe,

I have returned to Dambana having gone to Colombo from Dambana as a university student. Why did I return to Dambana after being graduated? Dambana is a very remote village. The word Dambana reflects our primary status, rustic nature and undeveloped status. Then why do we return in search of this undeveloped status? This is incomprehensible as development means moving forward rather than taking steps back. Why we returned is itself an issue for us. Why do people return in this manner? Why do the majority think so?

The word “Veddha” itself is derogatory. Because of the derogatory nature of the word “Veddha”, since of late, people have been using the word “Indigenous” in place of Veddha. .This alien word is being used because of this perceived derogatory nature. The word “Veddha” entails three reasons to be perceived as derogatory: Being dirty, not being literate (not knowing anything) and killing animals.

When we remember veddhas, it reminds us that they are people who kill animals and eat. They are very dirty and they do not know anything. These three things come to the fore front. On surface, we do se these three reasons. When we look at these superficially, being derogatory is transpired to be reasonable since only when we penetrate deep into, we see what reality is. They are apparently dirty, apparently not knowledgeable. They do not know what big shots do. True, the current crop of children knows certain things. Cellular phones and kind of things are used. They use even computers .But our elders do not know these things. Truly enough, they apparently do not know anything.

They kill animals for flesh, though it is rare today. Earlier our fathers used to kill animals everyday. That is true and not a lie. From that point of view, there is nothing in it. First issue is killing animals which is a bad act. It is not worth for anyone, a human in particular, to kill an animal. Animals cannot think too much. Therefore, when they are hungry, they kill another animal to appease hunger. But in contrast to animal, humans are an emotional lot. A collective that can think to a great deal. As such, when an animal is killed, when an animal cries, humans feel it. They are supposed to feel the sorrow. An animal does not die at once. It cries, struggles, shouts, attempts to flee. Blood is shed, skin is severed. A man cannot be senseless when he sees all these. Lets say that an indigenous people do not understand this phenomenon. But can a developed man say so as developed means he has developed his senses further. But, if you ask a developed man what he ate, he will respond “ Oh I have not eaten flesh, I have eaten rice “Just leave the whole plate of rice a side and take one grain of rice. Think how many animals have been killed to produce this one grain of rice, first when clearing the ground, then setting fire to weeds, ploughing the earth, applying and due to the toxic effect of agrochemicals and fertilizers. So when calculated in this way, millions of animals have been killed to produce a grain of rice. These animals are not large ,visible animals. They may be unapparent, tiny animals. A heap of such grains we call rice. So, can you calculate the number of animals killed by humans who are more developed than a veddha ? Veddha kills one animal for one meal. Sometimes, it is not for his but for the meal of the entire village. They had a methodology to share the kill. A cave was inhabited by several families. One clever chap goes hunting and kills after contemplation. Say two go into the jungle and if they intend to come tomorrow, they will not kill a deer or sambhur even they collide on to hunters since they cannot finish eating the flesh of the animal. So they track until a fitting animal to their need is found. That is the veddha’s method. Only when they return home, do they kill an animal adequate for the need of family members. For one meal, never do they kill two animals. This is the act of said , undeveloped, unknowledgeable and dirty humans. But developed , trekking on the moon, humans kill millions of animals for one meal. Who is morally more developed ? more humane ? more important man ? These are unapparent phenomena . Those phenomena are not seen by the naked eye. A person who studies needs to study these. It will show whether those humans who are derogated have inhumanness or they bring destruction. If we destroy millions of animals for a meal, what will be the outcome if we live 100 years. These things continue without being seen by us. They add a piece of meat of a killed animal to the heap of rice. Then add a boiled egg without letting the embryo a chance to develop. Who did this? The one who is sensible and overflowing with love, affection and compassion. Why are not those feelings generated ? Feelings are there to be generated. May be as said sometimes, they may be compassionate about humans, not compassionate about animal though. But how does one believe when he sees what happens in the society or the way wars are fought. Let alone others, are there qualities such as feeling equality, unity, sorrow of the others at home and giving a hand at least to those at home. There is an enthusiasm with the word “ Humans”. Though enthused, the real truth is that humans are the least developed animals in the world.

We are great destroyers of the world. Without us , this world is enormously beautiful. We humans have greatly destroyed the world. The acceleration of the destruction is development. Earlier one tree was felled with an axe per a day
Whereas now with the development, a machine will need five minutes to fell a tree. We think our world is developed in terms of technology. So what did we do? We have accelerated the destruction. We do so by what we learned . The degree to which I destroy is inadequate. I need to expand it. Acquiring more resources means a great destruction. My home means a place with accumulated great destructions. The plate of rice that I eat is a small fruit of a great bio destruction. When we compare what we collect and destroy to collect the same, we are satisfied with the small grain of our gains and the mountain of destruction. This is the kind of situation which the world is in today. This is the perspective which you should come to Dambana from. Dmbana is not all about that village but about ancient world, being rustic and rural.

