ECONOMYNEXT – Sri Lanka’s health care system was hostile to sexual minorities and has institutionalised unfair treatment of ethnic and religious minorities, a top physician said Friday vowing to battle against inequalities.
The new President of the College of Physicians Upul Dissanayake told fellow doctors at his induction in Colombo on Friday that the health sector had failed to recognise diversity and there was widespread discrimination.
The majority of healthcare personnel discriminates against 12 percent of Sri Lanka’s population estimated to be from the LGBTIQ (people who have identified themselves as lesbian, gay, bisexual, transgender, intersex, or questioning), Dissanayake said.
He quoted a 2013 study showing that sexual minorities feared seeking help from psychiatrists or psychologists to discuss the violence they may have faced. And of those who sought assistance, 12 percent had a negative reaction from a doctor.
He also recalled how a motivational speaker hired by the police department as recently as 2021 had told officers that homosexuality was “unnatural” and was a psychiatric issue to be treated and cured.
“The situation has changed during the last few years under the leadership of the Sri Lanka College of Psychiatrists and now a person can expect to see a psychiatrist, with no prejudice against non-heteronormative orientations and genders,” Dissanayake said.
Start with doctors
However, Dissanayake urged fellow doctors to ensure a change of attitude to end discrimination by also educating other health care staff in state and private hospitals.
“As a professional medical organization, we will start among our members, then medical officers, and medical students. We will further go into our co-workers, nursing professionals and other categories of health staff.”
Dissanayake said he was hopeful that proposed legislation to decriminalise homosexuality would be passed by parliament see an end to the colonial-era penal code that had outlawed gay and lesbian behaviour.
Dissanayake was also critical of the treatment of women at hospitals where patients were often examined or subjected to tests such as ECGs without consideration for their privacy.
Language-based discrimination was also rampant, Dissanayake said noting that all doctors wrote diagnosis cards in English which a majority of the patients did not understand.
He said while medical education should be in English doctors must also be sensitive to the patients’ need to know in a language they understood.
Doctors considered their patients “not even as subjects but mere objects.”
“Imagine yourself in the patients’ position. You are there sick, not knowing what ails you, when you would go home, whether you are going to go home at all; the big boss (doctor) does the (ward) round in a strange language (English) which only 23.8% of the population understands.”
“How do we include them in the equation and make our health service inclusive,” he asked.
No solace in hospitals
He said not being a follower of a religion that was the majority religion in the area was a disadvantage for a patient in Sri Lanka.
“In the time of adversity, the patient and the family try to obtain some relief psychologically and spiritually by turning to religion. We have temples, Buddha statues and Bo trees in almost all the hospitals.
“In Hindu majority areas, there are Kovils. In some hospitals there are Christian churches. In a few of them there are some prayer rooms.
“However, the unfortunate patient who is in the minority in such a locality is not thought of. We are not sensitive to the diversity of religion in the populace.”
Patients with HIV or hepatitis B had difficulty in obtaining medical care, mainly from private institutions, he added.
“Who is responsible for this social injustice,” Dissanayake asked. “It is you ladies and gentlemen and I, who are going along with the flow not having the will or the strength to swim against the tide.”
During his tenure, Dissanayake said the College of Physicians will recognise diversity of the population “fight” for inclusivity and equity in the healthcare sector of the country. (Colombo/Jan20/2024)
A commendable attitude and initiative adapted by the new President of the College of Physicians Dr. Upul Dissanayake.
I think the focus should start with how doctors in Sri Lanka, both in the government and the private sector, relate to their patients in general. Etiquette and manners, including bedside nanners, so to speak.
Simple things like how doctors address their patients. The attitudes displayed and dispositions adapted by doctors, including and most importantly by specialists, in wards, at bedsides, in clinics and in consultation chambers in the private sector.
Let’s hope that Dr. Dissanayake succeeds in his efforts.