Tuesday, December 15, 2020

A Truth Universally Acknowledged

Image credit: MyDoctor.lk



Sri Lanka has universal health care. What this means in theory is that public health care and treatment by doctors and nurses is free of charge to patients in the public system. 


What this means, in practice, is that those who do not have the financial resources to access private health care options have no alternative but to seek the assistance of doctors, nurses and medical personnel in the public system. 


There is a great deal of fallout from certain ineffective processes in the current health care system, in terms of diminished quality of care offered to patients. 


A friend of mine lost her sister after a standard surgical procedure that resulted in infection. It was a relatively ‘standard procedure’ in medical terms, but a serious matter for the patient undergoing it - a hysterectomy. No accountability was admitted to, and no responsibility taken. The surgeon refused to take the family’s calls. 



Another friend of mine, herself a doctor, told me she had suffered a completely avoidable infection when a nurse in a reputed private hospital cut a suture with scissors taken from her own pocket instead of sterile dressing scissors. ‘I literally had no time to react or shout NO!’, my friend said. 


Due diligence and extreme vigilance are required by patients faced with these kinds of lapses in the standard of treatment and care they are offered. Patients themselves are often in a weakened condition due to their illness, and are vulnerable as a result. So they need to have someone with them, who is prepared to advocate for them, and make sure their medical rights and human dignity are upheld. 


There is no real peace of mind possible until the patient has recovered and is released to go home. This is confirmed by the direct experience of a doctor working in the public health care system in Sri Lanka: 


‘When my husband was very sick with pneumonia he was under the best available care at NHSL. I was 34 weeks pregnant and sat on a stool next to him all night because of the fear that he might die due to the negligence of some of the nursing staff’.  


Another lady told me that her niece died because of an avoidable error which occurred due to medical carelessness during surgery, which was not treated properly by those presiding over her procedure. This tragic outcome was preventable, and it was not possible, in the scapegoating and gaslighting scenario that followed, to hold those concerned accountable: 


‘In 2009,  my 23yr old niece, who was 8 months pregnant, was admitted with high blood pressure to hospital, and was given a C-section, during which they had nipped one of her large intestines which of course resulted in septicemia. The incompetent doctors had no clue as to what was going on, and it was too late to save her. As you know, septicemia treated immediately does not result in death; but those who were treating her had no idea, and when they eventually did, they tried to cover it up.’


Behind the lack of concern and care a patient in this system is unfortunately quite commonly faced with, are multiple systemic issues. 


Consultants see multiple patients a day in the private sector due to poor pay in the public sector (private practice was approved in SL because the government cannot afford to pay the salary according to the admin grade). 


The primary issue is that the skills of the consultants are accessed through multiple means, including self-referral of patients seeking expert opinion, instead of through a proper referral pathway. In other countries, your General Practitioner must refer you to the relevant consultant, after the appropriate tests are done. There is no such filter mechanism here.  


Damned if they do and if they don’t, doctors who self-limit the numbers of patients who can consult them are often also blamed, because there aren't  enough doctors to meet patients’ demand. This situation would be far less vexed if there was a proper referral system in place. For example, one consultant neurosurgeon only sees patients on referral. He has limited the patients who he sees, to only those who actually need a neuro-surgical opinion.


There is absolutely nothing limiting a patient with a headache in Sri Lanka self-referring to a neurosurgeon, instead of a GP or Physician or Neurologist, which would be the proper referral pathway in the UK and Australia. 


The notoriously long waiting times for patients are blamed on the doctors, but are actually often due to administrative issues. Doctors working in hospitals are emplaced in a situation which gives patients access to their skills in ways which maximize profits for the hospital. There is nothing stopping the hospital giving a tiered/staggered appointment system, which means multiple patients are booked in at the same appointment time. The pressure of time is then strong on the doctor to give a mechanical and brief consultation with minimum patient contact, and move on to the next one, in a form of conveyor belt medicine. 


The vast majority of smaller private hospitals catering to the majority who choose private healthcare still only give an arrival time. There is no need for patients to be waiting for 3-5 hours for a 5 minute consultation. It should be possible for patients to find out the approximate time that their appointment will be coming up in the schedule list, and ask to be notified 5 or 10 minutes before by the hospital administration assistants. This would help mitigate the frustration and stress of delays. 


Some hospitals demand that doctors take a minimum certain number of patient appointments for a day, saying they cannot cover their overheads. If the doctor is just starting out, it makes it very difficult for them to decline. 


A central issue is the low pay for doctors, even in the private sector. Doctors in Sri Lanka are aware that their medical colleagues in the US, UK and Australia laugh at consultants in this country for charging a fee of less than $10 per patient for their service, time and skill. (In the breakdown of fees, the major component is the hospital charge). But this is the case in many industries in this country, where professionals are forced to adjust their fee rates according to the lower economic capacity of their clients, relative to the training they have themselves received. 


Many patients complain about the long waiting times to see a consultant in this country. For example, when a specific specialist procedure has to be performed, where the doctor in question is the only one with the extensive training needed, frustration often ensues. Although it doesn't take very long, and it is not immediately apparent, multiple parts of the baby are seen and assessed and measurements taken, and a judgement given, regarding the situation in a foetal anomaly scan, for example. 


When a doctor is known to be excellent, people they know personally, and the patients referred from the private sector, are naturally interested in getting an appointment with them. The lack of clarity and open access to the doctors in the current health care system means that doctors are overwhelmed with numbers of patients. 


Now there are several doctors who self-restrict numbers of patients per day, and have weeks to months-long waiting lists. This cannot be done for scans and other procedures that need to be done within particular time frames. 


In this era of high social media usage, the social media posts expressing patient frustration would read something like: “I wasn't able to get an appointment, and this problem was missed, and it could have been corrected. Why should the doctor restrict patients? S/he is duty bound to serve them."


Many doctors have taken a decision to work even until the small hours of the morning to do tests and scans. This is at the expense of their own family life and their own health. And this is despite the prevailing recommendations they themselves give to their patients: that everyone needs healthy food, exercise, relaxation and at least 6 hours of sleep. They are putting themself at risk for an early heart attack or stroke. 


However dedicated a professional person is, working 18+ hours a day, even doing work you are passionate about, is challenging in a less than effective structure. Not when it's 4-5 days a week, for the past 5-6 years and possibly for the rest of your working life. 


Many doctors in this situation would prefer a good job in a big city in the UK, with a high salary, and a limited number of patients per day. To keep talented, skilled and dedicated medical personnel in the country, the systemic clinical administrative/support structure really needs to improve. Thorough training in communication and attitudes needs to be seen as essential, and sought after by doctors as part of offering professional best practice to the vulnerable patients in their care. 


One of the present Deputy AGs, Dr. Avanti Perera, wrote her doctoral thesis  in this area, and the thesis was published as a book titled "Medical Negligence in Sri Lanka". So there is currently some realization that systemic change needs to be formulated and implemented. 


Social media has helped draw attention to actionable areas of improvement by providing a public forum in which the lack of accountability, poor communication skills, dismissive comments and uncaring attitudes of doctors are frequently brought up and debated. On FB and WhatsApp groups, doctors are frequently complained about by name, with specific details of complaints being mentioned. 


Of course, it is entirely the right of patients to complain. However, as they lack insight into the systemic challenges faced by doctors, this unfortunately leads to lowered morale and confidence in the health system in the community at large. It has been noted that almost 40% of the cases brought for complaint are due to poor communication between doctor and patient, rather than actual negligence. 


While researching this issue for this column piece, I received a letter from a Sri Lankan doctor who had trained in this country, and is now working in the U.K. Her comments are worth listening to: 


“I worked briefly in the medical league in Sri Lanka and sought ‘pastures greener’ over a decade ago. I was always fighting an inner battle with my conscience when I was working in Sri Lanka, and have found definite peace with my chosen calling in a different and satisfying atmosphere here in the UK.

I have shied against coming back to work in Sri Lanka mostly to avoid the confrontation it would require with the system in order to work there with a conscience. 


I dread the situation for the common man and woman who has to deal with this on a day to day basis.


My parents are alive only because I wasn’t living in Sri Lanka and was able to demand what was necessary for their care. I shudder to think what would’ve been the alternative. 

I would have liked to be brave enough to change the culture in the health care system I worked in, but it is not a decision to be taken lightly.

The first step would be getting enough people talking about it to make a change.”


It is my hope that this article will be part of that community conversation that prompts this change.

Beauty in the Post-Feminist Era

 

Image credit: ‘The Dream Come True’ rose



There’s a perception that beautiful people have direct and unfair access to the good things in life: success, fame and admiration from an early age. This complicates their lives in sometimes unwanted ways. While they have all been  greatly admired, and desired, they have all also often been objectified, stereotyped, suspected of using their looks as a shortcut to success - and resented by some (often ‘frenemies’) who would like to see them fall flat on their lovely faces! 