What is this that I am doing as a human ? What is the outcome of this? If the destruction continues in this manner, what will happen to the destroyer ? He will be cursed. If you approach secretly to any developed man and ask “are you contented ?”, or say that he is transpired to be so, his answer will be “ What content, I live with great difficulty “.

The self inflicted destruction returns to trouble once again, worries and irritates the sub consciousness of the destroyer. You live not for your self . You get the feeling that to make you live , it is prudent to deprive many animals of their right to living. That makes you feel uncomfortable. Under a shade of a tree, one of our kinds chewing a betel is smiling. He hardly has areca nut or betel leaves. But he doesn’t feel dejected. His mind is trouble free. He has not been involved in a great mess to anybody. Nor has he taken someone else’s property. Free. That is life. What one gets by doing the destruction and by being a part of the nature under the tree is the same.

What we obtain from birth to death is satisfaction. When one reaches the moon , he is satisfied. The same satisfaction is obtained when one of our kind digs a large root or tuber . So both have done the same. This is the reality of the world and that is why you need to return to Dambana, being rustic or rural. Inside those, you need to have your studies. Inside the study, you need to find things of your life. The difference in your life is the certificate or awards that you receive and not the paper that testifies that you have a BA,MA or PhD. That is only a piece of paper.

Within all these studies, you understand the nature of your life, contradictions of your life, how your life should be, if your life is subject to any transformation. Getting through an exam or not is not a big deal. It is just a matter of a profession or job which is irrelevant to life as we are able to initiate a physical transformation with all these. To make an inner change , none of these things is relevant.

The other reason is the fact that we do not know anything. Being knowledgeable means the knowledge to deprive somebody of his rights. According to the law of the nature, any given animal has no rights other than the right to take food till stomach is full, right to protect the life, and right to reproduce. Though there is the right to take food till stomach is full, the right to rob and possess someone else’s property, and depriving someone else’s right has not been provided. Every animal has preserved that right. This has been violated only by humans. A bird picking berries on a tree does not claim the right for the tree. It lets other birds to pick berries. Humans have only defined borders for their possessions. Who gave this right to us ? It has been formulated by us and not the nature.

The right that was accorded to me by the nature is that I am free to live anywhere. It will be mine till I continue to live. Once I leave, it is no longer mine. This right has been formulated by humans. With the time being, humans have formulated rules and regulations, possessed things belonging to others, generated their own power and made attempts to get all factors under their ownership. Knowledge means this effort to possess every thing by humans through rules and regulations and powers that enable them to possess properties of others. Our own kind doesn’t have this knowledge. But, the knowledge essential for living is possessed by our own kind. That is the knowledge to dig a root, to find a honeycomb or to protect themselves from scorching sunlight, rain or animals. We don’t have the knowledge of possessing something belonging to others or that is beyond the nature. Had we acquired the other type of knowledge , then we would have inflicted a huge destruction. I am the first graduate from the veddha tribe. By having obtained the degree, I have committed something that leads to destruction. My degree has helped me to distance myself from the nature and not to be with it. Degree provided me an opportunity to dissociate from the nature. It gave me impetus to do so. Nothing else.

The other reason is the purity. How beautiful are wild animals? The deer here is pure. But never has it used soap. To the extent that you are exposed to the nature, there is nothing called being dirty. Being dirty emanated from being hidden from the nature. When in unison with the nature, there is nothing called being dirty. No need to cleanse in particular. The cycle of cleansing is engrained in the nature itself. We are not a group of people just fell down from the sky. This earth, water, wind are in us too. We derive energy from earth, wind, trees, sun and moon. We hide from all these. Having a roof over our head prevents us from being exposed to sunlight. Clothes make sunlight fall on them and not on the body. That causes diseases, this and that, in humans.

Do wild animals get sick ? Do they have hospitals ? Do they seek care of midwives in delivery ? No. We too had this energy. We live refusing and having shielded ourselves from all these. But what was our objective? Living in comfort. This is the biggest joke. We built air conditioned rooms having shielded ourselves from the nature to live in comfort. Didn’t we? Did we live in comfort? No.

We had to be in hospitals. But animals in the wild did not do any effort and to date live in comfort. If we are searching comfort, then this is the wrong track. If we are in search of joy, satisfaction or humanness, then this is the wrong track. This does not mean that we as veddhas too live as it was before. We are too moving with mistakes. Indigenous tribes, veddha tribes mean not the tribes that used to be earlier. We are also a lot that has to follow the destructive world. But that minute beauty is visible to us. With the existing situation, that is also enough. Seeing that beauty is seeing Dambana.


Tuesday, July 15, 2008

Surveillance of rotavirus diarrhea: A new frontier for the mature EPI in Sri Lanka
( Abstract of the presentation made at the Rotavirus symposium in Istanbul, Turkey, on 3-4 June 2008 )
Wijesinghe PR1 , Batuwanthudawe R1, Galagoda G 2, Abeysinghe MRN1, De Silva S3, Nyambat B4, Kirkwood CD5, Kilgore PE4
Correspondence – Gunathilake@khalsa.com
1Epidemiology Unit, Ministry of Health, 2Medical Research Institute, 3Lady Ridgeway Hospital for Children, Colombo, Sri Lanka; 4International Vaccine Institute, Seoul, Korea; 5Murdoch Childrens Research Institute, Melbourne, Australia.

