W D K (Kasturiratne) Gunawardene as a young man (left) and at 80
Kasturi was born in another century in what now feels like an entirely different country. It was called Ceylon, a British colony, and the year was 1933.
Kasturi’s was a very ordinary life, which was mostly dedicated to education. But it was punctuated at various points by key events of his country and people. Tracing his life thus offers us some glimpses of his nation’s turbulent times.
At age two, he survived malaria during the major epidemic of 1933-35 which killed as estimated 80,000 to 100,000 Lankans. (He lived to see malaria being eradicated from Sri Lanka by 2016.)
At 15, as a schoolboy he walked to Colombo’s Torrington square to personally bear witness to Ceylon becoming independent (1948). The following day, he wrote the best essay in class in which he outlined high hopes and dreams for his now self-governing nation.
At 20, he entered the University of Ceylon and was among the first students to experience the newly established Peradeniya campus where he studied history and Sinhala language. From the scenic hills, he would see the political transformation of 1956, as well as the cultural revival heralded by Maname (landmark Sinhala drama) and Rekava (landmark Sinhala movie).
At 25, as a fresh graduate entering the world, he witnessed the 1958 ethnic riots that foreshadowed the Sinhala-Tamil ethnic conflict that consumed his nation for the next half century. Among much else, it evaporated young Kasturi’s dreams of an inter-racial marriage.
At 50, as a teacher and father, he saw the far worse anti-Tamil pogrom of 1983. For the next quarter century, he would watch in horror — and guilt — as his generation’s collective blunders consumed the next generation’s future.
At 76, as a senior citizen still active in social work and literacy circles, he saw Sri Lanka’s civil war being ended brutally (2009). He had the audacity to hope once more, even if only cautiously. And yet again, his and many others’ hopes were dashed as political opportunism and corruption soon trumped over true healing and nation building. The nation was polarised beyond recognition.
At 82, he voted for a common opposition candidate (January 2015) and for political parties (Aug 2015) who pledged good governance (yaha-palanaya). That was his last public gesture, after having voted at all national elections during his time, and having spent 25 years as a public servant. He played by all the rules, but was let down by the system.
At 84, as he coped with a corroding cancer, Kasturi watched in dismay the much-touted promise of yaha-palana being squandered and betrayed. On 13 September 2017, he departed as a deeply disappointed man who remained highly apologetic for many wrong-turns taken by his generation.
Kasturi isn’t a figment of my imagination. Neither is he a composite character. Until yesterday, Kasturi was all too real. He was my father, whom we returned to the Earth today at a simple funeral. – Nalaka Gunawardene
Half a century after narrowly missing the opportunity to eliminate malaria in the mid 1960s, Sri Lanka seems to have reached this significant public health goal.
“With no indigenous malaria cases being reported since October 2012, Sri Lanka is currently in the malaria elimination and prevention of re-introduction phase,” says the website of the Sri Lanka Anti-Malaria Campaign.
In this week’s Ravaya column (appearing in the print issue of 22 May 2016), I summarise how we reached here, and what challenges remain.
I point out that Malaria is an ancient enemy in Sri Lanka that has killed tens of thousands and affected millions over centuries. There is speculation that malaria contributed to the historical shifting of the seat of government (kingdom at the time) and majority of human settlements from the dry zone to the intermediate and wet zones.
A severe epidemic in 1934-35 led to an estimated 5.5 million cases and 80,000 reported deaths – around 2 per cent of the total population of 5.3 million in the 1931 census. My father, now 83, is one of its survivors.
In the mid 1940s, Ceylon became the first Asian country to develop a scheme of indoor industrial spraying using DDT. In 1946, when spraying commenced in earnest, the island still had around 3 million malaria cases, high for a population of 6.6 million (1946 census). With widespread use of DDT and other measures, there was a drastic reduction: down to 7,300 cases in 1956 and just 17 in 1963.
Then there was a resurgence, which took over two decades to bring under control. As Dr Risintha Premaratne, Director of Sri Lanka’s anti-malaria campaign, told WHO, “Key components in the elimination efforts included enhanced malaria parasite screening in high transmission areas through active case detection using mobile malaria clinics; early diagnosis and prompt treatment effectively reducing the parasite reservoir and the potential for transmission; and strengthening the malaria mosquito surveillance leading to evidence based vector control.”
