By Chamintha Thilakeratne, Ayesha R. Rafiq, Faraza Farook, Nilika de
Silva,Wathsala Mendis and Udena Atygalle. Pix by Ranjith Perera
Last week The Sunday Times investigative team probed the provincial
council system in detail, it's advantages and drawbacks, exactly how the
provincial councils had benefited, if at all, the people they were set
up to serve and an overall glimpse of the life available to the people
of the Wayamba province in general.
Last week we also focused on the provincial council system and the education
sector, and this week we analyse the health and transport sectors, as we
consider these to be the sectors that most affect our day-to-day lives.
Speaking to a cross section of people across the province we gathered
that there is a general sense of apathy towards the elections, the provincial
councils and all in all the implementation of the entire system, because
provincial councils or not, life for the people will go on just the same.
On a field interview in Wayamba, we were surprised to see how bad things
were, though the government claims it has carried out large scale development.
To begin with, the ride nearing the province was a bumpy one, as many
of the roads were full of potholes, many of them caused by half complete
and abandoned road construction projects, and the others by projects initiated
just before the start of the election campaign.
Even in the centre of Kurunegala town, there were huge potholes caused
by projects which the residents told us had been abandoned for at least
the past two years.
Another surprise that greeted us was the sight of people travelling
in hand tractors, despite reports that a large number of buses had been
gifted to the province recently.
In hospitals the situation only seemed to get worse. The main drain
outside the Kurunegala Teaching Hospital was completely clogged, with dirt
and refuse piled about two feet high. It was a breeding ground for flies
and germs, and the stench was almost unbearable.
Fruit vendors complained that the drain had been clogged for the past
four years, and repeated requests to the authorities had also fallen into
the drain.
Entering the hospital we met seventy-year-old Kamala Madawela. "I
came to the clinic at 5.00 a.m., and by 12.00 noon I still haven't got
it. There are people here who have come early last morning to get the medicine,
and they too are still here," she lamented. The demand is much more
than the hospitals can cope with, which results in patients being kept
waiting for hours on end for something as small as an asprin..
Even projects meant to benefit the people take a long time for implementation,
because of political opposition and vested interests serving to delay and
obstruct such projects, as was the case with the construction of the Chilaw
Base Hospital and the administrative block at the Kuliyapitiya Hospital.
With such a situation, it is no wonder that most people have "no
idea what we stand to gain from the PC system" as one disgruntled
resident told us.
Operation Success; patient Dying
With the implementation of the provincial council Act in 1987, the health
services were devolved, resulting in the retaining of the Ministry of Health
at the National level and separate provincial ministries of health in the
eight provinces being established.
In the provincial system the hierarchy comprises the Provincial Health
Minister at the top with the Provincial Secretary and Provincial Director
of Health Services below him.
The provincial ministry of Health is responsible for the establishment
and maintenance of public and rural hospitals, and maternity homes and
dispensaries. Teaching hospitals and those established for special purposes
such as cancer or leprosy hospitals, are the responsibility of the central
government.
The Provincial Health Ministry also has to formulate and implement a
Health Development Plan and the Annual Health Plan for the province. Health
education for the community is also the responsibility of the Provincial
Council.
The Provincial Council Health system seems to be a quagmire of administrative
problems with the administrative line between the provincial council and
the central ministry being unclearly defined, and the provincial minister's
powers being undermined by that of the minister and the Governor, as investigations
by The Sunday Times revealed.
This results in next to no development, giving rise to the question
as to whether the provincial health system is a matter of the treatment
being worse than the disease.
"Development plans can't be targeted well because of political
decisions instead of policy decisions," a former Government Agent
points out.
Due to political and policy differences between the Centre and Provinces,
in the entire North Western Province only one hospital has been constructed
on the own funds of the Provincial council during the past 10 years.
Although the public is deluded by state media reports as to the number
of hospitals and the like being constructed the actual situation is different.
