SLMAnews-2012-07 by Sri Lanka Medical Association

SLMANEWS

Contents

THE OFFICIAL NEWSPAPER OF THE SRI LANKA MEDICAL ASSOCIATION

July 2012 Volume 05 Issue 07

President’s Note Dear SLMA Members, Colleagues, and Friends, We wish to thank all those who participated in the 125th Anniversary International Medical Congress of the SLMA from the 1st to the 6th of July 2012. Your participation enabled the SLMA, your national medical association to celebrate its 125th Anniversary in a grand scale. The scientific and social aspects of the Congress were well attended. Over 1000 attended the scientific sessions, over 2000 participated in the Walk and Run, over 350 attended the Doctors Concert and 250 attended the Banquet. There were international delegates and resource persons from Canada, USA, UK, Sweden, India, Korea, Philippines, Malaysia, and Australia. We would like to congratulate those who won various prizes and awards. We look forward to your continuing participation in future SLMA activities and to your feedback to improve the quality of the services that we provide to you. Thank you. On behalf of the Council of the SLMA,

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

Page No. 

Notice Board 4



SLMA Ethics Committee



125th Anniversary International Medical Congress

Developing Capacity For research Ethics Review in Sri Lanka



Opening Healthcare Gateways for Ergonomics



Welcome Address by the SLMA President at the 125th Anniversary International Medical Congress

UNESCO chair in Bioethics opens Sri Lankan Unit at National Instute of Mental Health

Southern Province Department of Health Services wins the Taiki Akimoto 5S Awards 2011



Dr Thistle Jayawardene Trust Fund

Our Advertisers Glaxo Wellcome (Ceylon) Ltd. Senok Trade Combine (Pvt.) Ltd.

Publisher & Printer

This Source (Pvt.) Ltd.,

236/14-2, Vijaya Kumaranathunga Mawatha, Kirillapone, Colombo 05, Sri Lanka Tele: +94-112-854954 info@thissource.com

TOYOTA Lanka (Pvt.) Ltd. Asiri Heart Centre Citihealth Imports (Pvt.) Ltd. Hemas Hospitals (Pvt.) Ltd. Emerchemie NB (Ceylon) Ltd. Astron Ltd. A. Baurs Healthcare (Pvt.) Ltd. SmithKline Beecham (Pvt.) Ltd.

SLMANEWS

July, 2012

Notice Board UPCOMING EVENTS Annual Scientific Sessions of the Anuradhapura Clinical Society in Collaboration with the SLMA on the 17th and 18th October 2012 in Anuradhapura SLMA Foundation Sessions 9th to the 11th November 2012 at the SLMA Medical Dance 2012 8th December 2012 at the Cinnamon Grand Sri Lanka College of Paediatricians Annual Scientific Congress August 10th to 12th, 2012 at the Water’s Edge http://www.srilankacollegeofpaediatricians.com

Asian Congress of Paediatric Infectious Diseases November 28th to December 1st, 2012 at the BMICH http://www.acpid2012.org

FERCAP 2012 12th Asia Western Pacific IRB/IEC conference “Ethnicity, Culture, Religion and Ethical Research for Health” 18th – 22nd November 2012 Colombo, Sri Lanka Organised by the Forum for Ethics Review Committees in Asia and the Western Pacific and the Sri Lanka Medical Association http://www.slma2012.com/pdf/FERCAP

Are you the one to steer the SLMA in the future? The SLMA elects a President-Elect at its Annual General Meeting in December every year to take over as President the following year. It has been the practice that the Past Presidents consider the names of suitable persons and make their recommendation to the Council for Council Nomination. Any member who wishes to be considered for nomination in the future is invited to contact Dr. Malik Fernando, Past Presidents’ Representative in the SLMA Council. His contact details are as follows: Mobile - 0777678606; Email - malikfern@eureka.lk. 4

SLMANEWS

July, 2012

SLMA Ethics Committee

he SLMA Ethics Committee has been in the forefront of promoting various aspects of Professional and Clinical Ethics in Sri Lanka. On a suggestion made by Prof. Vajira H. W. Dissanayake in 2007, the committee, under the Chairmanship of Dr. Malik Fernando and convened by Prof. Anuja Abeydeera, took on the task of formulating a framework for establishing and operating Clinical Ethics Committees in Sri Lanka. During the latter part of 2009 the SLMA Ethics Committee invited a Consultant from the National Hospital of Sri Lanka to list some common problems encountered in clinical situations in Sri Lankan hospitals. His views are summarised below as three statements followed by commentaries that highlight ethics implications.

1. The heavy workload compromises obligations regarding respect for patients. Inability to spend time with patients to discuss the diagnosis, therapeutic options, and recommended procedures leaves the patient ignorant about his condition. If consent is required for investigative procedures or surgical operations, then the signature obtained on the consent form is not valid informed consent. There is then no respect for persons. 2. Working in an environment of scarce resources creates situations where investigations and facilities have to be rationed. Allocation of scarce resources, if done arbitrarily, may cause harm to some by denying them some essential investigation or therapy, and is contrary to the principles of non-maleficence and justice. Denying access to operating theatres, intensive care beds and even ward beds (resulting in floor patients), when indicated, are instances of lack of justice. 3. Clinicians pursuing academic interests by ordering investigations and unnecessary interventions without the knowledge

and consent of the patient. There is a place for clinical research. However, wherever procedures, whether intrusive or non-intrusive, that are not part of the usual work-up or treatment as practiced in that particular unit or setting are contemplated, it is obligatory that the patient is informed of its experimental or speculative nature and consent obtained prior to carrying it out. Else, there is breach of the principle of autonomy. The Ethics Committee considered the issues and felt that there was a need to: a. Provide ethics input into hospital management policy and guidelines around patient care; b. Facilitate ethics education for health professionals within the hospital; and c. Provide ethics advice to clinicians in individual cases or situations.