Malaria elimination in Sri Lanka has been achieved through a period overlapping with a 30-year separatist war in areas that were endemic for malaria. The challenge now entails sustaining a malaria-free country and preventing the reintroduction of malaria to Sri Lanka…in the context of rapid postwar developments in the country, say three Lankan leaders in this struggle writing in WHO South East Asia Journal of Public Health in Jan-March 2014.
Over the weekend of September 25 – 27, the United Nations headquarters in New York hosted the Sustainable Development Summit 2015. It was a high-level segment of the 70th UN General Assembly that was attended by many world leaders including Sri Lanka’s President Maithripala Sirisena.
Sustainable Development Summit 2015 Logo
The UN, which turns 70 this year, is once again rallying its member governments to a lofty vision and ambitious goal: to embark on new paths to improve the lives of people everywhere.
For this, the Summit adopted a new and improved global task-list called Sustainable Development Goals (SDGs). Prepared after two years of worldwide consultations, the SDGs offer a blueprint for development until 2030.
There are 17 SDGs tackling long-standing problems like ending poverty and reducing inequality to relatively newer challenges like creating more liveable cities and tackling climate change. These are broken down into 169 specific targets. Their implementation will formally begin on 1 January 2016.
SDGs in a nutshell – courtesy UN
The SDGs are to take over from the Millennium Development Goals, or MDGs, that have guided the development sector for 15 years. Sri Lanka was among the 189 countries that adopted the MDGs at the Millennium Summit the UN hosted in New York in September 2000. On that occasion, the country was represented by Lakshman Kadirgamar as Minister of Foreign Affairs.
The eight MDGs covered a broad spectrum of goals, from eradicating absolute poverty and hunger to combating HIV, and from ensuring all children attend primary school to saving mothers from dying during pregnancy and childbirth.
Much has happened in the nearly 5,500 days separating the adoption of the original MDGs and now, the successor SDGs. This month, as the world commits to ‘leaving no one behind’ (as UN Secretary General Ban Ki-moon has said), it is useful to look back, briefly.
Good ‘Report Card’
How has Sri Lanka pursued the MDGs while the country coped with a long drawn civil war, political change, and the fall-out of a global economic recession?
In fact, it has done reasonably well. In its human development efforts, Sri Lanka has quietly achieved a great deal. However, there are gaps that need attention, and some goals not yet met.
We might sum it up with a phrase that teachers are fond of using, even on good students: “You’re doing well – but can do better! Try harder!”
For the past 15 years, the MDGs have provided a framework for Sri Lanka’s national development programmes. Progress has been assessed every few years: the most recent ‘report card’ came out in March 2015.
The MDG Country Report 2014, prepared by the Institute of Policy Studies (IPS), is a joint publication by the Government of Sri Lanka and the United Nations in Sri Lanka. Data from the 2012 census and Household Income and Expenditure Survey 2012/13 have generated plenty of data to assess MDG situation across the country, including the war affected areas.
“Sri Lanka has already achieved the targets of 13 important MDG indicators out of 44 indicators relevant to Sri Lanka. Most of the other indicators are either ‘On Track’ or progressing well,” says IPS Executive Director Dr Saman Kelegama in his foreword to the report.
Highlights
The report offers insights into how Sri Lanka’s ‘soft infrastructure’ — all the systems and institutions required to maintain the economic, health, cultural and social standards of a country – are faring.
Consider these highlights:
Sri Lanka’s overall income poverty rates, when measured using accepted statistical benchmarks, have come down from 2% in 2006/7 to 6.7% in 2012.
Unemployment rate has declined from 8% in 1993 to 3.9% in 2012. However, unemployment rate among women is twice as high as among men.
While food production keeps up with population growth, malnutrition is a concern. A fifth of all children under five are underweight. And half of all people still consume less than the minimum requirement of daily dietary energy.
Nearly all (99%) school going children enter primary school. At that stage, the numbers of boys and girls are equal. In secondary school and beyond (university), in fact, there now are more girls than boys.
More babies now survive their first year of life than ever before: infant mortality rate has come down to 9.4 among 1,000 live births (from 17.7 in 1991). Deaths among children under five have also been nearly halved (down from 2 in 1991 to 11.3 in 2009).
