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Serving Sri Lanka

This web log is a news and views blog. The primary aim is to provide an avenue for the expression and collection of ideas on sustainable, fair, and just, grassroot level development. Some of the topics that the blog will specifically address are: poverty reduction, rural development, educational issues, social empowerment, post-Tsunami relief and reconstruction, livelihood development, environmental conservation and bio-diversity. 

Sunday, June 05, 2005

30 psychiatrists for 20 million in Sri Lanka

Asiantribune.com: Forum for Research and Development: Date : 2005-05-31

In a written submission to Minimize the Damages from Natural Disasters the Forum for Research & Development has revealed to the Select Committee of Parliament some glaring gaps inadequacies:
• The recent tsunami revealed that the nation neither had a policy nor the capacity to identify dead bodies. Therefore it is of paramount importance to raise awareness of this basic principle and then work toward developing the necessary capacity.
• Sri Lanka has only 30 psychiatrists for a population over 20 million, and no formal psychology service. Mental health services are more or less based on institutional care and lack any kind of public health or multi disciplinary perspective. Psychological and psychiatric services have been grossly neglected, although Sri Lanka had one of the highest suicide rates in the world and also was subjected to civil and political unrest, including a civil war for 20 years.
• The psychological as well as ethical considerations of electronic media’s repeated telecasting of highly emotionally charged scenes containing dead bodies and other recordings of sensitive nature with regard to this disaster is of particular concern as it can lead to re-traumatisation.
• In Sri Lanka genetic testing in a satisfactory scale is only available in the private sector - by Gene-Tec. Why is the state sector unable to provide such services in spite of genetic research facilities being available (although fragmented) in some universities? This is particularly important considering that our research group had secured funding to establish a genetic laboratory and were attempting to set up such services within the Health Ministry, for more than 2 years. It had no costs implications to the state, and it is collaboration with the Human Genetic. Programme of the Non-Communicable Department of the WHO.
• Lack of an efficient and central ethical framework, specifically to deal with disaster related human subject research have left room for foreign nationals to perform unethical “Parachute Research” because it is easy and cheap in the developing world. Establishing a Central Ethics committee under the Ministry of Health is needed to ensure highest standards in research and to prevent exploitation of disaster survivors.
• A revealing positive feature highlighted in the report says: “Buddhist and Hindu children were less vulnerable to depression compared with Christian children, even though they reported more exposure to violent events such as bomb blasts. There may be protective factors in the Buddhist and Hindu philosophies (e.g., active acceptance of pain and suffering, an understanding that the future can provide relief through rebirth), which may be utilized to maximize recovery for survivors.”Forum for Research and Development is a professional organization dedicated to establish a research culture in Sri Lanka. It is linked to the UK Sri Lanka Trauma Group, a charitable non profit professional organisation led mainly by employees at the Institute of Psychiatry, Kings College, University of London. It has been active for over eight years working to provide care for people traumatised by direct experience of the Sri Lankan civil war. Dr. Athula Sumathipala has been an active member of this group. He spent most of his time from 1997 up to 2003 in Sri Lanka for his academic work. He also contributed to capacity building in mental health services, training and research particularly through the medium of the Forum for Research and Development, which he co-founded. The Forum recommends the following components for a central disaster management plan.
• Efficient grass root structures and networks that can be mobilized with short notice are essential to execute disaster management .
• Capacity for compressive forensic service, including genetic capabilities.
• Should ensure ‘National Plan of action for the management of psychosocial and mental health services for people affected by the Tsunami’ developed by the Mental Health Directorate of the Ministry of Health should be implemented in full.
• Expansion of Mental Health Services based on a Primary Care and Public Health approach to cater to the long term needs.
• Research and Development should be one of the most important ingredients of future disaster management.
• Central ethics committee should be formed in the Ministry of Health to ensure highest standards in research and to prevent exploitation of disaster survivors.
• Media is an important stakeholder in the national disaster plan and should be involved in all stages- Asian Tribune –

Dr. Athula Sumathipala MBBS, DFM, MD (Sri Lanka), MRCPsych, CCST (UK), PhD (London)Honorary Director, Forum for Research and Development in Sri Lanka. Hon. Research Fellow, Section of Epidemiology Institute of Psychiatry, Kings College, University of London, UK
Forum for Research and Development in Sri Lanka


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