I recently interviewed 4 Sri Lankan women who are famous for their beauty, about their experience of being seen as exceptional  in a world which idolizes and commodifies them. Three of them have been crowned with National and International honours, and are judges and mentors in the Beauty industry. Shirlene Chiba has been additionally associated with the luxury hotel industry, and is renowned for her generous charity work. Angela Seneviratne is a famous actress, dramatic artiste and columnist. Shivani Vasagam Wedanayake is a super model, beauty queen and entrepreneur, and Natasha Rathnayake is a celebrated singer and performance artist, recipient of many awards in the music and performance industries, and a goodwill ambassador for ‘Educate To Protect’. 

Shirlene Chiba


Shirlene was Miss Ceylon 1965, Miss Universe contestant 1965, Miss World contestant 1965, Miss Asia contestant and Miss Talent winner 1969, Miss International Contestant and Representative at the World Trade Fair 1970. 

Angela was Miss Sri Lanka for Miss World 1975 and First Runner up to Mrs Sri Lanka for Mrs World, 1984.

Angela Seneviratne


Shivani was Model of the Year, ‘92,

Miss Sri Lanka for Miss Universe, ‘95,

Mrs Sri Lanka ‘99 and

Mrs World - 4th runner-up ‘99/2000.

Shivani Vasagam Wedanayake


All four are public figures, familiar with receiving attention from the Sri Lankan community, both local and international. I asked them: What did it feel like to inhabit this publicly praised face and enviable body? Did they enjoy being lovely to look at, and did they succeed in achieving the happiness they wanted, as well as all the prizes and trophies and career opportunities that have accompanied their progress through life? 

Physical beauty makes those who possess it feel ‘like a million dollars’, but it is an asset that does not hold its value - giving the owner diminishing returns as it fades over time, but prompting their character to grow. All four ladies concur that there must be more to us than surface beauty if we are to develop our whole selves in response to the challenges to which life exposes us, and the opportunities it brings us. 

When I interviewed Shirlene, Angela, Shivani and Natasha, I found them to be powerhouses of intelligence and vitality. Their creative and multi-faceted personalities make their life experiences interesting to read and listen to. I thank them all for taking the time to answer my questions with honesty, thoughtfulness, insight and openness. 

Natasha Rathnayake


What have they loved about being beautiful? And what have been the drawbacks? What do they think about society’s obsession with external appearances? 

All of them commented on the benefits of the international experience and perspective their success has brought them. Shirlene said: ‘I am blessed and grateful for my looks, which have done so much for me. My life changed forever after winning the Miss Ceylon 1965 Beauty Contest.’

Natasha comments that: ‘I love that most perceive me as a role model. It gives me a sense of purpose to use my platform to do good and educate the present and future generations to see beauty in a different light.’

The drawbacks, according to Shirlene, include: ‘Being misunderstood. In this country of ours, being a beauty queen has a little stigma added to it. It is taken for granted or assumed by some men that you are “available“ for them to have some fun with. THIS IS NOT TRUE - in fact, I feel we ‘beauty queens’ have more power to say NO. I have always fully exercised this power!’ 

Shivani directly addressed the unwanted attention which beauty evokes from the opposite sex, to the point of constant harassment: ‘The advances from the opposite sex... have no limitations, along with the fear of walking into a place unaccompanied.’ It has also impacted her professional life: ‘As an entrepreneur, I co-founded a company called WEB Syndicate, Sri Lanka’s first web development company, in 1996... an era in which we never saw women in the IT industry, which was dominated by men. So ...wherever I went for board meetings or to meet clients, it was challenging, since it was tough to handle the many stares from men. As good as it is receiving attention to get your point through, or beating your competition, it’s a NO when attention is given for the wrong attributes. The worst of all is that your talent and knowledge get overshadowed when physical beauty overpowers them’. 

The same society that praises you can also be very vicious in its judgment, as Shirlene says: ‘We are all judged for the wrong reasons. We live in a back stabbing, throw away society. I assure you, my heart is more beautiful than my face. I wish people to see my heart.’

Angela points out that: ‘Envy, jealousy, the venom of people’s malice, are all a part of the hurt one has to bear. In Sri Lanka, where there is intense belief in sorcery, there is the additional fear of “evil eye”’. 

All concur that it is important to develop inner character, so that, as Shirlene says, ‘I don’t depend on my looks to see me through: it is the love, helping others, compassion and empathy that I have for everyone that will live in me till I die. So even if my looks fade or any calamity befalls me, I hope I will be loved and remembered for those virtues more than for my looks.‘

It’s important to realize that beauty is constructed, as Angela notes: ‘Over the years, beauty has moved from natural to manmade: botoxed, carved, shaped, tinted, tanned, bleached, sutured, lifted, tucked, and reshaped, re-molded and recast. The artificial addition of false hair, lenses, nails, bosoms, and buttocks, all take physical beauty to another level, but an impermanent one. With ageing, the effects of all those would be almost grotesque... I do urge everyone to accept the process of ageing as gracefully as one can, as whatever we  do, we cannot defy the natural changes that nature bestows upon us with time.’

Being beautiful in our youth, we can become distracted and desensitized to the fragility of human life. Perhaps even more so in the disrupted and uncertain times we live in, we need to be aware that health and well-being are more important than surface appearances: 

Shivani asserts that: ‘Physical beauty fades with time, but the inner beauty shines through the extraordinary circumstances that you are faced with. Accepting your losses, and moving away from the tragedy of losing your looks as a result of illness or accident is painful, but the key is to keep your mental equilibrium in check... Setting an example for the next generation is important. Therefore, panicking and putting too much emphasis on the physical attributes alone will only bring unhappiness when you lose it all’. 

Natasha succinctly states: ‘If we base our validity on superficial things, it would have a catastrophic effect on our mind, body and soul.’ 

We talk about constructed realities and it would seem Beauty is one of them. For example, how different we look after a makeover or with our face sculptured, and our eyes done up and our hair styled. It’s hard to embrace inner beauty with all that going on. Women are influenced and manipulated by a myriad social cues to look a certain way. 

Modern beauty queens are especially aware of this. Shivani says: ‘Beauty today is defined by a confident woman...No longer is beauty defined according to another’s perception...If a woman is of substance, that’s the key to her appeal.’ 

Angela agrees: ‘Beauty contests give women the platform for empowerment and also the confidence to represent an entire country to the world outside.’

Focusing instead on core character values is what has shaped their lives: 

Shirlene confirms: ‘It’s 3 words: Empathy, love and kindness. I did not have to do much to develop it... I have seen a lot of wickedness in the world. And this is my response.’ 

Angela gives us some important context: ‘In the present day, there is a whole new race to keep up to expectations that life, society, community and the generation throw in our paths: one is almost buried under an avalanche of pretense and hypocrisy, largely projected onto us with the easy access to social media, and misused more often than not. The core of it all, sadly, is to show off!!’

In contrast to that, Angela says, is the power we all have to develop the capacity to respond to life’s challenges with wisdom: 

‘My greatest strength I know now, is the ability to forgive, to accept, to move on, and to shut my mind to vindictiveness and revenge, which are by nature the normal ways of dealing with the wrongs of life... It is all a matter of choice... our minds are a very important tool to cope with situations.’

Natasha points out that the publicity that beauty and success brings with it also makes beautiful women a target of unwanted negativity: ‘Having been subjected to sexism, sexual harassment, cyber bullying and constantly having to prove my worth - showing that I’m way more than what meets the eye. I speak for every woman who experiences misogyny. 

The superficial judgments we make of ourselves and others stem from the limitations of our conditioning and the way we perpetuate stereotyping of people. As if there was one box that fits all?! Those who don’t conform, are usually known as the trouble makers or the unpopular individuals of society that are demonized for simply being themselves and living their truth, whatever that maybe, and most times these societies end up deciding they would be their judge, jury and executioner, and ridicule them in social circuits or on social media. 

Do I think it’s fair? Absolutely not! ...We should be accepting people for who they are, rid of all biases and labels. There is beauty in every person, if we choose to see it with an open mind.’

Beauty pageants in the contemporary world are criticized for playing to the male gaze and drawing attention only to women’s appearance. But, as Shirlene points out: ‘We have many kinds of contests. Sports of all kinds and much more, so why not beauty contests? A beautiful woman is an amazing creation. Admire it! In my time, beauty contests were physical. Beauty of face and body. Today beauty contests have taken a whole new meaning. Intelligence being a big one.’

