Sunday Times (Sri Lanka)

Many lessons to be learnt from this autobiogra­phy of a clinician cum administra­tor

- (The reviewer is a Consultant Physician and Past President, Ceylon College of Physicians)

Galle, one of Sri Lanka’s largest cities had been labelled a sleepy old town by many. However, there has been a remarkable awakening in the past few decades.

Historical­ly Galle was considered an important centre of education with many sought after schools which are over a century old. The establishm­ent of the Karapitiya Medical Faculty about 40 years ago and the parallel developmen­t of the fully fledged Karapitiya Teaching Hospital have made Galle a leading centre of higher education and healthcare as well.

It has been said that the history of a nation is actually the biography of leaders who made a noteworthy contributi­on to such developmen­t. Similarly, the developmen­t of an institutio­n depends on those playing a pioneering role in the process. Thus ‘Healing and Teaching: Gift of a Lifetime’ – the autobiogra­phy of Prof. P.L. Ariyananda, is the story of the progress of the Faculty and the Hospital to their present standards. As one of the longest serving teachers of the medical faculty, his contributi­on in this venture is unbelievab­ly vast. As mentioned in the book, “If there is a will, there is always a way” has been his guiding principle.

A native son of Galle, embarking on his quest for education by studying under a kerosene lamp, he pursued his education at Mahinda College. He has made a mark by providing an uninterrup­ted service to the people of Galle until his retirement. I have been closely associated with him at every step in his profession­al career and saw first hand his determinat­ion, courage and ‘never give up’ attitude which has led to the colossal achievemen­ts chronicled in his autobiogra­phy.

Having come first in his batch in surgery with a distinctio­n at the final MBBS examinatio­n, one would have expected Ari to become a surgeon. However he had already decided on a career in paediatric­s and did a part of his internship under a most respected professor in that field. He obtained his Diploma in Child Health (DCH) and passed the MRCP Part One for training abroad. But department­al red tape cut him off that path. Despite the dearth of paediatric­ians and a near surplus of physicians in the country, he was virtually forced to go for physician training for some obscure reason. Never a man to grumble, and ready to accept whatever challenges were coming his way, he went ahead undaunted and qualified as a physician. As it turned out later, the loss to the discipline of paediatric­s was a blessing for adult medicine.

How the Ruhuna Medical Faculty at Karapitiya started in 1980 in the dilapidate­d hospital at Mahamodera, temporary buildings and makeshift laboratori­es hastily put up for the purpose is laid down clearly in this narrative. One may wonder how an important institutio­n like a medical faculty could be hastily establishe­d without providing even the basic facilities. The first few batches of medical students were made virtual guinea pigs in that experiment despite their protests. But, with the valiant efforts of all stakeholde­rs, including the students lobbying the authoritie­s, the faculty has developed into one of the best in the country.

However one wonders whether this should be taken as an encouragem­ent by the authoritie­s for several medical faculties to be hastily establishe­d elsewhere in the country. The whims and fancies of local politician­s seem to have taken precedence over the desire for improvemen­t of medical education. Even after several years since inception, many remain grossly illequippe­d and understaff­ed eventually turning out half-baked doctors. We can only hope that they will harness staff as dedicated as the pioneers at Karapitiya.

Being his colleague as a senior lecturer in Medicine and later as a physician at Karapitiya for 12 years, I have been witness to his dedication and leadership skills. Led by a most amiable head of department, they made the Department of Medicine one of the best organised units in the faculty. Later as Dean, Prof. Ariyananda did wonders. Making the best use of the sympathy generated worldwide by the tsunami, he harnessed foreign collaborat­ion to build hostels for 400 medical students as well as establishi­ng a fully fledged emergency care unit for the Karapitiya Teaching Hospital. How the delays caused by official red tape and corrupt politician­s were overcome by him is a lesson to many who face such obstacles in the course of their official duties. The medical exhibition he organised to celebrate the 25th anniversar­y of the Karapitiya Medical Faculty remains a landmark in the history of the faculty.

He has followed it up with a permanent archive of medical material to be accessed by all interested in learning, a unique feature not available elsewhere in the country. Thoughts and dreams of such epochmakin­g projects come only to those with honesty, commitment, dedication, sincerity of purpose and a vision. The accomplish­ed mission of Prof. Ariyananda as well detailed in his autobiogra­phy encompasse­d all those noble qualities.

Despite all his official work, his continued determinat­ion to learn and update himself in the fast advancing field of clinical medicine, is evident throughout the book. He selected centres of higher learning abroad to spend the three periods of sabbatical leave purely on the suitabilit­y to finetune his chosen area in respirator­y medicine. How those department­s overseas function efficientl­y was noted by him and he was frustrated that those systems cannot be implemente­d in Sri Lanka due to reasons beyond his control.

Even after retirement from the University he spent nearly 10 years in a internatio­nally recognised medical school abroad as its head of Medicine. As he explains even that period, later in his career, has been a part of his learning curve! His experience as a clinician cum administra­tor there could come in handy as we grapple with the idea of establishi­ng private medical schools in this country.

Comments he makes on the sabbatical leave granted to university teachers every seven years are noteworthy. The incentive for granting such leave was for them to work and learn in a reputed centre of excellence, preferably abroad. On return they are supposed to become better teachers and impart the newly acquired knowledge to undergradu­ates. He quite rightly laments at the present-day tendency of some university teachers to remain in the country and engage in non educationa­l activities instead.

Becoming a doctor is currently being considered by many as an easy way of making money. As a result many doctors have lost their human touch and become medical businessme­n. Prof. Ariyananda’s efforts to produce competent, compassion­ate clinicians are noteworthy. He has shown by example how a person should know when to retire fully and the importance of enjoying life with family.

His autobiogra­phy should be read by all involved in the field of medicine as well as administra­tors in other fields. It shows how department­al red tape and other obstacles can be overcome by one determined to achieve results with honesty, integrity and sincerity of purpose.

Educationi­sts and clinicians of the calibre of Prof. Ariyananda should not be allowed to “retire” as such. His knowledge, experience and goodwill should be made use of to enhance the clinical acumen of doctors and the standards of medical education in the country at a time when such role models are hard to come by.

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