A patient sleeps on a chair at a day of doctors strike on April 7
We have always been good at political slogans. “Api Wenuwen Api”, created to advertise the previous regime’s all-out war, was hugely successful. It was very clever psychology too, gift wrapping a very self-centred idea (‘api’ standing for the majority) as an altruistic social exercise when the whole idea was rooted in a completely selfish ‘Me’ generational thing. This became abundantly clear by the way the Rajapakse regime cut the cake after the war was won.
And now, “Api Wenuwen Api” has been hijacked by the anti-SAITM lobby. A slogan at the gate of a government hospital in Colombo said: ‘Oba Wenuwen Api’ (We are for you) which sounds even more altruistic. Doctors earning their living thanks to free education subsidized by taxpayer’s money are now waging a no-quarter-given struggle to safeguard that free education from an amoral private education enterprise. They are fighting for our rights to sneeze without fear of an exorbitant bill. Or so, they say.
Doctors earning their living thanks to free education subsidized by taxpayer’s money
The shortage of doctors in state hospitals is so acute that at one stage the employment of foreign doctors was being discussed
This isn’t just a question of private vs. state enterprises. It’s about monopolies
GMOA and its affiliates have obviously forgotten this oath
But, as things actually, stand: “Api Wenuwen Oba” (You are for us) sounds more appropriate. Everyone who could be enlisted to the anti-SAITM cause - doctors, medical students, nurses - are now expected to champion free education. Its benefit to our doctors can be gauged by a simple survey - stand outside the gates of any government hospital and watch the parade of shiny new cars. One should be grateful indeed for free education. But, as if all this emotional and vocational power isn’t enough, the general public too, needs to be made aware and their sympathy harnessed - hence, oba wenuwen api.
Too bad about those who fail to win this state medical lottery - those who fail to gain entry to medical college by just one mark (some even commit suicide). The shortage of doctors in state hospitals is so acute that at one stage the employment of foreign doctors was being discussed. The medical profession, like the national security apparatus, is a sacred cow. People are offended when its standards are questioned. But no proper survey of deaths due to negligence, overwork and other negative factors can be done because GMOA won’t cooperate. In the entire history of Sri Lanka, only one case that was filed against a doctor for causing death by negligence has been successful (the complainant was a lawyer) but the ruling was later overturned by the Supreme Court.
"Nationalising SAITM would be as pointless as what was done to Buhari Hotel and Sri Lankan Airlines. Our doctors aren’t going to help make things less equal here by screaming for nationalization because they are very much a part of those inequalities"
The medical lobby in this country is insular and all-powerful, and wishes to remain that way. They determined that only the state has the privilege of producing doctors. This Brahmin class living well thanks to the taxpayer’s rupees display no democratic niceties in going about this struggle. Participation in SAITM protests isn’t voluntary. There isn’t any pro-or-con discussion about it within the GMOA or medical college unions. One wonders if this was because Rohana Wijeweera was once a medical student, but the JVP and its nemesis Peretugami Pakshaya (Progressive Socialist Front) who control the medical student unions have found common cause here. They too, don’t want to see any privately-educated doctors in this country.
Private education has its bad side. It’s too expensive for quite a lot of people. But nationalization of SAITM is not a solution to that dilemma. Sri Lanka has a ‘trigger-happy’ mentality when it comes to nationalization. This writer holds the view that some essential services, such as public transport, education and health should receive state subsidies given current income levels and gross inequalities. But there should be a clear rationale and logic for nationalization. Nationalising SAITM would be as pointless as what was done to Buhari Hotel and Sri Lankan Airlines. Our doctors aren’t going to help make things less equal here by screaming for nationalization because they are very much a part of those inequalities.
"The medical profession, like the national security apparatus, is a sacred cow. People are offended when its standards are questioned. But no proper survey of deaths due to negligence, overwork and other negative factors can be done because GMOA won’t cooperate."
This isn’t just a question of private vs. state enterprises. It’s about monopolies, which are always bad. It is also about ethics. There is an aphorism taught to all medical students, attributed to the Hippocratic oath: “First, do not harm.” The GMOA and its affiliates have obviously forgotten this oath. Doctors, by negligence, overwork, or genuine mistakes, do a lot of harm. Patients are damaged beyond repair, or die. But this monolithic medical structure makes it impossible to obtain justice.
British brain surgeon Henry Marsh wrote in his memoir about both his successes and failures. He describes visiting a nursing home outside London dedicated to the long-term care of patients with catastrophic brain damage. Inside, he recognized at least five former patients of his. “They call us heroes, and sometimes gods,” Marsh writes of his patients. “Perhaps they never quite realized just how dangerous the operation has been and how lucky they were to have recovered so well. Whereas the surgeon, for a while, has known heaven, having come very close to hell.”
Of course his successes are far more numerous than his failures. But what he says about surgeons is true of doctors, too. What is needed is candour, self-criticism, and compassion towards patients. We have doctors with such qualities, but they remain strangled by the omnipresent tentacles of our monolithic medical structure with the GMOA as its head. It’s a beast devoid of reason and compassion, ever ready to hold hostage the very people it professes to care for.
The government should not yield to it.