Shivani strongly agrees: ‘Pageants of years gone by united women of different looks from all over the world to compete and celebrate their beauty which was purely physical... Today, beauty pageants give opportunities for women to advance their careers... and gives them a platform to voice their opinions. Since stardom and fame propel you to become a public figure, it’s important to have pageants of this nature for women to propel change in the status quo. You are heard because of the status you hold as a well known personality in the country and in society... The pageants today want to promote women to play leadership roles in their community and country, in today’s context. This inspires other women to be part of a larger milieu. To be a role model for other women, rather than be just wives, mothers and daughters. Beauty pageants today are held to celebrate accomplished women who embody ‘’beauty with brains’’ in the modern world.’

There’s plenty of competitiveness and injustice behind the scenes in the beauty sphere, and the enforcing of ideals of beauty which are body shaming, sizeist, and colour shaming, but these industry challenges call participants to have the courage to look beyond their own good fortune, to what is being endorsed - and often to challenge it. 

Natasha highlights the resilience that is required to use the superpower of beauty well: ‘The beauty of life is that it allows us to use even the bleakest of situations to our advantage. Beautiful journeys have started from these platforms, giving opportunities to countless young women around the world, to pursue their hopes and dreams, instilling values to our societies, championing other women, using their voices to implement change for women and children’s welfare, changing government policy to make it more women-friendly. There is still more work to be done, but it’s beautiful to see this revolution amongst us women, taking effect at least now.’

Woke Rather Than Awake

Image Credit: Loughborough University



We live in an era when the rise of the recognition of previously unrecognized human rights coincides with the perceived inadequacy of governments to address them. 


This gap between social needs and their fulfillment has resulted in the rise of a group which is popularly known as SJW - or ‘Social Justice Warriors’. Many of these are millennials, born into a disintegrating global world in the past 25-30 years. They are highly educated, and often poorly paid in exchange for their qualifications and skills. 


They are highly articulate, and often come from minority ethnic groups in majoritarian nations. They are combative, challenging and often incensed by the world around them, in which primitive ideas like patriarchal supremacy, racism and class bias proliferate. They sometimes use their ‘victim status’ to gain sympathy, support  and access to liberal humanist circles in first world nations, which they then criticize from within, protected by the political systems of the countries to which they have gained admission. Pushback for this is inevitable, given the power structures of the world as it is, yet it seems to come as a surprise to many of them when they are accused of victim narcissism, hypocrisy or trauma peddling. 


They have had to fight for their social and political space, from a marginalized and disrespected race, gender and class position. This makes identity politics their sigil and their war flag. This also makes them almost permanently frustrated, accusatory, stressed and angry. They are constantly mocked, accused of being ‘fragile’, ‘snowflakes’ and ‘easily triggered’. (It’s enough to make anyone furious.) They are offered ‘cheese with their whine’, because everything they write is seen as a complaint. 


But they do themselves few favours by constantly arguing with people who they stereotype as ‘against them’, and who they frequently assume are biased towards them, as they pride themselves on ‘speaking Truth to Power’. ‘Justice’ is their catch cry, but they are often unjust in their own dealings with others, quick to make demeaning assumptions about those who oppose or do not agree with them. 


In fact, it is eye-opening to see the way some of the SJWs operate on social media. Acutely aware of their own rights, they are frequently not so aware of their responsibilities in social discourse. They focus on what is due to them, and praise themselves and each other for their contributions to making the world a better place. They form cliques and conduct campaigns to raise awareness. Not all of them are well educated in the issues they dispute about.


And many of them are card carrying, core citizens of Cancel Culture. 


They are the products of a narrowing world, and a highly technological era, where many of the views they hold have been prompted, influenced and disseminated by global social media platforms like Facebook and Twitter. It is important to recognize that these  platforms were created not (as their creators assert) to enable the construction of communities but to mobilize interest groups and weaponise opinion. And they have been very effective in doing so. The social and political world today is a divided place, noisy with the self assertions of everyone with an opinion to put forward. Which is everyone, especially those who were not often listened to in their youth. They are given a platform on which to perform. And perform they do. 


The journalist and social media commentator Thulasi Muttulingam recently commented on what she saw as ‘The habit of the Generation X, Y, Z generations to label people they disagree with as “ist” or “phobe” of whatever kind, along with the push to cancel their lives and employment’, observing that ‘They act like a witch-finding mob on Twitter... (exhibiting a) crazy mob mentality,’ making the experience of participating on the Twitter platform like navigating ‘a minefield’. 


The very same people who campaign for human rights and social justice are often both cruel and malicious to others, justifying their viciousness with accusations that their target ‘deserved it’, because of whatever transgression they had committed. Sometimes the target’s perceived transgression is expressing a racist or anti-LGBTQI or anti BIPOC viewpoint. Reductive labels are routinely thrown at the perceived transgressors, along with accusations of white supremacism, elitism, and unconscious or conscious bias, and their reputations are shredded and their metaphorical statues toppled down. 


Those who behave like this start by criticizing, commenting and getting rewarded for their sassy sound bites with accumulated likes and positive emojis. Some grow out of this performative reactiveness, often after achieving some professional success, and realize that constant arguing is not a good look, after a certain age. But some increase their efforts until they cross the boundaries into slander, defamation and libel, conscious only of their own freedom of speech - and impervious to the equal rights of others to express their opinions without being targeted as criminals. 


‘Too many people alert and woke rather than awake’, commented Muttulingam. I would say they are not so much ‘alert’ as constantly vigilant. On the lookout for anything offensive. Glorying in causing disruption, to admittedly unjust and out of date systems. Constantly triggered. To the point of exhaustion, burn out and compulsive bridge burning. Each time they offend someone in retaliation for offense given to them, they tell themselves they are too big for the littleness of that person. Very little self evaluation is undertaken, and indeed in such a stone-throwing, volatile, reactive context there is neither time nor mental space for such a  necessary activity. The enforced democracy of the platforms results in experts and amateurs co-existing, and the value of their contributions being equated in real time. Some of the differences which are thereby erased should instead be noted and recognised. 


The entire culture suffers as a result of all this. Instead of engaging in a litany of clamorous complaint and retributive remonstrance, these people could be engaging in politics, and pushing through legislation to change the society as pioneers of socio-cultural innovation. 


But first they must comprehend that reactivity blocks reciprocity. This combative conduct does not build community, but incites mockery, vengeance and contempt. SJWs are accused of being attention-getting opportunity hogs, focused primarily on their own self advancement, and hitching their campaigns to the causes which gain the most primary traction. In their wish to assert themselves and provoke response, a pathological narcissism is sometimes evident. Some might say this is a primary qualification for entry into politics. 


Yet at their best, SJWs are admirable people: many of their ideals are deeply and sincerely held: they believe in the decolonising and equitable redistribution of wealth, power and privilege. They believe that access to privilege should be shared, for the benefit of all. They believe in giving opportunity to those who have often been systematically overlooked, and whose voices have been suppressed and overridden. Because they themselves have been denied a seat at the tables of influence, they are more mindful of who is missing in any social space they come to occupy. They tend to compulsively critique and challenge stagnancy and inertia. 


They proudly and loudly assert their identity markers - gender preference, ethnicity, neurodivergent status and political beliefs - in their Twitter handles and Instagram and Facebook profiles. They believe in accountability and try to live lives aligned with their values. They discount objectivity and detachment as goals of conduct, or even a possibility, and state that their own subjective biases influence every choice they make. Their communications are laden with acronyms and jargon. Their favourite word is ‘unapologetic’. It’s sometimes a veneer for a lot of disrespect and rudeness. 


It can be noted that many of the active participants in cancel culture are formed by a heavily virtual world. They study and interact online, and in their formative years spent hours playing video games, with a heavy focus on combat and war set in fantasy worlds where violence had no consequences in the real world and the damage inflicted carried no moral or legal accountability. They blur professional and personal boundaries. And many have a library of memes with which they respond to others, to save time in formulating a personal response. It takes some painful mistakes before people so prideful and self focused develop any empathy or compassion for anyone’s rights other than their own. 


There’s an intensely oppositional and confrontational attitude prevalent wherever cancel culture club members congregate in cliques. This can only be remedied if it is not rewarded, and when the systems which they are at war against self correct, in response to the sustained attack on their citadels. Which they should. Because racism, sexism, systematic inequity and normalized discrimination are unjust. And this blocks and prevents full social participation by many talented people. 


But any gains in social equity will be delayed if over-reactions occur, incited by those who go too far, armoured in self justification, reinforced and amplified by echo chamber buddies, and impervious to alternative ways of seeing the world. It is in the power of choice of these creative individuals to course-correct, and refrain from becoming iterations - and grotesque versions of - what they started off protesting against. Then we can truly advance - collectively - towards a higher level of social justice, led by their brilliant instinct for disrupting the status quo.

