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Health and misrule

Three or four decades ago, Sri Lanka's social welfare system could have been considered the pride of Asia. Today, it would be extremely difficult to make the same claim. For, social welfarism has begun to play a declining role in Governmental policy and decision-making.

These issues are brought to the fore once again by the country's dismal failure to meet, for instance, the health needs of its population, in which more and more elders are beginning to figure prominently.

When social welfarism inspired State policy in a significant way, it was possible to establish primary health care services islandwide, which had the positive impact of increasing the life span of the average citizen. Today, the average female life span in this country exceeds the Biblical three score years and ten.

However, an increasingly shrinking budgetary outlay for health care services ensures a declining quality of living for almost the entirety of the poor and vulnerable groups, such as the elderly. Today, we are compelled to face the grim reality that "increased longevity without quality of life", is, indeed, "an empty prize". Increasing beggary among some sections of the elderly bears this out very cogently.

We are compelled to take up these issues by a thought-provoking report by Professor of Forensic Medicine and Toxicology, Prof. Ravindra Fernando, excerpts of which we published in our 'Health Watch' page yesterday. The principal thrust of Prof. Fernando's paper is that we have failed to attain the World Health Assembly-mandated, health for all by year 2000 goal. Some vital statistics in this report provide the reader with the main reasons for this failure. "In 2000, Sri Lanka's total national expenditure was over Rs. 450,000 million. On the health sector the expenditure was just over Rs. 19,000 million, amounting to only 4.2 per cent," the report points out. Considering this comparatively minuscule budgetary allocation for health, it shouldn't come as a surprise if the vast majority of Lankans are experiencing a drastic decline in their quality of life. The majority of Lankans, after all, belong to the non-affluent strata.

We agree wholly with Prof. Fernando that the "trickle down effect" in economic growth couldn't be relied on to meet the basic needs of the poor. Somehow, economic wealth hardly "trickles down" to the people who need it most. When the acquisitive instinct in man is wetted by market forces, this process cannot be expected to take hold. This is the reason why, the world just cannot afford to say "bye for ever", to the welfare state.

The world needs to look sharp on this score. Hunger breeds discontent and discontent produces bloodshed and violence. Some waves of discontent in our region which are conveniently labelled as "Maoist" rebellions, bear the hallmarks of this hatred and anger.

It is usually misgovernance and naked exploitation, which facilitate these conditions. Sri Lanka saw this happening over the past seven years. Misrule and mismanagement reached such daunting heights that by the end of last year, the Government exchequer was almost empty. Economic performance had hit an all time low.

We are now witnessing a period of economic reconstruction. The hostilities in the North-East are on hold and more and more money should be accumulating in Government coffers. It is vitally important that the Government learns the lessons of the past. The poorest of the poor and other vulnerable sections cannot be allowed to fend for themselves. If this happens, only the country's beggar population would increase, producing grave consequences.

One lesson that needs to be learnt well is that the welfare state cannot be totally dismantled. Welfare benefits need to be revived and siphoned to the needy so that there will be more productive persons around.

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