Background
Over the past several years there has been a dramatic decline in diarrhea-specific mortality rates and diarrhoea-related case fatality among infants and children in Sri Lanka. Despite this reduction in deaths, diarrhoea-specific morbidity continues to impose a heavy burden on the health care system with diarrhoea ranking as the 6th leading cause of all in-ward admissions. Though diarrhoeal diseases continue to be a public health problem, aetiologic diagnosis is infrequent. As a result, the proportional morbidity and the local epidemiology of rotavirus diarrhea is not well-known. , surveillance was initiated with a view to estimating the proportion of diarrhea due to rotavirus and describing local epidemiology of rotavirus diarrhea among diarrhoeal admissions of under five children in the premier paediatric hospital in Sri Lanka.

Methods
Fecal specimens were collected from all diarrhoeal admissions from children less than 5 years of age in the diarrhoeal treatment unit (DTU) and inpatient hospital wards during a 24-month period. Specimens were frozen at –20 °C and rotavirus testing was performed (IDEIA rotavirus enzyme immunoassay, Oxoid, United Kingdom). Rotavirus positive specimens were analysed by RT-PCR genotyping assays to determine the distribution of rotavirus G and P types. Relevant data were collected from parents using an interviewer-administered questionnaire and surveillance data were entered into a standardized database management system.

Results
Overall, the proportion of rotavirus among [ 1179 total diarrheal patients tested] all-cause diarrhea admissions was 23.9%. Rotavirus diarrhea was most common among children in the age groups of 6-11 (37%), 12-23 (23%) months. Rotavirus diarrhea patients were hospitalized throughout the year, however, the rotavirus peak from January to March was consistent with the pattern of increase in all cause diarrhea admissions. Although 65% of rotavirus diarrhea patients had vomiting, the duration of vomiting was <3 color="#ff0000">Conclusions
A significant proportion of diarrhoeal admissions proved to be due to rotavirus and occurred mostly in children below 2 years of age. These data, despite their limited generalisability, will help policy decisions to introduce rotavirus vaccines to the mature Sri Lankan EPI in the future.

Friday, June 06, 2008

Curriculum Vitae

Dr.Pushpa Ranjan Wijesinghe (MD, MSc, MD)
271/6, Samanala Mawatha,
Galagedera , Padukka ,Sri Lanka
00 94 11 2831799
, Gunathilake@khalsa.com

EDUCATION

Doctor of Medicine (Community Medicine) – 2005
Post Graduate Institute of Medicine, University of Colombo
Thesis: Pharmaceutical Consumption among adults, private pharmacy services and implementation of Drug Regulation in a selected urban and rural district in Sri Lanka

Master of Science (Community Medicine) -2000
Post Graduate Institute of Medicine, University of Colombo
Dissertation: Evaluation of Rubella Immunization Programme in Polonnaruwa district in Sri Lanka

Doctor of Medicine (General Medicine) -1994
Order of people’s friendship state medical university, Rostov on Don, Russia (Former USSR)
Basic medical degree

Post Doctoral Training -2006
A requirement for Board Certification as a consultant in Community Medicine in the Post Graduate Institute of Medicine

Institutions where training was completed:
University of Otago, Dunedin, New Zealand,
“Public Health South” of the Otago district health board, Dunedin, New Zealand A visiting staff member attached to the
Department of Preventive and Social Medicine of the Otago University New Zealand
Pharmacovigillance centre
Pharmacy School of the Otago University
Public Health section of the Otago District Health Board
“Med safe” -Dunedin

Responsibilities/ courses followed
A member of the Pharmacy practice Research group and conducted the research project on “ Medicines advertising on New Zealand TV “
Audited post Graduate courses: Health Economics, Occupational safety, epidemiology and
biostatistics
Pharmaco-epidemiology and pharmacovigilance at the New Zealand pharmacovigillance centre
Involvement in planning, implementation and monitoring of preventive health programmes at the Public Health South of the Otago district health board

EMPLOYMENT HISTORY

Medical Officer – Epidemiology Unit, Ministry of Health, Sri Lanka
Period: 2005 to date
Responsibilities:
Consultant Epidemiologist in the Ministry of Health
Surveillance of communicable diseases
Planning, implementation and monitoring of control of priority communicable diseases
Planning , designing and conducting research for formulation of immunization policies
Ensuring disaster preparedness and initiating outbreak response
Involved in enhancing capacity of public health staff

