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Begining my nursing career and some of my early patients
Excerpted from Memories that linger…. by Padmani Mendis
Early on in the year that I started nursing, an epidemic of Poliomyelitis or polio had occurred across the United Kingdom. It had left very many people with varying degrees of paralysis in different parts of the body. The paralysis in polio followed no pattern. It would affect muscles scattered all over the body; anywhere on the trunk or chest or arms or legs. Polio damaged the nerves of the body that made muscles work. When muscles were paralysed, a person could not move the joints served by those muscles.
Many who were more severely affected had come to the ROH for rehabilitation. Looking to the future, however, polio immunisation had come and this would be the last such epidemic in the UK.
Mrs. Wilson was one of the first patients I met who had been part of the epidemic. She had all parts of her body affected and could move no part of it. She could not even breathe on her own. To enable her to breathe, she had been placed in what was called an “Iron Lung”. Because of this, she was nursed in a separate room but had to be under constant observation. A nurse was allocated to visit her room at regular intervals. Mrs. W’s iron lung was the first and last such machine that I had seen.
It was a large machine that covered most of her body. It used a negative pressure to pull her chest out. This would draw air into her lungs. Then pressure would be released and the air would be pushed out of Mrs. W’s lungs. Mrs. W’s head was outside the machine so she could be fed. There were holes on the sides of the machine through which we could carry out nursing care. In the same way, she would have daily physiotherapy too.
Between breaths, Mrs. Wilson communicated with us in a whisper. So we could have some sort of conversation. I don’t think iron lungs are in use any more. They have been replaced by modern “respirators” or “ventilators” which use a different mechanism called positive pressure.
During the time I was in the same ward as she was, Mrs. W’s husband and two young children would visit her on Sundays and spend time with her. The children were quite young and could be seen playing outside the ward. We knew that Mr. W. had employed a nanny to look after the children.
After I left Woodlands I heard that Mr. W. had divorced his wife and married the nanny. Her family no longer came to see her in hospital. I followed her condition. Mrs. W. never recovered the use of any of her muscles. She remained in the iron lung until she died of a lung infection about a year later.
A Pause to Fast Forward with Technology
This was Mrs. Wilson, dependent on an iron lung, confined to a hospital bed and requiring total nursing care. The memory of an exceptional lady very early on in my journey, circa the year 1959. To fast forward now, passing through the next three decades and more of my journey, to another individual called Adolph I was fortunate to know. He was as severely affected by polio as Mrs. Wilson was. Not able to breathe by himself. Not able to move his body except for his fingers,
I met Adolph as a young man, a little younger perhaps than Mrs. Wilson. Adolph lived in a comfortable apartment together with his partner. I was so fortunate to have been invited by this couple I had made friends with to spend time with them when, on my journey, I stopped over in their city in Northern Europe. Adolph had the use of an electric wheelchair fitted with buttons on the arm of the chair; buttons that he could press with the little movement he had in his fingers and use the chair in just the way he wanted to.
To me these advances were miraculous. His chair was so designed as to be able to accommodate and transport a specially designed ventilator to help him breathe. This ventilator Adolph had to have with him 24 hours a day – the technological advance of the iron lung that kept Mrs. Wilson alive in her bed. Such was the construction of the chair and the ventilator that when required, which was every few minutes, Adolph could breathe for a short while and then take a break for a few minutes. A never-ending cycle to ensure that Adolph had access to the essential respiratory function that kept him alive. And which enabled him to carry on a lively discussion and intensive debate, to read aloud and teach, to lead a full and active life.
Adolph had a full-time job with regular hours of work. Disability advocacy was part of his job. He had a specially designed vehicle in which he was driven to wherever he wanted to go. He had an assistant who would drive his vehicle. This assistant was there also for Adolph and his personal needs and to maintain his home – to get him in and out of bed and in and out of a bath (with the use of an electric chair-lift), in and out of his vehicle, prepare his meals, do his laundry, and write his communications.