Fewer women die needlessly of complications arising from pregnancy and childbirth. The maternal mortality rate, which stood at 92 deaths per 100,000 live births in 1990, plummeted to 33 by 2010. Doctors or skilled health workers are now present during almost all births.
Sri Lanka’s HIV infection levels have remained now, even though the number of cases is slowly increasing. Meanwhile, in a major public health triumph, the country has all but eradicated malaria: there have been no indigenous malaria cases since November 2012, and no malaria-related deaths since 2007.
More Lankans now have access to safe drinking water (up from 68% in 1990 to almost 90% in 2012-2013.)
These and other social development outcomes are the result of progressive policies that have been sustained for decades.
“Sri Lanka’s long history of investment in health, education and poverty alleviation programmes has translated into robust performance against the MDGs, and Sri Lanka has many lessons to share,” said Sri Lanka’s UN Resident Coordinator and UNDP Resident Representative, Subinay Nandy, at the report’s launch in March 2015.
Proportion of Lankans living below the poverty line – total head count and breakdown by district
Mind the Gaps!
Despite these results, many gaps and challenges remain that need closer attention and action in the coming years.
One key concern is how some impressive national level statistics can eclipse disparities at provincial and district levels. The MDG data analysis clearly shows that all parts of Sri Lanka have not progressed equally well.
For example, while most districts have already cut income poverty rates in half, there are some exceptions. These include eight districts in the Northern and Eastern provinces, for which reliable data are not available to compare with earlier years, and the Monaragala District in Uva Province – where poverty has, in fact, increased in the past few years.
Likewise, many human development indicators are lower in the plantation estate sector, where 4.4% of the population lives. An example: while at least 90% of people in urban and rural areas can access safe drinking water, the rate in the estate sector is 46.3%.
Another major concern: the gap between rich and poor remains despite economic growth. “Income inequality has not changed, although many poor people managed to move out of poverty and improve their living conditions,” the MDG Progress report says.
In Gender Equality, Sri Lanka’s performance is mixed. There is no male-female disparity in education, and in fact, there are more literate women in the 15 to 24 age than men. But “these achievements have not helped in increasing the share of women in wage employment in the non-agricultural sector,” notes the report.
Disappointingly, women’s political participation is also very low. The last Parliament had 13 women members out of 225. That was 5.8% compared to the South Asian rate of 17.8% and global rate of 21.1%. The report has urged for “measures to encourage a substantial increase in the number of women in political offices”.
Of course, MDGs and human development are not just a numbers game. While measurable progress is important, quality matters too.
The MDG report highlights the urgent need to improve the quality and relevance of our public education. Among the policy measures needed are increasing opportunities for tertiary education, bridging the gap between education and employment, and reducing the skills mismatch in the labour market.
On the health front, too, there is unfinished – and never ending — business. Surveillance for infectious diseases cannot be relaxed. Even as malaria fades away, dengue has been spreading. Old diseases like tuberculosis (8,000 cases per year) stubbornly persist. A rise in non-communicable diseases – like heart attacks, stroke, cancers and asthma – poses a whole new set of public health challenges.
Sri Lanka offers the safest motherhood in South Asia
Open Development
So the ‘well-performing’ nation of Sri Lanka still has plenty to do. It is just as important to sustain progress already achieved.
The new and broader SDGs will provide guidance in this process, but each country must set its own priorities and have its own monitoring systems. The spread of information and communications technologies (ICTs) has created new sources of real-time data that can help keep track of progress, or lack of it, more easily and faster.
Whereas MDGs covered mostly “safe” themes like poverty, primary education and child deaths, the SDGs take on topics such as governance, institutions, human rights, inequality, ageing and peace. This reflects how much international debates have changed since the late 1990s when the MDGs were developed mostly by diplomats and technocrats.
This time around, not only governments and academics but advocacy groups and activists have also been involved in hundreds of physical and virtual consultations to agree on SDGs. In total, more than seven million people have contributed their views.
As the government of Sri Lanka pursues the SDGs that it has just committed to in New York, we the people expect a similar consultative process.
Goodbye, closed development. Welcome, Open Development!
Science writer Nalaka Gunawardene wrote an earlier version of this for UN Population Fund (UNFPA) Sri Lanka’s new blog Kiyanna.lk. The views are his own, based on 25 years of development communication experience.