Sunday, December 6, 2020

A WRITER’S GIFT TO HIS COUNTRY

A Writer’s Gift To His Country’ by Yasmine Gooneratne and Devika Brendon. Published in The Sunday Island in two parts in December, 2014.




Martin Wickramasinghe: The Uprooted Trilogy (Gamperallya. Kali Yugaya and Yuganthaya in English translation) three volumes. Translators: Ranga Wickramasinghe. Lakshmi de Silva, Aditha Dissanayake, Deenesha Wickramasinghe. Paperback reprint. 2014 


The search for roots is a central theme in Martin Wickramasinghe's writings on the culture and life of the people of Sri Lanka. When he published his novel Gamperaliya in 1914, it was instantly recognized as a landmark in Sinhala fiction. attracting praise from some of the most important critics of the time. Yuganthaya followed (in 1949). Both books, quickly recognized as two parts of a single work, were readily accessible, but only to readers of Sinhala: few English or Tamil readers of the 1940s, even those familiar with Scott, Trollope, Dickens or George Eliot, but with no great expectations of pleasure from the reading of a Sinhala novel, would have made the effort to access them. If English translations of Gamperallya and Yuganthaya had been undertaken at this point, the literary value of the work and the important issues it raises might have been brought without delay to the consciousness (and the conscience) of the nation as a whole. Written "by Malalagama Martin Wickramasinghe to give serene Joy to the people by presenting a microcosm of the life of the Sinhala people of our times". Gamperaliya could then have really become the possession of "the people" as a whole: i.e., of a public constituted not only of Sinhala readers, but of Tamil and English readers as well. 

With good English translation. Wickramasinghe's novel could also have reached an international readership, and taken its rightful place among other classics of world literature. 

Sadly, English translations of Gamperaliya and Yuganthaya were not undertaken in the late 1940s or even in the 1950s. a circumstance attributable partly to the Pact that in the mid 1950s. tragically. politics overtook literature. The Official Languages ('Sinhala Only') Act was passed in 1956, Installing Sinhala as the island's 'official' means of linguistic communication, and effectively down-grading the use of English. The long-term effect of this well-intentioned but ultimately disastrous piece of legis-lation was to discourage the local reading public from engaging seriously for many years with con-temporary English-language literature, including translations from Sinhala and Tamil. Gamperaliya did not make It into English until 2009. when the author's youngest son Dr Ranga Wickramasinghe undertook a translation. Collaborating with Dr Lakshmi de Silva (the experienced critic and trans-lator who had earlier produced a superb translation of Wickramasinghe's Ape Gama under the title Lay Bare the Roots), Dr Wickramasinghe published an English translation (Uprooted) that made his father's ground-breaking novel accessible to all. 

This long-awaited event was welcomed in The Island. in a fine review by Carol Aloysius, who rec-ognized the publication of Gamperaliya in English as fulfilling an important need of the English speaking read-ership in this country: namely, to gain an insight into what the peasant society of Sri Lanka was real-ly like. in a period of transition. The author, with his roots in the deep south, was able to portray that society in an authentic and convincing manner to his readers, often drawing on his own observations. experiences and feelings. 

The Galle Literary Festival was evolving the first of its annual programs at the time and, having some input into the planning of that, one of the present writers suggested to the organizers that they might consider giving Gamperaliya. a classic Sinhala work now available in English for the first time, a continuous reading at the Festival. The inspiration for this was, of course, the annual read-ing of James Joyce's Ulysses that takes place in Dublin every year as part of the '13loomsday' celebrations. The concept was considered a good one, but time was short, and although a celebration of Martin Wie.kramasinghe's life and work was even-tually undertaken at the GLF. it happened in a later year, and did not focus on Gamperaliya. 

A third novel to complete Wickramasinghe's Sinhala trilogy appeared in 1957. Its title. Kaliyugaya (The Age of Darkness) relates overtly to the darkening prospects of the Kaisaruwatte family as it leaves its life in a southern village for a cultur-ally rootless existence in the city From the cultural standpoint, however, the title of this third book car-ries overtones that are grimly apt in their relevance to the predicament of Sri Lankan society as a whole. Although in the areas of drama and poetry Sinhala literature did break new ground in the mid-1950s, the legislation of 1956 had ushered in what was, for the English•educated segment within the nation, truly a cultural 'age of darkness'. The prospects for culturally unified literary development in Sri Lanka continued to pro. gressively decline, and a disgruntled English-speaking middle-class (which Includ-ed many dedicated teachers of literature) left the island for employment abroad. 

Then in 1963. the unexpected occurred. Film-maker Lester James Peries, an admirer of Martin Wickramasinghe's writing. attempted an adaptation of Gamperaliya into a movie. It seems that the author had been ini-tially reluctant to proceed with the idea, think-ing his novel wouldn't make good cinema, but he had eventually agreed. Peries's invitation to the late Reg! Siriwardene, a scholar of exceptional skill and sensitivity. to script the film, was another inspired move. Viewers of Gamperaliya duly acclaimed it: they had already seen an earlier film made by Peries (Rekawa), and they were aware, too, of the parallel success in India of Satyajit Ray, with similar material, In Pather Panchali. 

(Influences from India might not be as healthy today as they were in 1961. Viewers have become addicted in recent years to Hollywood musicals and over-heated teledramas, and the difference between novels and the movies that are made of them is not always understood. Teachers of English literature hear evidence of this quite often, even in a class-room, when the question "Have you read Pride and Prejudice?" or Great Expectations, or even Hamlet. can receive the wholly inadequate reply from a stu-dent: "No, but I've seen the movie". Pressure exert-ed by the box-oMce, too, is often responsible for dis-disastrous mis-casting in Peries' filk of the village in the Jungle. Arthur C. Clarke with his American accent was quite unsuited to the role of Leonard Woolf's British Government Agent. Incompetent reading of the text, too, has sometimes occurred in these benighted times: the scripting of a key scene in the same film, for instance, missed a golden opportunity provided by the novel, when the 'civi-lized' West in faultless evening dress meets the 'primitive' East clad only in a loin-cloth on the AGAs veranda. 

Encouraged by the local and international acclaim that greeted his film of Gamperaliya and undeterred by the culturally divided nature of the viewing public, Peries then made movies based on the other two novels of the trilogy. He could not, unfortunately, secure Siriwardena's assistance in scripting them, but it is to Peries that readers of Tamil and English owed (until 2014) some acquain-tance, at least, with the work of Sri Lanka's great-est Sinhala author. 

It is, of course, sadly true that great – even the greatest – novels seldom make it into the movies without some kind of distortion. This occurs chiefly because novelists and film-makers have different objectives in view, and the genres in which they work, though related, are by no means the same. Any knowledgeable film critic can cite dozens of examples in support of this statement: despite the charm of Greer Garson and the gallant bearing of Laurence Olivier (its principal stars), the film made of Jane Austen’s Pride and Prejudice in 1947 is a well-known instance of such distortion.

Coming closer to home, the movie made by Dev Anand in 1965 of R.K. Narayan’s masterpiece The Guide is another. (Readers interested in following up this latter reference could look up Narayan’s brilliantly humorous essay ‘Misguided Guide’, which tells the story of the travesty that was made of his novel by well-meaning Indian movie-makers.) Fortunately for Martin Wickramasinghe’s trilogy, the genius of Peries, Siriwardene’s sensitivity and subtlety, and the responsiveness to text and direction of a perfectly chosen cast that included Punya Heendeniya as Nanda and Henry Jayasena as Piyal, saved Gamperaliya from becoming what it could very well have become in less competent hands – just another romantic story of thwarted love with a fortuitous, happy ending, obscuring Wickramasinha’s serious theme: the gradual replacement of the traditional economic and social structure of the village by commercial city influence.


Sixty-five years is a long time for a gift to await unwrapping, but at last, in 2014, all three volumes have become available in English translation as a single three-part publication, under the title of The Uprooted Trilogy. Published in the form of three neat paperbacks, Uprooted, The Age of Kali, and Destiny, the texts vary somewhat in literary quality: none of them benefited from professional literary editing. (Destiny, in particular, could have done with some editorial advice relative to pp. 122-123, where a detailed description of a surgical operation on an infected abscess, derived, we understand, from the author’s observation of the late Dr P.R. Anthonis at work, and therefore valuable in itself as a memento of friendship between two great men of the time, but quite out of place in a novel, is inserted into the fictional text.) The three parts can, however, be read as a continuous work in the style of a three-volume 19th century English novel. Gamperaliya in translation is certainly a substantial book (222 pages), the other two are much slighter in size. But even a reader who has acquired the short attention-span of a teledrama addict would find The Uprooted Trilogy a much less daunting proposition than a novel by George Eliot or Charles Dickens.


