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| Friday, 2 August 2002 |
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The professionals who took this view included among others Prof. Tissa Vitharana, former head of the MRI and a WHO consultant on viral diseases, Dr. Mrs. Ajantha Perera, a specialist on Environment, a former lecturer in Science, Colombo University and presently Director Housing in the Ministry of Fisheries, Dr. Neville Fernando a former MP. The discussion itself which was open to the professions and the public was poorly attended, with not more than 50 persons present in the SLMA auditorium which can take in about 250
This in itself reflected the failure on the part of those in authority to have been able to generate sufficient interest in the public on the subject all these years on the active role they have to play in controlling the disease. So far the authorities responsible for health have failed to design any effective programmes to bring about this much needed attitudinal change in the public. Fogging and spraying an eye wash Prof. Tissa Vitharana speaking on the topic towards a successful Dengue control programme said public corporation is vital in controlling the dengue mosquito. you can't just do it by carrying out a few fogging and spraying exercises for the public to see - here we are active on the control. Those are mere eye washes. The mosquito cannot be eliminated like that by doing just a few fogging and spraying exercises. What has to be done is to take measures and implement schemes to motivate the public to be at it on their own . To be dengue conscious proper programmes have to be worked out for that. Dengue Monitoring Unit at MRI Prof. Vitharana said: when I was the head of the MRI I had set up an effective Dengue Monitoring Unit in the MRI that worked throughout the year. They had the data with them day by day and they knew before hand the likelyhood of an outbreak of the disease and thus were able to control it. This unit remains ineffective now. In Cuba the authorities had been able to successfully control dengue by adopting a series of realistic measures. They had used health volunteers effectively in the programme. Then in Singapore too the disease has been put down effectively. They had besides health awareness programmes also imposed fines for environment pollution from $ 50 to $ 1000. We know by experience that in working with the public you can't always use the prayer book, the stick also has to be used. Sri Lanka could very well study the controlling methods adopted by those countries and use some of them with the necessary modifications to suit our country. Devastating experience - Dr. Neville Fernando Dr. Neville Fernando came out with a devastating dengue experience he had recently when a 10-year-old child afflicted with the disease died before his own eyes while pleading to the doctor who were attending on him to save his life. Dr. Fernando said, "We couldn't bear to see this death. We were all so moved that we waived all charges (fees) in this case and I took a decision then and there to effectively participate in all dengue control programmes. That's why I am here today." Stupid exercise Dr. Fernando described as stupid the use of schoolchildren in dengue cleaning up programmes exposing them to mosquito bites thus endangering their lives. He said, "I know of a few cases where children who had taken part in these programmes had themselves gone down with dengue and been hospitalised. That is why I say it is a stupid exercise. Some health officials think that they can control the disease by holding a few press conferences in Colombo, and making a few TV appearances. It won't work that way. They have to get to the field and work out programs to motivate the public to get on with the cleaning up work. Statistics unreliable - dengue is not going down Dr. Fernando had this to say on statistics. "The health department statistics on dengue are very unreliable. Recently they said dengue is on the decline. I don't believe it. Taking their own figures, I can prove it. In July the number given was 57. So how can it be a decline. We are a selfish nation - Dr. Ajantha Dr. Mrs. Ajantha Perera dealing with the environmental aspects of dengue said, "we are a selfish nation. Some of us would clean-up our premises and throw the dirt to the neighbour's garden, or heap it on the public road. They think 'let anything happen to the others'. If I am safe that's enough. If there is an economic gain we all rush to do it not otherwise. Even politicians join in the cleaning-up work with the ulterior motive of getting some votes. Most of our people have lot of garbage in their heads. So they can't think clearly. That is the cause for most of our problems, and some of us who genuinely work for the public good have to suffer as a result. I am one who had that experience. I lost my job in one of the higher educational institutions here as a result. While working there I was engaged in a garbage recycling project for households. I had designed a barrel garbage pit that can be used in any house to make compost of the kitchen and garden refuse. Some of those in authority in that institution did not like this, because I was getting popular on this project. So they sacked me at the end of my probation period. Dr. Mrs. Ajantha said that she