-
Recently transferred Dr. Amal Harsha discusses issues at the Covid Ministry
Dr. Amal Harsha De Silva[/caption]
You are known as an experienced health administrator. Why were you transferred?
I joined the Ministry of Health in 1985 and have been in it since. I graduated from the University of Peradeniya and obtained further education on medical administration by completing a Masters Degree and a PhD in the field. I could claim that I am one of the most qualified health administrators in the country. I had a key role to play in strengthening private healthcare in Sri Lanka. I was also the Director of Lady Ridgeway Children’s Hospital and then the Director of Private Health Sector Development. It was during this time that we established the private hospital regulatory system. I was also the Provincial Director of Health Services for the Western Province. All this time, ministers were fighting with me for various things. At some point I was labelled the previous government’s man. Tales were carried to authorities which resulted in my transfer. But later as these politicians exited politics, they became my friends and they said that I am an excellent administrator. Wherever I was sent, I enjoyed it and performed well. It’s like they say “when the going gets tough, the tough get going”.
There were reports of an incident involving a cricketer. Did this directly result in your transfer?
A lot of people called us to get the vaccine, and cricketer Sanath Jayasuriya called me and asked me to instruct him on getting vaccinated. I said that I would check and put him through to a doctor at a centre for further assistance. When he got vaccinated, Jayasuriya had posted it on Facebook and a tale had been carried to His Excellency the President that this was a big offense. This is why I was transferred. How such matters are presented to a leader is very important and people who are responsible should not do dirty politics with the country. When personal rivalries and grievances are brought into the work we do, it is the country that suffers. Sanath Jayasuriya is eligible for the vaccine as he is above 50 years of age and he is a public figure. He is a person we had selected to promote healthcare at the grassroot levels. We got him as an ambassador for our HIV AIDS control programme. If I was present on that day, I would have told His Excellency that Jayasuriya would be a great ambassador for the vaccination programme. There is an element in society, about 10-15% who are avoiding the vaccine. There are myths around the vaccination that prevent the public from taking it. A public figure like Sanath Jayasuriya taking the vaccine would help in combating these myths.
Do you think you could have contributed to the Covid-19 control efforts better if you were kept in your previous ministry?
I would have been as I have a lot of experience. The Ministry of Health is not a place where work can be done through orders. You have to pick up the telephone and work with people to get the job done. One’s knowledge of the system and how you communicate matters a lot in the Ministry of Health. I am very grateful for President Gotabaya Rajapaksa for selecting me to be the Secretary of the State Ministry of Primary Health Care, Epidemics and Covid Disease Control and allowing me to work with the State Minister Dr. Sudarshini Fernandopulle who was an excellent politician and a doctor and an amazing person to work with. Unfortunately, when we came there a lot of people thought that it was a subsection of the Ministry of Health. It did not have any seperate powers. As Covid-19 was going on, a lot of decision making was done at different levels. Though we were trying to get everything together, it was a difficult task for us to dabble around. In the meantime, we were trying to discuss and take certain steps, but even State Minister Dr. Fernandopulle felt that it was difficult for our ministry to make certain changes. Though the ministry was created, the gazette did not have the budget lines separated for us.
What other issues did the State Ministry for Covid-19 control face?
There was a bit of confusion. Although my previous Ministry was the ministry for Covid-19 control, others thought that Covid-19 was their business. Therefore, they tried to influence us and interfere. These were ownership issues. When it’s a pandemic, personal egos must be put aside and work. When everybody in the world is suffering, if I tried to say that I am going to be a big man by handling Covid-19, I would be heading down the wrong direction. We must help the people and getting credit for the work you do is a blessing. But a lot of people don’t see it this way. Ego balancing and jealousies of people lead to a lot of problems inside the health system. Dr. Anil Jasinghe who was the Director General of Health Services was removed as he became very popular outside. Dr. Jayaruwan Bandara who was at the Medical Research Institute who did a lot of good work faced the same fate. The whole curse in the ministry was that when you shine, you are kicked out. What happened to me was something to this effect. It is very detrimental.
Were there problems within the Ministry of Health that affected the decisions that were made?