Medical Officer - Anti Leprosy Campaign, Ministry of Health
Period: 2003-2005
Responsibilities:
A member of the policy planning team for integration of leprosy into the General Health Structure
Epidemiological analysis of the Leprosy status in Sri Lanka
Planning monitoring and evaluation of leprosy control programmes,
Conducting training modules for different target groups on detection and management
and control of Leprosy,
Editor of the News Letter of the Campaign
Lecturer in Community Medicine, Department of Community Medicine at the University of Colombo ( Doctoral training )
Period: 2001-2003
Responsibilities:
Teaching Basic Epidemiology, Research Methodology and Medical Statistics for undergraduates in Medicine
Supervising field attachments of Family and Community Medicine of undergraduate Students
Curriculum development for community medicine stream

Medical Officer of Health (MOH) and Divisional Director of Health Services (DDHS), Lankapura, Ministry of Health, North Central Province of Sri Lanka
Period: 2000-2001
Ministry of Health, North Central Province of Sri Lanka
Responsibilities:
Middle level Management of public health activities and staff
Planning, monitoring, co ordination, implementation and evaluation of Primary Health care( MCH, Immunization, occupational, environmental health etc) in a defined health division( MOH area)

Medical Officer in Anesthesiology and Intensive Care, Base Hospital, Polonnaruwa, Sri Lanka
Period: 1996-1998

Internship for Medical Officers as a requirement for registration as a Medical Practitioner in Sri Lanka,
Period: 1995-1996

PROFESSIONAL EXPERIENCE:
Current research works:
Co-principal investigator for the study (clinical trial) assessing the safety and Immunogenicity of the JE live SA 14-14-2 vaccine among Sri Lankan children sponsored by the Program for Appropriate Technology in Health (PATH-USA).
Sri Lankan co-coordinator of the South Asian Pneumococcal Surveillance Network Alliance (SAPNA) sponsored by Pneumo ADIP
Coordinator of the Rotavirus Surveillance project among Sri Lankan children” project sponsored by International Vaccine Institute(IVI).
Coordinator of the Hib surveillance project in Sri Lanka sponsored by the HIB initiative
External Consultancy:
Consultant for the WHO project of “ multi-disease surveillance project in tsunami affected areas” in Sri Lanka

A member of the Epidemiology unit which conducted the “Health Review “for the North Western Province for the Ministry of Health in collaboration with the World Bank.

Other collaborations :

A member of the team of the Anti Leprosy Campaign which was involved in leprosy elimination activities in Sri Lanka in collaboration with Norvartis International

Reviewing submissions for Journals
Peer reviewer for the “Journal of the Royal Society of Tropical Medicines and Hygiene”, United Kingdom

Memberships
A member of the National Influenza Technical Evaluation Committee
A member of the National Advisory Committee for Leprosy Elimination
Participation in international workshops/symposia
8th
1st International symposium on Pneumococcal vaccination in Asia Pacific held in Seoul, South Korea, 12-13 December, 2007
6th Asian Rotavirus Surveillance network (ARSN) workshop held in Thailand ,3-4 December ,2007
South Asian Pneumococcal Network Alliance (SAPNA) annual Investigator’s meeting in Mahabalipuram, India, 21-22 September, 2007

RECENT PUBLICATIONS
Wijesinghe PR, Norris P. Increased advertising of medicines on New Zealand television since 2001. New Zealand Medical journal. Volume 121, No .1271, 04, April, 2008.

Wijesinghe PR, Settinaykae S. An analysis of the pattern of detection of leprosy patients by institutions in the General Health Services in Sri Lanka after the integration of leprosy services into General Health Services – Leprosy review, volume 76, No.4, December, 2005.

Wijesinghe PR, Jayakody RL. Seneviratne R De A. An assessment of the compliance with Good Pharmacy Practice (GPP) by private pharmacies in a selected urban and rural district in Sri Lanka. Pharmaco-epidemiology and .Drug Safety. 2007; 16:197-206

Wijesinghe PR. Obesity: A wake up call for developing countries too. British Medical Journal 2006; 333:809 (14 October),


Wijesinghe PR, Wijesinghe TS. Evaluation of rubella immunization programme in Polonnaruwa District- Journal of the Community Physicians of Sri Lanka, Volume 5, 2000

Wijesinghe PR, Banduthilake C, Wijesinghe TS. Rapid assessment of the quality of services in rubella immunization provided through the Primary health care Network in Polonnaruwa District - Journal of the Community Physicians of Sri Lanka, Vol. 6, 2001

Siyambalagoda, R. R. M. L. R., Perera, P. A. J., Wickremasinghe, A. R., Sumanaweera, N. P., Wijesinghe, T. S., Soyza, D. N. N. de, Maniwannan, S., Wickramasinghe, W. K., Wijesinghe, P. R. Hemoglobin levels among pregnant women in the Polonnaruwa district-The Ceylon Journal of Medical Science, vol. 46, 2003

Wijesinghe PR, Jayakody RL. Seneviratne R De A. Development and validation of a scale measuring perceived access to medical care. Journal of the Community Physicians of Sri Lanka, Vol. 10, 2005.

