by Dr A.C.Visvalingam
Towards the end of its war to establish an independent state, the Liberation Tigers of Tamil Eelam (LTTE) did not allow civilians to move out of those areas from which it was attacking the Sri Lanka Army. It has been accused of deploying these hapless fellow citizens as human shields so as to discourage the security forces from firing in their direction or dropping bombs in their vicinity. The LTTE took advantage of the fact that the government was bound by its inherent obligations to its own people and in line with international humanitarian law. The net effect was that the LTTE treated the lives of the residents of the North as an expendable commodity in the prosecution of its political and military aims.
The ISIS has been doing something similar, but even worse, particularly in the city of Mosul in Iraq. It has effectively compelled the residents of Mosul not to move out of their homes and has then booby-trapped nearby static structures and vehicles of every kind. If a bomb or gunfire from the government side hits one of these booby-trapped locations, the explosives installed by ISIS blow up and multiply the devastation caused by the incoming missile. The ISIS, like the LTTE, is playing fast and loose with the lives and limbs of defenceless men, women and children in its determination to resist the advance of state troops.
Whenever the Government Medical Officers’ Association (GMOA) calls upon its members to strike, the painful reality is that it is the poorest sections of our society who are subjected to inhuman hardship. Anyone who has seen (on TV) the impotent resignation on the faces and in the words of those suffering patients who had had to travel long distances, in pain, after waking themselves up during the darkest hours before dawn, and spending for their travel from the meagre resources available to them, cannot but fail to be disgusted by the heartless members of the GMOA, who think nothing of depriving these desperate fellow citizens of the medical care which is owed to them in terms of the Hippocratic oath, ordinary humanity and the deep debt that these professionally-qualified ingrates owe to the public of Sri Lanka for having given them free education from the age of 5-6 years until they graduated and completed their training.
What is the significant moral difference, if any, between the LTTE and the ISIS getting civilians killed in furthering the objective of their vicious and inhuman “struggles” and doctors blackmailing the government by using poor, sick citizens as helpless pawns in their dispute with the authorities. How many of these citizens suffer irreparable medical damage or even die is a statistic that the GMOA is hardly likely to publish. Whatever merit there may be in the GMOA’s position on private medical education, it does not justify their callousness and cruelty to the very public, even the poorest of whom have paid indirect taxes all their life to educate our youth and our professionals, including doctors. The public are not so naive as to be fooled by the GMOA’s assertions and justifications about how conscientiously it is looking after the interests of the people of Sri Lanka by its efforts to maintain high medical standards, forgetting that internationally our universities with medical faculties rank between 2100 or so and 9900 and the GMOA does not worry at all about this. Indeed, it has been reported that one or two of our medical faculties employ veterinarians to teach human medicine on account, presumably, of the unwillingness of our medical heroes to go to the outstations to help improve the teaching at our poorer medical facilities.
It is totally unconscionable of the GMOA to use sick members of the public as pawns in the dispute that it has with the government regarding the South Asian Institute of Technology and Medicine (SAITM) and other potential private medical teaching establishments. Doctors are regarded as persons with a high IQ and social sense. Hence, Sri Lankan doctors are treated by the people with a reverence that is greatly misplaced. It is surely worse than immoral for persons of this quality and standing to resort to what amounts to thuggery and blackmail in their dealings with the three arms of government.
Moreover, with the active encouragement of the GMOA, hundreds of students from our state universities have been wantonly squandering the precious resources that members of the public, including their own parents, have contributed to the coffers of the government to provide every kind of infrastructure, laboratories, equipment, libraries, teachers, ancillary staff, financial assistance and much more for their education. Instead of attending lectures, they are spending their time marching, shouting, causing damage to public property, physically attacking law-enforcement personnel and, not least of all, disrupting the lives of thousands of members of the public by recklessly and selfishly hindering people from going to work, to schools, to hospitals and to wherever else that citizens have a right and need to go. Currently, members of the GMOA can hardly be regarded as worthy exemplars for medical students to follow to become competent, responsible and humane professionals who would become entitled to be shown the regard in which the public now holds doctors.
The members of the GMOA insincerely and sanctimoniously assert that it is their great concern for the welfare of the sick that compels them to oppose the establishment of privately-run, profit-making medical teaching institutions. They remain deliberately blind to the fact that the government cannot find enough money even to run efficiently some of the existing poorer universities in the public sector, let alone build more universities to meet the demand for more doctors. They conveniently ignore the fact that the first private medical teaching institution, SAITM, was established with the blessings of the government and the University Grants Commission without objection by members of the GMOA, obviously owing to their dread of President Mahinda Rajapkasa and Secretary of Defence, Gotabhaya Rajapaksa, who also established a fee-paying medical faculty at the Kotelawala Defence University. The medical students at state universities, who are so brave now, also remained prudently silent at the time. It is only after January 8, 2015 that members of the GMOA and medical students appear to have re-discovered their backbones vis-a-vis the government but not the powerful secret groups whose orders they dare not disobey.
If the numbers of doctors were to increase as a consequence of private medical colleges proliferating, the earnings of doctors with their feet in both sectors may tend to diminish a little. The public believes that it is principally to keep doctors’ earnings high that the GMOA does not like to encourage private medical education. Claiming to be highly conscious of their duty to serve the public, they stipulate that anyone is free to run private medical courses providing they do it for free! Would anyone with a modicum of common sense come up with such a hare-brained concept? Would members of the GMOA, even though they were educated solely at public expense, consider giving their services free to the public instead of charging unconscionable fees when they moonlight in private sector hospitals? How do they manage to be so absurd as to insist that investors spend their own money, without any return, to train doctors? Our position is that Sri Lanka needs more doctors. However, the demand for training more and more doctors will level off after two or three private universities churn out enough doctors to meet the national demand. Government regulation of all aspects of the functioning of private medical education institutions is, of course, a must but it should not be done in such a manner as to destroy these institutions.
If it is acceptable for other professionals to pay for private education, what are the grounds on which doctors want to be treated as a super-class of professionals? We are told by them that the reason why they require to be treated as belonging to a superior calling is because it is only their profession which deals with life and death decisions and this entitles them to special consideration. What an utter load of rubbish this is!
Doctors are not the only professionals who deal with safeguarding people from death or unjury. Most engineers, especially those whose work involves interfacing with natural objects like bad soil, floods, earthquakes and so on, cannot rely on book-learned formulas to construct safe buildings, bridges, dams, roads, railway tracks and so on, where a design or construction error could cause the loss of dozens, scores, hundreds or even thousands of lives. They cannot bury their mistakes like doctors inevitably do. What about policemen, soldiers and nurses? Do they not take a multitude of risks to protect the public?
Repeated many times, “Physician, heal thyself!” sums up what needs to be done.