The Captivating Initiation of The Sri Lanka College of Paediatricians

The Captivating Initiation of The Sri Lanka College of Paediatricians: The Historical First Steps of Veritable Splendour

The Sri Lanka College of Paediatricians (SLCP) celebrated its Silver Jubilee on the 07th of June 2021. The 25-year long trek has indeed been a voyage of incomparable class and splendour, right through infancy, adolescence, and now into adulthood. It is most definitely the time for us to take a nostalgic look back over the shoulder at the way things have turned out for this splendid edifice, which took over the scholastic responsibilities directly related to child healthcare from 1996 onwards.

In the recorded annals of history, the Sri Lanka College of Paediatricians is the glittering successor to its forerunner, the much-respected Ceylon Paediatric Association (CPA), which had been inaugurated in 1952. In that landmark year, Dr L.O. Abeyratne was the Founder President, Professor C.C. de Silva the Vice-President and Professor Milroy Paul was the Honorary Secretary of the Ceylon Paediatric Association. The name of the original organisation was changed to the Sri Lanka Paediatric Association (SLPA) in 1972, with the promulgation of the country as the Democratic Socialist Republic of Sri Lanka.

In January 1995, the Council and the Membership of the SLPA unanimously decided to convert the association into an Academic College. A sub-committee of senior members was appointed to attend to all aspects of the proposed commencement of The Sri Lanka College of Paediatricians. The sub-committee consisted of Dr B. J. C. Perera, Professor Sanath P. Lamabadusuriya, Dr Dennis J. Aloysius and a couple of others. A retired Registrar of Companies, Mr J. Allan I. Wijeyekoon, Notary Public, acted as an advisor to the Sub-Committee. It took a lot of meticulous work to sort out the details and the logistics of converting the Sri Lanka Paediatric Association to the Sri Lanka College of Paediatricians. Frequent meetings were held and a Constitution and Articles of Association for the College were painstakingly formulated. The finalised Constitution and the Articles of Association were presented to the Council of the SLPA, unanimously accepted, circulated to the membership of SLPA and formalised.

The finalised Constitution and Articles of Association were signed on Thursday the 12th of October 1995. We had to choose one of two pathways to legalise the new college. One was by an Act of Parliament and the other was by officially registering the College as a Limited Liability Company through the Registrar of Companies. We discussed this at length and finally opted for registration as a company. Our advisor, the retired Registrar of Companies, helped a great deal in sorting out the legal framework for registration as a company. The necessary documents were then submitted and the Sri Lanka College of Paediatricians was registered by the Registrar of Companies on Tuesday the 28th of November 1995. All in all, it took close to a year.

Then the SLPA called for applications for the positions of the Office bearers and the Council of the Sri Lanka College of Paediatricians. It just happened to be my turn, according to our time-honoured practices based on seniority, to be the next President of the SLPA and that made me the most likely aspirant for the Founder Presidency of the Sri Lanka College of Paediatricians. Although I was a bit reluctant and even hesitant on that issue, the senior and junior colleagues firmly pressurised me to apply for the post. In the end, I capitulated.

The Inaugural General Meeting of the College was combined with the regular Annual General Meeting of the SLPA and held on Friday the 7th of June 1996. There were no other applicants for the Presidency and I was unanimously elected as the Founder President of the Sri Lanka College of Paediatricians for 1996/1997 at the very first Annual General Meeting of the Sri Lanka College of Paediatricians. Our Honorary Secretary was Dr D. H. Karunathilaka and the Honorary Treasurer was Dr Jasmine C. Nanayakkara. Both of them were dear friends of mine and I was quite sure that they would do their best for me and the College. The members of the College also elected an efficient and capable set of colleagues, 17 in number, with proven track records as other Office Bearers and Council Members. I took over this hallowed mantle of the Presidency at the age of 49 years.

