By Lasnthie Wickremesinghe –
As a child I was fascinated by the idea of being a doctor. At that time, I did not know the financial and social benefits that came with it. I thought I may treat people and that I assumed would make them happy and that I might share that happiness with them. I was wrong and I later realized that if I were to share happiness best place would be in the entertainment industry and not the healthcare industry. Still healthcare could be a satisfying industry if not controlled by a few greedy individuals. I decided to write this article because I cannot in a clear conscious continue to work and support this corrupt system.
Few years back I came back to Sri Lanka, having spent more than five years in a different country. I was coming home for the greatest surprise in my life. Not influenced by the brainwashing in local universities and hospitals, not understanding political struggles, poor quality of science education and corrupt unions, I was amazed by the backing that the GMOA had by its self-proclaimed 16k members. I asked my-self how could the most “learnt” group of graduates be following a pseudoscientific group of morons? It seemed to me that most Unions of Sri Lanka have been looking for opportunities to have substantial amount of power, to change everything to their benefit(Not that there is anything wrong with that unless those benefits come with a huge cost to the majority of citizens).
I then turned my hopes towards the Sri Lanka Medical council. Generally medical councils of many countries have good reputations amongst both doctors and patients. Therefore, I thought maybe they were what actually represents the doctors’ mindset of Sri Lanka. Every interaction I had with them taught me it was a council of imbeciles who had no idea how to run a professional group. They took decisions that came out from nowhere and implemented them without considering any consequences. None of their actions were research based, they have no annual reports, they were not responsible for anyone and answered to no one. Apart from having notices for licensing exams for foreign educated students and barriers for all non-doctor medical personnel, they did very little to improve quality of healthcare in Sri Lanka. It was like most regulatory bodies of Sri Lanka, guarding the interest of the people they should be regulating. I do admit however that the current Chair Person of SLMC has openly stood against GMOA involvement in SLMC matters and seem to be interested in improving some standards. Whether it is just gallery talk or actual action, we are yet to see.
I know most people think of Ministries as money stealing useless institutes but looking at the achievements of the health ministry I felt for a moment that maybe, possibly we had at least one competent group in the health care sector that did work in a professional level. Although quality of Ministry was much higher than SLMC and the GMOA, it seems the only success stories the ministry has is largely on projects that give international recognition or cover WHO goals that give political benefits or commissions for the people involved. The ministry’s failure to safeguard working conditions of medical personal and its failure to improve the 50+ year old corrupt system that breeds ignorant shit as doctors have given way to the rise of power of GMOA and its right hand SLMC.
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Although at first it seems that majority of GMOA office bearers were the garbage dumps of the medical profession, people who found no recognition in their professional circles and so resorted to gaining recognition by appearing to fight for any medico who supported them (taking revenge on those who opposed them). It seems most of their actions were really for personal gains. Many assume that it is for gaining a ministerial position in a future government, but it could be far more than that.
If we take ambulances, SAITM and milk poison-they all seem to be political moves but what if it was more than that? Who benefits from people not having free ambulances? Who benefits from students having to study abroad? Who benefits from dealing shares in milk industries, if a sudden collapse of foreign milk imports, when no one else was expecting it?
Why did the Singapore deal that threatened the country so much that GMOA launched multiple protests against, wrote a whole pseudoscientific book about and even came on TV and challenged an economics professor about his integrity (they did become the laughing stock of the country in this debate but in their heads it seemed they won the argument) suddenly deem that the Singapore deal was OK when Mahinda unexpectedly snatched the position of Prime Minister?
Why did GMOA along with medical student unions try to stop nurses from gaining a degree and better education? Why did they want nurses to be school pass outs who pay diploma fees private businesses owned/managed/lectured by medicos? Why do they want nurses to be partially educated and unable to question the doctor’s orders? Why did they welcome nurses who have good A/L with black flags denying them infrastructure that the government built to train them?
How did the union that keeps denying people access to positions due to a long forgotten A/L result sheet, be bold enough to ask its members children to have exclusive access to National Schools? Could they not demand that their children also pass scholarship and earn a rightful place? (according to their own way of judgment?) How have some GMOA members’ children enter national schools when they clearly don’t meet National School criteria?
Why did GMOA claim exclusive access to nutritional advice when the head of the organization being a pediatrician doesn’t know about false claims/interpretation by their own organization had on effects of milk to breastfeeding mothers?
