NEWS
September 2nd, 2007
On the 15 June 2010 Sally Hulugalle received the news from Mr. Peter Baumann, President of the Swiss Foundation for World Health:
I have great pleasure in informing you that you have been chosen as the laureate of the Award 2010 for an “Outstanding achievement in the field of Mental Health Care” offered by the Swiss Foundation for World Health in collaboration with the World Health Organization. The award of 5’000 CHF is given to a person whose efforts have led to a significant improvement of the provision of health care for people with mental illness.
Pr Fritz Baumann
President
Swiss Foundation for World Health
Sally was most humbled and delighted with the news and asked whether the Foundation would be so kind as to send the award money direct to Nest Ban Account in Colombo, which they did.
BOOK REVIEW by Jenny Chamier Grove
DRINK AND ENJOYMENT – RESISTING THE INFLUENCE
“Oh, go on – Have one more”
by Diyanath Samarasinghe
“Oh, go on – Have one more” by Diyanath Samarasinghe, is an eminently readable account of the role of alcohol in people’s lives. He does not set out to indoctrinate, however, or deliver a tub-thumping lecture on cirrhosis of the liver and the disruptive consequences of drinking to excess. Instead the book is a rich meditation written in the conviction that we have lost the ability to consider the subject dispassionately.
Alcohol affords the drinker a kind of permitted abandon, a temporary relief from critical scrutiny, but sometimes, the occasion can be misused by the downright boorish or enable the loutish few to “have fun” at others’ expense, he warns.
Those “loutish few” should not go unchallenged, he suggests, while acknowledging that such intervention is not always welcome. “Among youth groups, the dethroning of louts is not so easy to accomplish. There is the risk of acquiring broken teeth.”
Samarasinghe also recommends confronting “oppressive self-appointed authorities” on drink, for whom he reserves a particular scorn. “All it takes to become a bar-room specialist is the temerity to overrule others on the basis of one’s assumed greater experience with alcohol,” he writes, witheringly. “Alcohol is one of those subjects, like sex or music, on which apparently better qualified individuals feel free to dictate to us the best way to get maximum pleasure from it and to overrule our personal experience on the basis of theirs.”
Samarasinghe’s strongest censure is reserved for those self-proclaimed experts who promulgate an opinion that he considers highly pernicious - the view that “bingeing regularly until blindly drunk is the way to have a blinking good time.” They may exert a bogusly benign influence, but they work unceasingly to encourage people to drink more, and such tyrants should be toppled, he suggests, adding that, anyway, their views are likely to be those of an unrepresentative minority.
Never sanctimonious, Samarasinghe recognises that alcohol allows us to show solidarity, to become one of the crowd, or even, for instance, by sipping champagne or sophisticated cocktails, to demonstrate social status. He is uneasy about the cumulative effects of such occasions, however, fearing that good times spent drinking can deteriorate into the “glamorised tedium” of getting drunk. A similar fate can befall fun-loving young people, who risk becoming dull and boring within a few years, he points out. “Link fun habitually to drunkenness and other times eventually become bland.”
He recognises that being teetotal or an alcoholic are not the only alternatives we have to choose between, and he considers a whole spectrum of categories, from teetotaller, selective abstainer, pseudo-drinker and occasional light drinker to delayed drinker, chronic drinker and addicted problem drinker. The inherent danger, as he sees it, lies in slipping down the list to the point where alcohol becomes a necessary ingredient of good moods and central to the enjoyment of life. He also points out that most of the victims of alcohol’s damaging side are women and children.
Given that drink can be a formidable menace in such circumstances, what remedies does he suggest? Like Socrates, Samarasinghe raises questions for his readers to answer, such as: Would I drink more or less if it were not for the standards imposed by my group? Is somebody in the group that I drink with obnoxious, overbearing, intolerably rude or domineering? Do some of them become violent when drunk? People should examine whether alcohol is gaining centre stage in their lives, and should also become more aware of outside influences, he advises. He also recommends that a heavy drinker should set out periodically to spend some good times with very little or no alcohol, choosing the company of people he or she likes and trying to take some physical exercise. Although this strategy might at first provoke “downright glum” or moody feelings, it is worth pursuing because “periodic relearning efforts, including reaching out to others, can forestall progression into dependence,” he says.
