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Sunday, March 3, 2024

With Malaria, Avoid All Indians – Sri Lanka Doctors’ New discovery

(GMOA General Secretary Dr Nalinda Herath addressing news conference on 10th April)

GMOA Secretary Dr. Herath’s amazing warning to public.

By don Mituna.
No one has the foggiest as to what the Economic and Technology Cooperation Agreement (ETCA) to be signed by Sri Lanka and India really is for the simple reason that no details as to its exact terms and clauses have so far been revealed.

But this has been no impediment for the Government doctors union, the GMOA, from launching a no-holds-barred campaign against its signing and subsequent implementation based on what has trickled down the grapevine. The possibility raised by some that Indians will be allowed to enter the Lanka job market has sent the doctors’ union up the gum tree, like it has done no other professional body.

Fearing an Indian medical invasion by an army of Indian doctors will commandeer Lankan doctors’ employment, the GMOA has raised the red flag and threatened to launch nationwide strikes if ETCA is implemented, the same tactic they adopted to protest against the Government’s decision to withdraw the vehicle permit for doctors recently. More and more the GMOA has shown all the signs of turning from a professional body into a ragamuffin group of political activists whose sole interest had been to further their financial benefits.

They have abandoned their duty to demand of the Government better medical facilities for their patients, to fight for sufficient drugs to be available at government hospitals and at the Maharagama Cancer hospital, to call for better monitoring of the activities of private hospitals and private teaching hospitals and to act to advance the cause of their patients. Instead they have taken patients hostage and held their lives to ransom to win demands for themselves. In their quest to fill their coffers, they have had no qualms in using patients to fill coffins, if need be.

But now their anti-ETCA protest has taken a bizarre turn and shown that, in the depths to which they have sunk to achieve their aims, they have found a deeper still to stoop. The GMOA General Secretary Dr Nalinda Herath has thought it fit to pounce on an isolated case of an Indian national working in a construction site in Nuwara Eliya who has contracted malaria in the first week of this month and to hold his illness as a warning to the Lankan public as to what will happen if the ETCA agreement goes ahead and opens the floodgates for Indian doctors to come to Lanka and work here on a long term basis.

On Monday, the GMOA General Secretary held a media conference. The subject that hung heavy on his mind was this Indian who had taken ill. His concern, however, was not how the patient was faring and what steps have been taken to alleviate his medical condition or how he had come to acquire the mosquito borne disease. His motive was pure and simple: to use this case as evidence to brand a billion Indians as foul disease carriers who should not be touched with a barge pole. His aim was to cause widespread alarm amongst the public that if ETCA is signed by the Lankan Government, the nation will be embroiled in a malarial epidemic again.

“After 2012 there have been no cases of malaria been contracted in Lanka,” the GMOA’s Secretary Dr. Herath declared at the media conference. “But there have been cases where locals returning from Africa or India with malaria. There have also been cases where Indian tourists and other foreigners have come to Lanka with malaria. This case is one such instance. But in this case there is a difference. Though this man had come on a tourist visa he had not come to tour the land. For several months he had been working as a carpenter in Nuwara Eliya. This must not be taken lightly. Merely because malaria is not there today in Lanka if we allow people to come from epidemic ridden countries and allow them to stay here freely, then once more there will be a malaria epidemic in this country.

“As recently as the year 2000, Sri Lanka had over 100,000 cases of malaria,” Dr Herath continued. “In 2012 malaria was eradicated. Our doctors and health officials worked hard to gain this remarkable achievement of making the country free of local cases of Malaria. We should not let it destroyed by any one. Indians have already started to work in our country even before the proposed ETCA is finalised. And as a result of that, our health status is dragging into danger slowly. If the ETCA is finalised, the situation will get worse. The authorities should do something to this in advance.”

