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by Geoff Wijesinghe

The crisis caused by the current epidemic of Dengue has exposed the pathetic state of the disease prevention mechanism of our health care services. It has also once again brought into sharp focus the total lack of civic consciousness on the part of the public.

Ever so often, there is a hue and cry by both the authorities and the public, after the outbreak of an epidemic - a case of attempting to lock the stable door after the horse has bolted.

It is apt to quote Izaak Walton (1593-1683) who said, "Look to your health; and if you have it, praise God, and value it next to a good conscience, for health is the second blessing that we mortals are capable of a blessing that money cannot buy". How very true!

Every time there is an epidemic of one disease or another, which raises a public furore, the health authorities themselves run to panic stations and embark on hurriedly put together what could well be described as salvage operations, whether it is to salvage the health of the nation or to salvage the prestige of the health authorities is not very clear, possibly it's a mix of both.

Time was when health inspectors from local authorities paid weekly visits to each and every home, schools, every hotel and eating-house, in fact each and every premises, clad in their white uniform with green epaulettes. Those who were violating the health regulations were first advised on the proper importance of hygiene and if they failed to comply, they were taken into court and prosecuted.

Of course, even in those days of "clean" living, there were a few and not many as now, who were willing to turn a blind eye to violations. But, on the whole, the health inspectors were conscientious and carried out their duties with a sense of dedication. Today, the health inspectors are as inconspicuous as much as they were conspicuous in the past. While they may be playing truant, public apathy in completely ignoring, and in the case of offenders, welcoming this sad state of affairs are equally to blame.

The preventive mechanism that has been put into operation during the current Dengue epidemic should be made to continue permanently. The health authorities both at national and local levels should have special units to monitor the work done by their field staff and they in turn, should be made to report to directors of health.

Those who head the health services should be made directly responsible for the proper functioning of preventive services and penalised if they are found wanting. The new Mayor of Colombo Prasanna Gunawardena is a breath of fresh air in the highly polluted metropolis.

Mr. Gunawardena states that in his childhood, Colombo was a "gentleman" city. It was then a Garden City. Colombo was even then cosmopolitan and did not have the ingredients of a big time city. It was clean and orderly - leisurely and not quite vibrant - a garden city in which people lived and worked in relative harmony. It remained so for most of the last century.

The Mayor of Colombo, a renowned town planner and former chairman of the Urban Development Authority is of the view that there has been a system's breakdown and economic downfall that followed since 1994, having almost fully demolished such achievements.

The main challenges in the City now are two fold, to which his plans have to respond.

They are:-

1. Attending to problems that are the real concerns of the larger majority that lives in Colombo, and on which the time and efforts of the city fathers is almost wholly taken up.

2. Carrying out major tasks of forging the future development of the city. He says that the perception that there is neither professionalism nor equity in the approach of the Municipality in dealing with the day-to-day problems of the population. recognising that is the key to resolving them. He plans to establish and sustain systems based practices in providing municipal services, which would thereby also ensure equity in municipal practices. The tasks may appear to be daunting, but they are necessary.

Another welcome factor introduced by the Mayor is that the top management of the Municipality will have to review and re-identify their responsibility, duties and tasks towards a program of highly involved and sustained action to ensure that the city is clean and orderly, and the needs of the population are fairly and regularly attended to.

He says innovative solutions to what are too commonly and too easily written on as impossible needs to be worked out. Systems to ensure that the work force is meaningfully engaged and that that machinery and equipment is always in good order, their use optimized and that they are not filtered away, needs to be put in place - along with mechanisms for easy supervision and monitoring.

The citizens must be taken into confidence and provided with opportunities for involved participation in reviewing and resolving matters that affect their day-to-day lives. They should not be made to go from pillar to post within the numerous departments and offices of the Municipality as well as to other institutions. The plan is to make the Municipality their one-stop shop.

Mr. Gunawardena who himself answers his telephone without the caller being filtered through aides, told me when I placed a problem concerning sewage that he would call for a report with proposed solutions within five days, from his engineers, and phone me as to what solution he has decided on. Now, that's efficiency and courtesy. The Chief Medical Officer of Health, Dr. Tissa Kariyawasam is doing a king sized job in handling the Dengue epidemic. When he was referred to about a deep hazard faced by my neighbour, he gave me a number of a hotline. When I phoned that number, I was asked to phone another.

The person at the given number advised me to phone yet another. I was then referred to the MOH Kollupitiya who referred in turn to yet another MOH. After four days of being driven from pillar to post, in exasperation I phoned Dr. Kariyawasam again and told him of my plight. He, promptly said he would send health officials to my neighbour's who has three children, one of whom is down with fever while the entire premises and the area around are infested by mosquitoes throughout day and night.

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