was using this barrel garbage pit in the fisheries housing schemes and it has become very popular with the fisher families. Mosquito coils harmful to people She said mosquito coils are being marketed saying it is to save people from dengue mosquito. But those fumes could be harmful to the people in the long run. Dr. Ajantha went on to describe research she had done when she was in the Colombo University on the harmful effects of mosquito coils on fish. The results proved that the fumes had adverse effects on the fish. She said she couldn't use humans for the experiment. However her view was that the results would be the same. She asked it cigarette smoking and passive smoking could cause heart disease. How could there be any difference in passive smoking of mosquito coil smoke? She said what is urgently needed in this country end in rest of the world today is to bring about an attitudinal change in the people. In the dengue control also this is most necessary. Dr. Eugene Corea speaking on responsibility of professional organisations in the control of Dengue said, the SLMA itself had only one seminar on dengue last year. The SLMA Publication Ceylon Medical Journal had carried only one article on dengue for the last 6 years. It had failed to carry any editorial on this topic for the last 6 years. The Ceylon College of Physicians had only one seminar on dengue so far. He said Sri Lanka has 35 professional medical organisations, most of them have failed to address this dengue issue properly. Dr. Preethi Wijegoonewardena president SLMA chaired the discussion. (This article has been written by Edward Arambewela, Coordinator
Health Watch who attended the SLMA discussion on invitation) HealthWatch Question
Box Use of bitter oranges in hypertension Dr. D. P. Atukorale replies A reader from Wattala wants to know how good are bitter oranges (Ambul dodang) nutritionally for good health, and for hypertension? Originally from China the first variety of orange variety to appear in the west was the Brigarade (bitter orange). The sour taste of bitter orange renders the orange unsuitable for desert use. The bitter oranges produce a far more intensely orange flavour than any of the sweet varieties of orange. Oranges whether they are sweet or sour should be squeezed fresh from the fruit because much of the nutrient value is destroyed by storage. Oranges are best known for their high vitamin C content and an average sized orange (bitter or sweet) will generally supply all of an adult's daily requirement of vitamin C. It also contains one fifth of the folic acid requirements and useful amounts of calcium and thiamin (vit B1). Orange in view of the high acidity should not be used in cases of gastric ulcers or other intestinal inflammations. Oranges have been used to assist withdrawal from alcohol, to reduce mucous secretions, and to treat hypertension, arthritis and pulmonary diseases.
T. S. Perera from Nugegoda writes I am 21 years old with an inborn defect in one of my legs as such I cannot do much of walking, however I like to keep fit. A relation of mine in Canada recently wrote to me advising me to take breathing exercise regularly to keep fit. I just went to know wether it really helps. Rajgopal Shri Shankar, Fitness Consultant and a member of the Health Watch centenarian study team replies. Your relation is quite right. Let me quote what a US fitness expert Jane E. Brody has to say on this "Fitness in the simplest terms is the ability of ones body to work at optimal capacity for as long as one lives. To achieve this it is not always necessary for one to workout in a gym for hours. One can keep fit to some extent also by doing heavy breathing 20 to 30 minutes a day moving limbs rhythmically through air or water." I think in your case you can start off doing this exercise for about 15 minutes a day and then increase the time. If you give me a call at any of these members, I can advise you on the type of limb movement you have to do 077-789917.
Reader S. Fernando from Anderson Flats wants to know the effect of garlic on bad cholesterol and heart conditions. Garlic has been used to lower blood cholesterol mainly bad cholesterol (L.D.L.) which is responsible for thickening and plaque formation in the inner wall of arteries (atherosclerosis) thus in the prevention of heart attacks and strokes. Garlic is known to prevent sticky blood platelets from clumping together and thus lessen the risk of heart attacks and strokes. Garlic also reduces high blood pressure (hypertension). The main active principle in garlic is allicin which has been shown to be effective against 23 kinds of bacteria and sixty types of fungi and yeasts. There is considerable variation in the reported effective dose of garlic. Some studies suggest that as little as 1.8 gm of garlic a day is effective whereas other studies suggest that between 7 and 28 cloves daily are necessary to achieve a significant drop in cholesterol and blood pressure. (Three cloves of garlic roughly weighs 10 gm). Most of the research has been done using raw garlic and not garlic tablets whose effect is questionable. Consumption of more than 20 gm of raw garlic per day can make your red blood cells fragile increasing the risk of anaemia. Because garlic contains irritants people with stomach disorders should not consume large quantities of raw garlic.