Technically, from that day onwards, we took over the reins of the newly-born fledgling College. All of us were more than determined to see that the newborn would be provided all the necessary facilities to thrive and serve the children of our Motherland. The smooth transition of the Sri Lanka Paediatric Association to the Sri Lanka College of Paediatricians took place promptly. The College inherited the rich traditions of the SLCP, its members and the finances. The new constitution took effect immediately and a new mace and a fresh symbol or logo were designed. In that new emblem of the Sri Lanka College of Paediatricians, portrayed and used in all official documents and events, the silhouette of a child is encircled by twenty-four lotus petals representing round-the-clock care and services provided by members of the Sri Lanka College of Paediatricians towards the welfare of our children. We thought of them only as one of the national treasures of this land. The traditional earthenware pot, the “pun kalasa”, on which the main emblem rests, together with sheaves of coconut flowers surrounding it, depicts prosperity and reiterates that children are the precious jewels of this resplendent isle. Dr Karunathilaka was extremely good at implementing decisions as well as programmes and of course he made my life that much easier. The Sri Lanka College of Paediatricians was committed to developing an island where all children, regardless of age, location or family situation could live healthy lives.

My Induction Ceremony as the First President of the Sri Lanka College of Paediatricians took place with all the usual pomp and pageantry on Saturday the 24th of August 1996 at the Auditorium of the Sri Lanka Foundation Institute. Dr Lucian Jayasuriya, Additional Secretary to the Ministry of Health in Sri Lanka was the Chief Guest. In my Induction Address, I outlined our road map for that year with some particularly important issues that needed urgent attention. The event terminated with cocktails, fellowship and dinner.

The lofty ideals, the charismatic visions and the committed mission of the SLPA were taken over by the College. However, it was essential to venture into new and unchartered territories. The Child Health Indices were quite high with an under-5-year mortality rate of around 20 per 1000 live births. Our work was cut out to improve the facilities and care for the children of our land.

One of the major issues that needed immediate attention was the unacceptably high neonatal and infant mortality rates. The Neonatal Mortality Rate was around 12 per 1000 live births and the Infant Mortality rate was around 17 per 1000 live births. One of the major causes of neonatal mortality was asphyxia neonatorum. We needed to address this urgently and the solution, as we saw it, was proper neonatal resuscitation. It meant training on basic resuscitation techniques of the doctors and labour-room staff who attend deliveries right around the country. For this, we needed training equipment which included bag and mask units and electronic CPR Training Manikins. These were quite expensive and the College did not have the necessary funds to purchase these. I just wrote one letter to the newspapers explaining the details and appealing to the general public for donations to purchase these essential pieces of equipment and the letter was published in all the newspapers. Within a week, donations poured into the coffers of the College and the philanthropic generous public in a humanitarian gesture of tremendous goodwill gave us more than enough money for this endeavour. We purchased all the necessary equipment and organised an island-wide programme of in-service training of all health personnel dealing with childbirth, with the willing cooperation of all members of the College, scattered far and wide. We had around 75 Training Workshops and trained close to 2000 medical and para-medical personnel in the resuscitation of newborns. The initiative gained tremendous momentum and was converted in later years to the wonderful Neonatal Advanced Life Support (NALS) programme and then the Advanced Paediatric Life Support (APLS) programme, both being spearheaded by that virtuoso Dr Srilal De Silva. The College, with all these efforts, managed to reduce the Neonatal Mortality Rate to around 9 by the year 2000. It is an eternal tribute to the efforts of the College that in the year 2020, the Neonatal Mortality Rate was around 4 per 1000 live births and the under-5-year mortality rate was 7.9 per 1000 live births.

There is an authentic plethora of activities that the College has been involved in during this journey of 25 years. For the sake of brevity, all those ventures can be concisely categorised into several broad groups such as: –

  • Continuing Professional Development for all members as well as those of Allied Health Sciences.
  • Providing advice and advocacy to all stakeholders involved in child healthcare, the Sri Lankan Ministry of Health and the Government of Sri Lanka.
  • Interactive engagement with international paediatric organisations.
  • Facilitating optimal healthcare to the children of our land together with the provision of welfare services and facilities for conflict-resolution to the membership.