The SLMA Ethics Committee believes that the establishment of Hospital Ethics Committees (HEC) in large hospitals, both in the State and Private sectors, would pave the way to resolving ethics issues that have a bearing on patient care, staff relations and other related matters. These proposals were discussed at a workshop held at the SLMA on the 8th of May 2010 on the â&#x20AC;&#x153;Role of Clinical Ethics Committeesâ&#x20AC;?. It was attended by hospital directors and clinicians from public and private sectors, as well as presidents and representatives of academic colleges. The resource persons were: Dr. Malik Fernando, Dr. Sarath Gamini de Silva, Dr. Ajith Amarasinghe, Prof. Vajira H. W. Dissanayake, Prof. Anoja Fernando and Prof. S. D. Jayaratne.

Contd. on page 8

SLMANEWS

July, 2012 Contd.from page 6

SLMA Ethics... The first session was chaired by Dr. Sarath Gamini de Silva and Dr. Narada Warnasuriya. SLMA President gave the welcome address. Prof. Vajira H. W. Dissanayake, in the first part of his presentation, spoke about the different types of bioethics committees that can be set up and how their functions differed. In the second part he presented some of the results of a survey he had conducted relating to ethical

dilemmas in clinical practice. The results showed that many doctors would be faced with ethical dilemmas at least at some time during their career. It is clear from this data that the ethical dilemmas faced by our doctors are not different to that encountered in other parts of the world. Measures need to be taken to support doctors faced with such situations to handle them in an ethically acceptable manner.

Results of a Survey on Ethical Dilemmas faced by Sri Lankan Doctors There is very little empirical data on ethical dilemmas faced by Sri Lankan doctors. In a recent survey done by Prof. Vajira H. W. Dissanayake and colleagues, 118 Sri Lankan doctors answered a questionnaire. A sizable number admitted to having encountered the following ethical dilemmas in practice (percentage answering in the affirmative): 1. When caring for a terminally ill patient the question of limiting life sustaining treatment or writing a Do Not Resuscitate order came up – 57per cent; 2. Cared for adult patients whose capacity for decision-making with respect to their own health was uncertain or impaired – 86per cent; 3. Was uncertain whether to maintain confidentiality of medical information – 63per cent; 4. Encountered significant disagreement among family members or caregivers on the proper course of treatment for a patient

– 81per cent; 5. The preferred course of treatment conflicted with institutional policies, professional codes of ethics or laws – 56per cent; 6. The preferred course of treatment was not pursued because of a patient’s insurance status – 31per cent; 7. Rules for payment of services prevented the preferred course of treatment – 47per cent; 8. Scarcity of resources resulted in making a difficult choice – 89per cent; 9. A patient’s cultural or religious views conflicted with the proposed course of treatment – 67per cent; 10. A patient disagreed with the preferred course of treatment for other reasons – 79per cent; 11. Was uncertain if a diagnosis should be disclosed to the patient – 80per cent; 12. Was asked for assisted suicide or euthanasia – 12per cent.

This article will be continued on the SLMANews August issue

SLMANEWS

July, 2012

125th Anniversary International Medical Congress

he 125th Anniversary International Medical Congress was held from the 1st to the 6th of July 2012 at the BMICH in a grand scale. The scientific and social aspects of the Congress were well attended. Over 1000 attended the scientific sessions, over 2000 participated in the Walk and Run, over 350 attended the Doctors Concert and 250 attended the Banquet. There were international delegates and resource persons from Canada, USA, UK, India, Korea, Philippines, Malaysia, and Australia. The SLMA wishes to thank all those who participated to make the Congress extra special.

Professor in Paediatrics and Consultant Paediatrician, Prof. Pujitha Wickramasinghe MBBS, DCH, MD, PhD delivering the SLMA Oration on “Control of Non Communicable Diseases: Where Do We Begin?”

Senior lecturer and Consultant Surgeon, Dr S. Sivaganesh MBBS, MS, DPhil delivering the S.C. Paul Oration on “Allograft Rejection – a Novel Pathway of CD8+ T-cell Cytotoxicity”

Minister of Health Hon. Maithripala Sirisena, addressing the gathering.

Guest of Honour Dr. Ferdosi Rostum Mehta, addressing the gathering.

Senior Consultant Physician and Endocrinologist, Dr Henry Rajaratnam MD (Ceylon), FRCP (London), Hon. FCCP, Hon. FRACP, Hon. FSLCGP, FACE delivering the inaugural S Ramachandran Oration on “Is Surgery for Diabetes Effective?”