Research submitted for consideration for publication
Integration of leprosy services into the GHS in Sri Lanka: Overcoming challenges in a remote district. Leprosy Review (Accepted for publication)

Self medication and it’s predictors in a selected urban and rural district in Sri Lanka. Pharmaco-epidemiology and drug safety.

Other activities:
Co- editor of the manual “Zoonotic Diseases “prepared by the Bio-diversity department of the Ministry of Environment, Sri Lanka

Contributor to the manual “Guide to prevention of teen suicides” published by the Ministry of Health of the North Central Province, Sri Lanka -1998
Translation of the manual “ Fact sheet on infant feeding “ to Sinhalese language for Primary Health Care workers published by the Ministry of Health of the North Central Province , Sri Lanka- 1998
Editor of the Newsletter “From segregation to Integration” published quarterly by the Anti Leprosy Campaign

Scientific contributor to the “Weekly Epidemiological Bulletin “of the Epidemiology Unit.

Contributor to the action plan for integration of Leprosy services into the General Health services in Sri Lanka prepared by the Anti leprosy Campaign and Norvartis Foundation for Sustainable Development, Switzerland.

Visiting lecturer to the Post Graduate Institute of Medicine, Colombo for courses leading to masters and doctorates

Visiting lecturer to the Faculty of Medicine of the University of Colombo, Kelaniya and Sri Jayewardenepura universities for undergraduate courses in medicine and nursing


Presentations
Abeysinghe MRN, Wijesinghe PR. Landscape of new vaccines for JE: Country level strategies for introduction. Presentation made at the 13th International Congress on Infectious Diseases (ICID) in Kuala Lumpur, Malaysia on 19-22 June, 2008.

Wijesinghe PR, Batuwanthudawe R, Galagoda G, Abeysinghe MRN, Niyambat B, Kirkwood CD, Kilgore PE. Surveillance of rotavirus diarrhea: A new frontier for the mature EPI in Sri Lanka. Presentation made at the 8th international Rotavirus symposium in Istanbul, Turkey on 3-4 June, 2008.
Wijesinghe PR, Wickramasinghe G. Influenza surveillance in Sri Lanka. Presentation made at the 2nd meeting of National Influenza Centres in the Western Pacific regions and South East Asian region, Tokyo, Japan on 21-24 April, 2008.

Wijesinghe PR, Karunaratne K, Abeysinghe MRN, Batuwanthudawe R, Guruge K, Steinhoff M, Thomas K, Kesawan L. Surveillance of pneumococcal invasive disease in Sri Lanka under the South Asian Pneumococcal Network alliance. Presentation made at the 6th international symposium on pneumococci and pneumococcal diseases in Reykjavik, Iceland on 8-12 June, 2008

Kulkarni P, Thomas K, Steinhoff M, Laitha K, Balaji V, Rijal B, Sharma P, Nhuchche T, Gami F, Singh A, Thorson S, Murdoch D, Pollard A, Adhikari N, Lewis J, Karunaratne K, Abeysinghe N, Wijesinghe PR, Batuwanthudawe R. Epidemiology of Invasive Pneumococcal Disease in Nepal, Sri Lanka and India: An update on 3 years of SAPNA surveillance (Nov 2004- Dec 2007). Presentation made at the 6th international symposium on pneumococci and pneumococcal diseases in Reykjavik, Iceland on 8-12 June, 2008.

Wijesinghe PR, Mazaitzewa T. A case study on “Porphyria” in the 48th annual academic sessions at the Rostov Medical University, Russia in 1992

Wijesinghe PR, Jayakody RL, Seneviratne R De A. Self medication practice and predictors in a selected urban and rural district in Sri Lanka. At the 25th Anniversary Academic sessions of the Post Graduate Institute of Medicine of the Colombo University.

Wijesinghe PR, Jayakody RL, Seneviratne R De A. Validation of a scale measuring access to medical care in an urban and rural area. At the 10th annual scientific session of the College of Community Physicians held on 29th October 2005.

Abeysinghe MRN, Palihawadane P, Wijesinghe PR, Thissera H. National Avian Influenza Pandemic Preparedness Plan

Saturday, April 14, 2007

Abstract presented atr scientific sessions on the eve of the 25 th anniversary of PGIM

Practice and predictors of self-medication among urban and rural adults in Sri Lanka

P R Wijesinghe, R De A. Senevirathne, R L Jayakody

Introduction: Self medication is practiced in all communities to varying degrees and information about it in Sri Lanka is scarce.

Objective: To describe the practice and predictors of self-medication in a selected urban and rural area.

Methods: A community-based cross sectional survey of 1800 adults, selected by stratified, multi-stage, probability proportional sampling procedure was carried out in Gampaha and Polonnaruwa districts. Medication use was modeled as a function of predisposing, enabling and need variables.

Results: Self-medication was practiced by 12.2% urban and 7.9% rural adults (p<0.05). A majority had self medicated for acute onset conditions of short duration (urban-58%; rural-67%) and conditions perceived as non severe (urban-55%; rural-64%).