Equal numbers of girls and boys go to school in Sri Lanka today, But women struggle harder to find employment.
I just killed a few dozen ‘girls’ before breakfast. It wasn’t always easy or pleasant, and after a while there was blood all over the place. But I feel good about getting them – and I saved an innocent baby in the process, and even helped a researcher doing good work!
Now online: a game we have played over millennia against 'em blood suckers...
The aim of the game is to use the fly squatter to SPLAT mosquitoes before the baby gets malaria. For each mosquito you SPLAT, you score 10 points. For every 100 points scored, advertisers will make a donation to support malaria research projects at the National Institute for Medical Research in Tanzania. We also score 10 points for everyone we invite to play the game – plus there’s a link taking us to an online donation page in case we want to support the research directly.
“It’s quick, easy and fun, and a great way to do your part for one of the most serious global health problems in the developing world,” say the game’s promoters.
Indeed. Nearly 500 million cases of malaria occur each year, resulting in over one to three million deaths (figures online vary enormously on this). Malaria is particularly devastating in Africa where it is a leading killer of children. Every 30 seconds a child in Africa dies from malaria.
The fact is, malaria deaths are entirely preventable with modest investment and spread of knowledge that mosquitoes spread malaria (not everyone knows this, and as I wrote in another blog post, that’s a challenge that educators and broadcasters are now working on).
McLaughlin-Rotman Center for Global Health: Taking anti-malaria campaign onlineBut more needs to be done to engage the Digital Natives in this global public health challenge. It’s not just the exposed people in malaria-prevalent parts of Africa, Asia and Latin America who are at risk. As development economist Jeffrey Sachs has been reminding us eloquently, malaria reduces productivity, increases poverty, weakens people’s bodies and makes them vulnerable to other diseases. In a globalised world, such massive suffering in some parts of the world would quickly manifest in different ways all over the planet.
Little biology lesson: Usually, people get malaria by being bitten by an infective female Anopheles mosquito. Only Anopheles mosquitoes can transmit malaria, and they must have been infected through a previous blood meal taken on an infected person. When a mosquito bites an infected person, a small amount of blood is taken, which contains microscopic malaria parasites. About one week later, when the mosquito takes its next blood meal, these parasites mix with the mosquito’s saliva and are injected into the person being bitten.
Today is World Malaria Day. It’s a day to reflect on an ancient disease that continues to kill and sicken so many people in the majority (developing) world.
Malaria accounts for one death every 30 seconds. Malaria kills more than 1 million people every year. Each year, between 350 million and 500 million people are infected with malaria.
Malaria plagued Europe and North America as recently as 60 years ago. Simple public health measures were crucial to eliminating the disease and helping those regions achieve growth, prosperity and stability. Many countries in Africa, Asia and Latin America have yet to achieve this level of control.
Public health officials have been trying to contain and control malaria for decades, most measures targeting the malaria vector mosquitoes. In recent years, educators have joined hands — for stopping malaria begins with awareness on how it spreads and what simple measures can be taken to prevent it.
The Buzz and Bite Campaign is the creation of Canadian animation producer and director Firdaus Kharas, working with a team of skilled professionals. Firdaus earlier took on another public health challenge, HIV/AIDS, through his highly popular animation series The Three Amigos.
Watch a sample Buzz and Bite Spot (in English, British Accent)
According to the Buzz and Bite website, PSAs have so far been produced in 22 languages, and are being adapted into more. “The goal is to enable a potential reach of 80% of the world’s malaria at-risk population or over 5 billion people in their own language.”
The PSAs are available to any television broadcaster, radio station, NGO, hospital, doctor, community group, university, school, educator or other user, free of charge, anywhere in the world.
Malaria has been eradicated in many parts of the world but continues to thrive and even grow in other parts, especially in tropical areas. “This anti-malaria campaign focuses on sub-Saharan Africa (where up to 90 per cent of all malaria fatalities occur), on South America, and on South and South-East Asia, where the rates of malaria are alarmingly high,” says the website, adding: “Malaria is preventable. The easiest and cheapest way to prevent malaria infection is through the use of long-lasting insecticide-treated bed-nets (LLINs) which can last up to 5 years. This campaign promotes the use of nets.”
More bugs from Gates...Bill Gates can’t seem to get enough of bugs.
