|Monday, 10 September 2001|
The whole country was watching with interest the outcome of the episode where the food allegedly supplied by a cafeteria managed by a leading star class hotel for the annual dinner organised by the GMOA was affected by 'Salmonella Bacteria'. According to newspaper reports, the whole of Exco and a large number of specialist doctors had been treated for diarrhoea as a result.
The citizens of this country expected the GMOA to act in the interest of public health instead of treating this incident as a personal matter that had affected only the GMOA and take whatever steps including legal action to protect the general public in future from this type of careless attitude by the hoteliers. This is relevant especially to the BMICH since it is patronised by a large segment of general public during exhibitions, seminars, auction sales, examinations, film and art shows. This may not be an isolated incident since even on earlier occasions this type of a situation may have gone unnoticed since the hapless public of this country are helpless in such situations. Also running a restaurant without a legal permit from the CMC for more than a decade in itself is a heinous act and deserves a separate inquiry.
The people of this country expects from the main body which is responsible for providing health services to them to lead the way and set an example to fight this type of health hazards. This incident has been an eye opener and should pave the way to maintain high standards in all the hotels in the country. But what happened at the end had dismayed the public since according to the newspapers, the GMOA had come to an amicable settlement with the hoteliers concerned by recovering the Rs. 500.00 paid by each doctor and accepting an undertaking to provide catering free of charge in the next annual dinner. Meanwhile the same caterer is carrying on regardless. Suppose at the next annual dinner, the "Salmonella" appears again, what then would the GMOA do?
We are sure that the members of the noble medical profession would honour the "Hippocratic Oath" which bind them.
Discussing the relationship of doctors with the pharmaceutical industry is currently a global phenomenon. The pharmaceutical industry produces an intimately connected item in the practice of medicine, namely the drugs. On the other hand the pharmaceutical industrialist has an obstacle between him and his customer, namely the doctor. He by-passes the doctor with the drugs that can be dispensed without the prescription, known as over the counter products (OTC products) in pharmaceutical jargon. As far as the drugs that need prescriptions for dispensing or perspiration only medicines (POM) the doctors prescriptions are important. It is natural for the industrialist to try to influence the doctor in these circumstances. As far as influencing the doctor takes place at the ethically acceptable level no problem will exist. Dr. Sarath Gamini Silva, a much respected senior consultant physician attached to the National Hospital of Sri Lanka, in his article "Doctors and Pharmaceutical Industry: A Conflict of Interest" published on 4.8.2001 dealt with many aspects of the Sri Lankan scenario of this relationship.
In Sri Lanka the State does little or nothing towards up dating the professional knowledge of the doctors. We have about twenty medical associations and colleges in Sri Lanka. They keep on up dating the professional knowledge of their members quite actively. The doctors organising themselves in this manner is praiseworthy. However all these activities are sponsored by the pharmaceutical industry. This explains the silence of medical associations and colleges about any malpractices in the pharmaceutical industry. The Government Medical Officers Association (GMOA) is the most powerful out of these. Once it went on strike when the Director of the Drug Regulatory Authority (DRA) was sent on transfer. The transfer was cancelled. They are silent about the current questionable omissions or commissions of the DRA which contributes to chaos in the pharmaceutical market putting the pharmaceutical industry in an advantageous position. When I was the President of the Independent Medical Practitioners Association, I exposed alleged corrupt practices of drug firms despite their sponsoring events for the Association. My action was subject to criticism by at least a few members of the medical profession. This minority was however very aggressive in showing their displeasure. They used the same armoury used in cheap party politics of Sri Lanka like anonymous letters, anonymous faxes and creating splits in the Association.
All major events in medical associations and colleges are sponsored by the pharmaceutical industry. The pharmaceutical companies try to out-do each other when sponsoring these events. As a result some events are held in five star hotels with cocktails served after the event followed by a sumptuous dinner. Sometimes free gifts are doled out at the meetings. The non medical spouses who has nothing to do with the academic activity too are invited. The century old Sri Lanka Medical Library too, is currently run by a multinational drug company. The passage leading to the library is decorated with advertisements from this company. This company took over the management of the library when it was on the verge of being closed due to financial problems. All drugs for health camps conducted by some doctors are provided by the pharmaceutical industry. Most of medical research projects are funded by drug firms. Under the circumstances some doctors jutisfy their "under obligation" feeling towards the pharmaceutical industry. This feeling is not towards the best interest of the patients. Some committees of medical associations having influence in taking decisions at national level, is sometimes influenced by drug firms. Even employees of some firms are in these committees. Communicable diseases committee of one medical association has an employee of a drug firm dealing with vaccines! A publication of this committee meant for the medical profession was printed by the drug firm. The launch of the booklet took place in a five star hotel. The publication has the potential of influencing vaccine prescribing pattern of the doctors. The drug firm is the sole importer of some of the vaccines mentioned in the booklet. This is an example to show to what extent the pharmaceutical industry infiltrate into professional activities of the medical profession. I do not blame the drug firm concerned. It is simply wisely exploiting the situation to promote their products.
The pharmaceutical industry sometimes offer a very personal favours to doctors. When a doctor is induced as the president of an association or a college or delivers an oration it is traditional for him to host the gathering at a reception. This is very frequently sponsored by a drug firm. Thus the drug firm gets a powerful medical personality with high lobbying power into their favour. Many pharmaceutical companies offer gifts of liquor to doctors and deliver Christmas hampers to them. At least one pharmaceutical company exists which provide tyres for vehicles, provide toilet suits, do up floors of houses with tiles or granite and, sponsor weddings of offspring of doctors. Majority of doctors do not accept any personal favour from drug firms. Many drug firms do not offer unethical gifts or favours even when demanded by doctors.
It is nothing but fair to keep public informed about what goes on between doctors and pharmaceutical industry. My candid articulation on the subject should not be regarded as "washing dirty linen in public". Valid criticism by public should be seriously considered by both medical profession and pharmaceutical industry. This will lead to a process of self improvement beneficial to the medical profession, pharmaceutical industry and to the public.
DR. B.G.D. BUJAWANSA -Dehiwala South
I wonder whether any of the readers are aware that in times of national racial intolerance, St. Anthony's College, Kandy has become a pioneer of inter-racial amity through the most popular sport of our country - cricket. In our country St. Anthonys College has become the only school to have produced cricketers of all religious faiths, and those belonging to all racial groups, to have represented Sri Lanka in cricket at the national level. In the 1930s an Antonian belonging to the burgher community named Jack Anderson established a batting record for the schools playing against S. Thomas' College, Mt. Lavinia.
It was the match when Thomian supporters unable to weather the Antonian attack which comprised the batting of Jack Anderson encouraged P. Saravanamuttu for the Thomians by shouting era! Sara era! A memorable innings by the Thomians. In the 1950s Mohammed Lafir a Muslim from St. Anthony's College opened batting for the Sri Lanka national team.
Again in the late 1970s Mahes Goonatilake a Sinhalese Buddhist from St. Anthony's College kept wickets for the Sri Lanka cricket team. In the late 1980s a Sinhalese Catholic Bernard Perera of St. Anthony's opened batting for the national cricket team. Then came the spinning wizard Muttiah Muralitharan a Tamil Hindu from St. Anthony's, Kandy still blazing a trail of bowling excellence in the national cricket team.
St. Anthony's College, Kandy is one of the few institutions to have regular fixtures with Colombo schools being situated in the outstations. How far St. Anthony's College will produce eminent sportsmen of national importance will depend on authorities who promote sports in the outstations and those in charge of sports at St. Anthony's.
MIRAN PERERA -Kandy
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