Consultant Clinical Immunologist, Dr Suranjith L Senevirathne MBBS, MD, DPhil(Oxon), FRCP, FRCPath, FCCP delivering the N. D. W. Lionel Oration on “Managing Drug Allergies - the Past, Present and Future”

The dignitaries at the head table at the Inauguration SLMA Orator, Prof. Pujitha Wickramasinghe, (From Left), World Health Organisation Representative in Sri Lanka (Guest of Honour), Dr. Ferdosi Rostum Mehta, Sri Lanka Medical Association, President, Prof. Vajira H. W. Dissanayake, Minister of Health Maithripala Sirirena (Chief Guest), Sri Lanka Medical Association, Secretary, Dr. Lasantha Malavige.

SLMANEWS

July, 2012

Developing Capacity for Research Ethics Review in Sri Lanka

he SLMA has been in the forefront of developing capacity for research ethics review in Sri Lanka. The Forum for Ethics Review Committees in Sri Lanka (FERCSL) convened by the SLMA is actively promoting capacity development in the Country. FERCSL held three regional workshops on capacity building in research ethics review during the regional conferences of the SLMA in Jaffna, Galle and Kandy. Two more workshops would be held in Anuradhapura and Batticaloa. FERCSL has a management committee, which is chaired by the Chairperson of the SLMA Ethics Review Committee. The secretary is annually chosen by the members of the committee. Prof. Anoja Fernando is the current Chairperson of FERCSL. Prof. Fernando was a founder

member in the steering committee of the Forum for Ethical Review Committees in Asia and the Western Pacific (FERCAP). She served in the committee until 2010. Prof. Vajira H. W. Dissanayake, the current President of the SLMA, is the only Sri Lankan member of the FERCAP steering committee at present. He was elected to the committee on his personal capacity in 2010 for a three year term. During Prof. Dissanayake’s tenure as the Secretary of the Ethics Review Committee of the Faculty of Medicine, University of Colombo in 2009, the committee was successful in becoming the first committee in Sri Lanka to receive recognition under the Strategic Initiative for Development of Ethics Review Capacity (SIDCER) program of the WHO. The program is administered by FERCAP. The 125th anniversary of

the SLMA was an opportunity for further development of ethics review capacity in the country with the assistance of FERCAP. An International Course on Surveying and Evaluating Ethical Review Practices was held on 30th June 2012 at the Lioenal Memorial Auditorium of the SLMA with the participation of over 50 members of Ethics Review Committee from all parts of the country. From the 1st of July 2012 to the 3rd of July 2012, two teams of FERCAP surveyors surveyed the Ethics Review Committees of the Faculty of Medicine, University of Colombo and the Faculty of Medical Sciences University of Sri Jayewardenepura for re-recognition (Colombo) and recognition (SJP) under the SIDCER programme. A workshop titled “Clinical Trials - A Workshop for Reviewers and Researchers”

also was held at the 125th Anniversary International Medical Congress of the SLMA with the participation of members of ethics review committees from around the country. The final activity for 2012 in the series of activities aiming at promoting ethics review capacity in Sri Lanka would be the FERCAP International Congress 2012 – the Asia Pacific IRB Meeting – with the theme of “Ethnicity, Culture, Religion and Ethical Research for Health” hosted by the SLMA, which would be held from the 18th to the 22nd November 2012 at the Water’s Edge. The SLMA looks forward for active participation of research ethics review committee members and researchers at the FERCAP congress. You can find details of the Congress at http://www. slma2012.com/pdf/FERCAP.

Members of Ethics Review Committee from all parts of the country participated at the International Course on Surveying and Evaluating Ethical Review Practices held at the Lioenal Memorial Auditorium of the SLMA

SLMA

July, 2012

Opening Healthcare Gat Taking into account, several factors including feasibility of implementation and acceptability by the school children and their parents, it was considered that issues related to schoolbags should be a priority area for intervention. The efforts were focused on: strategies for bag-weight reduction, introduction of a model healthy bag and bag behaviour changes.

rgonomics (or human factors) is an evolving specialty all over the world. It is the scientific discipline concerned with the understanding of the interactions among humans and other elements of a system, and the profession that applies theoretical principles, data and methods to design in order to optimize well-being and overall performance. Ergonomics also provides solutions to health and safety problems. With the advance-

Figure 2 â&#x20AC;&#x201C; Ergonomically-designed model Schoolbag

ment of technology and growing evidence, ergonomics has also penetrated dramatically in to the healthcare field i. e. Doctorpatient interfaces, healthcare equipment, service delivery environments, occupational safety and health (OSH), child ergonomics, and school health. The practitioners of ergonomics should contribute to the planning, design, implementation, evaluation, redesign and continuous improvement of tasks, jobs, products, technologies, processes, organizations, environments and systems in order to make them compatible with the needs, abilities and limitations of people. The National Healthy Schoolbag Campaign is an exemplary health-led ergonomic initiative based on research evidence and good practices of developed countries. In a background of growing public concern

