The Sunday TimesPlus

4th May 1997



Not all doctors are immoral

Point of view
By Dr. Hemamal Jayawardena
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The Government Medi cal Officers’ Associa tion (GMOA) threatened recently, if their demands are not met, they will start a continuous strike. The GMOA wanted the govt.’s assurance of the correction of salary anomaly in writing. What they want is what they have asked for. Nothing less. No compromise. No prolonged negotiations. That is how people with more arrogance than brains act.

At a time when the doctors of the GMOA whom some refer to as terrorists, behave like this, it is heartening to note how another group of doctors behaved when they had a graver salary anomaly.

I refer to the doctors of the medical faculties.

The Establishment Code (EC) of the University Grants Commission (UGC) clearly states the medical and dental teachers should receive a salary higher than their counterparts in the Ministry of Health. The reason is clear. Only then the Universities will attract doctors to their staff. As the public knows it is extremely competitive to get into the faculty of a medical school. There is no automatic offer for jobs as in the Ministry of Health. There is a tough process of interviewing for screening.

However, when the GMOA obtained two sets of allowances of Rs. 2000 and Rs. 3000 in early nineties, the UGC did not give equal salary increases to the University doctors. In fact the GMOA received those allowances from the previous govt. threatening strike action!

The doctors in the Universities could have easily resorted to strike action in 1994 quite justifiably. They found their colleagues of similar seniority receiving Rs. 5000 more than them, truly contrary to what at the University EC has mentioned.

A strike meant the immediate closure of the medical faculties and prolonging the agony of the medical students, who had already lost nearly two years due to the 1989/1990 disturbances.

The university doctors did not strike. From 1994, they negotiated with the new Minister of Education and Higher Education, Richard Pathirana. Had they struck at that time, about 2000 of the current GMOA members would still be in Medical School.

When the Federation of the University Teachers Association (FUTA) contemplated trade union action making various demands including salary issues in 1995, the Federation of the Faculty of Medical Teachers Association (FFMTA) led by the distinguished academic Prof. Neil Fonseka and the Faculty of Medicine Teachers Association (FMTA), Colombo, led by Prof. Ravindra Fernando continued negotiations with the Minister.

The negotiations were slow and at times going nowhere. For example, when the Minister, who clearly saw that the demands were quite reasonable, presented a Cabinet paper, the Treasury rejected it stating that all salary matters should be referred to the B. C. Perera Committee.

Professor Ravindra Fernando, himself an esteemed teacher of medical law and ethics saw that the University doctors did not strike. They went before the B. C. Perera Committee. Prof. Fonseka and others presented their case. The members of the committee grasped within minutes how reasonable the request was. But they said the doctors should await the committee report.

The doctors waited patiently for another several months.

Once the report was published Prof. Fonseka and Prof. Fernando again discussed their two year old request with Mr. Pathirana. He agreed to re-submit a Cabinet memorandum. Mr. Pathirana by now realized that the doctors have waited long enough that there is a possibility of trade union action.

After the B. C. Perera Committee report was published, the FMTA, Colombo wrote to the UGC that their members were reluctantly compelled to take trade union action in April 1997, if their three year old salary anomaly was not corrected. The Chairman of the UGC, who was also quite sympathetic to the doctors’ request, stated he was helpless as the Treasury has to give funds. He informed the Minister of the impending trade union action. He re-submitted a Cabinet memorandum.

To the dismay of the FFMTA, Minister’s Cabinet memorandum was again referred to the Treasury! Delay of several weeks again. The doctors waited, but did not strike.

Finally, the Treasury stated they have no objection to paying the arrears as long as the additional funds are not requested from the Treasury in 1997! The Ministry or the UGC has to find the money. The Cabinet then approved Hon. Minister’s memorandum.

Soon after the Cabinet meeting, the Minister who had by now developed a close link with the trade unions of the doctors in the Universities, telephoned Prof. Ravindra Fernando.

The UGC Chairman and the other officials were also with him, anxiously awaiting the response of the Unions.

The Minister informed Prof. Fernando of the new situation. He indicated that there was no way that the arrears accumulated in the last 3 years could be paid at once.

The Minister and Prof. Fernando had a long discussion on the issue. Finally, they came to a compromise. The Minister suggested that 25% of the arrears to be paid in June 1997 and another 25% in December. The balance in 1998!

The Minister awaited Prof. Fernando’s response. He told him that he personally approves the compromise formula considering the financial situation of the country, but he will have to get the approval of the members of the KFMTA, Colombo and the FFMTA. The Minister agreed.

In fact, the academic staff (doctors) of all the medical faculties in Sri Lanka unanimously approved Richard Pathirana’s formula, i.e., to receive 50% of the arrears accumulating from 1994, in 1997 and the balance, four years later in 1998!

The Minister was relieved. The doctor-teachers realised that though they have been the losers (receiving their due salary, several years later) that was the best they could expect from a govt. fighting a war, without disrupting the future of the students by taking trade union action.

