As controversy has erupted over the topmost post of the Epidemiology Unit with shouts of protests in health circles, there are also strong fears that Sri Lanka’s much-commended public health system is set to crash with the next outbreak of disease. This follows the appointment of a non-technical, non-specialist medical administrator to the post of [...]

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Top-post dispute may dampen Epidemiology Unit’s disease combat task

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As controversy has erupted over the topmost post of the Epidemiology Unit with shouts of protests in health circles, there are also strong fears that Sri Lanka’s much-commended public health system is set to crash with the next outbreak of disease.

This follows the appointment of a non-technical, non-specialist medical administrator to the post of Chief Epidemiologist of the Health Ministry for the first time in the nearly-60-year history of the Epidemiology Unit, the Sunday Times understands.

Giving the sequence of events which had come to a head recently, sources told the Sunday Times that the Chief Epidemiologist, Dr. Paba Palihawadana, sought and obtained no-pay leave from the Health Ministry to join the UN service for one year, in 2017. While she was on no-pay leave, another senior public health specialist of the Epidemiology Unit acted for the Chief Epidemiologist.

However, when Dr. Palihawadana reported back for duty as Chief Epidemiologist on January 1, this year (2018), she found that someone else was seated in her chair, sources said. Blaming the Health Ministry for meddling in a crucial public health programme which would adversely impact the men, women and children of Sri Lanka, other sources alleged that the person who has been appointed for this technical position of Chief Epidemiologist had not even served as a Medical Officer of Health (MOH), neither was he qualified as a specialist.

“After securing his MBBS, he has only acquired an M.Sc in Medical Administration,” the sources said, asking whether this would be adequate to manage and guide the massive workload of both technical and non-technical officers spread across the country, coming under the Epidemiology Unit. Has not the Health Ministry learnt a bitter lesson through the experience at the Dengue Control Programme, another asked, citing the example of how the non-technical head allegedly just “abandoned” his post during the height of the dengue epidemic last year.

The planning, implementation, monitoring and evaluation of public health preventive activities of communicable diseases such as influenza, dengue and leptospirosis (rat fever) to a name few, are handled across the country under the guidance of the Chief Epidemiologist, the Sunday Times understands.
“This is a challenging task as the epidemiological scenario changes constantly,” said another source.

When contacted by the Sunday Times, a Health Ministry official assured us that the ministry has not violated or flouted the Medical Services Minute. However, many health sources are seriously concerned that if there is a major outbreak of a communicable disease, the Epidemiology Unit, with a non-technical head without a background in epidemiology, will not be able to handle the crisis.

According to the interpretation and identification of the post of Chief Epidemiologist by the Health Ministry circular No. 02-132/2000 dated September 26, 2000, the Chief Epidemiologist should be a Board (Postgraduate Institute of Medicine) certified Consultant in Community Medicine with work experience in epidemiology, sources pointed out. These criteria are also included in the Medical Services Minute of 2014, while Cabinet paper No. 10/1138 dated May 24, 2010 also states that the post of Chief Epidemiologist has been approved on special criterion, they added.

This appointment of a non-technical, non-specialist medical administrator as the Chief Epidemiologist has raised a hornet’s nest with a flurry of protest letters being sent by the Government Medical Officers’ Association (GMOA), current Epidemiologists, former Chief Epidemiologists and senior academics not only to President Maithripala Sirisena but also to Health Minister Dr. Rajitha Senaratne and other Health Ministry officials.

According to the job description of the Chief Epidemiologist, he/she is responsible “for the administration of the technical and non-technical staff of the Epidemiology Unit; National Focal Point for disease surveillance excluding tuberculosis, animal rabies, filariasis, malaria, malignancies and leprosy; Manager of the National Expanded Programme on Immunization; National Focal Point (health) for avian influenza and influenza pandemic preparedness; Secretary of the Advisory Committee on Communicable Diseases; and Chairman of the Polio Expert Committee”.

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