Figure 1 â&#x20AC;&#x201C; Dissemination of research outcome

over unhealthy schoolbags, in 2007, Dr Kapila Jayaratne, as a postgraduate trainee in Community Medicine, conducted a school-based epidemiological research on ergonomic factors of educational environments and their influence on health of children for his doctorate. A sample of 1607 school children from 55 schools participated in this study. This study was funded by the School Health Unit of Family Health Bureau. The results revealed many deficiencies in ergonomics within classroom settings; sub-standard seating arrangements, mismatched furniture (desks and chairs) and deficiencies in weight, model, ergonomic features and the carrying behaviour of schoolbags. Children experienced several negative effects, especially musculoskeletal pain and perceived discomfort, in part, attributable to mismatched

ergonomics. With the generation of scientific evidence and dissemination of the findings to key stakeholders; Ministry of Education, healthcare professionals, parents, children, media and general public, the research utilization efforts were catalysed by the demands for solutions. Several articles were published in print and electronic media emphasizing and attracting the attention to the gravity of the issue (Figure 1). Research findings necessitated identification of priority areas and formulation of feasible solutions to improve the existing scenario. Change of classroom furniture may need substantial financial cost as well as would be a complex process. Taking into account, several factors including feasibility of implementation and acceptability by the school children and their parents, it was considered that issues related

ANEWS

July, 2012

teways for Ergonomics The new bag was field-tested and introduced to the Ministry of Education. School bag manufacturers were educated on the ergonomic features and the healthy model. to schoolbags should be a priority area for intervention. The efforts were focused on: strategies for bag-weight reduction, introduction of a model healthy bag and bag behaviour changes. Following the sharing of research outcome and rec-

ommendations, the Ministry of Education initiated strategies to lessen the weight of books; splitting text books in to several volumes and recommending only page-80 writing exercise books. A healthy schoolbag was modelled by Dr. Jayaratne according to ergonomic standards with inputs from international experts and the International Ergonomic Association. Main ergonomic features included; two compartments, cushioned back wall, wider and cushioned shoulder straps with movable buckles and a waist-belt (Figure 2). Physical quality assurance was provided by the Sri Lanka

Standards Institute. The new bag was field-tested and introduced to the Ministry of Education. Schoolbag manufacturers were educated on the ergonomic features and the healthy model. A large scale media mobilization of effort, in one specific direction, promoting an ergonomically-designed healthy schoolbag was carried out with the launch of the National Healthy Schoolbag Campaign as a joint project of the Ministries of Health and Education in 2011. A leaflet providing information on correct selection, ergonomic features and proper bag behaviour was prepared. It was distributed

to all the schools by the Ministry of Education and also it was mandatory to include the same in all the healthy schoolbags approved by the Ministry of Education (Figure 3). The aim is to promote the healthy schoolbag to entire school children population of nearly four million. This initiative was recognized both at local and international level. Dr. Kapila Jayaratne, Consultant Community Physician, who pioneered the project, was awarded the prestigious SLMA Oration 2010, the highest recognition for medical research, conferred by the Sri Lanka Medical Association (SLMA). Contd. on page 26

නිවැරදි පැළැදීම nr ieye,a¨jg

yßhg wyqrkak

nE.fhys uq¿nr isrefrys nfrka ishhg oyhlg ^10]& wvq kï jvd fydohs'

nr jeä fmd;a msg <Õg jk fia;a" we;=<; oE tyd fuyd fkdhk fia;a nE.h fyd|ska wvqla lrkak'

th flfiaj;a ishhg myf<dj ^15]& fkdblauúh hq;=h'

mdie,a ld,igykg wkqj toskg wjYH foa mukla nE.hg oukak'

yßhg m<|skak ² Wrysia foflysu nE.h t,a,d .kak' ² weÕg yd msgg nE.h fyd|ska ysrfjk fia Wrysia má .dxpq ;o lrkak' ² bk máh .dxpq oud bosßfhka ;olrkak' ² msg osf.a nE.h nqre,g t,a,d jefgkak yßkak tmd' ² nE.fha há odrh bK uágfuka wÕ,a y;rlg jvd my, fkdhd hq;=hs'

mdi,a nE.h ksjerosj Ndú;d fkdlsÍu ksid ² ² ² ²

uiams~q yd ykaosj, fõokd we;sfõ' blaukskau úvdjg m;afõ' fld÷ weg fmf<ys weoùï we;súh yelsh' wk;=rej,g ,laj ;=jd< úh yelshs'

ksjeros mdi,a nE.hla iu. ieye,a¨fjka mdi,g msh k.kak' ffjoH lms, chr;ak mjq,a fi!LH ld¾hdxYh" fi!LH wud;HdxYh'

Figure 3 – Health Education Leaflet

SLMANEWS

July, 2012

Welcome Address by the SLMA President at the 125th Anniversary International Medical Congress

hief Guest, Maithripala Sirisena, Guest of Honour, Dr Ferdosi Rostum Mehta, SLMA Orator, Prof. Pujitha Wickramasinghe, Secretary SLMA, Dr Lasantha Malavige, Chairperson of the Board of Trustees of the SLMA, Past Presidents of the SLMA, Council Members of the SLMA, Members of the SLMA, Distinguished

Invitees, Ladies and Gentlemen, It gives me great pleasure to welcome all of you to the inauguration of the 125th Anniversary International Medical Congress of the Sri Lanka Medical Association â&#x20AC;&#x201C; the Global Forum of Sri Lankan Doctors. The Council of the Sri Lanka Medical Association is happy to host all of you this evening and during the next few days.