The College has been at the forefront of Continuing Professional Development activities by way of hosting a dedicated web portal, conducting Didactic Lectures, holding Symposia, Clinical Updates and the Annual Scientific Congress, as well as the publication of its official scientific journal, the Sri Lanka Journal of Child Health (formerly the Ceylon Journal of Child Health). Space constraints do not allow me to document all the activities that the institution has been involved in but the journal needs special mention. That publication, was an annual issue when the College started life. Subsequently, I took over as one of the two Joint Editors, the other being the iconic Dr Stella G. De Silva and we changed the name to the Sri Lanka Journal of Child Health and converted it into a quarterly journal. In the year 2003, Dr G. N. Lucas replaced Dr Stella G. De Silva when she retired. Dr Lucas and I have continued to guide the destiny of the journal as its Joint Editors, right up to the present time. The journal joined the internationally visible electronic portal of Sri Lanka Journals Online (SLJOL) in 2008 providing free full-text access over the World Wide Web and is the only journal of child healthcare in the country. It is now indexed in SciVerse Scopus, Index Medicus for South-East Asia Region (IMSEAR) of the World Health Organisation (WHO), Centre for Agriculture and Bioscience International Global Health Database (CABI). The journal is listed in the Directory of Open Access Journals (DOAJ) and is available in Google, as well as Google Scholar. The policies of the journal are modelled on the Committee on Publication Ethics (COPE) Guidelines on Principles of Transparency and Best Practice in Scholarly Publishing. Sri Lanka Journal of Child Health is recognised by the International Committee of Medical Journal Editors (ICMJE) as a publication following its recommendations.

The College has been at the forefront of providing advice and advocacy to the Ministry of Health and the Government of Sri Lanka in issues related to child healthcare. We have had, and continue to have, the expertise available to deal with these aspects of caring for children in the island. Our considered opinions have always been sought and respected by all stakeholders and the Ministry of Health. During the current COVID-19 pandemic, the College has discussed the problem at length on repeated occasions and provided well-considered advice to the authorities of the Ministry of Health and the Sri Lankan Government on matters directly related to children in the island, including the issues encountered with schooling.

We have developed abiding connections with many international paediatric organisations, such as the WHO, UNICEF, the Asia Pacific Pediatric Association (APPA), the International Pediatric Association (IPA) and the Royal College of Paediatrics and Child Health (RCPCH) of the United Kingdom. It is particularly relevant that we have had a fruitful and mutually beneficial relationship with the RCPCH, which shares the same year of birth as the SLCP; we beat them to it by just a few months. From 1996 itself, our College, the SLCP, started to develop more and more meaningful ties with the RCPCH. In fact, for our very first Annual Scientific Congress from 16th to the 20th July 1997, the RCPCH was kind enough to send their Treasurer Dr John Osborne, as a representative of their college to be the Guest of Honour at the Inauguration Ceremony and to attend the congress in person. In addition, the RCPCH sent a delegation of 5 erudite scholars as well. We also had two Guest speakers from India. At the Inauguration Ceremony on the 16th of July 1996, the Chief Guest was Dr Nanda Amarasekera, President of the Ceylon College of Physicians.

The Scientific Congress was of the highest scholastic calibre. We had the Professor C. C. De Silva Memorial Oration on “The problem of child abuse in Sri Lanka: Time for action” delivered by Professor D. G. Harendra De Silva, 11 Plenary Lectures, 02 Scientific Seminars and 24 Oral Platform Presentations of Original Research. The Scientific Congress ended with a glittering banquet hosted by the college at Hotel Taj Samudra in Galle Face, Colombo, which commenced at 8.00 pm on Saturday the 19th July 1996.

Following the rigours of the Scientific Congress, on Sunday the 20th of July 1997, we had a Family Day and a Cricket Match with our college playing against a team from The Ceylon College of Physicians. It was a matter of ‘putting the hair down’ to enjoy the day and the event was held at The Health Department Sports Club Grounds down Castle Street in Colombo 8. The idea was to get the families with their children of the members of both colleges to come in for the match which started around 10.00 am, enjoy a sumptuous lunch, stay on till the end of the cricket match and witness a Netball Match between the Ladies’ Teams of the Sri Lanka College of Paediatricians and The Ceylon College of Physicians.

The cricket match was a 25 over softball encounter. I captained the Sri Lanka College of Paediatricians team, won the toss and promptly put the Physicians to bat first. They scored 112 all out in their allotted 25 overs. In return, we easily overhauled their total score and got 113 for 5 wickets in 23.2 overs. I was over the moon as I was extremely keen to win the inaugural cricket match. Most unfortunately, our Ladies Netball Team was beaten comprehensively by the Lady Physicians team. This day-long sporting affair and the Family Day became an annual event and has continued right up to the present time.

