Letters to the Editor

5th November 2000

MMR is safe

MMR vaccine. Is it safe? Not too long ago, a little child died at a medical institution at Kadawatha after receiving the MMR vaccine. This of course caused a lot of anxiety in the minds of parents, as expected. 

Some of them decided not to give this vaccine to their children. After an inquiry and postmortem the cause of death was given as an allergic reaction to the vaccine. Since the reaction occurred shortly after the administration of the vaccine, the child's symptomatology suggests that this is probably correct.

Now the question is whether it is still safe to give this vaccine to children or not.

The truth is, this kind of reaction can occur almost with any vaccine and if we stop giving the MMR we may have to stop giving all vaccines.

This type of allergic reaction is called anaphylaxis and can be fatal if appropriate treatment is not given rapidly. 

Anaphylaxis can occur due to other causes as well. They are drugs (penicillin), foods (seafood,eggs), insect bites (hymenoptera, fire ants) biological agents (vaccines), food additives (monosodium glutamate) etc.

What is the solution to the problem? First of all, anybody who administers a vaccine should be knowledgeable about the likelihood of an anaphylactic reaction occurring in the recipient of the vaccine. Next, he or she should be able to recognize it and give proper treatment immediately. 

The necessary medications, equipment and competent staff should be readily available. 

The most important drug that should be available is called aqueous epinephrine. The names and dosages of all the drugs used should be printed on a piece of paper and pasted on the refrigerator door for all the staff to see for implementation of prompt action. Another important thing to remember is that anaphylaxis generally occurs within the first half-an-hour or so after the administration of the vaccine. Therefore, it is best that you should stay in the hospital premises for a while after receiving the vaccine. 

In countries like the USA there are even anaphylaxis treatment kits that the patients themselves can use on themselves in case an anaphylaxis reaction should occur. 

This can be taken along with them wherever they go. 

Generally people who are prone to such severe allergic reactions are the ones who need to have it with them. 

The brand name of this kit is 'Epipen' and 'Epipen junior'(for children). Since most measles and MMR vaccines are made in egg medium, a special word of caution about doing a skin testing, if there is a known severe allergy to eggs. 

There are also measles and MMR vaccines that are not made in egg medium, however, that can be given to such individuals. 

Thus, a vaccine cannot be condemned based on an anaphylaxis reaction since it can occur in anyone due to any foreign substance. No vaccine is 100% safe. However, all vaccines go through thorough testing before they are passed and given the licence. They are also constantly monitored even after approval. 

Thousands of children are also getting this vaccine right now without any adverse effects.

In conclusion MMR vaccine is as safe as any vaccine that is used in modern times.

Dr. Ajith Fernando 
Colombo 5

Boom-box weddings

Wedding receptions have become stressful for the older folk. I had the singular ill-luck to attend a 'grand show' held at one of our leading hotels in Colombo and returned battered and bruised by the sustained sonic boom of loudspeakers that belted out a kind of music that must have registered high values on the Richter Scale. 

Sedate conversation was impossible and the less enterprising lapsed into silence - beaten by the booming decibels. Others used short-range mouth-to-ear tactics to get their message across. 

Being an acoustic specialist myself, I looked around to find the source of this sustained misery in a place that was supposed to encourage bonhomie and good cheer - together with good food. I found a pair of 18-inch woofers fitted to the floorboard to generate that disturbing bass thump. 

A battery of speakers to the left and right filled in the rest of the acoustic spectrum. Listening to the strange sound delivered by this powerful assembly, one noticed that the middle frequency-range had been excised. The vocal output was a thin, reedy and unpleasant upper frequency belek-tone that was drowned out by the booming bass. 

Needless to say, a kind of 'hard-rock' or 'punk' music was the favoured genre. The effrontery of all this left me astonished and bemused - the wedding was a conventional Buddhist affair with few kalusuddha types around. 

Yet, a contemptuous hotel administration gave 'beans to the godayas' by blasting their ears with the kind of sound they would not inflict on their worst enemies. They collected good money for all this and our poor local fools were too cowed by the 'fashion ' imposed by the western overlord to register even the slightest protest. 

This supine acceptance of an alien and harmful pattern of behaviour is part of the process of 'acculturation' that continues apace in our country - the readiness to bear pain if it is western and fashionable. Actually, no civilised westerner would put up with the rot dished out to the natives in the so-called 'star class hotels'. 

