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Quadriplegic doctor aspires to walk again

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Dr. Dinesh Palipana Queensland’s Australian of the Year 2021

By Sajitha Prematunge

Dr. Dinesh Palipana does not have the full command of his fingers and his usual offer of a handshake took the form of an awkwardly extended fist. President Mahinda Rajapaksa, like a good sport, fist bumped the quadriplegic doctor, gangster-like, an act of empathy Palipana appreciates to this day. Such are the trials and tribulations Sri Lankan-born Australian doctor, lawyer and disability advocate, Dinesh Palipana is faced with, on a daily basis. But such technicalities didn’t prevent him from recently being named Queensland’s Australian of the Year 2021.

The quadriplegic doctor, the first of its kind in Queensland, and the second in Australia, is currently a lecturer at the School of Medicine, Griffith University; Adjunct Research Fellow at Menzies Health Institute Queensland and Senior House Officer (Emergency Department) at Gold Coast University Hospital. “Eleven years ago I was lying on an intensive care bed, I couldn’t move my arms and legs, I couldn’t eat or breathe. My life was falling apart all around me. But to be here after all that trauma seams surreal. But I am grateful for life, for my community, friends and family that supported me,” said Dr. Palipana.

He is a founding member of Doctors with Disabilities Australia, an advocacy group for physicians with disabilities and the ambassador for Physical Disability Australia. Palipana is a member of the scientific advisory committee of Perry Cross Spinal Research Foundation. In 2019 Palipana was awarded the Medal of the Order of Australia for his service to medicine; Junior Doctor of the Year at the Gold Coast University Hospital; Henry Viscardi Achievement Award, a global award in recognition for his work in disability advocacy; and ‘Change Making’ in National Awards for Disability Leadership. All these accolades and achievements would have been impossible without the love and support of his mother, Chithrani Palipana. “My mother taught me what love, strength, commitment and perseverance are.”

 

Tragedy

Born in 1984, Palipana and his family migrated to Australia in 1994, when he was 10. Not only physical disability, Palipana knows only too well how debilitating mental health disorders are as well. He battled with depression, anxiety and panic disorder while studying law. “It took some time. I had to readjust my life and thinking. Finding my purpose really helped.” He realized that law was not his calling. He commenced his Doctor of Medicine at the Griffith University in 2008. When he was 25 and half way through his medical degree, he lost control of his car while driving home on a wet night. The car aquaplaned and rolled. When it finally stopped, he realized that he could not move or feel his legs. Palipana was far enough in his medical education to self diagnose it as a spinal cord injury. It left him quadriplegic.

He lost all sensory and motor function below his chest due to the injury. “I can’t move my fingers,” said Palipana. He has had to make a lot of adjustments to life. “Initially, going from a normal life to being paralysed, was very challenging.” Palipana pointed out that even day-to-day activities can be difficult with impaired movement. Despite a life-changing disability, Palipana decided to go back to medical school. Against all odds he graduated in 2016, with quite a few awards, as the first quadriplegic medical graduate in the state of Queensland, the second in Australia. He also completed a medical clerkship at Harvard Medical School.

Prof Harry McConnell of Griffith University was instrumental in getting Dinesh back on his feet, no pun intended. “He is a passionate believer in inclusivity and has always fought for the rights of those with different abilities. He did a lot of work to facilitate me coming back to medical school. He also helped me a lot with getting my life back together.” Palipana was inspired by Dr Harry Eeman, Australia’s first doctor with tetraplegia, who sustained a severe form of Guillain-Barré syndrome (GBS), a rare neurological disorder that left him paralysed, halfway through medical school. “Dr. Eeman spent time with me to figure out solutions to some of the physical challenges. His experience really laid the foundation for my journey.”

 

Medical school

Palipana adapted new methods to train as a quadriplegic doctor, in partnership with Griffith University and the Gold Coast University Hospital. Quadriplegia can turn everyday activities into obstacles, but he learned his way around them. “Before coming back to medical school I spent a lot of time finding solutions to challenges. I had a great team helping me.” And with persistence, he learned how to hold a stethoscope making use of the natural grip of his fingers. He learned how to examine patients. “I even learned how to insert a cannula with some assistance.”

When asked how inclusive Australian professional culture is, in terms of employment opportunities for the differently-abled, as opposed to a country like Sri Lanka, Palipana admitted that it initially proved difficult to secure an internship in medicine in Australia. Despite two years in clinical training as a medical student at the Gold Coast University Hospital, Palipana had trouble securing an internship. In 2016, he was the only Queensland medical graduate without an employment offer. “I worked really hard in medical school and got good grades. It was very frustrating that non of those things mattered.”

Palipana admitted that medicine is not the most inclusive profession, but said it has improved much in the past five years. Although he explored the possibility of pursuing a medical degree in a Sri Lankan University, Palipana said that most university administrations were reluctant to accommodate him, “Except for Kelaniya University. Other universities have a long way to go in terms of inclusivity.” As a quadriplegic doctor working in Australian, Palipana said that shortcomings of accessibility are not restricted to Sri Lanka. “Accessibility needs a lot of work globally.”