In order to assist new readers who may be unfamiliar with both book and author (and where necessary to point up the differences between the films and the fiction), we give below a brief summary of the plot – or ‘plots’- of the three parts of The Uprooted Trilogy.

Part I: Gamperaliya. Published in Sinhala in 1944, The Uprooted depicts the crumbling of traditional village life under the pressure of modernization. That life, which is symbolized by the Mahagedera (Great House), located in the village of Koggala, is the ancestral home of the Kaisaruwatte family, Sinhalese people of quality who belong to the rural gentry of southern Sri Lanka. The head of the family holds the distinction of ‘Muhandiram’, which confers upon him both official authority and social leadership: the Muhandiram and his equally well-born wife, Matara Hamine, are the acknowledged leaders of Koggala village society, respected and looked up to by every person in the community. Like them, their children (two daughters and a son) have been brought up in the unostentatious but nonetheless dignified consciousness of an ancient lineage. In this close society, where every individual knows the family background of everyone else, high-born or not, personal aspirations must give way to social considerations. And so, when Piyal, a personable young bachelor from a neighbouring family, is hired to teach English to the Muhandiram’s younger daughter Nanda, and falls in love with his beautiful student, marriage with her cannot, according to the elders of her family, be a possibility: Piyal’s family, though respectable, is well known to be of lower social standing – his grandfather is remembered to have been at one time a vendor of vegetables to the Mahagedera kitchen.


Although the Mahagedera in its pride would most certainly regard a marriage proposal from him as an insult, Piyal, who is intelligent and energetic, aware of his own abilities and deeply in love, is hopeful that it will be accepted. (Regi Siriwardena’s film script, imaginatively substituting an European fairytale for the Robinson Crusoe of the novel, shows that Piyal cannot not see why, in the words of the text he is teaching Nanda to read, a commoner should not marry a princess – when and if he can become wealthy enough to win her as his wife.) Nanda is, in her turn, attracted to him, but, restrained partly by her duty to her parents and her lineage, and partly by the confusion in her own mind as to whether she is in love or not, cannot articulate her feelings either in speech or in letters. Consequently she submits, at her parents’ urging, to marriage with Jinadasa, a young man with little to recommend him beyond an acceptable appearance and an unexceptionable family background. The latter, though it is by no means comparable to their own, the Muhandiram and his wife are willing to accept. Piyal, disappointed and resentful, leaves the village to better his prospects in the city. Nanda devotes herself to her social role of good wife and dutiful daughter, and tries to forget him.


This is not an easy thing to do, as Shakespeare demonstrated long ago: like the lady in Twelfth Night, who ‘never told her love, but let concealment, like a worm ‘i th’ bud, feed on her damask cheek’, Nanda pines ‘in thought’. Her melancholy results in a psychological condition, the treatment of which drains the financial resources of her family. Despite the Muhandiram’s efforts to preserve his family’s prosperity, his finances dwindle and the Mahagedera, the symbol of his status, begins to show signs of dilapidation and decay. The ladies of the family, hitherto accustomed to dress, decorate, and conduct themselves in a style befitting that status, are forced to adopt various stratagems in order to conceal their predicament from those outside the immediate family circle.


Uprooted describes these stratagems in detail: they include maintaining strict domestic economy in matters of household diet, crocheting lace for sale through discreet third parties, pawning their valuable personal jewellery, and gilding silver beads for everyday wear so that the most critical eye would take them for pure gold. Such seeming trivialities are not trivialities at all, for a great deal is at stake.


[This theme is carried to its logical end in Destiny when, seated alone in her husband’s Jaguar, Nanda’s daughter Nalika removed the valuable jewellery that adorned her ears and her neck. She had lost her son. She would not be able to prevent her daughter leaving her. As [the car] neared Anoma Villa, she saw the image of her face in the car mirror. She was shaken by the grief and the fear she saw in the reflection. (Destiny, pp. 219-220) The gesture (a potent symbol that was, alas, omitted in the film made of Yuganthaya), signifies Nalika’s recognition of her situation: she has lost the love of her children, her status in society, everything she values most.]


After the loss of his first child, and the death of the Muhandiram, Jinadasa, unable to support his wife or himself, leaves for the interior, hoping to make a better life for his family. He never achieves his goal and a six-year silence ensues, during which Nanda returns to the Mahagedera, and Piyal, far away in Colombo, becomes a successful city businessman. When Jinadasa is rumoured to have died, Piyal makes a second proposal for the girl he has never ceased to love. This time he is successful, and the lovers can now come together in marriage.


Although her new life takes her away from her mother, her sister Anula, and the ancestral house in Koggala, Nanda is pleased to leave the village for the comforts and opulence of city life with Piyal. Her happiness is haunted, however, by feelings of guilt, born of the knowledge that the gossips of Koggala society attribute Jinadasa’s unhappy end to his wife’s liking for high style and good living. Piyal, becoming aware that Jinadasa is still a presence in Nanda’s mind, is angry and jealous. His attitude very nearly sends her back to the Mahagedera. Piyal’s love for her is unshaken, however; and although Nanda’s family pride initially resists her husband’s apologetic overtures, both the novel and the film that was made of it in 1964 end on a note of reconciliation.


Part 2: Kaliyugaya. A drastic change of theme and temperature is immediately evident in the opening pages of The Age of Kali, which was first published in Sinhala in 1957. Although village values are still strong in Tissa and Anula, attempts by Piyal and Nanda to have their parents and her sister Anula leave the Mahagedera and live with them in Colombo are not successful. As long as she is alive, Anula, a repository of folk stories that fascinate the children, provides a link with the village for Nanda and Piyal’s son Alan and their daughter Nalika. But when Anula falls ill in the city and eventually dies, that link is broken for Alan.


Nanda, who is permanently resident now in the city and is energetically seeking acceptance in what she thinks of as Colombo’s ‘high society’, listens angrily to the 100-page letter of analytical reproach that her self-exiled son Alan has written from Britain, where he had gone with Irene, the Burgher girl he married in protest against what he had seen as his parents’ closed, insular minds. Although she had learned to read English under ‘School-master’ Piyal’s tutelage (cf. Uprooted), had taken lessons in English conversation for a year in order ‘to socialize’ since settling in the city, and has consistently spoken English at home in order (she claims) to assist Alan with his studies while he was growing up (p.3), Nanda appears to avoid reading Alan’s letter. Tactfully edited extracts from it are read aloud to her by her younger brother Tissa, who has himself changed from the playful, precocious lad the reader first met in Gamperaliya, into a thoughtful, sometimes cynical, observer of the social scene as it changes around him. His comments on Alan’s letter as he reads it, are rejected by his sister:


"So Alan [has] given up his studies and gone to England with a girl because we tried to educate him?"


"Alan has not suggested anything of the kind," said Tissa.


"Tissa, don’t you see that he is writing … with that in mind, to blame us?"


"I don’t think so. Your conscience knows it was wrong of you to have opposed Alan’s affair with Irene so harshly."


"We never thought and will never think what we did was wrong. When a child who is still studying has an affair with a woman, is it wrong to stop him?"


Although Nanda ‘aggressively’ rejects her brother’s truth-telling, asserting that their unsympathetic treatment of their gifted son was entirely justified since it was meant for his own good, Nanda’s restless mind cannot find comfort. Memories crowd in on her: she recalls her sister’s death – was it brought about by her own neglect? - and guiltily remembers occasions on which she had been unfaithful to Piyal, in mind if not in body. She might try to close her mind to Tissa’s observations, and stop her ears from hearing Alan’s reproaches, but she cannot escape ‘the intuition that … her pride in her family lineage was just a mask for hiding her self-centred thoughts and feelings’. (p.24) In the violence of her conflicting emotions – guilt and sorrow (vigorously repressed), and seething anger (violently expressed) – Nanda speaks more truly than she knows:


"This must be the beginning of Kali Yugaya, the age of destruction! When did you learn to preach this outrageous sermon, Tissa?"


"Only after coming to Colombo," murmured Tissa. (Chapter 2)


From this point on, the family’s history is a tale of unremitting change that frustrates the social-climbing Nanda, and is interpreted by her as decline, a punishment inflicted by a revengeful fate (karma). Nalika, the daughter for whom she has planned to arrange a brilliant marriage with a successful young doctor which will lift the family into the ‘professional’ class, admits to a relationship with another young man her mother cannot approve: Saviman Kabalana is, according to Nanda, the son of ‘an unscrupulous man who collects taxes from slum-dwellers on behalf of rich landlords’. Nanda learns that her daughter’s intended husband had spent his childhood amongst ‘children of the slums’, and that his father had become ‘a contractor for the city council, to remove garbage from the city streets, earning thousands of rupees from each contract’(p.156). It is clear that Nanda has not given up her pride in her family lineage, choosing to forget, perhaps, that her husband Piyal had been rejected by the Mahagedera on his first application for her hand, for similarly prejudiced reasons.