GMOA if not for financial crimes should be prosecuted at least for its massive misinformation and putting patient lives in danger by ruining trustworthiness of doctors in the eyes of the public.
Does The GMOA/SLMC Help Its Medicos? Or The People?
I have not delved in to the history so maybe decades ago they were a benevolent bunch (unlikely but possible). If we look at dumps that are called living quarters for medical officers, the way transfers are given to people who do not support GMOA, professionals who lack continuous medical education, absence of standardized/transparent licensing exams, lack of competency in other staff categories in the hospital (that requires better education and professional growth), the ever growing work hours and dwindling staff numbers it appears that even in the past GMOA had not been doing enough, by the members, profession, patients or the institutions they work for. Instead of trying to address any of the above they choose to squabble with the Minister, on charges of corruption, with the hope of putting someone who will grant personal favors to GMOA, but not necessarily to Medical officers as a whole.
During our licensing exam foreign graduates (Sri Lankans educated abroad) are treated like 2nd grade citizens. We were never treated this badly in our respective countries in which we had our education, having to go through the SLMC office which has people who have zero training on how to be professional, who write insulting/possibly illegal (with self-proclaimed rules) letters of recognition with zero professionalism, without making an effort to provide very basic facilities such as getting registered online so even from Jaffna (or even while working/studying in countries abroad) people have to take leave from jobs (sometimes fly home from other countries) and come and see the glory of SLMC, failing to administer exams even after ordered by courts (SLMC has continuously failed to hold proper exams on time).
Quality of the exams are so poor that one year they had 3 questions repeated in the same paper (SLMC continues to deny the allegation on quality and even have a rule written by themselves that exams cannot be questioned by any candidate). The MCQ exam has a negative mark assessment which has been removed from almost all licensing exams around the world due to extensive research that such marking does not benefit the outcome quality of candidates. During exams which are held when SLMC and all Local universities have time (making random sudden announcement of dates) they ask people who come from all over the county not to bring a phone or even bag without providing a place to keep them securely. The exam coordinators who have no idea how to talk to people. (These doctors probably never have witnessed how well exams like CIMA are organized). GMOA while showing foreign graduates fake support have throughout the years made it even harder to pass the exams by removing compensation marks, increasing pass marks and creating problems after problems and then blaming it on the Ministry and “hidden groups at work”.
While countries like Australia are randomizing intern positions so that all hospitals will improve and get better doctors Sri Lankan Medical council and GMOA have been endorsing a merit system that benefits mostly Colombo based hospitals and let the rural base hospitals to suffer.
During the whole year of internship when we are almost forcefully recruited in to the GMOA, the only messages we see from chat groups is “you are supposed to support our strike in this region” and then a representative of the Union comes to the hospital like a creep to see if we follow orders. People who refuse to cooperate with this squads will have much harder time getting what they deserve professionally.
Of course most of this is forgiven and forgotten when we come to a post intern appointment when GMOA (now heroes) have made sure that we don’t have to sign and be in hospital as long as no one finds out. So our medicos become grateful, we start doing businesses, private practice and other stuff to try and earn the salary we deserve for all the hardship we went through. Thanks to health Ministry being unwilling to give competitive salaries and improve the system we see no folly in abusing this GMOA given power of corruption. So instead of developing our hospitals and patients we start developing our lost fortunes.
The consultants in the country of my education dedicated their knowledge to improve hospitals and protocols, most of our consultants are busy improving their personal pockets so they can send their children to study abroad. Rationale is very clear. Why would they build systems in Sri Lanka that would help thousands of Sri Lankan children to study, learn and compete when they can thrive on the benefits of system wide corruption.
Quality Of Sri Lankan Healthcare
If you go to the General Medical Council web page (of UK) you will see the research they have conducted to apply regulation, you will see the patient report instructions, colleague report instructions, step by step transparent licensing details, current ongoing policy changes (when they wanted to change exam rules in 2019 they announced it in 2016). They also have a whole bunch of details on how to improve a system that many countries already take example and follow. Yet the SLMC web page has absolutely nothing of value, apart from the very non-standardized, non-transparent exam result publications. So it’s no wonder we are at such a pathetic stage.
