At a time when there’s nothing very much going right in the country, the recent news from the World Health Organisation is a silver lining in an otherwise pervasive cloud of gloom and pessimism. On July 1, Sri Lanka was declared by the WHO as having eliminated endemic measles after a detailed review of the [...]

Editorial

Health feats; beware of comebacks

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At a time when there’s nothing very much going right in the country, the recent news from the World Health Organisation is a silver lining in an otherwise pervasive cloud of gloom and pessimism.

On July 1, Sri Lanka was declared by the WHO as having eliminated endemic measles after a detailed review of the country report, followed by an in-depth review of the measles surveillance and laboratory data, discussions and observations from field visits.

The Primary Healthcare Service staffs, mainly those who work at ground level such as the frontline family health workers, the Public Health Inspectors (PHIs), the Public Health Nurses (PHNs) and the Medical Officers of Health (MoHs), have to be congratulated on this major achievement.

However, Sri Lanka has to be extra vigilant as communicable diseases such as measles could also come into the country as imported cases. Although the local transmission has been curtailed, strong surveillance and laboratory facilities need to act in tandem along with quick and direct reporting to the relevant authorities such as the MoHs at ground level and the Epidemiology Unit at national level to sustain the eliminated status.

Measles is considered an ‘important’ cause of death for young children worldwide according to the WHO. The WHO also reports that “many countries are in the midst of sizeable measles outbreaks, with all regions of the world experiencing sustained rises in cases.” The United States is currently facing an outbreak of the disease, partly due to the reluctance of some parents to give their children the measles vaccine. The US Center for Disease Control and Prevention has recorded over a thousand cases of measles in 28 states in the first six months of this year, the highest number of cases reported in the U.S. since measles was declared eliminated in that country in 2000.  So the need for continued vigilance cannot be overstated.

Another childhood disease that Sri Lanka eliminated a while ago is polio with no cases being reported since 1993.

However, the battle against dengue continues to require multi-pronged action as the onset of rain in parts of the country has seen an alarming rise in the number of cases reported. As our investigation last Sunday spotlighted, 25,200 dengue cases were recorded in the first six months of this year with 39 deaths, 20 in the Western Province alone. Last month, around 7,000 people were affected by dengue in many areas of the country.

Other health concerns that require the state’s continued attention are the unacceptable air pollution levels in major cities. This causes increased cases of respiratory illness among the people, with children and elders being particularly at risk, diabetes and childhood obesity –given the predilection for fast food among city dwellers and the lack of exercise. Greater education and awareness are clearly crucial on all these fronts.

PCs: Systems deficiency —not elections

Prime Minister Ranil Wickremesinghe this week called the Chairman of the Elections Commission and asked him to stay on in his job without quitting. He has told the Chairman that his services are needed as this is “Election Year”. The Premier clearly refers to the Presidential election – not any other election.

It really ought not to be the role of the Chairman to be threatening to quit to force the hand of the President or the Government to hold an election. He has done so saying Provincial Council elections are long overdue. If he thinks his position is being compromised, he must simply resign and go home – not badger the politicians who are looking for a force majeure – putting it on the non-availability of legislation for such an election.

One would hope, however, that the Chairman remains in office to oversee the forthcoming elections – Presidential (this year) and Parliamentary (next year). He has, despite a tendency to verbosity, performed exceptionally well in his job and his departure might open the door for some maverick to creep into his chair.

That said, the issue of elections to Provincial Councils – eight of the nine are now under Presidential rule — must be looked at from a completely different perspective. We have said this before, and say it again, it is not elections to these Councils that need the urgent attention of the Government – and the Opposition, but the entire structure of the system that was forced down Sri Lanka’s throat in 1987.

Clearly, the compulsions that led to the creation of the Provincial Councils at the time are not prevalent today. This is proven by the very fact that the political alliance that dominates the Northern Province, and strenuously argued for autonomy is content that the current Northern Provincial Council is under Presidential rule.

With these eight Councils run by Governors on behalf of the President, it is the very antithesis of devolution of power. What is needed is not elections to Provincial Councils ‘which serve neither man nor beast’ but have only duplicated local government, fattened the councillors and complicated the lives of the citizenry.

A complete overhaul of the system of devolution – or decentralization, whatever it be called – is required. The existing system needs to be replaced altogether. One suggestion is to make the District the unit – not the larger Province. To bring in technocrats into these councils – not just elected persons; and to base the unit on economic and administrative necessities rather than political or ethnic considerations. Already, there is a move to carve of an AGA division for the Tamils in Muslim populated Kalmunai. These ethnic enclaves must stop.

The problem is, with Presidential and Parliamentary elections looming, thoughts on such progressive action is probably farthest in the minds of the Government – and the Opposition.

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