Looking at the impact of alcohol on poverty, he begins by listing the various efforts being made in different countries to alleviate neediness. The results of pure handouts to those of low income are not promising, but efforts to make handouts conditional, for instance, on sending children to school, as tried in some South American countries, have performed better, he concludes. Setting up small businesses or collectives, as in Bangladesh, works better “when women have been in the driving seat,” but promising enterprises may collapse if others copy them, he warns.
People may remain poor because they have limited aspirations, suffer from the envy and jealousy of neighbours, always spend their money unwisely, or borrow for a special occasion, but alcohol can play a part in all these situations, he points out. “People don’t become wealthier by drinking more.”
Samarasinghe suspects that big business and the alcohol trade are secretly in cahoots and that they manipulate public perceptions, suppressing unpalatable truths, such as the fact that in poorer families, wives spend considerable amounts of their meagre earnings on alcohol for their husbands, in order to keep the peace. He believes that individuals and families will have to learn how to insulate themselves from such commercial pressures, designed to increase consumer spending, and also from time-honoured customs, such as the tendency among farmers to drink heavily at harvest time. Although it might be difficult for a single person to resist these influences, he considers that local communities might have more success, and that, as a result, people might choose better ways of spending their money.
It would be easy to accuse Samarasinghe of idealism, or of overestimating the power of poor communities, but, as he points out, some poor families do work hard and go on to prosper, and when they do, their successes are rarely reported.
Ultimately, this book is not just a meticulously observed, witty and disarming attack on the mystique and manners of modern drinking. For those who know more about the pitfalls of alcohol, rather than its benefits, it offers hope.
Jenny Chamier Grove
Ends.
1,010 words.
FROM: Jenny Chamier Grove, 24 Forest Road, Kew, Surrey TW9 3BY
Tel 0208 940 3469 Email jchamiergrove@hotmail.com
In 2007 Diyanath Samarasinghe wrote this about Padmal de Silva who died in UK
POSTPONING DEATH
I well recall a discussion with Padmal de Silva some months before he died. It centred on the declaration, ‘Old age is a shipwreck’ by, we believed, Francois Mitterand.
My position was that a shipwreck is no bad thing and quite natural too. Padmal felt that a real shipwreck was not long drawn out. We agreed that patching up a dying ship to keep it afloat beyond its time may be considered inglorious, especially if the ship was Mitterand. Mitterand was after all a man of stature, we felt, unlike many of the serious lightweights presented by the media as if of substance: Berlusconi, Blair, Bush the father, Bush the son, Chirac, Clinton, Hussein, Morales, Putin, Reagan, Thatcher – the list is interminable.
I don’t know how Mitterand died, but I am relieved that Padmal was spared what he may have considered an ignominious end. For me though, the loss of an extraordinary friend is awful. A buddy who combined an impish sense of humour with scholarly wisdom is irreplaceable. I celebrate my good fortune even as I grieve.
Padmal was the professional most sought after in our department at the time that I joined it as beginner. People with all kinds of ailments wanted his opinion. Academics sought his views on matters of psychology, religion and how to deal with Sri Lanka’s social ills. He was inundated by requests from students on how to excel in their studies and examinations. The mass media (mainly radio and newspapers in those saner times) could not do without him. Any ‘discussion forum’ without Padmal on the panel was incomplete. He was the final authority on matters of the mind and close to being so on matters of religion, ethics and enlightened social conduct. His expertise generalised, in the collective Sri Lankan consciousness, to all human affairs. The only person who did not notice at all his fame and academic authority was Padmal himself.
Our most inspiring luminary then inexplicably took flight to England, at the height of his fame here. I was among those who felt he was making a horrible mistake in moving from influential agent in a testing environment to anonymous outsider in an undemanding set up. He proved me wrong. Padmal’s cerebrum, so celebrated during his student and post-student days here in Sri Lanka, began to assert itself in the UK too. That his eventual intellectual contribution to the discipline of Clinical Psychology was substantial is indisputable.