The Anniversary International Medical Congress is the most important activity in the calendar of the SLMA. The SLMA held its first conference, when it organised a conference in 1937 to mark the 50th anniversary. The Association has held an annual conference every year since then. So the Conferences that we are inaugurating today is the 75th in an unbroken series of conferences. 16

We hope that you would enjoy both the scientific and the social programmes of this Congress.We are pleased, to welcome Honorable Maithripala Sirisena who has been a tower of strength to the SLMA since he assumed office. I think he has set a record by been the only minister of health to have been invited to the inauguration of the anniversary congress of

the association for three consecutive years. We are also pleased to welcome the Guest of Honour Dr Mehta this evening. The relationship between the WHO and the SLMA has grown in leaps and bounds since you assumed office in Colombo. We thank you very much for the role played by you in fostering that relationship. Contd. on page 18

SLMA President, Prof. Vajira H. W. Dissanayake delivering the welcome address at the Inauguration of the 125th Anniversary International Medical Congress

SLMANEWS

July, 2012 Contd. From page 16

Welcome Address... Ladies and gentleman, all of you have honoured the SLMA with your presence here this evening, and we welcome you all. On an historic occasion like this, it is incumbent upon me as President of the Association, to indulge on the history of the Association and the men and women who have made this association what it is today. The Sri Lanka Medical Association, the SLMA, is the oldest national organisation of medical professionals in Asia and Australasia. It represents all doctors of Sri Lankan origin. The SLMA started life as the “Ceylon Branch of the British Medical Association” on the 17th of December 1887 with 65 members on its roll, and Dr P D Anthoniz as its first President. However, the moving force behind its inception was Dr W R Kynsey (later Sir William Kynsey), who persuaded 15 doctors to meet on the 26th of February 1887, at the Colonial Medical Library on Maradana Road, Colombo and resolved to form that Association. He had declined to be the first President as he was going abroad on vacation. We marked that anniversary on the 26th of February this year with a talk on the history of the SLMA by one of our eminent past presidents Dr. Dennis Aloysius. The change of name of the Association to “Ceylon Medical Association” came in 1951, after Ceylon gained Independence from the British, and in 1972

The Council of the SLMA being introduced to the Chief Guest, Minister of Health, Maithripala Sirisena at the Inauguration of the 125th Anniversary International Medical Congress

The SLMA started life as the “Ceylon Branch of the British Medical Association” on the 17th of December 1887 with 65 members on its roll, and Dr P D Anthoniz as its first President. However, the moving force behind its inception was Dr W R Kynsey (later Sir William Kynsey), who persuaded 15 doctors to meet on the 26th of February 1887, at the Colonial Medical Library on Maradana Road, Colombo and resolved to form that Association. when Ceylon became a Republic, and changed the name, the name of the Association changed again to “Sri Lanka Medical Association”. The SLMA therefore, ladies and gentlemen, has been an integral part of the socio cultural as well as political transformation happening in this country. In fact several of our prominent members, such as Sir Marcus Fernando and Sir Nicholas Attygalle, have been members of the legislature and senate. The office of the SLMA

is at “Wijerama House”, named after Dr E M Wijerama, who formally gifted the house he lived in at McCarthy Road, now named Wijerama Mawatha, to the Association on the 23rd November 1962. We celebrate the 50th Anniversary of that gift this year. The historic Sri Lanka Medical Library the successor to the Colonial Medical Library, which is over 168 years old, although a separate entity, is also accommodated in the Wijerama House and has become synony-

mous with the SLMA due to that reason. The Journal of the Association, the Ceylon Medical Journal, was first published in August 1887, and fittingly, the first article in that issue was authored by Dr W R Kynsey the founder of the Association. At 125th years, it is the oldest surviving English Medical journal in Asia and Australasia, and the leading scientific journal in Sri Lanka. The Anniversary International Medical Congress is the most important activity in the calendar of the SLMA. The SLMA held its first conference, when it organised a conference in 1937 to mark the 50th anniversary. The Association has held an annual conference every year since then. So the Conferences that we are inaugurating today is the 75th in an unbroken series of conference. I am not sure whether there is any other association anywhere in the world that can boast of an achievement such as that. Contd. on page 20

SLMANEWS

July, 2012 Contd. From page 18

Welcome Address... Our association, the SLMA therefore, ladies and gentleman is an association rich in history and it is up to us the present generation to preserve it for posterity. The SLMA today is a vibrant organization. It is run by the President and the Council. There are many committees dealing with its day to day affairs. These include what could be called statutory committees such as  the Finance, Management and Housing Committee chaired by the President,  The Corporate Planning Committee chaired by the President;  The Honours Committee chaired by Dr. Malik Fernando;  The Ethics Committee both chaired by Dr. Malik Fernando;  The Ethics Review Committee chaired by Prof. Anoja Fernando;  The Research Promotion Committee chaired by Prof. Maharoof Ismail;  The Centrla CPD committee chaired by Dr. Sunil Senevirathne Epa;  The Sri Lanka Clinical Trials Registry Management Committee chaired by Prof. Colvin Goonaratna;  The Ceylon Medical Journal Editorial Board jointly chaired by – Prof. Janaka De Silva and Dr. Annuruddha Abeygunasekara, and  The Social Activities Committee jointly chaired Dr. Preethi Wijegunawardena and Dr. Denis Aloysius. The SLMA also has Expert Committees, which deal with various subject areas. They include Expert Committees on  Communicable Diseases chaired by Prof. Jeniffer Perera;  Disabilities chaired by Dr. Lalith Wijeyarathne;  Ergonomics chaired by Dr. Kapila Jayarathne;  Health Equity chaired by