What a contrast to the action of another set of doctors! The public, when they condemn doctors as a professional group, must realize there are doctors who devote their time to heal the sick and train others to heal the sick. Not all doctors are immoral. They, unlike some other doctors believe in the Hippocratic oath. They understand that a strike is the last resort; not the first as the GMOA thinks. They understand that blaming respected treasury officials does not help their cause. Not to mention it is unfair and unethical.

The students of the medical faculties, their parents and the patients cared for by the university doctors have thanked in more than words, the academic staff for their patience.

Minister Pathirana and Viswa Warnapala were willing at any time of the day to talk to Prof. Fonseka and Prof. Fernando. Prof. Tillekeratne, the Chairman of the UGC was always supportive of the doctors’ demand. He in fact knew beforehand that doctors will accept any reasonable formula of the Hon. Minister.

It is high time that some trade unions, especially the terror propagating GMOA decide to act with restraint. After all, their members are certainly not starving. They are perhaps the highest earning public servants in the country. Their strike action lead to suffering and death of the poorest of the poor of our society. They know that. They also know that this is the easy way of winning demands. No, not prolonged negotiations or patience.

The GMOA itself is highly divided on the matter of striking, for many of them are moral doctors. However the delinquent few, including certain members with neurotic psychiatric disorders make the decisions.

The President of the GMOA exemplify this division. He is a famous eye specialist whose morals have never been questioned. The public had not heard a word of him favouring the killer strikes.

Another example is the Judicial Medical Officers. When the Assistant Judicial Medical Officer (AJMO) openly abstained from taking part in the recent strikes, they were sent letters of explanation by the GMOA in the form of asking for comments. Over 90% of them did not even care to respond. Even the few responses they received were not in the GMOA’s favour at all. The GMOA had to give into these conscientious, yet rebellious doctors by asking them to work even during their GMOA strikes, the AJMOs thought that it was the done thing. This is a great victory of the Patients Rights movements of Sri Lanka.

The real truth about allergies

Their sons, eight and 10 years old, were begging for a dog, but Laurie and Lou Gallo had always thought it out of the question because of Gallo’s allergy to cats and dogs.

Children are persistent though, and Mr. and Mrs. Gallo like dogs themselves. And they kept hearing that people with allergies could tolerate certain breeds of dog, particularly poodles, Airedale terriers, Portuguese water dogs and terriers which supposedly do not shed.

The Gallos knew that allergies were caused by dog dander, or flakes of skin, and not hair. But the theory went, dander tended to stick to hair, and with less hair being shed, there would be less dander in the air.

The idea made sense, sort of and they decided to test it by borrowing a relative’s miniature poodle. Peaches stayed with them in their home for a week and even slept in the couple’s bedroom. Gallo did not sneeze once.

Encouraged but still cautious, Mrs. Gallo consulted breeders, visited pet shops and borrowed library books about specific breeds. All promoted poodles and certain other dogs as allergy-safe. The family became enchanted with a type of toy spaniel called the bichon frise, which, they agreed, looked like a poodle, only cuter. Mrs. Gallo was delighted by a book that declared, “Bichons do not shed dander, making them more compatible to the family that has a member who is allergic.” On a Wednesday in December, they brought home a bichon puppy, freshly-shampooed and brushed by the breeder. They named him Clouseau, and by bedtime, the boys had fallen in love with him. By Saturday morning, Gallo was miserable: his eyes itched and teared, his nose had clogged shut, and he could not stop sneezing.

The puppy would have to go, Mrs. Gallo decided. The boys were heartbroken, and one demanded that his father move out instead of the dog.Nonetheless, Clouseau went back to the breeder, who insisted that she had never encountered, anyone allergic to a bichon before.

Their story does not surprise allergists. “I encounter the poodle theory all the time,” said Dr. William J. Davis, a professor of clinical pediatrics and director of allergy and immunology at Columbia Presbyterian Medical Centre in Manhattan. “There’s very little truth to it.” A week, the period the Gallos spent with Peaches, is probably not a long enough test period, Davis said. In sensitive people, allergies can develop at any time, even after a long exposure to an animal. Safe-pet stories abound anyway. The chihuahua theory is very prevalent,” said Dr. Harold Nelson, an allergist and senior staff physician at the National Jewish Medical and Research Centre in Denver. “The classic folklore tale is that chihuahuas actually cure asthma.” They do not, and Nelson said he did not know how the idea had got started. “I can think of only one possible explanation,” he said. They wheeze when they breathe, and I always had this feeling that maybe people thought the dogs were drawing the evil spirits out of the asthma patient and taking it into themselves.” Allergists say all the safe-breed theories are just wishful thinking. When people are allergic to cats or dogs, Davis said, the allergens that make them sick are the proteins in the animals’ skin secretions and saliva.

As for the idea that dander and saliva stick to hair and that non shedding dogs are therefore non allergenic, forget it, said Peyton Eggleston an allergist and professor of pediatrics at Johns Hopkins University in Baltimore. For those who want to try keeping a dog or cat despite allergies to the animal, allergists recommend several measures. The animal should spend as much time outdoors as possible, and it should never be allowed in the allergic person’s bedroom or other places where people spend a lot of time, like the family room or living room. The house should be kept clean, and carpets and upholstered furniture should be eliminated because they collect dander.

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