Fewer number of symptoms, perceived low acceptability of services and being a member of a small household emerged as significant predictors of self-medication in the urban sector. Inability to afford medical care, perceived higher technical competence of the pharmacy staff and fewer number of symptoms were significant predictors in the rural sector.

Conclusion: Prevalence of self medication, which is higher in the urban sector, is lower than the estimates reported for developed countries. Adults self medicate mainly for conditions of acute onset, short duration and less severity. Although medical services are available, poor acceptability of services prompted urban individuals to self medicate. Inability to afford medical services and perceived higher technical competence of pharmacy staff prompted rural individuals to self-medicate.

Thursday, February 15, 2007

NATURE OF GREETINGS EXISTED IN SINGHALA VILLAGES

Acceptance and rejection are concepts common in the animal world. The patient performance of this act differentiates man from the rest of the animals. Acts of the nature of greetings, respects etc are seen in all human societies. There are multitudes of these traditional acts in villages. They have found roots in our heritage by inheritance. They have enabled the cohesion of everyone in a village by friendliness . Preserved to date, methods of greetings in our villages have facilitated maintenance of professions, greetings , improvement of sociability and recognition of individuals. Sounds, voices, words, gestures are acts which are entailed in greetings. When a person was met in our villages, these acts were performed. When some one was met, they were greeted with AYUBOWANDA ( Please have a long life) . He was smiled upon. However, if the person who was met deserved rejection, spitting was done with a high voice to diplay denial. With a dejected face, looking at another direction in opposite of the face of the unpleasant person was another method of displaying contempt. On the other hand if the person was pleasant and deserves greetings, the question was asked “ Where are you going in the udanekke( morning) Ginimaddahane( mid day), Hendekore ( evening). If the person deserves more respect than the self, obviously, as a mark of respect, turban or the loin cloth or the towel on the shoulder is taken off and held in the hand. Though it has been erroneously interpreted as a sign of fear, this was an act of displaying friendliness or sociability. Being scared was demonstrated by getting themselves off the roads and bowing their heads in veneration . Greetings with two palms facing each other is a common act of greetings today. However, it was performed for members of the elitists in our villages. This has been certified in verses of the MALYAHN KOLMUR

Etha epita deepankara mula sita budu bawatama devinova lakka
Metha kapata budwenda patahgen thapase niveradi sil rekka
Buth nerthayen rangamadalata gos watakara deviyo mura rekka
Natha deva mtahu buduwana swamita kavikiyanda venda behe dekka


In recitation of deva varuna ( description of quality of gods), permission was sought having played udekki( a kind of drum) whereas Kolmura reciters greeted to the flower seat by bowing their heads. In exorcising bad omens, while reciting verses, patient was greeted with wiping of the patient from head to toe by theNON BURNING end of the lighted candle( this is called pandama which is made up of several layers of clothes and the end is made wet with coconut oil) , sprig of flowers or sprig of fresh leaves. Simultaneously. The reciter greets with collected palms saying “Awada Ayubowewa”. In some cases , two virgins or adolescent males or virtuous two grand mothers sat on either side of the patient to greet the patient by wiping the body .

An invitation to any good act would be performed by handing a sheaf of betel and explaining the deed in villages. Any person who steps on to another person’s house was greeted by the house owner having stepped out his house and gone forward to meet the visitor. Spreading the mat on the veranda displayed his willingness to accept the visitor. On his exit, accompanying him to the gate was another means of greeting. If the visitor is unacceptable, it is conveyed by having taken the mat which was spread on the veranda or leaned against the wall to the inside of the house. Another way of greeting those who come to a house is by giving them a jug of water or casket of betel and other ingredients for chewing.

Kids have been trained to get up when an elder steps into the house. When a pleasant person comes, as gesture of his acceptance, mats are cleaned by shaking however much they are in clean states, wiping dusts off chairs and benches by a clean piece of cloth in a way visible to the visitor. Covering seating by a white piece of linen is called PIRUWATA DEMIMA . Prelates are made to travel upon white sheets of linen. In alms giving, they are enabled to walk on white spreads from the gate to the door and then their feet are washed and water is wiped off. Prelates are seated on an elevated seat. The same procedure had been adopted for VIPs in a village. Having those who deserved veneration seated on elevated seating while those who venerate remaining in lower levels was yet another way of greeting by our people. When elders talk not disturbing them, being disciplined while going in between them were courteous manners. Seeking permission when comes to a place or leaving the place is explained by this verse of paddy harvesting.

Ehenam vigahata godata yamalla ( Then quickly get off the field)
Ethi hetiyata mada soda ganila ( Get mud cleaned as things are available)
Inata andina salu pili enda palla ( Get dressed with dresses for waist – refers to sarong-lungi)
Awasara genumen pitawa yamalla ( Having sought permission get off the field)

There were manners related to having head gears and footwear. While entering a place of veneration, headgears and foot wears are removed. When making an invitation, it was done with both hands with head being covered by a towel. .Sheaf of betel is accepted in the same manner as well.