As hefty an accomplishment resulted from his personal project with Wasantha, his unpretentiously strong Sri Lankan wife. The challenge for parents is to bestow on this world honourable children. Padmal and Wasantha’s achievement in this regard rival his hard-to-match academic accomplishments.
Death is not inglorious at all but its meaningless postponement is. Mitterand’s lament about old age would not have escaped him in less technologically advanced times. In that conversation of ours Padmal held that preventing the mad postponement of death requires the untangling of compassion, unthinking habit and avarice that underlie some senseless interventions by confused medical people. But we couldn’t come up that day with any useful suggestions on how to move things in the right direction.
Diyanath Samarasinghe
Department of Psychological Medicine
Faculty of Medicine
Colombo,
Sri Lanka
26th November 2007
In July 2008 Diyanath Samarasinghe, Nest’s Patron since its inception, wrote this about Nest:
Nest began out of concern for a forgotten group – women incarcerated in Unit 2 of Mulleriyawa mental hospital. A measure of its success is the improvement in their lives and the number of parties now engaged in the exercise. The most significant improvement is of course the change in level of respect given to the people concerned. That transformation, remarkable though it is, has not as yet led to anything near an acceptable standard being reached.
With the expansion of Nest’s focus, other forgotten and marginalized groups have benefited. People infected with hiv or considered at high risk of contracting the virus are an example. Here too, the change seen is noteworthy just as is the number of individuals and organizations that are now involved in what was initially an unpopular cause. The plight of children incarcerated in ‘Certified Schools’, after coming before the courts, is similarly better recognized and addressed today. Nest started its work on this matter long before many others were even aware of the discrimination that such children suffered.
The geographical spread of Nest is on similar lines, always homing in on forgotten areas. Many of these forgotten places, such as Moneragala and Mannar, are now more in the spotlight. Nest always moves in to where needs are least adequately addressed, well before others notice, and moves on when enough others take up the cause.
There are consequences of this way of working. Firstly, the marginalized and forgotten have hope of being noticed. Many hopeless lives cease to be so once they are noticed. Other concerned individual and agencies begin to take up the issues involved. All of this benefits society. But to build up the critical mass of interest on any new issue is exhausting. Mostly because contemplating any change is generally daunting and because it requires challenging or combating vested interests that want to keep things as they are. So there are hardly any individuals or agencies to take up new and unpopular causes. The few that are willing generally make themselves unpopular. But such courageous trail blazers are needed to make society move.
Society needs people and organizations ready to join in ongoing moves to improve it. Fortunately that need is well met. Some would argue that there are too many waiting to jump on popular bandwagons. What we are desperately short of are agencies with the energy to get wagons moving and the perspicacity to see where they should be heading. We are fortunate to have Nest.
Professor Jeanne Marecek, a Vice Patron of Nest, has been associated with Nest for nearly twenty years and has seen Nest flourish and grow during that time. Reflecting on those years, she says:
Whether it is the “forgotten women” of Mulleriyawa, a child whose parents are too ill to care for him, or a disabled teenager shut away in a dark corner at home, Nest brings dignity, happiness, and self-determination to all those with whom they work.Instead of focusing on deficit, diagnosis, and dysfunction, Nest workers embrace a strengths-based approach. They ask what is needed to enable people to reach their fullest potential and deepest satisfaction with life.Nest workers approach each individual, each child, each family, and each community as unique. Using their ingenuity and creativity, they offer fresh and innovative possibilities, not one-size-fits-all solutions.
As Nest has matured as an organization, its mandate has expanded to advocacy. Time and time again, Nest has courageously and forthrightly spoken truth to power. Nest is known for its uncompromising stance regarding humane treatment and justice for those labeled as mentally ill, for adults and children who carry the HIV infection, for residents of children’s homes, and for all those marginalized by society. It has shared its approach and its guiding philosophy with students, trainees, and caregivers and it is well known for awareness programs aimed at the general public.Nest has become what it is today through the efforts of its remarkable leadership, its dedicated workers, and a global community of ardent supporters. Poised on the threshold of its third decade of service, Nest looks toward a rosy future.