In many of the provinces over the past few years hospitals have been upgraded
with the mere change of a name board, without a change in the facilities.
A visit to the North Western Province over the week showed that most
Health sector related projects are incomplete and have been abandoned for
the past two to three years. Building materials meant to construct new
blocks for hospitals were abandoned and construction was resumed about
a month earlier, just before the provincial council elections.
The political differences between the central government appointed Governor
and the Political administration elected by the people of the province
have clearly affected the smooth functioning of the Health sector in many
of the provinces. In the case of the North Western Province the Health
system in particular was adversely affected by this.
The Governor of the NWP being a People's Alliance figure while the entire
provincial council was run by UNP the situation had been aggravated.
former Health Minister for NWP Johnston Fernando, said that he faced
opposition from the Governor during his term of office.
''We completed 26 of the 37 planned projects in the North Western Province.
Some of the projects were overlapping from the previous years. We were
able to achieve even this number because I fought so hard with the Governor,"
he said.
There is a severe lack of co-ordination, which is another one of the
root causes of the problems. But these facts never come out at the monthly
meetings held with the district and ministry secretaries and directors.
The Health sector like many other sectors are adversely affected when
the central Government Minister overlooks the advise of the provincial
Health Minister.
One example is the issue of central dispensaries. These dispensaries
should be located according to the population in the area. But what often
happens in practice is that they are located according to political influence
and in order to gain voters, says Mr. Fernando.
"I had such a problem with Minister A.H.M. Fowzie. He used to open
more dispensaries in areas where he had political interests. Because of
this we incurred unnecessary expenditure', Mr. Fernando said.
In the provision of services too, things aren't as they should be. In
theory the provincial hospitals should provide all services provided by
the central ministry such as general medicine, surgery, obstetrics, gynaecology
and paediatrics, in addition to having well equipped pathological laboratories
and other auxiliary services, except for the procurement of drugs.
But this too is riddled with problems. Provincial Director of Health,
Dr. Hemantha Herath says that to start off with many of the hospitals do
not have trained technicians.
"We don't receive any information about the latest technology.
We also have no research facilities, so no medical research is carried
out by us. Development in fields such as bio-medicine is set back because
of this," Dr. Herath said.
For example, about two years ago an X-ray machine was donated to the
Anamaduwa hospital. This has not been touched until today because there
are no staff who know how to operate the machine, he said.
Hospitals in rural areas also don't provide many of the services which
the public need.
In many of the provinces patients had to travel to the main hospitals,
Though the aim of the PC System was to provide most services in the town
or village itself.
With Kurunegala being a large town, transport at night is next to impossible
to obtain and many rural roads are in deplorable condition. a patient needing
an emergency operation will have to undergo much difficulty in travelling
to Kurunegala.
"If a patient makes a little noise he is transferred to the main
hospital, as the rural hospitals are scared to take on much responsibility
because they do not have adequate staff and equipment," said A.V Karunathillake
a resident from Dambadeniya.
An additional hurdle is to obtain funds allocated to the provincial
council from the central ministry. In 1998 the budget allocation for the
Provincial Council Health Ministries was Rs. 1039 million. Of this , the
NW provincial council was to receive Rs. 130 million.
The council should receive 25% of this sum every quarter, which works
out to around Rs. 30 million. But only 5% of this sum, seven million rupees,
was received in the first quarter.
The payment of this 5% too was delayed and the council received the
money in March and not January. The same thing happens every quarter, The
Sunday Times investigations revealed.
"We assume the money goes to fund the supplementary estimates of
the national budget and for the war effort. There is no proper administration,
so there is no money," Johnston Fernando said.
When funds get delayed in this manner the projects get prolonged. If
a project is not completed within the stipulated time it is put off for
the next year and included in the next budget. Because of this, the projects
that should have been carried out during the next year are delayed and
the process is repeated every year.