We had four professional Ministers running the Ministry as State Minister and Professor in pharmacology Channa Jayasumana, State Minister Senior Lawyer Sisira Jayakody, State Minister Dr. Sudarshini Fernandopulle who is a specialist in the field of public health and the Ministry of Health was under Senior Lawyer and Minister Pavithra Wanniarachchi. The presence of such professionals running the Ministry is a unique opportunity to do great work and they are all good people. The Ministry of Health Secretary Dr. Sanjeewa Munasinghe is also a specialist medical officer which was a very good opportunity for us to work together. But sometimes, it was difficult to work because there were difficulties in coordinating between the various sectors. There were a lot of actors in this process. The President has a meeting for Covid-19 control and although I was the secretary to the state ministry of Covid disease control, I was not included in this committee. When things are discussed there, those present at the meeting, would bring directives from His Excellency. The President is very clear on what is needed and His Excellency wants to get the technical advice to run the country. That technical advice should be absolutely right. There should not be any biases there. When advice is given to His Excellency, one must be sure and must put it into thinking and determine whether it is going to help the country. But some experts were expressing their own opinions. Unless the management screens it, it is difficult to distinguish a good idea from a bad idea. And there was an issue when it came to this. As a manager, A secretary of a ministry, one cannot rely on the technical advice of one person. A wider majority’s views have to be taken in when technical decisions are made.
Do you have any concerns about the vaccine deployment plan and its implementation?
We could have brought the whole country together through vaccination. It is not to say that we have done bad. But we could have done much better. The priority groups kept changing as those above 18 years of age were eligible for the vaccine at one point. Then it was announced that those between 30 and 60 years of age could get vaccinated. Sometimes, it said 60 and above. During this, I introduced a system to register for vaccines online. We had a link on our State Ministry website to register. Within four hours, we got 100,000 registrations. But some journalists raised questions as to how people are to get the vaccine if they don’t have a phone. So, we had to stop it as it was raised that the process was not fair by all people. But many people in Sri Lanka have a phone and if you did not own one yourself, you could get registered from another’s. If we had that system, we could have easily got the details of who is willing to take the vaccine and who is eligible for it. There are a lot of people who need the vaccine. We have the recognised target groups, people above 60 and those with comorbidities to reduce Covid-19 deaths and the 30-60 group to reduce transmission. My opinion is that we should also target people such as religious leaders, journalists, politicians, front end airport staff, garbage collectors and also corporate leaders who are providing employment for the country. Equal treatment for equal need is justice. But unequal treatment for unequal needs is also justice. It is like we get preferential treatment for pregnant mothers and elderly. Therefore, all of these aspects matter when vaccinating the public. The private sector should also be allowed to administer vaccines through public private partnerships and boost the government’s credibility through the vaccination deployment programme. The President is not a traditional leader and he has proved himself to be a doer. He is saving more than 200 lives a day and we must work towards strengthening those strengths.
Do you have criticisms or insights into how the pandemic should be managed in the country?
These mechanisms can always be criticised. I think that we should look at the strengths and work towards further strengthening those strengths and how to mitigate the threats. There were instances that we could have done better. But criticising would not make anything better. And it is not fair as this is a difficult effort made during a difficult pandemic. So, we must work with everyone with respect for each other. Whatever we do we must discuss with stakeholders and the people for the betterment of the country. We must not do things that would make the Government or the President unpopular. There are also other elements of social and political importance to be looked at in healthcare. International relations must be balanced through vaccination registration procedures of the country when it comes to registering the Chinese and Russian vaccines as they are of diplomatic importance. Technical advice is provided by specific units based on their limited specialised technical knowledge. Administrators and decision makers should not rely entirely on those advice. They must instead look at the larger picture and decide what is best for the country.
What do you think of the military’s role in Covid-19 control?
The military has a very specific place in the Covid-19 operation. People do not listen to doctors alone. The military and the police play an important role in changing the behaviour of a section of the public that behaves irresponsibly. They bring discipline into the picture which has a good influence in the public. Army Commander General Shavendra Silva has provided excellent leadership to the Covid-19 control operation. There may be small issues at the grassroot level which we do not know of but military assistance is a positive one. The correct mix of these things is what we must be concerned about. It has not been an issue, but there are people that try to make this an issue.
What is your vision for the new ministry?
I am thankful for the Government for appointing me as a secretary. Appointments are made at the discretion of the President and we support him in his efforts. This ministry’s portfolio is an area that has a lot of work to be done. People need the support of the Government. For the last 30 years, the backward areas have resisted change. People deserve a better deal. This is a ministry that can help the people. There have been decisions made that helped such as the President’s ban on importing turmeric as we now see turmeric being grown around the island. We must add value to our products and His Excellency is trying to do that. We must promote small crops and make these people self-sufficient. So, I hope that this ministry will also get better and better in time to come.