In our villages there were several ways of veneration. In the upright position veneration of the lord Buddha and gods with palms facing each other and having them placed on the forehead was called DOHOTH MUDUN DI WEDIMA. Veneration in lying position with forehead, hands, elbows, knees, ventral surface of the feet contacting the earth is called Danda Namaskar. Veneration of parents and elders is done by touching the head on the feet of the elders. Some paint oil on the feet of elder .When children excel , their hands are massaged with cooked hot kevum( a kind of oil cake) . Feet of parents are also massaged. In front of prelates ,sheets of linen are spread before worshiping. Some do kiss feet at this moment.

In a funeral, casket containing the corpse is entered into the makeshift crematorium and people travel around the crematorium thrice towards the south.. Sometimes this is done with the coffin with the body being carried out by the pall bearers. This is yet another way of venerating the expired person.

When a visitor makes a visit, immediately he is offered water, allowed to sit down and asked about how he is doing before inquiring the reason why he made the visit. There are reciprocal gestures to greetings. When some on greets, head of the person who greets is touched and told “May the Buddha’s or god’s grace upon you my son/daughter and the parents blessings “ When some one who from an other village stayed overnight returns , he is offered foodstuffs , fruits or vegetables at home. This is a gesture to consolidate the friendliness.

In traditional games acquired from generations to generations like angam fights, manners were strictly adhered to. Placing hands upon the shoulders, touching the chest with chest , showing points were some of those gestures. Bowing head, raising hands, exercises with legs were also greeting methods. In stage shows , worshiping earth, performances with hands and legs also are means of greetings.

Lighting lamps also is an act of veneration( greeting) .In both auspicious and inauspicious , this would be performed by villagers. Having selected the location, moment and time, this act was performed. Fur and eight angle worshiping, worshiping after remembering parents and teachers when drugs are ingested had also been among ways and means of greetings/venerations which have been preserved in our villages. It is the belief of the author that the adoption of these greeting methods which were used for a better society then helps betterment of the society today.


This article was written by A P B Illangasinghe of Maminiyawa of Sri Lanka to Meewitha supplement of the Divaina Newspaper on 04.02.2007.

Sunday, February 04, 2007

LAST POST FROM OTAGO UNIVERSITY- AN ACCOUNT OF A VISITING ACCADEMIC

The earliest memories of New Zealand goes back to my very early days and it was synonymous with multitude of brands of milk imported from NZ .Stretched up to the horizon, stunningly beautiful, green pastoral lands with grazing cows depicted on these television advertisements were the images that were created whenever the name “ New Zealand “ was uttered to me in my early years.
The bond with NZ was further strengthened by watching touring Black Caps with legendary names like HADLEES. My next stage of introduction to NZ was via my college which had a very rich and strong rugby and cricket tradition from British colonial era . We were demonstrated videos of ALL BLACKS matches just before the college’s annual Rugby encounter against Trinity College. Then the weird tribal dance ( HAKA) performed by ABs was a unique Kiwi cultural marker that was attractive and prompted us as kids to watch and play rugby matches, sometimes foolishly imitating HAKA. But, never in my life did I dream at that stage that I would be able to join the prestigious Otago University as an academic.
It all started, just after my doctoral thesis, when I wanted to complete an overseas appointment to fulfil a requirement of the Post Graduate Institute of Medicine in Colombo before being board certified as a medical specialist in Public Health. It may seem bizarre that a medical person was attached to the pharmacy school. The simple explanation is that my research interests were in PHARMACOEPIDEMIOLOGY and I simply wanted to bridge these two disciplines Thus, I ended up being attached to the Department of preventive and social medicine while working with Dr Pauline Norris as my overseas supervisor.
Dunedin was also not a new place for me; physically I had not visited the place before though. As a cricket and rugby fanatic, Carisbrook Oval in Dunedin was synonymous with Lords or Twickenham for that matter. So, subconsciously, I was elated that I was going to a place which was known to me in some ways than any other location. Later, it was proved to be the correct decision as my stay in the Pharmacy School and overall in the UNI was thoroughly enjoyable. It was so potent that I am sure with the passage of time, those nostalgic memories will keep me down to a certain extent.
The first semester flew really quickly as I was immersed in a dual load of work from both schools. Visiting the University pharmacy with Petty Napier to familiarise with Good Pharmacy Practice in NZ was pretty useful for me as it was one of those areas that I researched in SL. In hind sight , it was a pleasurable experience in comparison to what I encountered in pharmacy inspections for my doctoral thesis. Petty was jovial. So were the other staff. There were more inquiries on my native land than my inquiries about Pharmacy Practice in NZ. However, Petty took me through the legislation and procedures in a nutshell which enabled me to grasp late bombardments of information that I was exposed to when I started my appointment with MEDSAFE on drug regulatory activities.
Simultaneously, I stepped on to a controversial domain i.e DTCA in NZ with Dr Norris as a part of my research. We researched in to medicines advertising in NZTV and their health related claims and compliance with NZ regulations. Our findings will soon be published. But , quite interestingly, as a result of prolonged, exposure to TV in the analysis of data , I started watching countless numbers of soaps, reality shows like NZ and American Idol which, back home, I would have found hard to entail in my favourite list due to lack of time. Definitely, it seems like an occupational hazard for an academic who hardly finds any time even for high quality programmes of information, entertainment and education under normal circumstances. However, It was really interesting and richly rewarding working with people like Vickey, Stuart, Pauline etc in the Pharmacy Practice Research group .
During my stay, I was able to be a part of the New Zealand Pharmacovigillance centre .The experience that I gathered will be enormously useful for my routine work as the monitoring of Adverse Effects of drugs and vaccines is currently being carried out by the Unit I am attached to in Sri Lanka. Additionally, I worked with Denise Martins, the Southern Medicines Control officer of the MEDSAFE. It is with a deep sense of elation that I mention that these professionals went out of their way to accommodate all my requests related to their respective disciplines
In hindsight, I was really privileged to be a staff member of both the Medical School and Pharmacy School. It gives me a kind of satisfactory feeling that I was able to bridge two different academia and disciplines. The wealth of knowledge that I gathered was enormous. More than the benefits, I would be glad to contemplate on relationships and rapport I built with countless numbers of academics and non academics of diverse backgrounds in both schools. It is worth remembering the excellent time that I had with all those wonderful people. Those wonderful memorable, colourful and enjoyable brief stay that I had with all those wonderful people will linger eternally in my mind. Dunedin and Otago university is more like a second home to me now. Just before concluding this account ,let me remind that Dr Norris instructed me not to miss one other thing which I pen here lest I should forget.
Dunedin offered me the opportunity to meet the Sri Lankan test cricketers when they were down here in the summer. The rapport went to such an extent that these demi god like figures hardly contactable in SL, accepted our invitation for a dinner. It was also a novel experience in terms of behaving with superstars like Murali and Sanath. In Dunedin, I met one of my all time sports heroes, Jeff Wilson the Black caps and terrific ALL BLACKS winger. It was memorable too as Jeff was also from the South and one of the graduates of Otago University.
All these wonderful experiences sum up one thing: My stay in Dunedin and more precisely, at the Pharmacy school could not have been more terrific than this. I take all these wonderful memories with me and let me conclude this with a quotation from the Lord Buddha in Pali ;
Piyehi Vippa Yogo Dukko
Which literally means “separation from the loved ones is always a cause for sorrow”.
( PREPARED FOR THE NEWSLETTER " CAPSULE")