Prof. Saroj Jayasinghe;  Health Management chaired by Dr. Palith Abeykoon;  Herbal Medicine chaired by Prof. Sanath Lamabadusuriya;  Medicinal Drugs chaired by Prof. Gita Fernando;  Non Communicable Diseases chaired by Prof. Chandrika Wijeyarathne;  Prevention of Road Traffic Accidents chaired by Prof. A.H. Sheriffdean;  Snake Bite chaired by Prof. SAM Kularathne;  Tobacco, Alcohol and Illicit drugs chaired by Dr. Diyanath Samaras inghe;  Trade Services, chaired by Dr. Malik Fernando and  Women’s Health chaired by Dr. Vath sala Jayasuriya. In addition the SLMA’s flagship project NIROGILanka founded and chaired by Prof. Chandrika Wijeyarathne is in the forefront of the effort to fight non communicable diseases in the country. Over three hundred doctors and other professionals serve in these committees voluntarily. Their hard work and dedication has enabled the SLMA to realise its vision of being the most influential professional organization in Sri Lanka, and the mission of leading the medical community to achieve the highest standards of medical professionalism and ethical conduct, while being an advisory body on health policy to the government and the community at large. I extend a special welcome to all of them this evening. As you can see from that vast span of committees, ladies and gentleman, the SLMA is geared to serve the profession and

the nation and to work towards the upliftment of the profession and the health care services thereby contributing to a healthier nation, and we look forward to the future with confidence. In this new era of electronics the SLMA has not been afraid to embrace technology. Dr. Rikaz Sheriff and Dr. Deepal Wijesuriya have been driving the electronic transformation of the SLMA that you have been witnessing over the past few months. We have opened up these electronic services to all specialty and subspecialty medical colleges and associations, as well as regional medical associations and clinical societies in this country, thus enabling them to grow with us, after all they are part of us, and their membership is our membership. We have in fact even had requests from our neighboring country Maldives to help them. I welcome the Presidents and Council Members of all the specialty and subspecialty medical colleges and associations, as well as the regional associations and clinical societies and thank them for the support that they have extended to this Congress. I also welcome the foreign guests and resource persons to this Congress. These changes however cannot be brought about unless the association embraces a corporate mindset, in that context the SLMA was fortunate to have a pioneering medical

specialist and entrepreneur in the form of Dr. Lasantha Malavige as the Honorary secretary this year. Without his untiring efforts we could not have achieved what we have achieved in this process of transformation. On behalf of all of us, I thank Lasantha. We had several visitors at the SLMA office last week, who said, that SLMA, a sleeping giant has woken up. If SLMA is a giant, the credit for creating that giant goes to the men and women who lead this organization before me with distension, the Past Presidents of the SLMA, who dedicated and continue to dedicate their time, effort and finances to the SLMA, some of them are with us today, I warmly welcome them. We are indeed indebted to them. The best of SLMA however, is yet to come, this year we have only recharged our batteries, the 125th anniversary was the perfect excuse for us to do that, we are confident that we would achieve those greater heights that we aspire to under the leadership of Dr. BJC Perera who would take over as President in 2013 and others who would lead the Association after him. Ladies and Gentleman, the time has come for me to wind up my talk, but before I do that I would like to once again warmly welcome all of you to this inauguration and the Congress. I wish you an enjoyable evening. Thank you.

SLMANEWS

July, 2012

UNESCO Chair in Bioethics opens Sri Lankan Unit at National Institute of Mental Health

T Since the 1970s, the field of bioethics has grown considerably. While it is true that bioethics today includes medical ethics issues, its originality lies in the fact that it goes much further than the various professional codes of ethics concerned. 22

he Minister of Health, Mathripala Sirisena, officially opened Sri Lanka’s inaugural Bioethics Unit as part of the UNESCO Chair in Bioethics at a ceremony recently held at the Galle Face Hotel. Also in attendance were Guest of Honour, Professor Russel D’Souza of UNESCO, the Sri Lanka National Commission for UNESCO, Secretary General, R.P.Perera, NIMH Director Dr. Jayan Mendis, the team leader of the Sri Lanka Bioethics Unit, Dr. H. Gambheera, and the SLMA President Prof. Vajira H. W. Dissanayke. Sri Lanka’s Bioethics Unit will carry out four main action areas in the field of bioethics in the country: • Intellectual forum • Standard-setting action • Advisory role and capacity-building • Education and awareness raising Addressing the opening ceremony of the Sri Lanka National Commission for UNESCO, Secretary General, R.P.Perera, made the following remarks: As the Secretary General of the Sri Lanka

National Commission for UNESCO, which is the central focal point for all UNESCO activities in Sri Lanka, I feel honored and privileged to be amongst you at the inauguration of a futuristic and timely initiative in establishing a Chair for Bio-ethics in Sri Lanka. At the outset, I wish to thank and commend the Board of Management of the National Institute of Mental Health (NIMH) for agreeing to host a unit and a Chair program, together with a committee to administer a center to train, teach, research, network, at global, regional and national levels, develop curriculum, facilitate and co-ordinate programs, concerning matters related to furthering bio-ethics in Sri Lanka, which is truly, an important and path breaking initiative. Allow me please, a little bit of your time, to detail the evolution of Bio-ethics programs and the lead role that UNESCO plays in it, so that the Chair being established in Sri Lanka, could make best use of UNESCO’s functions, which are fivefold. They are, namely, to act as; • A Laboratory of Ideas

• • • •

A Standard Setter (Conventions) A Clearing House A Capacity Builder A Forum for Intellectual Co-operation.