On 4 February 2009, he let loose a swarm of mosquitoes at the TED 2009 technology, entertainment and design conference in California to highlight the dangers of malaria.
“Malaria is spread by mosquitoes,” he reminded his audience of leading scientists, designers, researchers and entrepreneurs. Turning to an upturned jar on stage, he announced: “I brought some. Here…I’ll let them roam around. There is no reason only poor people should be infected.”
Luckily, the mosquitoes were not carrying the disease. But it had the intended effect. Wired editor Chris Anderson, curator of the show, suggested a headline: “Gates releases more bugs into the world”.
Watch Bill Gates’s mosquito moment:
Watch the full 20-minute video of Bill Gates at TED 2009
As stunts go, this one was pretty mild and harmless. There are many shocking ways in which the harsh daily realities of the world’s poor can be brought into gatherings of the rich and famous. They could be served glasses of the contaminated, sludgy (and often smelly) water that tens of millions drink everyday. Or all the toilets could be locked up and the keys thrown away – for good. Or electricity supply could be cut off, or frequent ‘black-outs’ or ‘brown-outs’ could be staged. You get the idea…
Of course, few event organisers would dare try any of these, if only for health and safety considerations. Reminds me of a rare exception: when he was director of information with the UN’s population agency (UNFPA), journalist-turned-UN official Tarzie Vittachi once hosted delegates of a high level meeting to lunch which consisted soley of a bread roll and a glass water. He told his guests: the meal was better more than what most poor people in the global South on any given day.
Bill to the rescue...Meanwhile, billions of poor and needy – and not just those in the majority world – are glad that Bill Gates caught the ‘development bug’ and has switched his formidable creative energies (not to mention his billions) to address their survival issues. The Bill & Melinda Gates Foundation – which carefully manages the giving away of Gates wealth – operates on the belief that all lives have equal value. “We think all people deserve the chance to have healthy, productive lives”.
They have set priorities such as improving health and reducing extreme poverty in the developing world, and improving high school education in the United States.
The New York Times columnist Nicholas Kristof recently described it as a paradox: “In these brutal economic times, one of the leading advocates for the world’s poorest people is one of the richest.”
He noted: “Mr. Gates ended his full-time presence at Microsoft last July and since then has thrown himself into work at his foundation. He is now trying to do to malaria, AIDS, polio and lethal childhood diarrhea what he did to Netscape, and he just may succeed.”
In his TED talk, Bill Gates addressed two questions that occupy much of his time these days: How do we stop Malaria? How do you make a teacher great?
Look, no computers!He said: “The market does not drive scientists, thinkers, or governments to do the right things. Only by paying attention and making people care can we make as much progress as we need to.”
He called for greater distribution of insect nets and other protective gear, and revealed that an anti-malaria vaccine funded by his foundation and currently in development would enter a more advanced testing phase in the coming months.
“I am an optimist; I think any tough problem can be solved,” he said. That’s the geek in him talking: marshall all information, analyse problems, respond strategically — and keep at it.
A friend who now works with the Gates Foundation confirms how the charity seeks evidence and rigour in all its social investments. This is no bleeding-heart do-gooding or ‘social work’ for its CSR value. The new wave of geeks lining up to serve the meek bring business acumen to the development sector long under-served by unimaginative aid agencies and self-serving UN organisations.
As Kristof wrote: “Gates ended his full-time presence at Microsoft last July and since then has thrown himself into work at his foundation. He is now trying to do to malaria, AIDS, polio and lethal childhood diarrhea what he did to Netscape, and he just may succeed.”
In late January 2009, the billionaire philanthropist released the first ‘Annual Letter from Bill Gates‘ where he discussed his work at the foundation and spoke candidly about what has gone well, what hasn’t.
He compared his earlier work at Microsoft with the challenges he now tackles at the charitable foundation. “What I’ve found now is that really those same key elements are there. The opportunity for big breakthroughs is absolutely just as great–now it’s vaccines, it’s seeds that have better yield, it’s ways of sharing teaching practices…they will take the same kind of patience that we had for software breakthroughs.”
Just ahead of the letter’s release, Nicholas Kristof talked with Bill Gates about why aid to developing countries is more important during the economic downturn and vaccine breakthroughs on the horizon. Watch the interview:
Open Minds! (formerly: Moving Images blog) 