Features
Teaching physiotherapy in Colombo, a workshop in Indonesia & contact with WHO
Excerpted from Memories that Linger: My journey in the word of disability
by Padmani Mendis
Knowing how to teach using the scientific method gave me confidence in my work. It was during my time at Guys that participatory and learner-centred teaching came to be used in pedagogy. Helen, our tutor, had made sure we knew these well. I now had the chance to use them with responsibility to benefit my students.
They responded well. With the first course that I started using these approaches, all the students passed the final examination, not a usual occurrence at the school. Examiners, included as well as physiotherapy tutors, medical consultants specialised in certain areas. With this batch of students, I had helped Mrs. Thera Fernando, Senior Tutor, to introduce a Community Field Training Module into the curriculum in the second year. The University of Colombo, Department of Community Medicine, our neighbour, gave us permission to use their field training area for our students.
This was the Ethul Kotte Medical Officer of Health or MOH area. On Friday mornings for twelve consecutive weeks our students in pairs visited ten homes within a specified area. On visits, they studied the health of members relating that to their socio-economic situation. Included was a focus on finding those who had mobility problems.
After a break for lunch, in the early afternoon session back at the school, we had a discussion of their findings and what they may do about it. We focused on the advice they would give the family. A record of all this they kept and were assessed on it. This was the first occasion that student therapists and even I, for that matter, had exposure to what community living for this, the poorer segment of our urban society, was like.
Embarking on an International Career
Now at last I really enjoyed working as a physiotherapist in Sri Lanka. Perhaps because I was teaching it. But this would not be for long. I would soon have the opportunity to use this knowledge and experience and journey on to something even more rewarding.
The memories of these new opportunities I would have I will start sharing with you in the next section called “Three Pioneers in Geneva”. In this section I have recalled how my work for the World Health Organization or WHO came about. And how I helped WHO to develop a new strategy for rehabilitation which came to be called Community-Based Rehabilitation, well-known as CBR.
CBR was more successful than one could have imagined. The demand for it grew and I was called upon to visit an ever-increasing number of countries for follow-up, monitoring, evaluation, planning, teaching, and expansion of this strategy. I was required to spend more time in these several roles continuing my journey in disability over the next few decades to promote the global development of CBR for disabled people.
To do this and to balance it with my home life with Nalin, I gave up teaching at the school in 1981. I would miss my students and my colleagues.
How My Work for WHO Came to Be
The year was 1978. I was teaching at the School of Physiotherapy of the Ministry of Health in Colombo. My colleague and boss Thera Fernando had just been nominated by the Department of Health to attend a meeting on Disability and Rehabilitation organised by the World Health Organisation or WHO to be held in Solo, Indonesia in December of that year.
Since she had attended the previous meeting on the same subject in Indonesia, she suggested to the department that I be nominated instead. Very unusual in those days when competition was rife to grab any and every trip abroad. But she was an unusually unselfish person.
Named first was a medical specialist in rheumatology and I was the second nominee. We were to travel together to Indonesia. As pre-workshop preparation, WHO called for two documents which would then be presented at the workshop. One was a Situational Analysis of Disability and Rehabilitation in Sri Lanka and the second was a Plan of Action to introduce what was then called Disability Oriented Rehabilitation to improve the lives of disabled people. Being the junior nominee in a hierarchical health sector the task of preparing these two documents fell on me.
And did I not carry out the task with joyful enthusiasm! As I shared with you, I had returned from the UK and Denmark a few months earlier having followed a two-year diploma course on the teaching of physiotherapy in London and having obtained some practical experience of it in London and Denmark. Well-versed in objectives, strategies, activities, plans of action, monitoring, evaluation and anything and everything else that goes with that, I was up to the task.
The Situation Analysis and the Plan of Action were prepared. So were presentations that were to be made in Solo. This was through the use of transparencies and overhead projectors, long before the advent of computers and multimedia equipment.
I started sharing my memories with you in my belief that I was, since my birth, blessed with good fortune. Some 40 years later, I believe it was that same good fortune that brought me face-to-face with Dr. Einar Helander at this meeting in Indonesia. Dr. Einar Helander had come from WHO, Geneva to facilitate the workshop. He was in charge of the Disability Prevention and Rehabilitation Programme at headquarters. This meeting led to my participating as a co-pioneer of Community-Based Rehabilitation or CBR for the World Health Organisation.
Interruption – Why Disabled People?
Before going further, you may wonder at my use of the description “disabled people”. There is a demand from many Disability Groups and Movements that they be referred to as “persons with disabilities”. It is mandatory now in the UN system that they be called so. There are however scattered groups and individuals, including disabled people, who see this differently and I am one of those.