Getting to know Adolph was for me a truly amazing opportunity. One of the most vivid of the memories I have with him is of my first visit to his home. With the press of a button Adolph opened the lift door. With the press of another, Adolph led us into the lift. With the third press, he led us out of it – and then the wonder of it for me. With the next press his front door opened and all the lights of his apartment came on.
All these had been made possible by an individual who knew his rights, appropriate technology and a welfare state that acknowledged that all its citizens had the same rights to the best quality of life and a state that ensured it.
As a citizen of his country and because of his disability, Adolph was entitled to the apartment, the chair, the helper, the job, and to the other requirements he had. These were his rights as a citizen. It was the responsibility of the state, to have them met by the City Council serving the area in which his home was located.
In the course of his work Adolph was also required to travel abroad on occasion. This he did with his partner, his chair, his ventilator and all. And airlines were required to accommodate and meet the requirements necessitated by his disability. A truly amazing individual I was honoured to know, together with a charming partner.The changing world of disability. And within that, changing experiences for me. Now memories.
Annie
Annie was one of those patients who had a profound impact on me. I was doing my first night duty when Annie came into my life. I had been placed on the Private Ward which consisted of about twelve separate rooms. The Night Sister was known to be a bit of a snob. We all knew that she selected with care those nurses who she would put in the Private Ward. Those selected were always from a certain background. They would have paid for their education and attended a well-known school. She had obviously found out that I qualified in both areas even though it had been in faraway Ceylon.
The Private Ward was next to Ward Seven which was a short-stay Female Ward. Joining the two was a single room which belonged to Ward Seven. As she briefed me for my first night on duty, Night Sister said to me, “Nurse Padi, you have been given another job to do. You will look after Annie who is the patient in that end room belonging to Ward Seven. Annie needs special care and we think you can give her that.” During the day, Annie was the responsibility of Ward Seven. At night, she was mine.
Night Sister took me aside to brief me further in relative confidentiality. I learned that Annie was thirteen years old and had “sarcoma” or bone cancer. She had secondary tumours all over her body. She was in pain all the time. She was sedated heavily in an attempt to make her comfortable; she was almost always asleep, but there was a limit to that and she still felt intolerable pain; so much pain that she would not move, as a result of which Annie had bedsores on many parts of her body; so much pain that she did could not bear to be touched.
Because of all this, Night Sister told me she must be turned over in bed every three hours; and at least four nurses were required to do that in a way that would cause the least discomfort to Annie. Night Sister would send me three colleagues from other wards to help me turn Annie every three hours.
And so it was with much trepidation that I walked into Annie’s room that night. My colleagues had arrived at the pre-arranged time and we set about our task as gently as we could. Before entering her room, we had arranged between us how we would do that.
On removing the especially light covering sheet Annie’s eyelids fluttered, that was her only response. What we saw was a little girl who looked no more than eight or nine years old in age and in size. It appeared as though her illness had caused Annie to shrink. She was rolled into a ball and would not open her eyes when I addressed her and told her softly what we were going to do.
The sheets she lay on were soaked with the discharge from her bed sores. They smelled bad. We lifted her gently to change her sheets and then lay her down on her other side.Soft moans and groans from Annie turned into a crescendo of ear-wrenching screams as soon as she felt our hands on her. And then when she was back down on the bed, when she was free of our hands, she returned to the soft moaning and groaning. This three times a night, night after night.
Night Sister had told me when she briefed me the first time that the doctors did not expect Annie to live through that night. She told me this using other words every night for the next ninety nights. This routine of turning Annie continued on every one of those nights. And on those nights, as I had with Fernao and with many other patients, I spent as much of the little free time I had sitting by Annie’s bedside, talking to her or singing softly to her. And every night I was drawn closer to Annie in her unceasing and increasing pain. And then, during the last night of my three-month spell, Annie passed away.