Each year, the North Western Provincial Health Ministry has been deprived
of about 25% of its funds. For the four and a half years that the People's
Alliance government has been in power, the Wayamba province's health system
has been set back about one year in terms of development.
An agreement for over 200 million rupees was signed with the Korean
Government to improve the services of the Gampaha and Negombo Base Hospitals
and for Rs. 300 million to provide equipment for peripheral hospitals.
But further investigations reveals that foreign aid obtained on behalf
of the provincial councils does not often reach them.
Because of such delays contractors are unwilling to work for provincial
councils because they are not paid on time. It also results in estimates
going up every year because of inflation, and more and more money being
needed every year.
The money owed to them usually comes in a lump sum in late December.
All this money has to be spent by December 31, and the money that is not
spent has to be handed back to the central ministry. As a result the money
has to be spent on unnecessary projects.
The provincial council embarks on many projects with the central ministry
promising partial funding. But once the project is started, the central
funds never come through and the council has to utilise funds meant for
other projects to complete these.
The Chilaw Base Hospital and the administrative block at the Kuliyapitiya
hospital are two of the projects affected by the central government failing
to provide the funds promised.
Many workers are deprived of their overtime payments and salaries are
delayed, as in the case of Nimal Jayaratne who works at the Puttlam Base
Hospital.
When the provincial authorities are questioned, the only answer the
likes of Jayaratne receive is that the council does not have enough money.
The funds obtained for overtime payments and so on are allegedly used
for other purposes such as the maintenance of officers' vehicles.
The question of discipline is also a problematic one. The Provincial
Council does not have the power to take disciplinary action against any
doctor or dental surgeon, as all such personnel are on all island service
and come under the central ministry.
As such they do not abide by the rules laid out by the provincial council.
Even if the central ministry does take action, it often gets delayed. There
is such a problem allegedly going on at the Puttalam Health Director's
office.
The Health sector in most provinces has hardly seen any difference from
the facilities that existed a decade back before the Provincial Council
system came into operation.
Transport sector: Why we have missed the bus
Whatever the party that comes into office, transport is one sector that
makes little headway. Whether it is under the central government or the
provincial council system, the plight of commuters is the same — overcrowded
buses, unending traffic jams, reckless driving, few or no buses at night…
the list goes on and on.
In the rural areas the regularity of buses is a topic which can hardly
be mentioned. There are remote villages through which a bus plies just
twice a day. And the missing of a bus could mean the loss of a day's productivity
or worse. A tractor filled to overflowing with standing passengers is another
frequent sight.
Another problem which commuters have to face is the scarcity of buses
after dark. Trying to catch a bus at night is one that will most probably
entail a long and arduous wait and if you were living in a rural area there
might not even be a bus to wait for.
With private buses and cluster company buses doing the rounds within
the province, it is a decision based on profit margins as to whether a
bus will ply on any route. Often it is seen that the less frequented routes
have very few buses while the more populous routes have a large number
of buses passing at near intervals. Sometimes it can even be perceived
that buses just do not pass along a certain route as it is not sufficiently
profitable in terms of rupees and cents.
Ruban de Silva, president of the Private Bus Operators' Association
of the NWP, says that under the PC system, transport has gone from bad
to worse. When it was handled by the central govt., a bus owner could get
a route permit for Rs.1250, Rs. 50 of which was deposited in an account
set up for the benefit of the owners. But under the PC system this figure
has gone upto Rs. 3000 to operate between two provinces and Rs.1350 for
a route permit within the province.
Even if the person is willing to pay the sum, there are other hurdles
to get over. Politics, as in every other sphere of life, plays its part
here. A recommendation letter from the politician is a must for anybody
applying for a route permit. And that letter does not come cheap.
In addition, certain regulations introduced under the provincial council
system are playing havoc with their purse strings. For instance, a Log
Sheet which costs Rs. 400 has to be obtained before the first of every
month or in other words, between the 25th and 30th of the previous month.
