SAITM, Doctors in arms and Education - a Lesson from my Father

First up, I need to confess a couple of things. The first is I know very little about SAITM. All I know is that it exists and in recent times has managed to ignite a national uproar in Sri Lanka, which has led to Supreme Court Battles, the GMOA (Government Medical Officers Union) leading State sector doctors on strike and - from what I can see from my FB newsfeed - most of the rest of country so angered at the striking doctors that traders are refusing to sell petrol and other goods to them.

Second, what have I got to do with this, to prompt me to blog about it (given that I'm now an Australian and live in Melbourne)? Probably nothing! But I've found myself drawn into the heated debate that's going on between my friends - many of whom are doctors in Sri Lanka and many others who are not. And the lines of the debate are drawn between those two groups who seem to be in opposition on this issue.

My Sri Lankan doctor friends post regularly and passionately on the evils of SAITM and how Sri Lankan medical education needs to be protected against it and other like threats. They posit that the threat to the quality of health care in the country is serious, immediate and dire. Most also argue against any kind of private medical education institution which charges students for their education - claiming that the profit motive would seriously compromise the quality of education in those institutions.

My non-doctor Sri Lankan friends also post regulalry and passionately and are simply angry - for many reasons apparently, but mainly

• At the doctors for going on strike and causing so much hardship to patients and families by denying them treatment
• At some of those same doctors who - while on strike at their respective state hospitals which provide free health care, continue to do private practice on a fee-levying basis.
• At being denied the opportunity to pay for and provide medical education to their children, who may not have made the highly restrictive intake into state medical colleges.
• At the disruption caused to everyday life by rioting students and daily demonstrations.

As in the case of many such divisive and acrimonious debates, there are elements of truth on both sides and neither side can - or choose to - see the opposing merits of the debate.

Now where does my father come into this? Again, nowhere in particular. One might point out that he's a doctor, who for his entire professional life practised as one and for most of his professional life was involved in medical education and the pursuit of quality and excellence in both: medical practice and education. Most of my friends in Sri Lanka, would know him or know of him in some way or another; and many of my doctor friends would have studied under him.

As many of those who knew my father would know and acknowledge - as I do - that he was a human being and his faults and weaknesses were legion, including in the practise of and teaching of medicine. However, over the many years of our shared life journeys, there was one aspect of my father's approach to his medical career and profession, which I observed (often in frustration) but soon grew to admire and respect. This was the fact that he never denied or witheld treatment from anyone at anytime! Even when other doctors were on strike

 - sometimes about causes he himself passionately agreed with - he quietly went about treating anyone and everyone.

From the time I can remember, my father never did any sort of shift work. He had and was paid a salary for a 9-5, 5 days a week job. he never did any private practice nor did he ever charge for treatment from any of his patients. I'm not stating this in any sort of particularly meritorious light - that was his choice and we his family often felt we suffered for it when we compared ourselves with the comforts and privileges that the families of his colleagues who did practise privately enjoyed. However, as I said, that was merely his choice and doesn't detract anything from the people who honourably did otherwise. 

But what I couldn't get over as a child was the volume of people he treated and saw completely outside his paid employment, at all times of the day and night, whenever they happened to show up or call! My mother - also a doctor - would often protest in exasperation as he interrupted our family dinner to drive off into the night to see someone who was ill. As a routine he would leave two hours earlier for work in the morning to stop off on his way to work at Daya Nivasa - a home for the destitute - to treat the sick people there. He would do likewise on his way home from work arriving a couple of hours or more later to greet us than he should have - often to the face the ire of his wife and kids. Whenever I happened to drop in at his office at the University to see him, there would be a line of people queueing up to see him - he would treat students, staff - both academic and non-academic, their friends and their families, on his own time at his own cost. I've known him to stop his car by the roadside to crawl into a culvert to deliver a baby of a poor woman who happened to be in labour.

One day I asked him why he did it - never saying no to people who dragged him out of bed, house and home at all hours of the day and night (My mom was convinced some were taking advantage of him and I tended to agree with her). His answer was prompt, non-premeditated and simple. He said "When I qualified as a doctor and entered the profession, I took an oath. When I take an oath, I keep it."

Just as one can't defend democracy or a religion by subverting its founding principles, one can't defend a profession by subverting its founding standards: A lesson from my father - no fee, no charge, free to good homes!

ජය වේවා!