Piyal, devoid of family pride but regretfully aware that he had sometimes resorted to dishonest practices himself in advancing his own business interests, does not share his wife’s biased attitude to the Kabalana connection; but he has problems of his own. Disillusioned by the estrangement of his cherished son Alan, worried by apparent irresponsibility in his second son Chandrasoma, and anxiously dreading a break with Nalika, Piyal has begun to lose his grip on his businesses. His earlier entrepreneurial energy is giving way to feelings of futility. By the end of the novel, he has died; and although Alan and his second (English) wife manage to attend his funeral, England has ‘engulfed’ them both.


Part 3: Yuganthaya. Destiny opens on a new scene. The neglected Mahagedera, decaying with time, is little more than a memory in the minds of the fourth generation. It does not appear at all in the film that has been made of the novel. Instead, a generational clash between Saviman Kabalana, the son-in-law whom Nanda had instinctively dreaded acquiring, and their son Malin, is the focus of both film and novel. Saviman Kabalana has developed into a powerful business magnate who opposes the formation of the labour movement, while Malin, driven by ideas developed in Britain and powered by socialist theory, hopes to bring about social change. Challenging his powerful father’s uncompromisingly capitalist methods of making money and running his business empire, Malin rejects also the social snobbery of his mother Nalika Kabalana (Nanda’s daughter, who has achieved her ambition of entry into Colombo’s wealthy social world). It would seem that Nanda’s family pride, which was a key theme of Gamperaliya, has taken the form, in the new generation operating in the ‘new’ society, of social snobbery. Nanda’s younger brother Tissa, Nalika Kabalana’s elderly bachelor uncle, who still moves between Koggala and Colombo, is the family’s only remaining link with village life.


Malin, who is covertly encouraged by Tissa, has another supporter: his young sister Chamari. She (like her brother, and her self-exiled uncle Alan, before her) values her own independence, and has a kindly and charitable sympathy for the poor that is more reminiscent of her grandmother Matara Hamine than either of her parents. The film of Yuganthaya stops short after Malin obtains a parliamentary seat, by means of which he will presumably succeed in raising the living standards of the poor. The novel goes beyond that, projecting a future for Chamari as the wife of her brother’s England-returned friend Aravinda, a highly qualified surgeon with a village background not dissimilar to that of the Mahagedera family in past times.


When Martin Wickramasinghe died (in 1976, at the age of 86), independent Sri Lanka had become a republic, and undergone many changes of government. He had outlived both the Emergency of 1958, and the JVP uprising of 1971. It is fortunate that he did not live to witness the horrors of 1983 and escaped the sorrows and dangers of the LTTE war, although allusions made in Alan’s letters to underhand political moves made by Sri Lankans at home and abroad might cause the reader of Destiny to credit his creator with unusual prescience, and wonder what kind of sense Malin Kabalana, as an idealistic socialist MP, would have made of today’s murky political scene.


The publication of all three novels together is certainly a boon to the English reader who has had to wait 70 years (from 1944 to 2014) to read this classic of our literature in its entirety. One aspect of the staggered publishing history of the novels and their English translations might, however, be seen in some lights as an advantage, for as a result of it Martin Wickramasinghe’s work may encounter in some Sri Lankan readers today a much more sophisticated response than it would have met with in the 1950s. Study of post-colonial and world literature in English, which has developed in educated Sri Lankans an awareness of literary works that were once unknown or unavailable to local readers, and introduced them to new ways of assessing literature, has made its way into our schools and universities. Illuminating comparisons can now be usefully made between The Uprooted Trilogy and a long line of substantial literary works from both within and outside Sri Lanka that have common links relating to period, theme and style: among the latter would certainly be Thomas Hardy’s Tess of the D’Urbervilles and E.M. Forster’s Howard’s End, not to mention the works of the Russian masters that Wickramasinghe himself read so assiduously. In Africa, Chinua Achebe’s Things Fall Apart is an obvious candidate for literary comparison, while among works set in Asia one could cite Leonard Woolf’s The Village in the Jungle, R.K. Narayan’s The Vendor of Sweets, Bibhutibhushan Bandopadhyay’s Pather Panchali, and the Indonesian author Pramoedya Ananta Toer’s Buru Quartet.


A brief overview of some of the titles cited above may convey some idea of our reasons for suggesting them as comparable with The Uprooted Trilogy:


Pather Panchali (1929) was adapted into a film of the same name by the late Satyajit Ray, the distinguished film-maker to whose work in Bengali, Peries’ Sinhala movies have been frequently likened, and with which they (especially Gamperaliya) have been frequently compared. Pather Panchali, like Gamperaliya, deals with the life of a well-born rural family, both in their ancestral village in a rural setting (Bengal) and later when they move to Varanasi in search of a better life. Like Gamperaliya, it depicts the anguish and loss they face during their travels. Originally published in 1929, Pather Panchali was followed in 1932 by a sequel Aparajito, which was later also adapted into a film of the same name by Satyajit Ray, and that was followed by Apusansar.


Pramoedya Ananta Toer’s Buru Quartet,is a series of four novels chronicling the development of Indonesian nationalism and based in part, like The Uprooted Trilogy, on the author’s own experiences growing up. The English titles of the books in the quartet are This Earth of Mankind, Child of All Nations, Footsteps, and House of Glass. The quartet includes strong female characters of indigenous ethnicity, addresses the discriminations and indignities of living under colonial rule and, like Yuganthaya, explores aspects of the struggle for personal and national political independence.


Besides the fact that Thomas Hardy’s rich evocation of Dorsetshire in Tess of the D’Urbervilles has many parallels with the Koggala landscape depicted in Gamperaliya, Hardy from the first sources Tess’s tragic character arc in her mother and father’s unrealistic desire to resurrect their ancestral lineage and restore the family name. The scene in which Tess gathers her younger siblings and retreats to the ancestral family vault, which is the only piece of land to which she has legal claim, may seem to readers of the English Victorians as a sequence very reminiscent of Wickramasinghe. The Uprooted Trilogy is really a saga a story cycle, and cyclic in moral structure too tracing the rise and fall of a family across the generations: rising through energy and enterprise, falling through pride, inability to adapt, and insularity. It traces the rise from the Village to the City, and thus traces the aspirations of many modern Sri Lankan citizens, all of whom have rural origins, and are making their way in a post-modern commercial world, tempted by the bling, glitz and glamour of urban life, with its elegant veneers and sophisticated allurements.


We see how timely this translation is and how relevant to contemporary experience, when in modern Colombo traditional village life is represented only in architectural statements of whimsy, when traditional rural images and artefacts are routinely described as ‘iconic’, and fashionable ladies in Colombo invite each other almost apologetically for ‘just a simple rice & curry lunch’.


Although there is no evidence that Wickramasinghe, whose major interest in the European novel was apparently centred on the Russian masters, had ever read The Village in the Jungle (published in 1913) or been influenced by Woolf’s novel, it is interesting that both authors open their books with powerful evocations of southern landscapes in Sri Lanka and reflections on the effect such settings have on the characters who live in them. Both writers show us how deeply formative our social contexts are; and how, in contrast to the individualism and fragmented familial contexts of the Western world, whose lifestyle of conspicuous consumption is one to which our middle and upper middle classes aspire, people in the South Asian context can never really make their life choices independently of their sense of social obligation and the responsibilities conferred by their family ties.


In translating and publishing his late father’s masterpiece, Dr Ranga Wickramasinghe has made a valuable gift to the nation, and indeed to the world. It was high time that the trilogy really did become the possession of "the people" as its author intended, rather than remain a treasure owned exclusively by a Sinhala readership. This classic work in its English version, whole and entire, can now – at last - take its rightful place among the world’s great books. Our thanks are due to the dedicated translators who made the miracle happen while we were still alive to see it.


Dr. Devika Brendon is an award-winning Sri Lankan writer and teacher of English language and literature, whose short stories have been published in Australia and India. She is presently working on her first novel. Emeritus Professor Yasmine Gooneratne’s last-published novel, The Sweet and Simple Kind, was shortlisted for the 2007 Commonwealth Writers Prize and the 2008 Dublin International IMPAC Literary Award.



Mirrorwork

When I was a child, I abruptly exchanged a tropical bright green landscape for a dry one. Maybe when we’re young, because we are short-legged and closer to the ground, we are more acutely aware of the landscape around us when we are out in it. We immerse ourselves, as children. In order to understand something new, we go up close and touch it, and smell it and see how it feels to us. And its energy and its frequency enters our awareness. We haven’t yet learned to be cautious. It’s all a giant playground.