Recent subfertility issue with Dr. Shafi is a great example on how poor the standards of the Medical Council in Sri Lanka is. Because it seems to me still no one knows apart from the CID/Courts, if Dr. Shafi has committed a crime or not, which should be very clear in a proper system. Doctors have been giving contradicting public statement on a national level crime as solid facts without considering any consequences that might arise out of such behavior. Dr. Shafi even though might not have been cutting fallopian tubes has clearly done insane amount of surgeries, though who is responsible for such a thing is not clear. Why do we have no regulations to prevent this? How is one doctor allowed to preform so many surgeries in such a short duration? GMOA and many professors not so long ago published a journal with their pseudoscientific research (as usual) that claimed SL has too many doctors. If so why does one doctor had to preform so many surgeries?
Many medical students, doctors and even professors of Sri Lanka claim hospital beds are the only problem that Sri Lanka has and the hospitals of Sri Lanka are amazing! (For sure they have not visited hospital canteens and toilets for patients). How do they make such a bold statement? We surely rank high in benchmarks and have won 50% of the healthcare awards in the world, right? Well for all I can tell after talking with thousands of such believers, they have come to the conclusion because of praise they receive from visiting medical students, doctors and consultants. Surely for people who only know how to step on others (when they should be lifting them up) don’t understand that in a civilized world you don’t put people down. You say the most politically correct and nice things even if it is not true, and you encourage people to do better with what little they have.
Although many countries have medical post graduate programs such as Public Health, Health information technology, Infectious Disease and so on, for non-medical graduates Sri Lanka seems to be taking a step back. When few years ago a fellow nurse passed the exam and got in to Health Information Post Graduate program, the GMOA doctors got furious saying no non-doctor has ever set foot inside the PGIM and soon after, she was forced to step down. So it’s clear that these people are uncivilized people who have zero ability to nurture talent and too much power to influence everything inside our healthcare sector and need serious intervention soon.
Of course, if I am to write every dumb thing the GMOA, Ministry and SLMC has done and involved with, I may have to write a whole book.
Who Do We Blame?
The SLMC, Ministry and the GMOA (A Branch of the Pohottuwa political group) are all political arms, only real thing they do is blame each other and do petty favors for groups just enough to stay in power and rip everything they can from the country and people. I do hope this will change soon since there are many people within the SLMC and Ministry trying to change old ways.
We are to blame for giving them power and responsibility and hoping that a small group will change things for the better of the many. 16k members of GMOA who think that doctors will be able continue fooling uneducated people, medical students and unions who shamelessly and cowardly help political propaganda for seniority/placements in workplace, voters who accept Ministers as long as they give them leftover bread crumbs from the luxurious banquets they have. We are all responsible for this state of affairs.
Why Bother With Internal Problems Of The Health Care Sector?
Health Care sector is one of the fastest growing industries in the world while we have a unique opportunity to train nurses, pharmacists, physiotherapists, nutritionist instead of housemaids. The GMOA involvement in regulating these programs for their personal benefits have made it impossible to have health professionals in any of these fields… Future/Current students who study these subjects in Sri Lanka will have a hard time working because of the greed of these individuals.
Healthcare sector is filled with hatred that has been brewing because of the cowardly practices of the GMOA and Unions creating more and more cycles of hatred that has manifested in to more and more frequent violence and abuse in hospitals. Poor people are mistreated, yelled at and lied to in a daily basis.
Suicide of junior doctors, nurses and patients due to unsolved problems, mentally unhealthy senior doctors and irresponsible administrators have been ignored and swept under the rug.
For most people visiting Sri Lankan hospitals have become a huge mental burden, not because of the illness they have but with the unprofessional way they will be treated in hospitals. No hospital is responsible for the care it’s doctors provide so improving ethics of doctors is not even a problem for private healthcare providers. Considerable amount of people who seek treatment resort to trying their luck with unverified/unlicensed/unproven traditional healing methods instead of seeking evidence base treatment. The people who do seek care from evidence based institutes are supposed to constantly seek advice from doctors who they personally know because they are not sure of the doctor they are consulting. we can’t fix any of these if GMOA continues its hampering whenever policy changes affect their personal businesses.
It’ll soon be 2020 and we still can’t seem to simply train our doctors to write (or even better print) a clear prescription, yet GMOA runs around the county telling everyone else how to do things.
*Lasnthie Wickremesinghe is a pseudonym
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