Monday, August 7, 2017

SAITM As Model For Expanding Medical Education?

By Sumathy Sivamohan, Harini Amarasuriya, A. Karunatileke, Athula Samarakoon, Upul Wickramasinghe, Waradas Thiyagarajah, Chinthaka Rajapakse, Shamila Ratnasuriya, S.Thanujan, M.Mauran, Amali Wedegedera, Niyanthini Kadirgamar and Sylvester Jayakody –
logoA Response to the Subcommittee on Higher Education of the Parliamentary Sectoral Oversight Committee
On the 1st of August, concerned Academics and Activists gathered at the Honourable Speaker, Karu Jayasuriya’s office in the parliament and handed over a response to the report on SAITM made by a sub-committee of the Oversight Committee on Education and Human Resources.  Copies of the report to be given all the members of the Oversight Committee, Prime Minister, Leader of the Opposition, Government Whip, Opposition Whip and the Minister of Higher Education and Highways were also handed over to the Hon. Speaker. 
SAITM: An ill-conceived response to the question of health and education in Sri Lanka
The government appears ill prepared to address the unravelling situation around SAITM. Its current actions are mired in violence, bombastic rhetoric and unrealistic projections of great economic advances to be made in the business of education and health. The policy paper of the Subcommittee on Higher Education of the Parliamentary Sectoral Oversight Committee,  Expansion of Medical Education in Sri Lanka With the Participation of the Private Sector:  Adopting the South Asian Institute of Technology and Medicine (SAITM) as a Model published on 23 November, 2016 is a justification and conceptualisation of  SAITM as an educational institution, offering it as a panacea for the supposed ills dogging the heels of the two sectors. It is an illustration of the nature of the government’s approach to some very serious issues, undertaken in an ad hoc, unprofessional and unethical manner. The ill-conceived nature of the report unequivocally demonstrates the fact that SAITM is itself a poorly planned programme that barely addresses the problems that exist in the areas of health and education and creates new ones that will be insurmountable in years to come.
Both health and education have been the cornerstone of the democratic structure of the Sri Lankan state.  A policy shift on either of these sectors demands careful thought, public engagement, and the highest degree of integrity on the part of all the policy makers. Yet on both counts, the policy paper demonstrates abjectly poor thinking and a clear lack of vision for the country.
SAITM: Is it numbers?
Regarding Health, the paper says that SAITM will address the lacunae in the system presented by the inadequate number of doctors in the country. In other words, SAITM will be able to add to the number of doctors in the country. Such a claim, if stated with any sincerity, demonstrates that the policy makers have absolutely no understanding of the existing system of health care delivery. The problems besetting the health sector are not a mere matter of numbers. They are an integral part of the structure of health care provision, namely distribution and specialization. As medical professionals, researchers and those who actually care about the state of affairs in Sri Lanka will tell you:
a) The inadequate number of medical professionals lies in the areas of distribution of doctors across the country. In 2015, Colombo District had 182.3 doctors per 100,000 population (employed by the Ministry of Health) compared with 37 doctors per 100,000 population in Nuwara Eliya District (Vallipuranathan 2017). That same year, Colombo District recorded the highest number of medical officers (5344), while the lowest number was recorded in Mullaitivu District (Health Information Unit, Ministry of Health 2015).
b) Doctors on completing their internship are posted to peripheral areas, but can leave those stations before they are eligible for transfer if they pass a screening exam for a course of specialization. There is no mechanism in place to retain non-specialist doctors in such areas, resulting in a large number of cadre positions remaining vacant.

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