Soft piped music accompanies good food and conviviality. Bone-rattling bass sounds are for the inebriated at dance-floors and disco-bars. In Sri Lanka things have become unpleasantly mixed.

K. Meththananda

New Cabinet: A Guinness record

The unwieldy Cabinet of Ministers of the People's Alliance has become the butt of derisive comment. More so because this is a party that came to power in 1994 vowing to reduce the size of the Cabinet to 20 and cut down on expenditure. Now the PA has produced the largest Cabinet and might surely find a place in the Guinness Book of Records. 

Perhaps, experience has taught the PA that reducing expenditure at the higher levels is not that easy, whatever the promises made while in the opposition. 

Nevertheless, for a country among the poorest in the world with no known resources and a population of 18.5 million, half of it below the official poverty line, and saddled with a civil war, a council of 44 ministers and may be an equal number of junior ministers, will be a liability it can ill-afford.

Usually, inter-related subjects and departments are grouped together to form ministries for effective co-ordination and smooth implementation of various activities and programmes coming under them. 

Ministries should not be created to accommodate sectarian or group interests or as sinecure posts for individuals. The more ministries there are, the more cumbersome the administration becomes. 

The desirability of limiting the Cabinet to a bare minimum therefore, needs no emphasis. 

A look at the distribution of subjects and functions of the present Cabinet shows that there is overlapping and splitting of subjects which would create confusion and delays in administration.

This extra-large Cabinet maybe a direct result of the obnoxious proportional representation system foisted on the country during the J.R. Jayewardene regime. Under this system no political party, however popular it may be, can ever hope to capture an absolute or even a workable majority in Parliament. 

Even small parties with no following worthy of note, tend to receive representation under a complicated system of calculation. Consequently, coalitions of incompatible partners are becoming the order of the day. Major parties with large followings are compelled to bow down to the wishes of small parties to form a government. Small parties have thus become king-makers and try to extract a high price for their support, far in excess of their popularity or vote base. A stable government with clear-cut policies is not possible under these circumstances.

The PR system should, therefore, be thrown to the winds without delay. Let the two major parties get together and re-introduce the Westminster system, which is simple and reflective of the wishes of a majority of the population. Under this system a political party will either be accepted or rejected in clear terms. It would also be easier for the voter to make his choice of candidate. 

Above all, the bargaining power of minor parties would be reduced and would be in the interests of the public.

Henry Gallege

It's wrong, sir

A TV channel in its 8.30 p.m., news telecast compared the election of Anura Bandaranaike as Speaker in the new Parliament to that of T.B. Subasinghe some time ago.

However, Mr. Bandaranaike whose name was proposed by Ratnasiri Wickramanayake from the government and seconded by Ranil Wickreme-singhe from the Opposition was elected uncontested. 

But in the case of Mr. Subasinghe, there was a contest between him and another member from the government, which at that time was the UNP.

There was an election and Mr. Subasinghe won by a majority. Therefore, he was not elected Speaker uncontested like Mr. Bandaranaike.

Danapala Patabendi

Follow Mexican example

Mexican President-elect Vincente Fox immediately after his election set up a head- hunting team to look for talented Mexicans working for the World Bank, Wall Street, Inter-American Bank etc. for appointment to his Cabinet. 

According to him he needs the best team of Mexicans available to solve the problems faced by his country. He has now shortlisted several people identified by his team and will be selecting his Cabinet from among them.

In contrast, we could examine how it is done in Sri Lanka. 

Donald Munasinghe 

JVP: People still have doubts

A statistical analysis of the results of the recent general election clearly reveals that the real winners were the Janatha Vimukthi Peramuna. 

The JVP has increased its vote base from a mere 1% in 1994 to 6%, without the propaganda machinery or the funds available to the mainstream political parties - the People's Alliance and the United National Party. No doubt, voters - mainly those who comprise the so-called floating vote and who were disillusioned with the chicanery and tomfoolery of the PA and the UNP - placed their faith in the JVP. 

But a large number of voters are still sceptical, of the JVP, with the horrors of the late '80s lingering in their minds. It is time for the JVP to win over these sceptics by showing a genuine commitment to democracy.

The JVP MPs should ensure this by representing the common interests of the masses without looking after the interests of their supporters or henchmen. Whatever the funds available to them must be utilized to provide public amenities. Hope they would continue to channel their own allowances for public benefit.

The JVP MPs should also not ask for luxury vehicles and other privileges bestowed on parliamentarians.

A.G. Abeysinghe


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