I was devastated. I could not stop crying. Why tonight? Why could she have not lived another night? Everybody in the hospital came to know of my reaction and many shared my sorrow. I could not be comforted. So much so that Matron sent for me. She was gentle with me. She told me it would be best if I took my two-week summer vacation sooner than planned. She said a break from the hospital routine would do me good.
by Dr Gotabhya Ranasinghe
Senior Consultant Cardiologist
National Hospital Sri Lanka
When we sought a meeting with Hon Dr. Ramesh Pathirana, Minister of Health, he graciously cleared his busy schedule to accommodate us. Renowned for his attentive listening and deep understanding, Minister Pathirana is dedicated to advancing the health sector. His openness and transparency exemplify the qualities of an exemplary politician and minister.
Dr. Palitha Mahipala, the current Health Secretary, demonstrates both commendable enthusiasm and unwavering support. This combination of attributes makes him a highly compatible colleague for the esteemed Minister of Health.
Our discussion centered on a project that has been in the works for the past 30 years, one that no other minister had managed to advance.
Minister Pathirana, however, recognized the project’s significance and its potential to revolutionize care for heart patients.
The project involves the construction of a state-of-the-art facility at the premises of the National Hospital Colombo. The project’s location within the premises of the National Hospital underscores its importance and relevance to the healthcare infrastructure of the nation.
This facility will include a cardiology building and a tertiary care center, equipped with the latest technology to handle and treat all types of heart-related conditions and surgeries.
Securing funding was a major milestone for this initiative. Minister Pathirana successfully obtained approval for a $40 billion loan from the Asian Development Bank. With the funding in place, the foundation stone is scheduled to be laid in September this year, and construction will begin in January 2025.
This project guarantees a consistent and uninterrupted supply of stents and related medications for heart patients. As a result, patients will have timely access to essential medical supplies during their treatment and recovery. By securing these critical resources, the project aims to enhance patient outcomes, minimize treatment delays, and maintain the highest standards of cardiac care.
Upon its fruition, this monumental building will serve as a beacon of hope and healing, symbolizing the unwavering dedication to improving patient outcomes and fostering a healthier society.We anticipate a future marked by significant progress and positive outcomes in Sri Lanka’s cardiovascular treatment landscape within the foreseeable timeframe.
by Fr. Emmanuel Fernando, OMI
Jesuit Fr. Aloysius Pieris (affectionately called Fr. Aloy) celebrated his 90th birthday on April 9, 2024 and I, as the editor of our Oblate Journal, THE MISSIONARY OBLATE had gone to press by that time. Immediately I decided to publish an article, appreciating the untiring selfless services he continues to offer for inter-Faith dialogue, the renewal of the Catholic Church, his concern for the poor and the suffering Sri Lankan masses and to me, the present writer.
It was in 1988, when I was appointed Director of the Oblate Scholastics at Ampitiya by the then Oblate Provincial Fr. Anselm Silva, that I came to know Fr. Aloy more closely. Knowing well his expertise in matters spiritual, theological, Indological and pastoral, and with the collaborative spirit of my companion-formators, our Oblate Scholastics were sent to Tulana, the Research and Encounter Centre, Kelaniya, of which he is the Founder-Director, for ‘exposure-programmes’ on matters spiritual, biblical, theological and pastoral. Some of these dimensions according to my view and that of my companion-formators, were not available at the National Seminary, Ampitiya.
Ever since that time, our Oblate formators/ accompaniers at the Oblate Scholasticate, Ampitiya , have continued to send our Oblate Scholastics to Tulana Centre for deepening their insights and convictions regarding matters needed to serve the people in today’s context. Fr. Aloy also had tried very enthusiastically with the Oblate team headed by Frs. Oswald Firth and Clement Waidyasekara to begin a Theologate, directed by the Religious Congregations in Sri Lanka, for the contextual formation/ accompaniment of their members. It should very well be a desired goal of the Leaders / Provincials of the Religious Congregations.
