Much needed State Minister for Covid-19 prevention

The appointment of Dr. Sudarshani Fernandopulle M.P. as the State Minister-in-charge of Primary Healthcare, Infectious Diseases and Covid-19 Prevention, is a step in the right direction made by the government at this critical time. Dr. Fernandopulle, a Specialist Medical Officer in Community Medicine, has vast experience working as a Medical Officer of Health in several areas, and as a Consultant Community Physician at the Family Health Bureau. She is the most suitable parliamentarian to be appointed to this newly created post. The creation of this State Ministry is a timely decision made by the government, at a time when the need for enhancement of preventive healthcare and epidemic control has become a national need, to get away from this impasse regarding Covid-19 control.

Primary Health Care encompasses health education on prevailing health problems, nutritional promotion, maternal and child healthcare, local disease control, supply of water and sanitation, etc. These components actually help in the prevention of diseases and epidemics. The World Health Organization gives priority to these components to enhance the health of the people or communities in different corners of the world, although in Sri Lanka they had taken a back-seat in the recent past. The present Covid-19 epidemic has again put preventive healthcare in the hot seat, and it was inevitable that the government noticed the need to improve that system.

Covid-19 is now rampant in the Colombo Municipality area and the Ministry of Health has become highly worried. The reasons for the above are breakdown in primary healthcare services, lack of understanding of epidemic control, and shortage of qualified staff to run critical services. The main reason for Covid-19 patients dying at home was lack of knowledge about the disease, the breakdown in communications between people and public health services in the CMC, and disorganization of the communities in the lockdown areas. Health Education and promotion of health has taken a back seat in the Colombo MC as there isn’t a single qualified Health Education Officer for the City. The Health Instructors who linked the people in the poorer areas with the Colombo Municipal Council are hardly there, and they no longer organize the people and form Community Development Councils, which looked after the needs of the people in the respective settlements or apartment complexes. The same goes for the Public Health Inspectors who are less than the required number, the Public Health Midwives and Nurses. The maternity homes are closed, the Public Health Laboratory Services are depleted due to lack of material and staff, and food safety has taken a back-seat. To cap it all, the city has failed to fill the post of Epidemiologist, which is at the level of a Deputy Chief Medical Officer of Health rank, during the past three years. I understand that even the room assigned to this post has been taken over by another. That was the importance given to epidemic control in the main city of Colombo.

The situation in Colombo is the immediate concern the new Minister will have to handle, as without intervening and restoring the above services there, we cannot think of getting rid of the Covid-19 menace. If we do not do that the epidemic will first engulf the whole city and then move out of Colombo and spread into other cities and districts. Therefore, I hope the Hon. Minister will study the situation independently, and take necessary action to fill the posts and restore the services immediately; even by using the staff of the Ministry of Health.

Dr. PRADEEP KARIYAWASAM

Former Chief Medical Officer of Health, CMC