Dr. Diyanath Samarasinghe, Consultant Psychiatrist, University of Colombo, Sri Lanka
“The obstacles to giving voice to people who are powerless and more conveniently kept locked out of sight are difficult to overcome. The work that has been done by Nest has also brought relief to many forgotten people and introduced new thinking and attitudes in the mental health services. Nest has since ventured into the area of promoting health at community level and, to its credit, focussed on the most difficult and remote areas of Sri Lanka. The success of these ventures is remarkable. Nest is now ready to spread its philosophy and activities to a wider area. It still works hard in helping to get people who are incarcerated in mental hospitals out into happy and productive lives outside. And it now knows how to move the communities into which such persons go back towards showing greater respect for all human beings.”
Shyamani Hettiarachchi, Speech and Language Pathologist
“In my work in Sri Lanka, one of the difficulties I encountered is the lack of an appropriate and efficient process of ‘early identification’ of speech and language difficulties. It would appear that the optimum age to learn language is from birth to 5 years called the ‘critical years’ of language acquisition (Lenneberg, 1967). Unfortunately, a lot of children I was seeing were over 7 years of age. The reasons for this are manifold including socio-economic reasons (i.e. parents having to work to feed their 5 children with little or no time or money to spend on accessing services which are usually in the bigger cities). As speech, language communication difficulties have a range of implications in terms of literacy, behaviour and self esteem (Law et al, 2003), early identification is important to provide necessary intervention.”
Excerpts from a book Dr. Diyanath Samarasinghe co. authored called “Alcohol and Poverty”
The following words have been taken from the book Alcohol and Poverty in Sri Lanka written by Bergliot Baklien and Diyanath Samarasinghe, and published by FORUT in 2003. Permission to share what we have chosen from the book was given by the Resident Representative of FORUT. The book has many chapters, pages and photographs. Their researchists have contributed considerably. We have chosen bits of chapter 3 (45 pages) – ‘Colombo is where everything comes together’. The Nest Community health worker works in the remote and rural areas of Sri Lanka with families and individuals there and fewer families in Colombo. Ministry meetings, bank matters, purchasing power, Head Offices and endless other meetings, such as, conferences, workshops and seminars are organised to take place in Colombo city – either day events or residential to enable anyone living outside the city to participate. As a result these events run up pretty high bills and expense accounts. House owners are giving up their houses for rent or rebuilding them as apartment blocks, or selling out and buying or building holiday homes away from Colombo . Some buy a second pad in one of Colombo ’s many apartment (Condominiums) blocks. To buy an apartment in Colombo today costs between SL Rs: 9 – 14 million with access to tennis courts, swimming pool, restaurant, convenience shop, hairstylist and health club.
“The rural poor live on earnings from their family members who work in Colombo. The rural rich make their money mostly by selling to Colombo or bringing back money earned in Colombo. There is no significant urban centre other than Colombo. Kandy and Jaffna are the only cities that have potential to develop any degree of autonomous existence in the near future. Colombo gets from all the rest of the country, amongst other things, a workforce. And the city in return provides them not only with money, but also with normative ideas, attitudes and fashions.
“A significant proportion of the rural rich, middle class and poor send a significant time living or working in the city. The movement between city and village is continuous and massive. Many travel daily long distances from rural home to city workplace. Large numbers travel home at weekends from city ‘boardings’ (hostels) where they reside to work or study. So much that is new is learnt in the city and instantly transferred to the village. Equally large numbers travel ‘home’ monthly or every two to three months. This is because they live in more distant villages or don’t have breaks or leave on a weekly basis. They take home a larger amount of money along with their city training.”
“Patterns of expenditure and aspirations for life for the rural person are therefore strongly influenced by the same factors that influence the city dweller. Residence in a village is for many just a matter of having a home outside the city. Much of life is probably spent in the city by a fair number of those classified as rural dwellers.”