Besides being a formator/accompanier at the Oblate Scholasticate, I was entrusted also with the task of editing and publishing our Oblate journal, ‘The Missionary Oblate’. To maintain the quality of the journal I continue to depend on Fr. Aloy for his thought-provoking and stimulating articles on Biblical Spirituality, Biblical Theology and Ecclesiology. I am very grateful to him for his generous assistance. Of late, his writings on renewal of the Church, initiated by Pope St. John XX111 and continued by Pope Francis through the Synodal path, published in our Oblate journal, enable our readers to focus their attention also on the needed renewal in the Catholic Church in Sri Lanka. Fr. Aloy appreciated very much the Synodal path adopted by the Jesuit Pope Francis for the renewal of the Church, rooted very much on prayerful discernment. In my Religious and presbyteral life, Fr.Aloy continues to be my spiritual animator / guide and ongoing formator / acccompanier.
Fr. Aloysius Pieris, BA Hons (Lond), LPh (SHC, India), STL (PFT, Naples), PhD (SLU/VC), ThD (Tilburg), D.Ltt (KU), has been one of the eminent Asian theologians well recognized internationally and one who has lectured and held visiting chairs in many universities both in the West and in the East. Many members of Religious Congregations from Asian countries have benefited from his lectures and guidance in the East Asian Pastoral Institute (EAPI) in Manila, Philippines. He had been a Theologian consulted by the Federation of Asian Bishops’ Conferences for many years. During his professorship at the Gregorian University in Rome, he was called to be a member of a special group of advisers on other religions consulted by Pope Paul VI.
Fr. Aloy is the author of more than 30 books and well over 500 Research Papers. Some of his books and articles have been translated and published in several countries. Among those books, one can find the following: 1) The Genesis of an Asian Theology of Liberation (An Autobiographical Excursus on the Art of Theologising in Asia, 2) An Asian Theology of Liberation, 3) Providential Timeliness of Vatican 11 (a long-overdue halt to a scandalous millennium, 4) Give Vatican 11 a chance, 5) Leadership in the Church, 6) Relishing our faith in working for justice (Themes for study and discussion), 7) A Message meant mainly, not exclusively for Jesuits (Background information necessary for helping Francis renew the Church), 8) Lent in Lanka (Reflections and Resolutions, 9) Love meets wisdom (A Christian Experience of Buddhism, 10) Fire and Water 11) God’s Reign for God’s poor, 12) Our Unhiddden Agenda (How we Jesuits work, pray and form our men). He is also the Editor of two journals, Vagdevi, Journal of Religious Reflection and Dialogue, New Series.
Fr. Aloy has a BA in Pali and Sanskrit from the University of London and a Ph.D in Buddhist Philosophy from the University of Sri Lankan, Vidyodaya Campus. On Nov. 23, 2019, he was awarded the prestigious honorary Doctorate of Literature (D.Litt) by the Chancellor of the University of Kelaniya, the Most Venerable Welamitiyawe Dharmakirthi Sri Kusala Dhamma Thera.
Fr. Aloy continues to be a promoter of Gospel values and virtues. Justice as a constitutive dimension of love and social concern for the downtrodden masses are very much noted in his life and work. He had very much appreciated the commitment of the late Fr. Joseph (Joe) Fernando, the National Director of the Social and Economic Centre (SEDEC) for the poor.
In Sri Lanka, a few religious Congregations – the Good Shepherd Sisters, the Christian Brothers, the Marist Brothers and the Oblates – have invited him to animate their members especially during their Provincial Congresses, Chapters and International Conferences. The mainline Christian Churches also have sought his advice and followed his seminars. I, for one, regret very much, that the Sri Lankan authorities of the Catholic Church –today’s Hierarchy—- have not sought Fr.
Aloy’s expertise for the renewal of the Catholic Church in Sri Lanka and thus have not benefited from the immense store of wisdom and insight that he can offer to our local Church while the Sri Lankan bishops who governed the Catholic church in the immediate aftermath of the Second Vatican Council (Edmund Fernando OMI, Anthony de Saram, Leo Nanayakkara OSB, Frank Marcus Fernando, Paul Perera,) visited him and consulted him on many matters. Among the Tamil Bishops, Bishop Rayappu Joseph was keeping close contact with him and Bishop J. Deogupillai hosted him and his team visiting him after the horrible Black July massacre of Tamils.