Or else, the owner should be prepared to pay an additional Rs. 250, which
adds up to Rs. 650 in all.
On the other hand, an owner who has been lucky enough to be recommended
by the politician to get a route permit has to pay Rs. 500 for a month
during which he'll be put on supervision. If he gets through he has to
pay another Rs. 1350.
According to the Transport and Highways Minister A.H.M. Fowzie, "In
Sri Lanka 98% of the population use public transport."
Transport which is a largely devolved subject under the PC system has
proved more or less acceptable to commuters.
Taking the North Western Province as an example it became clear that
all in all the people appeared satisfied with the provincial transport
system, comparing it as being superior than the service which existed before
the PC system.
Twelve years ago before the PC system was put into place, all authority
was vested with the Ministry of Transport. Yet today although the Ministry
does wield a certain degree of power, the commuters journey within the
province is totally in the hands of the Provincial Transport Authority.
Transport authorities exist in each of the provincial councils and the
work carried out by these authorities is similar. The registering of buses,
issuing of route permits, preparing of daily time tables, issuing conductor
and driver licensces, maintenance of log sheets, management of bus stands,
allocation of parking places for lorries, three wheelers and taxis all
come within the purview of the Transport Authorities.
While all finances collected within the province are handed over to
the Provincial Council, the payment of salaries also takes place within
the province.
Sunil Jayaweera, a former chairman of the NWP Transport Authority, said
1200 private buses operated in the province while the Transport Authority
had 1250 buses in Kurunegala and 350 in Puttalam.
Speaking to a cross section of NWP residents, The Sunday Times learnt
their views on the subject of transport as it is today, a devolved subject
under the PC system.
Among the complaints was the inadequacy of buses, and the perils of
night travelling. But the majority of the people felt that transport was
one part of life that has improved.
In a province in which most people have to rely on public transport
it is indeed essential that enough attention is paid to this transport
system. But it was evident that on certain remote routes the frequency
of buses was as low as two buses for the whole day.
And further to this, there are even areas where the children are forced
to walk three to four miles just to get to school. In a country which is
listed as having a very high socio-economic ranking. this is indeed difficult
to understand.
The three wheeler phenomenon which was unknown in Sri Lanka until a
couple of decades ago has now taken over the roads. In the words of one
three wheeler driver, "there are more three wheelers than people on
the streets today."
Even hundreds of miles outside the capital city one can count on being
able to hire a three wheeler. Yet it is debatable if the presence of three
wheelers has led to a decline in the bus service, as people are forced
to hire a three wheeler in case of emergency and therefore no one has come
to rely on the bus service.
In the words of A.P. Sikurajavathi from Narammala, a mother of three
whose husband runs a private bus service, "after the PC system came
in there is no difference. Actually now the bus service is not very good.
When we are in a hurry we are obliged to go in a three wheeler."
As far as the private transportation is concerned there is no place
for the Central Government to intervene. Except giving the policy decisions.
They can't supervise, supervision powers are not with them, said S.
Amarakoon, Secretary of the Western Province Transport Authority.
The National Transport Commission - formed in 1992 - handles inter provincial
transportation.
Since the provincial councils came into being in 1988 the transport
sector appears to have lost its grip on a journey caught between the central
government, provincial council and the private sector. The transport system
had suddenly become multi-parental as had many other sectors which were
included in the list of subjects devolved under the 13th Amendment to the
constitution. Regarding the transport service in the Western Province many
commuters complain that they are forced to pay excessively for bus travel
because at the Central Bus Stand more semi-luxury buses are lined up than
ordinary buses. And the ticket costs almost double the normal bus fare.
In Puttalam the bus operators were disappointed with the system. They felt
they were getting a raw deal. A spokesperson for the North Western Province
Bus Operators Association said "We have fallen from the road to a
drain."
Editorial/Opinion Contents
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