Religion and noise pollution All of us may not be aware of the number of religious statues that are being built around our main and side streets, especially in the suburbs of Greater Colombo. Together with this activity now the faithful believers are busy installing 'mass communication' systems to spread the messages of various religious leaders! One could understand this sort of religious transmission to some extent, if performed within the officially recognised place of worship. But unfortunately this is not so as noise pollution is now commonplace on almost any public place. It beats the nuisance of lottery ticket sellers, because time of day and the so called devotional songs are a boring repetition of probably copyright material. In the Wattala area, where I live, there are three main places of worship in close proximity to each other. devotees have taken the liberty, it appears, to erect a 15/20 ft.concrete pole near a roadside statue. Firmly fixed are four large loudspeakers on top the pole. Every morning at 5-5.30 religious variety of 'bakthi gees' are broadcast to all directions as loud as possible directed towards some 150 householders. Each day a repeat tape is played making it as monotonous as possible. It is noise pollution at its extreme. Recently, the usual street procession that is organized in a dignified and relatively calm manner once a year throughout the streets in local areas turned out to be very noisy. The organizers had tied large loudspeakers on electricity poles a couple of kilometres away from the nearest place of worship and the whole day all sorts of "songs" and messages were announced/played at a loudest possible volume. When a complaint is made we are told to tell the other religious places as well. The police, of course, want a petition signed by complainants! It seems they are unable to stop this kind of practice! Further, the violent political culture today prevents the majority of us putting pen to paper let alone signing a document. Appeals to religious dignitaries or local counsellor s and MPs have produced no remedy at all. Perhaps only ENT medical practitioners may be able to show practical evidence with regard to damage to health of the younger generation with the proliferation of this religious noise menace. W.P. , Wattala.
Noise and hearing Mr. B. Abeywickrema from Kalutara South has written thanking the health watch page for focusing on noise pollution and at the same time informing how his sister has become a victim of noise pollution. I am grateful to the 'Health Watch Page' specially with regard to the series of articles published on the captioned topic. My sister is a down-trodden victim and a sufferer of "Noise Pollution" - noise emanating from the use of public address system, use of speakers, levels vibrating and exceeding dB 100 and above, from a heinous tutory existing in a peaceful residential neighbourhood, where we live. We have had mitigation, involved in law suits about this atrocious pollution but without help and now at the mercy of the heartless tutory owner, who always contrived and manouvered us into innocent civil cases, from which my sister and her husband get rid of seeking 'Pardon' which is very humiliating, degenerative and very demoralizing. I am really disappointed and furious over this set-up but as law-abiding citizens we are really helpless. Now my sister complains about loss of hearing and sometimes of pangs of pain, heartburns, which I foolishly at times attribute to 'gastritis'. Having given serious thought to Dr. D. P. Atukorale's explanation to the captioned article, I vehemently seek your kind help and intervention, about this notorious pollution, 'noise', after a thorough inspection. B. Abeywickrema , Kalutara South.
A young mother baked some cookies and put them on the kitchen table to cool. She had to play in a softball game, so she grabbed her bat and glove and went out the door, leaving her husband in charge of their two-year-old son. When she got home, she discovered a disaster. The little boy had gotten into the cookies. And he hadn't eaten just one or two. The little rascal had taken just one bite out of every cookie on the table. The whole batch was ruined and could not be served to guests. Meanwhile, where was the boy's father? Asleep on a couch. As the woman looked at the bat in her hand, she may have wondered where to use it first on her useless husband or on the little cookie monster. But rather than explode in a rage and make things worse, she just shook her head and burst out laughing. Healthy families know how to laugh. Not everything in life is a laughing matter, but life has plenty of funny moments. You just need to see the humour. Don't react to every little problem like it's a tragedy. Instead, see it as a comedy. If you run into a situation in which you're absolutely furious and can't find anything to laugh at, go look in a mirror. The red face, the swollen veins, and the bulging eyes you see may be good for laugh. Courtesy "Today Booklet" - May - June 2002 issue , Sent by