Sri Lanka-Singapore Free Trade Agreement
By Gomi Senadhira
senadhiragomi@gmail.com
“You might tell fairy tales, but the progress of a country cannot be achieved through such narratives. A country cannot be developed by making false promises. The country moved backward because of the electoral promises made by political parties throughout time. We have witnessed that the ultimate result of this is the country becoming bankrupt. Unfortunately, many segments of the population have not come to realize this yet.” – President Ranil Wickremesinghe, 2024 Budget speech
Any Sri Lankan would agree with the above words of President Wickremesinghe on the false promises our politicians and officials make and the fairy tales they narrate which bankrupted this country. So, to understand this, let’s look at one such fairy tale with lots of false promises; Ranil Wickremesinghe’s greatest achievement in the area of international trade and investment promotion during the Yahapalana period, Sri Lanka-Singapore Free Trade Agreement (SLSFTA).
It is appropriate and timely to do it now as Finance Minister Wickremesinghe has just presented to parliament a bill on the National Policy on Economic Transformation which includes the establishment of an Office for International Trade and the Sri Lanka Institute of Economics and International Trade.
Was SLSFTA a “Cleverly negotiated Free Trade Agreement” as stated by the (former) Minister of Development Strategies and International Trade Malik Samarawickrama during the Parliamentary Debate on the SLSFTA in July 2018, or a colossal blunder covered up with lies, false promises, and fairy tales? After SLSFTA was signed there were a number of fairy tales published on this agreement by the Ministry of Development Strategies and International, Institute of Policy Studies, and others.
However, for this article, I would like to limit my comments to the speech by Minister Samarawickrama during the Parliamentary Debate, and the two most important areas in the agreement which were covered up with lies, fairy tales, and false promises, namely: revenue loss for Sri Lanka and Investment from Singapore. On the other important area, “Waste products dumping” I do not want to comment here as I have written extensively on the issue.
1. The revenue loss
During the Parliamentary Debate in July 2018, Minister Samarawickrama stated “…. let me reiterate that this FTA with Singapore has been very cleverly negotiated by us…. The liberalisation programme under this FTA has been carefully designed to have the least impact on domestic industry and revenue collection. We have included all revenue sensitive items in the negative list of items which will not be subject to removal of tariff. Therefore, 97.8% revenue from Customs duty is protected. Our tariff liberalisation will take place over a period of 12-15 years! In fact, the revenue earned through tariffs on goods imported from Singapore last year was Rs. 35 billion.
The revenue loss for over the next 15 years due to the FTA is only Rs. 733 million– which when annualised, on average, is just Rs. 51 million. That is just 0.14% per year! So anyone who claims the Singapore FTA causes revenue loss to the Government cannot do basic arithmetic! Mr. Speaker, in conclusion, I call on my fellow members of this House – don’t mislead the public with baseless criticism that is not grounded in facts. Don’t look at petty politics and use these issues for your own political survival.”
I was surprised to read the minister’s speech because an article published in January 2018 in “The Straits Times“, based on information released by the Singaporean Negotiators stated, “…. With the FTA, tariff savings for Singapore exports are estimated to hit $10 million annually“.
As the annual tariff savings (that is the revenue loss for Sri Lanka) calculated by the Singaporean Negotiators, Singaporean $ 10 million (Sri Lankan rupees 1,200 million in 2018) was way above the rupees’ 733 million revenue loss for 15 years estimated by the Sri Lankan negotiators, it was clear to any observer that one of the parties to the agreement had not done the basic arithmetic!
Six years later, according to a report published by “The Morning” newspaper, speaking at the Committee on Public Finance (COPF) on 7th May 2024, Mr Samarawickrama’s chief trade negotiator K.J. Weerasinghehad had admitted “…. that forecasted revenue loss for the Government of Sri Lanka through the Singapore FTA is Rs. 450 million in 2023 and Rs. 1.3 billion in 2024.”