In a gesture of goodwill, a dedicated senior examiner was sent from the RCPCH every year to maintain the required standards of the MD (Paediatrics) examination of the Postgraduate Institute of Medicine of the University of Colombo, Sri Lanka. That degree, the cornerstone for a career as a Consultant Paediatrician, was the crowning glory for a Sri Lankan Paediatrician. Then the RCPCH started to facilitate the successful candidates to come over to the UK, get their GMC registration and be trained in the finer aspects of paediatric care before they returned to Sri Lanka as Consultant Paediatricians in the Sri Lankan National Health Service. All these activities were possible due to just one reason; the excellent relationship that we have between our two colleges. I believe our rapport will grow even stronger as the two institutions mature and there is a lot more to be undertaken through this connection in the future. We need the crucial support of the RCPCH to develop our speciality and we look forward to learning from the expertise of the RCPCH to improve and lead the way to achieve excellence in child healthcare in Asia from now onwards and even beyond the time when we celebrate our 50th birthday together.

The College has provided services to its members in very many ways. In addition to the Continuing Professional Development activities, it has been cognisant of the problems faced by the members, especially those working in remote areas of the island. We have made representations to the Ministry of Health if ever and whenever an issue has been brought to our notice. On the rare occasions where there have been some disagreements amongst our members on certain issues, the College has played a reconciliatory role without taking any sides in that endeavour. Most recently, the College has inaugurated a COVID-19 Fund for Children to help our members working in different hospitals to provide much-needed facilities, equipment and manpower support. The fund will also look at helping children afflicted and affected by the disease as well, especially in situations where families are disrupted due to the death of a parent or a breadwinner of a family.

The Sri Lanka College of Paediatricians, from its inception, was housed in rented accommodation in the headquarters of the Sri Lanka Medical Association, down Wijerama Mawatha in Colombo 7. Over the years, the coffers of the college swelled up considerably with the revenue garnered from many sources and the profits made from the Annual Congress as well as through other academic activities. In a landmark gesture, the college purchased a building of its own at 44/1, Gnanartha Pradeepa Mawatha (Maradana Road), Colombo 8, down a lane right in front of the entrance to the Lady Ridgeway Hospital for Children in Colombo 8. The refurbished office was ceremonially opened by Emeritus Professor Priyani Elizabeth Soysa, a renowned doyen of paediatrics of Sri Lanka, on 28th July 2015.

When we look back at our 25-year-long history of existence, the Sri Lanka College of Paediatricians can be ever so proud of the achievements of that august institution. The College has weaved a golden threaded canvass of progress in a relentless quest towards excellence in child healthcare. The much-honoured members of our college have seen to it that no child admitted under them has had to suffer unnecessarily nor lost his or her life without a committed fight undertaken by the Consultant Paediatricians of our country. Around the four corners of this resplendent isle, our members have worked tirelessly to attend to the little ones whose care has been entrusted to them. It is indeed a glowing tribute to all those enthusiastic and dedicated women and men who have devoted the vocation of their lives to ensure excellence in child healthcare. The fantastic vital statistics of child health that this island nation now boasts of, is legendary and irrefutable evidence of their commitment to the cause. Those of us who lit that torch of the obligations of our calling a quarter of a century ago have been undeniably pleased to hand it over to the younger generations of Consultant Paediatricians who have indeed been able to surpass even themselves in the way that our college has progressed right through the corridors of time. They have seen to it that our Motherland has now secured a much-celebrated reputation in paediatrics, even extolled by many international organisations, as a country that has achieved so very much in child healthcare with so few available resources. Those 25 years of unparalleled obligation has indeed been a captivating journey of veritable splendour.

In a nostalgic look-back, I have been holding fort about history; specifically, the times that have gone by as far as our college goes. Much water has indeed gone under the bridge. However, the truth is that this fantastic establishment is also the future of paediatrics in this resplendent island of ours. We have seen unbelievable progress in paediatrics over the last 25 years. Yet for all that, it is an undeniable fact that the future that beckons us is most likely to be even more challenging but at the same time hopefully glamorous for this college of ours. As for me, from a personal perspective, it is the loyal shroud that has covered the very soul of my existence. All of us will fade away someday but this august institution is here to stay, forever and more.

HAPPY BIRTHDAY, and take a bow, Sri Lanka College of Paediatricians; this superlative mother academic institution of ours. You are indeed the greatest. May you go from strength to strength in an inexorable mission to achieve even further greatness.

Dr. B.J.C. Perera

MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paed), MRCP(UK), FRCP(Edin), FRCP(Lon), FRCPCH(UK), FSLCPaed, FCCP, Hony. FRCPCH(UK), Hony. FCGP(SL)

Founder President, Sri Lanka College of Paediatricians