Wednesday, January 31, 2007

HAKA- MANIFESTATION OF PSYCHOLOGICAL DOMINANCE OVER OPPONENTS

In today’s professional sports arena, victory means the ultimate objective of any team in a contest. The greatness is determined by the consistency of better results produced over a significant period of time. In this background, given the equality of skill and technique levels, mental component has come to the fore as the determining factor of the sporting success. It has acquired such an important level, Aussie cricket legend Steven Waugh believes that the skill level of cricket matters only 10% in the success while more importantly mental status comprises the rest 90%.

Many teams adopt multitude of tactics to boost their mental confidence while extreme measures such as sledging are used to disrupt the equilibrium of opponents. Any person who is a fan of All conquering All Blacks rugby team may be aware the use of a different tactic by ABs to intimidate their opponents even before the game is kicked off. The method used by all blacks to ensure their psychological dominance over opponents is the tribal war cry called HAKA

Haka is performed by hand, feet, legs , bodily voice and concluded by protruding tongue and mimicking the slashing of the throat. This blending of these parts convey their completeness, challenge, welcome, exultation, defiance or contempt of the word . Haka has been defined as a disciplined and emotional expression of the passion, vigour and identity of the race. It has been identified as a message of soul expressed by word and posture.

There are versions of haka performed in NZ. Familiar to rugby fans KAMATE version is believed to be the interpretation of the 19th century warrior chief TE RAUPARAHA who was famous for his ruthless slaughter of Maoris in the South island. Kamate of ngeri style is described as a short free form where dancers interpret as they feel. The other version, PERUPERU is a style for true war dance performed with weapons and high jump with legs folded under at the end. If you happen to be a tourist in the North island, definitely you may be able to witness the performance of this version by Maoris in their native costumes with painted or tattooed faces. It is a spectacular view that raises ones hair on seeing the performance.
Rangi pakia
Kamate Kamate
Ka Ora Ka OraKamate Kamate
Ka Ora Ka Ora
Tenei Te Tangata
Puhuru Huru
Nana E Tiki Mai
Whaka Whiti Te Ra
A Hupane A Hupane
A Hupane Kupane
Whiti Te Ra!

It is death It is death
It is life It is Life
It is death It is death
It is life It is life
This is the hairy man Who caused the sun to shine again for me
Up the ladder Up the Ladder
Up to the top
The sun Shines!
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