People who have disabilities are, first and foremost human beings like you and me. They are that part of humanity that have been made disabled by society. Society does so primarily by considering them to be some other kind of human being, essentially different from us who are “normal”.
Society stigmatises them; by seeing only what they cannot do and not what they can do or have the capacities and potential to do; by not providing within our societies facilities that would enable them to do what they can do as human beings. That which would enable them to enjoy their rights as human beings. That which would enable them to carry out their role as citizens – such as adapting education systems with relevant legislation to meet the needs of all children and youth which will then include those who have disabilities participating alongside their peers; adapting transport and public spaces so that all people can use them, be they young or old or have disabilities, and so on.
By not doing these things it is we who disable them. It is not the fault of those that are born with or acquire disability at some point in their life. It is Society that creates disability.
Changing this first and foremost requires an acceptance that this is the fact, that this is the truth. Then only can we bring about change in our beliefs and attitudes so that we accept them as one of us; so that we make a change in our systems and services to enable them to access their right to share in the benefits of being a member of our families, of our communities and of global society; so that they could play their part and take responsibility within these as we do.
This is a Vision. But until we are well on the path to reaching that vision, Society will continue to be responsible for their situation. Society will continue to create disability. They will remain disabled people.
Back to Solo, Indonesia
The first day of the workshop in Solo was a novel experience. Thirty or so participants from the South-East Asian Region of WHO were present. Proceedings began with the customary round of introductions. I was floored when I realised that all bar one were medical specialists. Most in orthopaedic surgery, a few in rheumatology which was a relatively new speciality at the time. And yours truly was the only physiotherapist.
But I had youth on my side together with confidence because I had prepared for the workshop. Sri Lanka’s presentation was to be in the afternoon. I had handed over to my senior partner all the documents for presentation and briefed her on them. The time came for presentation, Sri Lanka was announced.
And lo and behold my senior partner got cold feet. She pushed the papers towards me with the words, “You present.” I tried to persuade her but her feet stayed cold. So I carried out my duty. That I had done so successfully was clear by the barrage of questions that I was asked at the end of the presentation.
And the challenge issued to me by the most senior orthopaedic surgeon of them all and the most eminent of the eminent. And what is more, from India – from the most prestigious rehabilitation institute in Bombay. This was, “We will see how Sri Lanka is going to do that.” Well I am happy to say that over the next few decades Sri Lanka did do a lot of that. Some of which I hope to share with you later in my memories.
Over the next few days we had many small group exercises, problem solving and plenary discussions. On the third day Dr. Helander called me aside and asked me whether I would have dinner with him. That evening we took two “Cyclos” which you may know as cycle rickshaws. I had been carried in a rickshaw to school when I was quite young. I was then staying with my cousins and the “rickshaw coolie” was sent for when their car which usually took us was not available. We had now progressed from man power to pedal power.
We went to a pleasant Indonesian restaurant. Einar, as he insisted on being called now, asked about me and my life back home. I asked about him and his family. And then he sprang a surprise on me. He asked me seemingly as a matter of course whether I would “do some work” for him. I thought perhaps that he would ask me to do some writing for him while sitting at home. Of course I agreed. There was no more talk about the subject for the rest of the week. I returned to Colombo content that I had made my contribution.
But many years later, when we were friends and colleagues working on a common agenda, I asked him about that workshop in Solo. I questioned him as to why he asked what he did and selected me without knowing me, for the pioneering work that he, Gunnel and I did together. He said it was because, “Every time I came round to your group you were challenging those eminent medical men.” Further, he said that I was, “doing it so very politely in a way that made them accept you.”
He did not refer to respect. But respectful I was, taking heed of their age and experience. If I had not done so, they would without doubt have crushed me to a pulp.
An Unexpected Invitation
Time passed. It was now a day in February 1979. I had just recently celebrated my 40th birthday with my family. The postman came as usual in the morning. Unusually though there was a letter indicating on the envelope that it was from WHO Geneva. I wondered, “What is this about?”
Soon to find out that it was from Einar, inviting me to come to Geneva for three months and undertake a short-term consultancy. I would be required to carry out a task preparing a Manual for implementing “Community-Oriented Rehabilitation”. My co-consultant would be Ms. Gunnel Nelson from Gothenburg, Sweden. He would work with us as well. I was expected in Geneva on May 15.
What excitement! With an increasing heart beat I ran next door to where my parents-in-law lived. Reading the letter, they shared my excitement and were oh so happy for me. In that excitement I remember saying foolish things to them – things like, “What on earth is community-oriented rehabilitation?” and “But I don’t know how to write a manual”, “What is a manual?” And I could hardly wait until Nalin came home from work to show him this marvellous letter.
That workshop in Solo marked a turning point in my life. It took me to an invitation to WHO Headquarters in Geneva to be a Consultant on the Disability and Rehabilitation Programme.
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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