Get the drift. One man’s infection has been raked up to raise a ruckus over ETCA and damned our billion Indian brethren as a diseased lot. With one swab dipped in vitriol Lanka’s closest neighbour and friend stands condemned as a diseased, epidemic ridden, malaria infected state whose citizens are walking corpses with malarial time bombs fused to explode without warning, infecting those in the vicinity indiscriminately. Run if you can or slink into the alley if you see one coming is the message. And if ECTA is signed it will be curtains for Lanka’s medical health.

So what must Dr. Nalinda Herath, the General Secretary of the Government doctors’ union, the GMOA, see this Sunday morning as he stares at his face in the mirror before leaving home to do his hospital rounds — or will it be to do his political trade union work on behalf of his members, Avurudhu Sunday notwithstanding?

Will he see a smug smile mushroomed on his shaved mug, flattered to bits of how he had singlehandedly struck a blow for his members last Monday when he exploited the ill health of a human being to make political capital and advance the GMOA interest? Will the smile be wreathed in glee when he recalls how he had ruthlessly used an Indian’s medical plight to protect the medical fiefdom of his members from Indian invasion? Especially from the thousands of Indian doctors whom the GMOA fears will pour into Lanka once the Government signs the ECTA agreement with India even though the terms of the agreement remain under wraps?

But even if Indian doctors are already packing their stethoscope into their medical bags and kissing their nurses goodbye before leaving for Lanka’s disease-free shores, was it right of him to have held up to scorn and ostracism the unfortunate case of an Indian who was diagnosed for malaria in Nuwara Eliya? Was it right for Dr. Nalinda Herath to have branded a billion Indians as possible carriers of foul diseases?

According to him the case of the Indian found in Nuwara Eliya is different because though this Indian has come on a tourist visa he has not come to tour the country. He had been staying in Lanka and had been working on a construction site in Nuwara Eliya for several months.

But according to established medical research, the signs and symptoms of malaria appear within 8 to 25 days of a person being bitten by a mosquito. In severe cases referred to as falciparum malaria it is nine to thirty days. If that is the case then did this particular Indian, who Dr. Nalinda Herath says has spent several months in Lanka, bring a malaria carrying mosquito in his hand luggage from India? Was the mossie released by him accidently a month ago when he unzipped his bag for a change of shirt? Funny, isn’t it when you consider the mosquito’s life cycle comprised of the egg, larval, pupal and adult stages, is just 14 days? It must also be noted that malaria is transmitted to humans solely through the mosquito. It is not transmitted by air or touch. It is like the dengue mosquito now rampaging in Lanka.

Perhaps malaria carrying mosquitoes are not dead for good in Lanka, after all. Hasn’t the thought crossed Dr. Nalinda’s medical mind that the poor Indian instead of importing Malaria from India may have, to his misfortune, contracted it here, even as he can contract dengue in Lanka from the dengue carrying mosquito?

Of course, in certain cases malaria can recur after a symptoms free period. Recrudesce and re infection can occur within two weeks. Relapses can occur with 8-24 weeks though in certain malaria cases it can happen a year after the mosquito bite or even years after the first infection but this is rare. Research statistics show that in 2013 the average duration to diagnose malaria after arriving in Lanka was 3.6 days. All imported cases of malaria had been detected within 18 days of arrival from abroad though nothing is known of those who may have suffered relapses later.

As the GMOA’s own website states in an article published this month on malarial imports, ‘Although indigenous transmission of malaria has been controlled, Sri Lanka still gets imported malaria cases mainly from India and African countries. At present Sri Lanka is challenged with maintaining the achieved success as the potential for malaria resurgence is high as in the past due to presence of vector and increased migration to and from malaria endemic countries. There were 36 imported malaria cases in 2015, which includes 17 cases each of Plasmodium vivax and Plasmodium falciparum and two cases of Plasmodium ovale. In 2016 there were 14 cases of imported malaria up to March 2016.”