Thus, a UNESCO Chair can also fashion its work under these types of functioning modalities in order to further its objectives. As concerns the evolution of the bio-ethics program, I would like to give a brief explanation. Since the 1970s, the field of bioethics has grown considerably. While it is true that bioethics today includes medical ethics issues, its originality lies in the fact that it goes much further than the various professional codes of ethics concerned. It entails reflection on societal changes and even on global balances brought about by scientific and technological developments. To the already difficult question posed by life sciencesHow far can we go?other queries must be added concerning the relationship between ethics, sciences and freedom. Over the years, UNESCO has confirmed its standard-setting role in bioethics.UNESCO has contributed to the

SLMANEWS

July, 2012

formulation of the basic principles in bioethics through and in particular, the Universal Declaration on the Human Genome and Human Rights, adopted unanimously by an acclamation by the UNESCO General Conference in 1997 and endorsed by the United Nations General Assembly in 1998, and the International Declaration on Human Genetic Data, adopted unanimously and by acclamation by the UNESCO General Conference on the 16th of October 2003. This declaration and the Universal Declaration on the Human Genome and Human rights are the only international points of reference in the fields of bio-ethics. It was in 1993, that the International Bio Ethics Committee (IBC) was created by UNESCO, comprising a body of 36 independent international experts that follows progress in life sciences and its applications, in order to ensure respect for human dignity and freedom. In 1998, an Inter-Governmental Bio-ethics Committee (IGBC) was created under the statutes of the IBC that came into being in 1993. It also comprises 36 member states of UNES-

Invitees at the opening ceremony of Sri Lanka’s inaugural Bioethics Unit as part of the UNESCO Chair in Bioethics, held recently at the Galle Face Hotel. the Minister of Health, Mathripala Sirisena is also present.

CO, whose representatives meet at least once every two years, to examine the advices and recommendations given by the IBC. With the initiation of a Chair in Sri Lanka today, it is hoped that, if the Chair evolves appropriately, our country could also play an important role in the International Bio-ethics Committees in the times to come. We have no doubt, Dr. Gambheera and the team will be up to this task, in the most fitting manner. Further, the International Declaration on Human Genetic Data, which was adopted unanimously by acclamation of the UNESCO General Conference on the 16th of October 2003, will address the concerns, which continues to worry us, that human genetic data will be used for purposes contrary to human rights and freedom, since each person’s genetic heritage is unique and must be

protected. UNESCO has since commenced a program to assist in the establishment and operation of Bioethics Committees (ABC’s) that would help reinforce UNESCO’s role as an international clearing house for ethical issues. Their primary focus will be on policy advice, public debate and education. We have no doubt, the Chair program in Sri Lanka will also give due focus to policy advise, public debate and education in Bio-ethics. Ladies and Gentleman; Bio-ethics has now evolved from the purely medical and scientific aspects like stem cell research, genetic testing and cloning, to embrace concerns about social, cultural, legal and ethical implications of such progress and to teaching programs in ethics, not only bio-ethics, but in all scientific and professional education.

Therefore, UNESCO has initiated an Ethics Education program since 2004, which had, at the initial stages, focused primarily on East and Central Europe, South East Europe and the Arab Gulf Region. Further initiatives are now underway, to address ethical dimensions of the information society, with the scope of info-ethics continuing to expand, due to the fast growing numbers of internet users, that covers ICT’s and societal transformation; freedom of expression and access to information; the use of ICT’s in Education; Infoethics Education, particularly in Media and Information Literacy programs, to prepare youth for the information society. Contd. on page 24

It was in 1993, that the International Bio Ethics Committee (IBC) was created by UNESCO, comprising a body of 36 independent international experts that follows progress in life sciences and its applications, in order to ensure respect for human dignity and freedom. 23

SLMANEWS

July, 2012

Southern Province Department of Health Services

wins the Taiki Akimoto 5S Awards 2011

othern Province Department of Health Services, which has as its vision “to be the best Provincial Health Department in Sri Lanka”, won the first place at the “Taiki Akimoto 5S Awards 2011”, the leading 5S competition in Sri Lanka, organized by the Japan Sri Lanka Technical and Cultural Association (JASTECA). Manufacturing and Service Sector organisations in the Private and Public Sectors participated in the competition. The judging was done by a world renowned panel including Prof. Seiichi Fujitha. Although health institutions like the Castle Street Hospital for Women, Colombo and the General Hospital, Ampara had won the award in the past, no administrative division of the health sector had won this award

The Southern Province Department of Health Services Team with the Award. Dr. Hemachandra Edirimanna is in the center.

previously. Provincial Director of Health Services, Dr. Hemachandra Edirimanne was instrumental in leading the Southern Province Department of Health Services to this historic award.

He is now working tirelessly to ensure that his department is compliant with the ISO 9001-2008 standard that would certify the department as providing a high quality service to the people.