W.P. Vincent of Stalmaj Housing scheme Athrugiriya. History making international conference on diabetes Causes for diabetes sorted out For the fist time in medical history the causes for diabetes have been sorted out at an international medical conference held in Colombo early this month. Dr. Mahen Wijesuriya president of the Diabetes Association of Sri Lanka and chairman of the organising Committee of this conference writing to the Health Watch on this historic event states. "For the first time in the wold, we can now base our global primary prevention strategies on a scientific foundation of aetiology (cause) of diabetes, which could be presented to respective governments and other agencies for consideration and necessary action. "We in the Diabetes Association of Sri Lanka feel happy and proud that this historic event was organised by us and Sri Lanka would be recognized as its venue in the history of diabetes in the world. A history making international medical conference on diabetes held in Colombo early this month. Pierre Lefebvre (Prescient elect of the IDF) and Prof Rhys Williams who represented the WHO and an international panel of speakers of great eminence presented the latest evidence in the way of their lifetime's research on each aspect of the subject. This was then deliberated by an audience of opinion leaders who came to a unanimous agreement after much thought and discussion that Diabetes Type 2 had a multifactorial origin arising from the interplay of the following aetiological factors namely * Genetics influences This agreement was then converted into a consensus document and presented to the IDF and WHO for action. Causes elusive for 2000 years Diabetes has been known to man for over 2000 years, but both the cause and cure have been elusive. In the light of this, management has been confined to early diagnosis, good control and prevention of complication. While this would still continue to be the best option for those with diabetes, we felt a programme of Primary Prevention should effectively reduce the numbers of new patients. Such a programme based on firm foundation of the aetiology (cause) was thought to be an urgent need. This is more so the case as a cure still remains elusive. In the light of all these two major problems, the Diabetes Association of Sri Lanka decided to play the role of mediator to bring together all evidence available on the different causative factors so that they could be deliberated by a globally representative group of experts. With this express desire in mind, we hosted an International Conference under the banner of "Diabetes In Asia 2002" on 6-7th July 2002 at the Colombo Hiltion. The chief guests at the Inauguration ceremony representing the Government of Sri Lanka was Prof. G.L. Peiris and Mrs. Peiris. This conference was fully dedicated for the above purpose and attended by 350 senior experts in the field from approximately 30 countries worldwide. The chief guest at the scientific sessions was Prof Sir George Alberti, the President of the international Diabetes Federation (IDF). Diabetes in epidemic proportions Diabetes is spreading across the world in epidemic proportions. World Health Organisation (WHO) has estimated that the people with diabetes, which numbered 150 million in 1995, would double to 300 million in 30 years by the year 2025. Seventy per cent of this increase is expected to occur in Asia. The rate of increase in diabetes is much faster in Asian counties than in the rest of the world. The current number is estimated to double in Asia in the next 10 to 15 years. This is mainly of the TYPE II variety originally called "Adult Onset Variety" and also called "Non Insulin Dependent Diabetes Mellitus". In addition to this massive increase of numbers, it has been noted that there is a significant decrease in the age of onset. What was an illness beginning in the second half of life, has now shifted to involve children and adolescents in increasing numbers. These two phenomena are very sinister and augurs badly for the future of the people of the world.
Health warning on peanuts by Dr. D. P. Atukorale Peanuts are easily affected by the fungus Aspergillus favus acquired in the field of during storage. Aflatoxins are poisonous alkaloids produced by the above fungus which thrives in the warm conditions in which peanuts are frequently grown and stored. It has been found by researchers that peanuts sold in Colombo have more aflatoxins than peanuts available in Kandy. Aflatoxins are capable of causing acute liver damage, liver cirrhosis and liver cancer in recent years. In recent years legislation has been introduced in other countries to try to prevent aflatoxin - contaminated food stuff from reaching the consumer and reputable food manufacturers undertake their own careful checks to ensure the safety of products they sell. There is little reason to worry about the dose of aflatoxins ingested by vegetarians but to be safe any products with visible mould or dampness should be scrupulously rejected. Courtesy: Guide to Vegetarian Living by Peter Cox
Next issues of Health Watch will be devoted to the following health issues: Future articles 1. Drugs and disease entities are the same - by D. Pathirana (Senior Lecturer in Pharmacology, Colombo Medical Faculty). 2. Clinical hypnotism - by Dr. H. B. Jayasinghe. |
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Several eminent professionals both medical and non-medical
participating in an SLMA (Sri Lanka Medical Association) organised
discussion on - Dengue outbreak- why have we failed? on Saturday took the
view that the measures taken by the health authorities like fogging and
spraying the dengue affected areas and using schoolchildren to clean up
the environment were mere eye washes, and were not realistic approaches
towards tackling the problem.