I used to play a game where I got an old round baking tray and filled it with earth from the garden, and picked bright flowers and pushed them into the earth, as if they were real, planted trees, in the tray around a small hand mirror which was meant to be a pond. I got the idea from a Ladybird Book. 

The flowers in my little imitation garden would wither and have to be thrown away in a few hours, but their parent plants remained vivid and growing in the real garden, the energy of the sun pouring over them, and the soil and water nourishing them from their roots. 

The first memory I have of Australia was the big sprinklers in the gardens of my school. The sound they made, like a combination of a trumpet and a large animal, as the powerful, rhythmic arc of water showered over the dry ground in scheduled circuitry. The hills, and the sparse trees in the grounds. The colours my eyes absorbed were a combination unique to Australia - olive green, ochre, grey and silver, and every variation and variegation of brown and gold. 

Australia for me then was asphalt roads and corner stores and hamburgers with the lot, with the beetroot staining through the corner of the paper bag, and potato cakes instead of chips. The safety of it, the orderliness and the sense I had of always moving in small, personally determined patterns under a vast sky, on a nature strip, as we called it in the suburbs, with radiant wattle bush and flaming red waratah, and those dry spiky freeze frame firework flowers that grow in the bush, alongside, not needing much water, but tough as they needed to be to survive. 

Sometimes in summer the heat was visible, and felt heavy in weight, the blazing sun thundering down on the landscape, the photosynthesis it prompted so violent you could feel it and hear it. In contrast, in winter the sky was often clear blue, and the plants seemed newly delicate, and the air crystalline, and the shadows slight and faint in the early afternoon. 

But it’s summer I remember - drinking fruit cup at parties, with store bought cordial and fresh fruit frozen in juice floating in the big glass bowl, adding fizzy drinks and seeing the ice dissolve and the fruit pieces freed. And before swimming pools became possible, all of us neighbourhood kids would get into our swimming costumes and run through the sprinklers in each other’s backyards, handkerchiefs pinned onto our towels with big safety pins. 

Once we went to Luna Park, at night, the giant fun fair, blazing against the dark harbour, and we saw our faces all stretched in the crazy distorting mirrors, and revolved on The Rotor, where the machine spun so fast we were stuck onto the walls by centripetal force, screaming with delight. 

We went to the red desert and the wild Northern Territory, and I saw the thousands of wildflowers in their little fluted casings like slender ladies with fragile necks and glowing faces, and the clean desolation of it all soothed me and calmed my pulse like a steady, even caress. The breezes were bright in The Whitsunday Islands, shot through with gold and turquoise lights. 

Now I’m immersing myself in a place far from this, back in the tropical extremes seven degrees above the equator. The wattle buds I used to put in my hair or in small vases have been replaced by jasmine. There aren’t as many protective layers here - on people, or on road ways or electrical wiring or the floors of houses. 

I stopped otherising my present situation some time ago. The similarities complicate those neat parallelisms. We are responsive beings, and our sensory systems inevitably attune to our climate and context, and, through our senses, our minds and thoughts adjust. Everything becomes a reflection of everything else, known and unknown. Shards and shimmering threads woven into a seam. It’s mirrorwork, I’m doing. 

Each day, I see the sun rise and set in the country of my birth. Slowly, by moving often between the two dualities of landscape, experience, and differently formed ideas of sovereignty, I am making a new, whole fused self. We moved out of the city when the illness threatened to spread, a few months ago, and the world slowed down. We packed our books and music and came up here where everything grows, and people sell every kind of fruit and vegetable by the roadside. 

The people here calibrate the passing of their months by the full moon holidays, and so it’s easy to measure the slipping away of the days. Every evening they light sambrani, a fragrant incense powder which is scattered on coals and taken through the house and garden to discourage insects and bless the home. The cook is astonished that Australians don’t add a multitude of aromatics to their roasts. When told that we just put salt and pepper and olive oil on our cuts of meat, and roast them, he asks, ‘But how can it taste good without any spices?’ He makes the household curry powder himself, using an ancient curry stone to pound it. 

No aerosol air freshener from a spray can, here. And coconut milk comes from the coconut flesh, squeezed and wrung by hand, and coconut water which is sold in Australia in packets and bottles is drunk in this place with a paper straw from the coconut shell itself. 

Culture shock is just a form of initial defensiveness. Judgment and condescension are exhausting to maintain. So, after awhile, those initial armored stances get dismantled. And it is what it is. These colours, these smells, current events, and present tense. 

There are little striped squirrels scampering around up and down every pole and wire and beam on the verandah, shy deer who briefly visit the lower lawns at dusk, porcupines who wreak havoc on the roots of the cana lilies at night, and rotund bunnies who nibble the herb plants I am trying to grow. 

I miss Australia in my body and heart. I miss its sunlight, and its dryness and its more subdued colours. I miss the freedom I felt as a girl to walk on my own anywhere I wanted, or to travel interstate on trains and buses without having to ever once be concerned for my safety. Australia has Quiet Carriages. 

I can’t walk anywhere alone, here. It sounds strange, I know. But people constantly come after you. Women begging defiantly, wanting your spare change, and raspy-voiced men forcefully selling you your horoscope or trying to say hi when they don’t know you. 

When I go back to Sydney, I do completely normal things like walk to the shops, on my own -  just for the joy of it! It’s as satisfying as a big day out. I chase the waves at Whale Beach or Curl Curl where we had bonfires as kids, and love the feel of my soul stretching, uninterfered with. I wear whatever I like. 

I recall the stacked, scrumptious afternoon teas at the QVB Tea Rooms, the slow unfolding paved gradient of Martin Place, with the cafes we used to go to after university classes, the sandstone and the metal all scoured and  wrought. The fairy lights in the trees in Hyde Park, which were put up for the Bicentennial and never taken down. 

And now this stasis, and paralysis. How long will this damnable groundedness last? I see on the 4 Corners show that people in Melbourne behaved carelessly in June and let the virus in. And now there are quotas for even Australian citizens like myself, trying to return for holidays. And the airlines can charge what they like. The richest get to be on the move first. 

Australia, now inaccessible, gets more and more refined and golden hued in my memory, and all the childhood days and dates and outings more vibrant and resonant as they ebb away. 

In my dreamscape, I can go back there, at will. Sit on stone steps heated by that particular sun, or on a beach towel watching the sea as if it was a giant plasma screen. Smell the astringent eucalyptus oils in the exfoliant scrubs and lotions as the Thai massage therapist unfolds me expertly, like an accordion. Buy cherries from stalls in Arcadia and eat them in the car, overwhelmed with longing. 

But here all the exotic fragrances are always everywhere, crowding in. It’s like a big sauna. An everpresent fiesta, pulsing and flexing. A lot of tropical things that were exotic - with a price to match - in Australia, are everyday here. And Tim Tams are almost 8 dollars a packet! And tinned Irish Stew nearly double that!!

My friend who grew up in Mildura as a boy is stranded in Russia right now, where he’s been teaching conversational English this past year, until the planes start flying again and the airports open. He thinks he might stop by and visit us, he says. When all this temporary madness is over. Australians never think there’ll be any barriers to their exercise of free will. 

And I am living in a place which is like paradise, except for the diurnal frustrations of the people. The birds’ cries are not so harsh, but the dairy products are not so rich. 

It’s like an inverse mirror image of the miniature garden I made when I was a child. Everything grows here, the minute you put it into the soil. Putting down roots.

Friday, November 13, 2020

What Death Can Teach Us

 


The title for this article is taken from the motto above the doorway to the Morgue. 

The Latin words translate as ‘This is a place where Death has much to teach those who are yet living’. 

    In days gone by, doctors used to swear a binding oath as a prerequisite to register in the medical profession. It was called The Hippocratic Oath, and a doctor, having graduated from many years of training, swore - before commencing their clinical practice - to do no harm to their patients, either by action or inaction, to treat each patient to the best of their ability, to secure the patient’s safety and privacy, and to pass on their skill to the next generation to ensure best practice and standard of care. The swearing of this oath is no longer a requirement for admission to the medical profession, although it was the basis for accountability in this vital industry. 

    Sri Lanka is very proud of its universal health care system, which provides free medical care for over 22 million people, from generally excellent medical practitioners. In fact, Sri Lankan doctors are known all over the world in the countries to which they have emigrated for their high level of skill, thorough professional training, and dedication. 

    However, in Sri Lanka itself today, the actual experience of seeking expert and timely medical care in the public system can be an ordeal for the patients and their families. This is important to know, because the powerful nationalistic narrative is that we are blessed to have universal health care - a public health care system which is free to all. In a nation where many are financially challenged, this is a blessing. However, due to certain factors inherent in the society as a whole, the quality of care offered in this much-praised system is often compromised. 