His perseverance paid off. He was eventually employed by the Gold Coast University Hospital as Queensland’s first quadriplegic intern. His disability makes him no less capable as a doctor compared to an able-bodies person. Gold Coast Health, Emergency Medicine Director, Associate Professor David Green, speaking to the Today Show Australia, vouched for Palipana’s ability to pull his weight, albeit on a wheelchair. “In a big, busy emergency with a lot of staff, his value is enormous…After a while you just forget about his disability,” said Green on the Today Show. Dinesh said that the team spirit gets him through. “Besides, there are plenty of patients, I can examine, who do not require me to perform any procedure.”

When asked whether his disability has made him more empathetic towards his patients and whether the accident and subsequent hospitalization made him more able to relate to his patients, Palipana said he remembers what it felt like to be a patient. “It can be disempowering and terrifying. Anchoring myself in my own experiences helps me to remember what it’s like being a patient.” On the other hand Dinesh said that he has never had a patient react negatively to him. “Every single patient has been amazing. I am privileged to be a part of their journey towards recovery.”

Cutting-edge rehabilitation techniques for spinal cord injuries has a major research appeal for Palipana, who is determined to walk again. As Griffith University’s Biospine Project co-lead, Palipana explained that thought-controlled rehabilitation involves translating thought patterns into movement. “For example, if someone’s thinking of walking, we can translate that thought to movement by electrically stimulating the leg.” Promising results suggest that it can re-programme the spinal cord to restore some function in people with paralysis. “Therapies such as thought-controlled rehabilitation, drug therapy and digital twins have separately shown to restore some function in people with chronic paralysis. It is our hope that people like me will be able to stand on their own power again.” His ultimate goal is to come up with a therapy for spinal cord injury.

 

Advocacy

After recuperating at hospital for eight months, Palipana came back to Sri Lanka, where he spent another year, recovering in the company of family and friends. While in Sri Lanka he raised awareness and funds for spinal cord injury victims. In fact, his disability was a catalyst to his advocacy for training medical students with disabilities in Australia. “I’m lucky to be in a position to advocate for people with different abilities,” said Palipana.

Palipana obtained his law degree from the Queensland University of Technology in 2007 and was admitted as a lawyer in 2020. His background in law gave new impetus for his advocacy work on inclusivity in medical profession and education in Australia. “Law is a great tool that can be used to do a lot of good. It allows us to navigate legal and social structures.” His advocacy work with the Australian Medical Association has paved the way for national policies on inclusivity in medical education and employment. He used his story to demonstrate how the community can work with disability, to overturn a set of guidelines issued by the Medical Deans of Australia and New Zealand in 2015, vesting Australian medical schools with the power to exclude students with a range of disabilities. “Another major obstacle faced by students with disabilities was the attitudes of education establishments such as universities and academics.” Palipana said that Griffith University was an exception.

Palipana is also vocal about disability rights in the times of COVID-19. “The COVID-19 pandemic highlighted some of the inequities that differently-abled people face. Everything from healthcare access to employment has been an issue,” said Palipana. When health resources are scarce, some would argue that they are better utilized on those with a higher chance of survival. When governments of the developed world are forced to consider how to ration ventilators between people with disabilities and those without, how has COVID-19 affected those with disabilities?

If one with lungs as compromised as those of Palipana’s, were to contract COVID-19, the prognosis would indeed be bleak. Palipana explained that people with disabilities, depending on the disability, can be at high risk of increased complications due to COVID-19. “Many disabilities affect lung function. My lungs for example, don’t function as well, because of the spinal cord injury. It’s 30 percent of what it should be. If I were to get COVID-19 or even the flu, the chances of an adverse outcome is relatively high. Similarly, people with multiple sclerosis and stroke victims are susceptible,” pointed out Palipana. That should not justify sidelining people with disabilities. Palipana maintained that it is all the more reason to safeguard such vulnerable groups. “Through different forums and organisations, I am fortunate to be able to make a contribution in this important area.”

His message to people with debilitating disabilities and illnesses, who may be contemplating giving up on life is, “As a good friend once said, life is about ups and downs. Whenever there is an up, just know that there will be a down. Things can get challenging, but anyone can overcome them and live their dream, if they have the will. If I can become a doctor and lawyer others can too. Just find your passion and chase it.”

Going from being unable to breathe without the aid of a respirator, to advocating for disabled people and developing medical aid, real life success stories such as that of Robin Cavendish, never cease to inspire. Dinesh Palipana who proved his mettle by doggedly pursuing a career in medicine, while advocating for disability rights is, without a doubt, of that same calibre and hopefully will inspire multitudes more to achieve similarly extraordinary aspirations.


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Islamophobia and the threat to democratic development

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There’s an ill more dangerous and pervasive than the Coronavirus that’s currently sweeping Sri Lanka. That is the fear to express one’s convictions. Across the public sector of the country in particular many persons holding high office are stringently regulating and controlling the voices of their consciences and this bodes ill for all and the country.