Contd. From page 23

UNESCO Chair... All these interventions value the inherent worth of diversity and pluralism, in a manner consistent with the underlying principles of respect for human rights, fundamental freedoms and human dignity. Ladies and Gentlemen; from what I have just mentioned, you may have observed that ethics could range from medical science to education, to information and communication from the human genome to human rights, to supporting equitable human centered knowledge societies. Therefore, holistic approaches and broader perspectives will need to be brought in, when tackling ethics of morality, which are most important in the

interfaces in human interactions. During the next biennium 2012/13, UNESCO’s International Bio-ethic Committee will work on the principles of nondiscrimination and nonstigmatization as set forth in article II of the Universal Declaration on Bio-ethics and Human Rights (2005). It will also continue its work on traditional medicine and its ethical implications. Holding a Chair is a unique opportunity. There is wide scope for development and networking. Funding can be had from diverse donors, if the ideas and concepts are good. The National Science Foundation of Sri Lanka has also established a Bio-

ethics Committee and they could become a valued partner of the Chair now established in the National Institute of Mental Health. The Global Forum of Sri Lankan Scientists, which is now an electronic interactive forum, created by the National Science Foundation will also be a useful link for networking including for issues on ethics of Nano Technology. It is important that we tap into our scientific Diaspora Communities to work towards a knowledge society I wish to conclude, wishing the UNESCO Chair, Dr. Harischandra Gambheera and the Foundation Steering Committee, the very best in their efforts at funds raising, networking,

researching, disseminating information, proactive provision of policy advise, public debate and education, which are required to take Sri Lanka’s Bioethics Committee to the next level, all of which will call for making use of five modalities of functioning, namely, being a Laboratory of Ideas, a Standard Setter, a Clearing House, a Capacity Builder and a Forum for Intellectual Cooperation. And success will depend on how well we can render these five functioning modalities effective. I wish Dr. Gambheer and all members of the steering Committee, the very best in their future endeavors, their commitment and team work.

SLMANEWS

July, 2012

Dr Thistle Jayawardene Trust Fund

Dr. Thistle Jayawardene

he Sri Lanka Medical Association is pleased to announce the establishment of the Dr. Thistle Jayawardene Trust Fund with a generous donation from the family of Dr. A. T. W. P. Jayawardene MBBS (Ceylon), D.A (London), FRCA (ENG.), FACC (USA), Hony. FCCP (Sri Lanka), Hony. FCGP (Sri Lanka). He was a pioneer Anaesthesiologist, Founder, Joint Secretary (1972) and President (1984) of the College of Anaesthesiologist of Sri Lanka, Member of the First Board of Management of the Postgraduate Institute of Medicine, University of Colombo (1980) and President SLMA (1991).

It is noteworthy that the first Scientific Sessions of the College of Anesthesiologist of Sri Lanka was held during Dr Jayawardene’s Presidency in 1984. The academic gowns, President’s medal and the College mace were all introduced by Dr Jayawardene for the Scientific Sessions. The Scientific Sessions of the College have been held every year since then. Dr Jayawardene held the post of President SLMA in 1991 with distinction. The primary purpose of the Fund is to award an annual grant for research in intensive and critical care. This award would be made starting in 2013.

Contd.from page 15

Opening Healthcare Gateways... He was also invited for the keynote speech of the 18th World Congress of the International Ergonomic Association, titled “Inculcating the ergonomic culture in developing countries: National Healthy Schoolbag Initiative in Sri Lanka”, held in Recife, Brazil in February 2012. The above success story is an eye-opener and a role-model for further ergonomic oriented work. There are numerous areas in the healthcare sector which warrant ergonomic interventions. A health-led concerted effort is essential considering the significance and applicability of ergonomics to healthcare professionals in Sri Lankan

contexts. The Sri Lanka Medical Association, being the premier professional organization representing the medical community, could take the lead role in promoting ergonomics in Sri Lanka. Considering the above facts, a proposal for a Subcommittee on Ergonomics was approved under the SLMA with the objective of promoting ergonomics to the medical community, general public and in healthcare settings. Tentative activities of the SLMA Subcommittee on Ergonomics will include;  To function as the umbrella body in promoting ergonomics  To map and collate evidence in

ergonomics and health consequences To synthesize and disseminate new knowledge on ergonomics  To advocate healthcare and other stakeholders in relevant sectors on issues related to ergonomics  To interface with national and provincial health professionals and other stakeholders (i. e. other government bodies, INGOs) as appropriate to generate funds and to facilitate the implementation and adoption of ergonomic initiatives  To initiate and sustain activities both at national and sub-national level to expand ergonomics in health and relevant fields The SLMA invites professionals from a wider spectrum (Public health specialists – OSH / Child health, Paediatricians, Neurologists, Orthopaedic sur-

geons, Rheumatologists, Healthcare Administrators and Non-medical professionals - Ergonomists, Engineers) as members of the proposed subcommittee. The outcome of the proposed ergonomic subcommittee is important when Sri Lanka is recognized as a model developing country. In a context of rapid technology transfer, promotion of ergonomics both at macro and micro levels will undoubtedly contribute to economic and human development of a nation. The SLMA, being the apex medical organization in the country, will be a partner in promoting ergonomics.

Assuring our continous support for the medical profession