“Lives of many people are poor in Colombo. They are poor in the range of things to do and be involved in, poor in variety of interests, poor in aspirations to aim for and poor in comfort and opportunities to enjoy leisure. The lives of women are remarkably poorer than that of men.”
“The middle class woman probably has a more comfortable physical environment in which to live. She will probably sleep on a more comfortable bed, for example, and hardly ever sleep on the floor.”
“Dimensions of poverty ………………………………The first dimension has to do with material well-being, lack of food, shelter, clothing, poor housing and uncertain livelihood sources, and in some countries also having enough to eat all year round…..possession of assets. The second dimension is physical wellbeing: Mainly described in terms of health, strength and appearance, seen as both important in themselves and as preconditions for work. The third dimension is security: Peace of mind and confidence in survival ……….not just in terms of livelihoods, but also in terms of sheer survival in the face of rising corruption, crime, violence, lack of protection from police and absence of recourse to justice, wars between ethnic groups, tribes and clans, frequency of natural disasters and uncertainties of season and climate.”
“It also appears that the battered women cannot expect much protection from the police.”
Some Excerpts from Dr. Diyanath Samarasinghe’s book, “Responsibility Matters.”
Economists can get away with murder, and with great pride. They can liberate a good part of humanity, but the fact be disregarded or even dishonored. And they can starve or kill, massively, without even knowing that they do. Economists have allowed themselves total freedom, to be irresponsible. A Nobel Prize for profundity with no trace of accountability is a mockery.
Most religions are, in essence, about winning freedom here and now. Threats and bribes connected to an afterlife are only an artifice to get the less enlightened to buy into the deeper religious vision, which has to do with liberating us here on earth.
When life revolves around trying to keep a hard-to-please person from being unhappy, it is time to bring this into the open, to work out how the responsibility may be sloughed off gradually. If that’s not at all possible, it’s time to run.
The human spirit can no longer reach a multinational corporation at its core. These corporate entities are pseudo-beings invested with human rights. Those who, in their wisdom, gave independent legal existence to such bodies forgot to give them feelings and ethics. The immutable mutant clones that our ancestors created have now escaped into the ether.
“Responsibility Matters”
Author: Dr. Diyanath Samarasinghe
reviewed by Maleeka Salih
“Dr. Diyanath Samarasinghe is well known to many of us who work in the area of wellbeing and mental health, even if we do not know him personally. It is always inspiring to see a person of his professional background and experience find the time to write on topics which are part of the everyday and which shape our lives as well as the lives of those around us in meaningful but often unnoticed ways.
Responsibility Matters , the latest book by Dr. Diyanath Samarasinghe, is exactly such a book that stimulates thinking and personal reflection in those who would read it. It is also a book that would help us to lead better and perhaps more rewarding lives.
The book seems particularly pertinent in an age where the primary consideration often appears to be self-interest. Dr. Diyanath Samarasinghe asserts the value of social relations and the inter-connectedness of behaviour. He emphasises the need to re-engage with the world and with what is happening around us and sounds a note of caution regarding the price we have to pay in terms of our personal happiness as well as the social consequences of choosing to look the other way. He also moves between the personal and the political, examining responsible action at broader and higher levels where people who make decisions affect the lives of many people rather than immediate friends and family and the additional burden of responsibility this carries.
What is in addition appealing is the style in which the book is written. It is not meant to lecture, advise or instruct. Dr. Diyanath Samarasinghe writes in a personal and reflective manner, inviting the readers to engage in such reflections about their own behaviours and attitudes.
In fact, I often found myself mulling over different points made in the book during the course of the last week when I was reading it. Hopefully, it is already making me a more responsible person! The book is also concise and easily read, even in the midst of a busy life. Responsibility Matters is the rare example of a busy practitioner caring enough and taking the time to share his experiences with the larger community and helping in a significant way to promote better wellbeing amongst all of us. It is a must read for those who are looking for ways to make their own lives and the lives of those around them more rewarding.
