‘Traditional medicine and primary health care in Sri Lanka: policy,
perceptions, and practice’
The fifth HSMT seminar of Michaelmas Term will take place at 16.00 on Monday 7th November (Week 5) in the Lecture Theatre of the History Faculty on George Street, and will be delivered by Margaret Jones.
Margaret Jones is a historian of medicine and colonialism in Sri Lanka and Jamaica. She joined the History Department at York after six years here at the Wellcome Unit as a Research Officer and then as a Wellcome Trust Research Fellow. She has worked extensively on the development of public health policies and the medical services of colonial Sri Lanka and Jamaica. She is currently working on the development of primary health care services and the impact of international initiatives in Sri Lanka, 1950-2000.
Primary Health Care was launched onto the international stage by the World Health Organization’s Alma Ata Declaration of 1978 and with it came the acknowledgment that traditional medical systems could play a vital part in its delivery. The traditional medical systems of Sri Lanka (termed collectively as Ayurveda) have been part of the official medical landscape from the 1930s and at least at the level of stated government policy have been seen as participating in the government health care system: their values and holistic approach to health being particularly appropriate for the delivery of preventive medicine. Faced with a double disease burden of communicable and non-communicable disease in the twenty first century this vital role was again emphasised in the Government’s Health Master Plan of 2007-16, ‘Healthy and Shining Island in the 21st Century’. The traditional medical systems were, it stated, to ‘collectively constitute an integral part of the health sector’ and its practitioners to participate fully in delivering its services. Through the means of a purposive qualitative survey of a sample of traditional medical practitioners in and around the Colombo area this paper seeks to explore the reality as opposed to the rhetoric of government policy.
Jones has written several books on the history of medicine in Sri Lanka herself, two of which we hold at the Wellcome Unit Library. The first, Health policy in Britain’s model colony : Ceylon, 1900-1948 (RA530.2 JON 2004) discusses within the context of British Ceylon (now the nation of Sri Lanka) whether Western medicine was a positive benefit of colonialism, or one of its agents of oppression. The research for this title is underscored by a detailed analysis of public health measures in Ceylon. Her second monograph, The hospital system and health care : Sri Lanka, 1815-1960 (RA990.S72 JON 2009) specifically examines the role and development of hospitals in Sri Lanka to ascertain the nature of the contribution of Western medicine to the health of indigenous populations. Across both titles, Jones explores government, mission and philanthropic initiatives in the provision of medical services, and sets her critique against a background of human needs and rights.
Jones has argued that the roots of Sri Lanka’s healthcare policies and infrastructure, and its record of achieving good quality of life indicators, lie in part in its colonial period. To gain a better understanding of this backdrop, a number of titles provide a useful insight into the medical and health issues surrounding colonialism. For example, Western medicine as contested knowledge by Andrew Cunningham and Bridie Andrews (RA441.5 WES 1997) examines the range and extrent of non-Western responses to western medicine across the spectrum of Western imperalist influence, and includes a chapter on the influence of the World Health Organization: ‘Who and the developing world: the contest for ideology’. Soma Hewa’s work, Colonialism, tropical disease and imperial medicine : Rockefeller philanthropy in Sri Lanka (RA530.2 HEW 1995), looks more closely at the impact of European colonial policies on the health and disease of the population of Sri Lanka.
Moving closer to the present day, Decolonisation, development and disease : a social history of malaria in Sri Lanka by Kalinga Tudor Silva (RA644.M2 SIL 2014) examines the politics of the devastating malaria epidemic of 1934–35 that shaped Sri Lanka’s transition from a colony to a postcolonial state, and also looks at the shift away from indigenous knowledge.
One online article of particular relevance to this topic is ‘Public Policy and Basic Needs Provision: Intervention and Achievement in Sri Lanka’ in The political economy of hunger (Vol. 3: Endemic hunger), which is available through SOLO. Ravi Kanbur studies the country’s intrinsic and directed public policies, exploring the role of the expansion of health services in mortality decline as compared with the effect of food subsidies.
Please come and ask library staff if you would like any help with locating resources, or conducting further research. We also welcome further suggestions for reading not included in this post!
Header image: International Nurses Day: President Mahinda Rajapaksa presides over a ceremony to mark International Nurses Day held at the BMICH on May 12 2014. From https://www.flickr.com/photos/presidentrajapaksa/14145702576, Flikr user Mahinda Rajapaksa. Image use permitted under Creative Commons license CC BY-NC 2.0: https://creativecommons.org/licenses/by-nc/2.0/