If these numbers are correct, as tariff liberalisation under the SLSFTA has just started, we will pass Rs 2 billion very soon. Then, the question is how Sri Lanka’s trade negotiators made such a colossal blunder. Didn’t they do their basic arithmetic? If they didn’t know how to do basic arithmetic they should have at least done their basic readings. For example, the headline of the article published in The Straits Times in January 2018 was “Singapore, Sri Lanka sign FTA, annual savings of $10m expected”.
Anyway, as Sri Lanka’s chief negotiator reiterated at the COPF meeting that “…. since 99% of the tariffs in Singapore have zero rates of duty, Sri Lanka has agreed on 80% tariff liberalisation over a period of 15 years while expecting Singapore investments to address the imbalance in trade,” let’s turn towards investment.
Investment from Singapore
In July 2018, speaking during the Parliamentary Debate on the FTA this is what Minister Malik Samarawickrama stated on investment from Singapore, “Already, thanks to this FTA, in just the past two-and-a-half months since the agreement came into effect we have received a proposal from Singapore for investment amounting to $ 14.8 billion in an oil refinery for export of petroleum products. In addition, we have proposals for a steel manufacturing plant for exports ($ 1 billion investment), flour milling plant ($ 50 million), sugar refinery ($ 200 million). This adds up to more than $ 16.05 billion in the pipeline on these projects alone.
And all of these projects will create thousands of more jobs for our people. In principle approval has already been granted by the BOI and the investors are awaiting the release of land the environmental approvals to commence the project.
I request the Opposition and those with vested interests to change their narrow-minded thinking and join us to develop our country. We must always look at what is best for the whole community, not just the few who may oppose. We owe it to our people to courageously take decisions that will change their lives for the better.”
According to the media report I quoted earlier, speaking at the Committee on Public Finance (COPF) Chief Negotiator Weerasinghe has admitted that Sri Lanka was not happy with overall Singapore investments that have come in the past few years in return for the trade liberalisation under the Singapore-Sri Lanka Free Trade Agreement. He has added that between 2021 and 2023 the total investment from Singapore had been around $162 million!
What happened to those projects worth $16 billion negotiated, thanks to the SLSFTA, in just the two-and-a-half months after the agreement came into effect and approved by the BOI? I do not know about the steel manufacturing plant for exports ($ 1 billion investment), flour milling plant ($ 50 million) and sugar refinery ($ 200 million).
However, story of the multibillion-dollar investment in the Petroleum Refinery unfolded in a manner that would qualify it as the best fairy tale with false promises presented by our politicians and the officials, prior to 2019 elections.
Though many Sri Lankans got to know, through the media which repeatedly highlighted a plethora of issues surrounding the project and the questionable credentials of the Singaporean investor, the construction work on the Mirrijiwela Oil Refinery along with the cement factory began on the24th of March 2019 with a bang and Minister Ranil Wickremesinghe and his ministers along with the foreign and local dignitaries laid the foundation stones.
That was few months before the 2019 Presidential elections. Inaugurating the construction work Prime Minister Ranil Wickremesinghe said the projects will create thousands of job opportunities in the area and surrounding districts.
The oil refinery, which was to be built over 200 acres of land, with the capacity to refine 200,000 barrels of crude oil per day, was to generate US$7 billion of exports and create 1,500 direct and 3,000 indirect jobs. The construction of the refinery was to be completed in 44 months. Four years later, in August 2023 the Cabinet of Ministers approved the proposal presented by President Ranil Wickremesinghe to cancel the agreement with the investors of the refinery as the project has not been implemented! Can they explain to the country how much money was wasted to produce that fairy tale?
It is obvious that the President, ministers, and officials had made huge blunders and had deliberately misled the public and the parliament on the revenue loss and potential investment from SLSFTA with fairy tales and false promises.
As the president himself said, a country cannot be developed by making false promises or with fairy tales and these false promises and fairy tales had bankrupted the country. “Unfortunately, many segments of the population have not come to realize this yet”.
(The writer, a specialist and an activist on trade and development issues . )
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