Letters to the Editor

17th June 2001

Towards better mental health care

My enthusiasm about promoting mental health care was at a very low ebb when I read the forthright remarks made by Dr. B. Waidiyasekera in the course of his recent presidential address at the Sri Lanka Psychiatric Association-(The Sunday Times, May 27).

After 15 years of unstinted effort towards the elevation of mental health care from the absymal depths it appears to be consigned to, I was in a mood to agree with much of what Dr. W. had to say, disagree with some of it, and also make a few suggestions as to how a "rescue plan" could perhaps be launched.

Our country requires a whole bunch of "rescue plans", ranging from anti-pollution measures to stemming the tide of widespread corruption.

Stemming the fast rising tide of mental ill-health is paramount to the whole continium of prevailing uncertainty that reaches beyond basic mental illness to encompass psychosomatic and psycho- social problems. Ironically, inmates of mental hospitals are, in a sense, protected against this onslaught. And as Dr. W. says, the expansion of community-based facilities to deal with mental disorders needs careful research and experimentation, with a view to changing the mindset of Sri Lankans, with its high proclivity to social stigma and avoidance of thinking about mental illness, let alone associating with it.

A great shortage, not only of psychiatrists, but also of all categories of mental health care personnel, is another major problem.

It is estimated that only three percent of persons with mental disorders get the required treatment. These factors have a bearing on the ambivalence in providing adequate care for people with mental illnesses, both major and minor. Solutions need to be found, and it is interesting that in the seventies, mental hospitals functioned as therapeutic communities. This is an ideal approach, but it need not be confined to mental hospitals. It should encompass the entire spectrum of mental health care.

Speaking as a care-giver as well as a care consumer, who has been closely connected, on behalf of the NGO sector, with various measures, such as the revision of the National Mental Health Act; Five Year Mental Health Plan, and the establishment of a National Institute of Mental Health, I feel that psychiatrists should participate in all aspects of enhanced mental health care.

Diagnosis and treatment of mental illnesses are two vital components. Rehabilitation too requires psychiatric collaboration. It may be noted here that when A. H. M. Fowzie was Minister of Health, the NGO sector presented a proposal for the setting up of a National Mental Health Centre, which was viewed favourably by Mr. Fowzie, who asked for a Constitution to be drawn up. The then Advisory Council for Mental Health, however, felt such a centre was not necessary.

The setting up of a National Institute of Mental Health is, as mentioned, the essential first step to be undertaken. It would ideally involve all categories of care givers, i.e. the public, private service and NGO sectors, and concerned persons, parents and patients themselves. Maybe a commission to formulate plans for future mental health care is the answer. Or isn't it? Prevention of an epidemic of mental ill health, as predicted in the Harvard Report, commissioned by the U.N. is a national concern. Self-help, is an alternative approach, which requires more than the transfer of a vision into a mission. It involves a spiritual element.

Malini Balasingam
Uswetakeiyawa

Killing himself and others

I saw a middle-aged man with his wife and two children seated in a 131 bus at Maharagama junction. The man was smoking a cigarette, which is not a common sight nowadays. When I objected to his smoking in the bus, his response was that I should get off.

This proves that there are foolish and ignorant people among us who not only endanger themselves but also others.

It is difficult to understand the attitude of such irresponsible and senseless fathers who smoke in the presence of their children.

Jeewaka Maithri
Nugegoda

Derailed hi-tech trains

I refer to Lincoln Wijey-singhe's letter "Bring on the experts" (The Sunday Times, April 29) calling for the electrification of the railway.

I have a clipping of a news item by Arshad M. Hadjirin, "Electric train, a reality by 2000", from The Sunday Times of September 22, 1996. We have waited nearly five years, but nothing has happened.

The news item stated that Sofrerail (France), Pacific Consultants Inc. (Japan), Louis Berger Inc. (USA) and Jarts (Japan) have confirmed in their reports that the project was feasible.

What does the Public Enterprises Reforms Commission have to say about this project? P. Rajagopal, Advisor on Transport to the then Minister had presented a report detailing the technicalities of the project which was to have been commissioned last year. This report also pointed out that the CEB would not be able to meet the power requirements of the project.

What about the monies spent by PERC at the initial stages of those ministerial daydreams?

Ivor Witanachchi
Moratuwa.

Don't we have a right to choose ?

As a student who sat for my Advanced Level last year, I wish to share my opinion regarding the setting up of 'private universities' and the commencement of teaching Advanced Level subjects in the English medium.

Due to various demonstrations the government has promised that they would not set up 'private universities'. This is to the detriment of the country. Though the government will not set up universities, even now one finds various affiliated colleges offering degree programmes. These institutions, charge students in foreign currency, as they have to remit the same to foreign universities. (eg. England, USA).

If the government goes ahead with the setting up of private universities, students who would otherwise patronise these institutions would have a choice. This would also save valuable foreign currency. Should education be the monopoly of the few 'brilliant' students who get the opportunity to enter local universities?.

While the cream of our society could benefit from free education, people should be given a chance to educate themselves. Those who do not obtain the necessary aggregate (average in my instance), do not have a choice but to follow courses in private institutions. (I did combined math and am entitled to enter the university, but not in the field I want.)

There are various organisations claiming to represent the Sinhalese making a lot of 'noise' regarding the introduction of the English medium. I am a Sinhalese and am truly sad that I wasn't given the opportunity of studying my chosen subjects in the English medium. After all, when we go out into the world, we have to communicate and work in English.

I am sure the children of the 'leaders' of these organizations can speak English, perhaps to the extent of shaming some Britishers!

It is time we are given a proper education system. Let there be a national consensus about our education. After all we would be the leaders of tomorrow. No one should play around with our education.

Let the future generations have a better education system than we did.

Mahisha Warusavitharana
Colombo.

Nature of love

When the sun rises
When the wind blows
When the birds sing
When the rain falls
I feel I hear
The beauty, the grace....
Wonderful nature
The nature of love....

When I see you
When I hear you
When I love you
When I adore you
When I call you
My dear father
When you call me
My dear daughter
I feel I hear
The beauty, the grace
Wonderful nature
The nature of love....

Kanchana Perera
Colombo

No need for heartaches

I read with concern the letter by S.M. Senevirathne of Maharagama titled 'Heartache' on May 27.

He refers to a cholesterol-lowering drug called Atronas recommended by his cardiologist which retails at a prohibitive cost of Rs. 90/- a tablet.

Once, I too had a high cholesterol level but managed to bring it down to normal at a cheaper rate through an 'arishta' manufactured by the Sri Lanka Ayurvedic Drugs Corporation. It was 'Medna Harawa' and is sold at Rs. 100 a bottle. Mr. S. could get it from the Corporation's sales outlet at Wijerama junction (on High Level Road).

Sisira M. Gunaratne
Moratuwa

Consider these victims

Government servants, pensioners and others have to wait for years to obtain compensation, such as casualty compensation or when houses and property are damaged.

When funds are allocated to pay such compensation, some man-made calamity takes place and they are diverted there.

This happens repeatedly. The latest one was the diversion of funds after the Mawanella incident. It does not mean that such victims should not be paid compensation. But they should not be paid at the expense of those who have been waiting for a long time, those who have been victimised over and over again.

We hope the President would come to the assistance of these helpless victims of circumstances.

C. Ramanathan
Batticaloa

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