So why was the Nuwara Eliya Indian’s case any different and why did Dr. Herath strive to make it different? Even if the Indian has suffered a relapse, the same can apply to any Indian tourist who arrives in Lanka and finds that he has suffered a relapse of the Malaria he had contracted a year or even years before back in India? What difference does it make whether he is an Indian who comes as a tourist or a doctor or a carpenter who comes as a worker? The danger of an epidemic breaking out is the same. What has ETCA got to do with it?

In 2013 there was no ETCA in the horizon but imported malaria cases abounded. The discovery of an Indian with malaria who had stayed here for several months is nothing new for Dr. Herath to hold media conferences and ring the alarm bells. A person who has once been infected of malaria can suffer a relapse at any time. It can happen to anyone of the twenty thousand Indians who come as tourists to Lanka every month on average. Or to any one of the thousands of Lankans who visit India on business, on holiday or on pilgrimage to the birth place of the Buddha, Dambadiva. Should they contract malaria, the relapse can occur in Lanka years after the first attack.

On that same basis, if indeed malarial imports were such a huge threat to Lanka’s good health as Dr. Herath painted it to be, what Dr. Herath should have asked for – to take it to its logical conclusion – is a complete ban on all Indian tourists and a complete travel ban for Lankans to visit India? Why the hush on that?

Is it because all he is interested in is to say that ETCA which may allow doctors to work in Lanka can also bring malaria and therefore the agreement should be abandoned? The inescapable fact that the thousands of tourists who come from India and the thousands of Lankans who return from India each month can also bring malaria with them and walk through the green channel without declaring it, is conveniently ignored by him not only for the implications such an issue will raise but because it will negate what he seeks to achieve which is to strangle ETCA at birth with the malarial virus Plasmodium ovale.

His true motive has been starkly revealed. So have the narrowness of his mind and the logical fallacy of his argument forwarded to justify the tearing up of ETCA.

But does this new anti-Indian phobia justify the GMOA to sink to the sewers of human callousness and denigrate, beyond cleansing even after sterilising, the immense respect and honour millions in Lanka still confer upon doctors? Consider the climax to Dr. Herath’s media conference on Monday where he delivered a special message to the Lankan public.

Without a blush of remorse at his own oozing callousness he tells the media conference: “The message I have to give the public is that when there is a dengue epidemic we tell the public to be careful of their environment and not to let water collect and not let mosquitoes breed. When there is a rabies outbreak and if you want to escape from getting it, we tell the public to be cautious of stray dogs. In the coming days we like to tell the people of this country that soon if Indian nationals come to your areas and stay near your homes then to be very cautious of all Indians.”

What a boorish, uncaring, downright callous, insensitive statement for a Lankan doctor sworn to the Hippocratic oath and, as secretary of the Government Medical Officers Association, the chief representative of more than 16,000 doctors in this country to gratuitously make against an entire nation of people – the citizens of Lanka’s closest neighbour and friend – merely in order to create a mass anti-Indian feeling to torpedo a proposed economic and technological cooperation agreement the exact terms of which he is not even aware?

How would Lankans feel if Indian doctors were crass enough to take the same perverse line and stigmatise all Lankans as dengue carriers and asked the Indians to shun Lankan pilgrims visiting Buddha Gaya like lepers were avoided in an unenlightened era not long ago or like street mongrels are shunned during a hydrophobia outbreak? How will such an unwanted cussed comment cast by Indian doctors reflect on the state of the medical profession in India? Perhaps it is time the 16,000 members of the GMOA considered the suitability of Dr. Herath to occupy the position of General Secretary of their union and to represent them as their chief spokesman in this unbecoming manner which revolts all sensitivities and reveals lack of compassion toward the ill and suffering. Perhaps they should dole out the same treatment to him that he prescribes to the nation to give to Indian visitors loitering in the vicinity.

(Original Caption:With rabies, avoid stray dogs; with malaria, avoid all Indians)

Sunday Times


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