    In other countries, it is possible to book your loved one into a hospital and leave them in the care of the dedicated professional staff, confident that they will emerge well, having been appropriately treated and supported in their recovery. In this country, we have found this, unfortunately, not to be the case. 

    I have heard many accounts from multiple people who have had similar experiences to ours, with hospitals and doctors all over the country, and I believe it is a national problem. Because of the dominant narrative of universal health care being such a gift and an asset to the people, these individual cases are treated as one-offs. But each statistic represents a family: all the loved ones the patients have left behind, whose grief can never be repaired, as well as patients who undergo avoidable and needless suffering from mismanaged procedures. 

    The underlying reality experienced by patients is that there is no limit on how many patients a doctor can see for a clinical appointment and diagnosis/ treatment each day. Many doctors, especially consultants, see patients in multiple hospitals, and see more than 200 patients a day. There is also no designated minimum limit on the time period allocated for a patient visit, of 15 minutes per patient, for example, as in other countries. Many people say that the doctor does not even look at them or speak to them - they simply look at the patient’s charts or test results, and sign a form to authorize a script for medication. This is not humane medical treatment. It is a form of factory processing, with inadequate quality control. 

    If you are in need of serious medical help, and want to survive the health care system, make the effort to choose a doctor who is willing to give you a proper consultation, and is able to verbally interact with you and your family members. As a patient, you have rights: you have pre-paid your appointment fee, via channelling, cancelled your work commitments and waited for a long time - up to 3 hours at times - for your time with the doctor, to have your complaint and condition diagnosed. The least you deserve is for your consultation to be an adequate and thorough one. 

    Unfortunately, a high level of professional dedication cannot be taken for granted in a system like this. While many doctors and medical personnel do genuinely wish to care for patients, which is why they see so many patients each day, many others are wholly or largely motivated by the desire for personal enrichment. As a result, patients are not human beings to them, but numbers on an appointment schedule. 

    Many doctors are defensive about this perception, justifying their situation by pointing to the years of competitive exams and study required before they can qualify to practise, and asserting that they naturally wish to be rewarded for their efforts. But the result is that the patient must ensure that the doctor is not rewarded at their expense, and that of their family - not only financially, but in terms of the energy, anxiety and regret involved in unnecessarily losing a loved one, or witnessing their unwanted suffering. 

    Regrettably, the situation as patients in this system is that we should equip ourselves not only to fight illness, but to fight for our rights within the medical system itself. With such time pressures on them, doctors cannot be expected to diagnose your condition accurately. And many often do not recognize their own accountability. 

       This means that the patient and their family have to identify and fill in the gaps themselves, between the level of care that is required, and that which is available. 

Patients in this system cannot afford to be ignorant. We must do our own research into our symptoms and ailments. Look into our family medical history, identify any risk factors, and keep a diary of our case, for our records. This will help explain our situation to the doctor, and also help us assess if the treatment we are receiving is correct. Given the heavy workload of the doctors, this is essential effort required from us. 

    It is not enough to go to your friends or social media. Look up reliable sources on the Internet, and medical text books. Ask doctors who you know personally for advice on where to do your due diligence.

         Be aware that infections can often occur as a result of negligence, unhygienic practices and carelessness in aftercare, after surgery. It is difficult but necessary to be vigilant with regard to yourself, in your time of vulnerability. 

The doctors and nursing staff in the hospitals are under stress, and are often rude, dismissive or even bullying to patients. This is unprofessional conduct. But because it happens so often, and without witnesses, it has become normalized. Often, stressed medical staff vent their own frustrations on those in their care. Be prepared for this. I have heard that some doctors even laugh at or mock patients who ask for information about what could make their hospital stay better for them, and that nursing staff are negligent, careless or deliberately withholding of attention if the patient is seen as ‘difficult’ for knowing their rights. Keep a record of what is said and done, in the interactions you have with medical staff, with dates and times, in a notebook. Take video or audio recording if necessary. Show from the start that you expect a high standard of care, to prompt them to give it to you. Keep in mind also that, contrary to the mythology of universal health care, in practice the social status of the patient in this country determines the quality and degree of care they receive. 

There is very little chance that any valid complaint of negligence or malpractice against a doctor will be upheld in the current system. Unlike in other countries, where doctors are routinely held accountable, and have to prove that their conduct in any medical case in which they are involved was professional, and beyond question, doctors in Sri Lanka have disproportionate power in the doctor-patient relationship. Many believe themselves to be above being questioned, or held accountable. They will band together and support each other against patient complaints.

    The rigid professional hierarchy operating within the hospital system enforces the culture of suppression of complaints or questioning. Some consultants are rude and abrasive to their juniors and nursing staff, as well as to their patients, relying on their own status and respect in the system to immunize them from accountability. 

       If a patient claims negligence in law against a doctor, the legal system is slow-moving and tortuous, and the outcome is not guaranteed. The insult of the legal fees, and the time and stress required for the patient to ensure that their concerns are represented, will be added to the injury the patient has suffered. 

        When you enter a hospital as a patient, and especially for surgery, you are in a vulnerable situation. Strangers will be designated to care for you, before, during and after your procedure. Their level of skill and dedication cannot be assumed. You need to know that the proper tests are being authorized and carried out, and that you are being cared for properly. From our experience, my family can say that the only way to ensure this is to accompany your loved one into the hospital, not only at admission, but during their hospital stay. 

   You may have to argue with the doctors and nursing staff to insist on the rights of your loved one, who may be too weak physically to do so themselves. You may have to question what is being done, or not done, and face outraged or annoyed accusations of interference or even disrespect for doing so. 

    Do not make the fatal mistake of assuming everything will be ok, and do not submit to bullying or intimidation. Insist on the appropriate care being given, at every stage. The only way to do this is to be physically present in the same room when medical personnel are in attendance at all times, except of course in the operating theatre. Be vigilant. 

   Most hospitals allow an extra bed to be placed in a patient’s room. I have been told that the availability of this has to be checked by the patient themself before admission. Some doctors don’t honour the patient’s right to request this basic support. From the beginning, know your rights. Show that you know them, or they will not be recognized or upheld. 

    The nursing staff may be ignorant or uncaring, or unskilled. They often lack sensitivity training. You know your own thresholds of pain and anxiety best. Make sure you have whatever you need with you to help you during the days of recovery, and don’t rely on them to administer it. They will not move to assist you without the head doctor’s authorization. And the head doctor is often not there to give the authorization when it is needed by you, because of their own busy schedule. The protocol and the hierarchical structure of externally-imposed responsibility within the health care system is more important to most doctors and medical staff than their personal accountability.

     In fact, the punitive and blaming aspects fostered by the current system - and endemic in our society - are responsible in large part, in my opinion, for the total lack of personal accountability on the part of many personnel across many industries and professions in Sri Lanka.  When anything goes wrong, or a mistake is made, people often engage in blaming and scapegoating rather than directly and honestly addressing the problem. They will never admit error or negligence on their own part, for fear of losing their job and their income. In the medical system, this is most serious, as any errors or mismanagement of your case can result in permanent or fatal consequences to the patient, who has no pathway of redress. And with no honest accountability, there is little likelihood of improvement, going forward. 

    It should also be noted that the private health care system is prohibitively expensive for ordinary wage-earners in this country, so it is not a viable alternative, and in effect the patients have no choice but to trust the care offered in the public system. Given this disempowering reality, the negligence experienced by patients by medical personnel is in fact a form of abuse. It speaks volumes in this situation that those patients who can afford it, including many politicians and those in the corporate sector, opt to have their personal surgical procedures performed in India or Singapore instead of locally. 

    In conclusion, it is important to take care when dealing with the hospital system in Sri Lanka. The patient, in addition to informing themselves of their condition, must try to pre-empt the challenges and difficulties they will face, as they seek professional care from often overworked and sometimes uncaring individuals, whose capacity to empathize and be compassionate to the vulnerable people in their care is exhausted, and frequently fails to adequately serve the sheer numbers of people they treat each day. 

    The recent Coronavirus Covid19 pandemic is a context in which people’s reliance on the dedication of doctors and nursing staff will become intensified. Citizens have been told to only come in person to the hospitals if they are extremely ill, and to manage their conditions at home to the best of their ability, as underfunded medical resources - in terms of apparatus, facilities, space, and personnel - are going to be under strain. 

    I wish the hospital my brother was booked into, with its basic facilities and inadequate support, had had the honesty to say that they did not have the facilities to appropriately diagnose and care for him, at the point of admission. He was admitted on a Wednesday, and by Monday he was my youngest ancestor. I had to identify his body at the Morgue. 

    Our heartfelt advice to all those seeking help in the health care system here is to educate yourself about your ailment, develop the superpower of self reliance, hold all personnel accountable to the best of your capability, and take responsibility for your own safety as much as you can - both in sickness and in health.