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Dr. J. H. F. Jayasuriya was founder chairman of the Ceylon National Association for the Prevention of Tuberculosis.

Today we pay tribute to the remarkable foresight of Dr. J. H. F. Jayasuriya who founded CNAPT which is in tune with the health challenges afflicting the world today. In 1948 the problem of Tuberculosis in Sri Lanka was formidable. The disease was rampant, the situation was hopeless, and a fatalism was born out of fear and ignorance.

No one of any class or economic level was safe, the disease was the special burden of the poor, drug treatment was in its infancy and a proper treatment was yet to be evolved at that time. The disease was always fatal and considered a stigma, and the stigma attached to it prevented patients from seeking treatment. The small number of hospital beds allocated to the disease was grossly inadequate to cater to the huge caseload. The efforts made by the then government was woefully inadequate to cope with the situation.

The Beginnings

Dr. J. H. F. Jayasuriya, realised the need for a voluntary organization to assist the Government's effort to control the disease. He decided to take up the challenge. He summoned a group of motivated men and women, people of stature, vision, great courage and determination and resolved to form a voluntary association.

On the 17th June 1948 the first National Voluntary Organization was formed, and its aim was to conquer the specific disease - Tuberculosis.

The inaugural meeting was held at the Town Hall with the Governor - General Sir Henry Monk Mason Moor presiding. The distinguished gathering included S. W. R. D. Bandaranaike, Minister of Health, Dr. S. E. Chellappah, the Director of Medical and Sanitary Services. A Committee was elected with Dr. J. H. F. Jayasuriya as Chairman. The newly formed Association was assured of Government and public support. The CNAPT was incorporated by an act of Parliament in 1957.

A poignant issue at the time was to find a suitable place somehow. The CNAPT stepped into remedy the situation by building three wards. Welisara Children's Ward (1952), Clarence Nathani Memorial Ward at Welisara (1960) and Hawke Memorial Ward at Kandana (1955) provided a total of 165 beds exclusively for children. The entire cost of Rs. 900,000 was raised through the efforts of the CNAPT.

Rs. 375,000 out of the total cost of Rs. 550,000 for the construction of the ward at Kandana came from the Joseph Hawke Trust bequeathed by an Englishman who had lived in the country for 50 years. It was a two-storied building consisting of two wings. Much interest was created by these wards. Hawke Memorial Ward was declared open by the Prime Minister, Bandaranaike, while the Governor General, Lord Soulbury and the Rotary International President paid official visits to Welisara children's wards.

Another commitment of the CNAPT to the cause of affected children was the running of a home for children of tuberculosis parents. The objective was to isolate the children and thereby preventing the spread of tuberculosis from their infected parents. The Sir Frank Gunasekera Trust owned a house in spacious ground overlooking the scenic Bolgoda Lake. The CNAPT took over the running of a prevention which provided a home for the children till their parents became non infectious.

Home visiting service

In the 1950s, there was hardly any systematic home-visiting by personnel from the Ministry of Health for the purpose of educating the patients and their families about the disease. CNAPT conceived the idea of organizing visits to such homes in Colombo. It was estimated that there were some 20,000 such homes in Colombo alone. The service was inaugurated by then Prime Minister, Dudley Senanayake on 25th February 1953. In the first 13 years of the scheme, over 2000 such homes were visited by CNAPT teams. The teams distributed dhal, dried sprats, milk foods and cod liver oil to under-nourished children. They also gave advice regarding family planning. Children were screened at to chest clinics and BCG vaccination offered.

Thassim Chest Clinic

Provincial chest clinics as a means of controlling the disease in the provinces were first mooted by the CNAPT, at a time when only Colombo had such facilities. The first such clinic outside Colombo was built at Galle at the insistence of the CNAPT. The Thassim Chest Clinic at Galle, named after its donor A. R. M. Thassim, onetime Mayor of Galle and President of the Galle Branch of the CNAPT, was declared open on 28th June 1953. It was built at a cost of Rs. 150,000.

The present

Advances in the drug treatment of tuberculosis over the years have basically changed the strategies required to control the disease. The incidence in the country has declined, and consequently several chest hospitals and tuberculosis wards have been closed down. Administration of BCG Vaccination at birth has made tuberculosis in children a negligible factor, and the result is the closure of the children's wards built by the CNAPT.

The regular administration of drugs, and not the provision of nutrients as was done by the CNAPT some decade ago in the important factor now. Duration of treatment, which originally dragged on for four years, has now been reduced to six months, thus enabling patients to continue in their jobs with only a short break. Rehabilitation, therefore, has little place in today's context. Stigma against the disease is now a minor factor, and does not appear to influence patient behaviour to any significant extent.

In view of these changes, the CNAPT has officially been given the task of promoting health education. The medium term plan for the control of tuberculosis in Sri Lanka, as formulated by the Ministry of Health in the late 1980s envisages a special role for the CNAPT. As a result, the CNAPT was allocated the official task of attending to all measures relating to health education of TB.

The Association provides the respiratory control programme (formerly Tuberculosis Campaign) pamphlets and posters necessary for the purpose. The CNAPT also conducts special booths on tuberculosis at all major exhibitions in the country.

-P. D. Fonseka , Executive Secretary ,CNAPT

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