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Nutrition Physicians as change agents
View(s):- Brand new SLCNP to work with other disciplines to guide decision-makers
By Kumudini Hettiarachchi
With a severe economic crisis gripping Sri Lanka, there has been strong focus on nutrition and it is at this critical juncture that the Sri Lanka College of Nutrition Physicians (SLCNP) is born.
Formed about six months ago, SLCNP will have its formal inauguration in Colombo tomorrow.
“We are the youngest of the 41 colleges and associations among the medical fraternity,” said Dr. Thimathi Wickramaseakara who has donned the mantle as the Founder President of the SLCNP.
Dr. Thimathi Wickramaseakara
Explaining why there is a need for the SLCNP, he says that back in 1972, the Nutrition Society was formed, encompassing professionals from different fields with an interest in nutrition, with the common goal of uplifting the nutrition status of the people of Sri Lanka. The overall picture at that time was poor nutrition among the people due to various reasons such as poor food distribution, lack of knowledge and also the economic situation.
“Now food has become a part of disease prevention, disease management, disease stabilization, a way of reducing the disease burden and sometimes a way of reversing diseases. Disorders such as diabetes, obesity, cardiovascular disease, inflammatory bowel disease, osteoarthritis and multiple sclerosis are some examples. This is why there is a need for medical nutrition and disease-related nutrition,” said Dr. Wickramaseakara.
Islandwide there are 22 medical nutrition units in state hospitals with 11 Consultant Nutrition Physicians and 19 acting Consultants.
With the realization that it is no longer ‘one disease-one treatment-one target’, but an interdisciplinary approach, he says that the key responsibilities of these specialists are to ensure that the meals provided in hospitals meet the required nutritional standards, especially the diet of patients in the Intensive Care Units (ICUs) and those who need disease-specific meals.
Referring to malnutrition, Dr. Wickramaseakara says it is two sides of the same coin – over-nutrition which leads to obesity and under-nutrition which results in stunting, wasting and underweight. Since about 1995, there has been a stagnant situation, with malnutrition at around 10-20% within some sectors in the country.
The main reasons, according to him are:
A problem with the definition of malnutrition and under-nutrition, as we along with other countries in Southeast Asia, follow the definitions set by the western world. There is also no consensus on what the definition should be as nutrition is a highly politicised topic.
Sri Lanka being hit by the recent economic crisis where the basic needs of society starting from the smallest family unit, have been compromised. Even the limited resources available have not reached the targeted and most vulnerable groups. The situation has been exacerbated by gaps in knowledge.
He cites the example of the time when the COVID-19 pandemic hit and how countries such as Sri Lanka with their strong programmes to face infectious diseases were better equipped to handle it than the west. “But when it comes to nutrition, it is the other way round. Streamlined food delivery and security systems are not in place in our countries.”
“This is why we as a college, are hoping to be the change agents to direct policy, while knowing our boundaries and not getting involved in the fields of expertise of others. We also need to minimize our biases. Our ability to work with other disciplines to achieve a common goal while appreciating and accepting the views, ideas and knowledge of other disciplines is the key in delivering the best possible healthcare. We hope to be part of a bigger team to make sure the decision-makers are equipped with the right knowledge,” added Dr. Wickramaseakara, assuring that the SLCNP would act with social responsibility.
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