The corrupting impact of fear was discussed in this column a couple of weeks ago when dealing with the military coup in Myanmar. It stands to the enduring credit of ousted Myanmarese Head of Government Aung San Suu Kyi that she, perhaps for the first time in the history of modern political thought, singled out fear, and not power, as the principal cause of corruption within the individual; powerful or otherwise.

To be sure, power corrupts but the corrupting impact of fear is graver and more devastating. For instance, the fear in a person holding ministerial office or in a senior public sector official, that he would lose position and power as a result of speaking out his convictions and sincere beliefs on matters of the first importance, would lead to a country’s ills going unaddressed and uncorrected.

Besides, the individual concerned would be devaluing himself in the eyes of all irrevocably and revealing himself to be a person who would be willing to compromise his moral integrity for petty worldly gain or a ‘mess of pottage’. This happens all the while in Lankan public life. Some of those who have wielded and are wielding immense power in Sri Lanka leave very much to be desired from these standards.

It could be said that fear has prevented Sri Lanka from growing in every vital respect over the decades and has earned for itself the notoriety of being a directionless country.

All these ills and more are contained in the current controversy in Sri Lanka over the disposal of the bodies of Covid victims, for example. The Sri Lankan polity has no choice but to abide by scientific advice on this question. Since authorities of the standing of even the WHO have declared that the burial of the bodies of those dying of Covid could not prove to be injurious to the wider public, the Sri Lankan health authorities could go ahead and sanction the burying of the bodies concerned. What’s preventing the local authorities from taking this course since they claim to be on the side of science? Who or what are they fearing? This is the issue that’s crying out to be probed and answered.

Considering the need for absolute truthfulness and honesty on the part of all relevant persons and quarters in matters such as these, the latter have no choice but to resign from their positions if they are prevented from following the dictates of their consciences. If they are firmly convinced that burials could bring no harm, they are obliged to take up the position that burials should be allowed.

If any ‘higher authority’ is preventing them from allowing burials, our ministers and officials are conscience-bound to renounce their positions in protest, rather than behave compromisingly and engage in ‘double think’ and ‘double talk’. By adopting the latter course they are helping none but keeping the country in a state of chronic uncertainty, which is a handy recipe for social instabiliy and division.

In the Sri Lankan context, the failure on the part of the quarters that matter to follow scientific advice on the burials question could result in the aggravation of Islamophobia, or hatred of the practitioners of Islam, in the country. Sri Lanka could do without this latter phobia and hatred on account of its implications for national stability and development. The 30 year war against separatist forces was all about the prevention by military means of ‘nation-breaking’. The disastrous results for Sri Lanka from this war are continuing to weigh it down and are part of the international offensive against Sri Lanka in the UNHCR.

However, Islamophobia is an almost world wide phenomenon. It was greatly strengthened during Donald Trump’s presidential tenure in the US. While in office Trump resorted to the divisive ruling strategy of quite a few populist authoritarian rulers of the South. Essentially, the manoeuvre is to divide and rule by pandering to the racial prejudices of majority communities.

It has happened continually in Sri Lanka. In the initial post-independence years and for several decades after, it was a case of some populist politicians of the South whipping-up anti-Tamil sentiments. Some Tamil politicians did likewise in respect of the majority community. No doubt, both such quarters have done Sri Lanka immeasurable harm. By failing to follow scientific advice on the burial question and by not doing what is right, Sri Lanka’s current authorities are opening themselves to the charge that they are pandering to religious extremists among the majority community.

The murderous, destructive course of action adopted by some extremist sections among Muslim communities world wide, including of course Sri Lanka, has not earned the condemnation it deserves from moderate Muslims who make-up the preponderant majority in the Muslim community. It is up to moderate opinion in the latter collectivity to come out more strongly and persuasively against religious extremists in their midst. It will prove to have a cementing and unifying impact among communities.

It is not sufficiently appreciated by governments in the global South in particular that by voicing for religious and racial unity and by working consistently towards it, they would be strengthening democratic development, which is an essential condition for a country’s growth in all senses.

A ‘divided house’ is doomed to fall; this is the lesson of history. ‘National security’ cannot be had without human security and peaceful living among communities is central to the latter. There cannot be any ‘double talk’ or ‘politically correct’ opinions on this question. Truth and falsehood are the only valid categories of thought and speech.

Those in authority everywhere claiming to be democratic need to adopt a scientific outlook on this issue as well. Studies conducted on plural societies in South Asia, for example, reveal that the promotion of friendly, cordial ties among communities invariably brings about healing among estranged groups and produces social peace. This is the truth that is waiting to be acted upon.

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Pakistan’s love of Sri Lanka

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By Sanjeewa Jayaweera

It was on 3rd January 1972 that our family arrived in Karachi from Moscow. Our departure from Moscow had been delayed for a few weeks due to the military confrontation between Pakistan and India. It ended on 16th December 1971. After that, international flights were not permitted for some time.

The contrast between Moscow and Karachi was unbelievable. First and foremost, Moscow’s temperature was near minus 40 degrees centigrade, while in Karachi, it was sunny and a warm 28 degrees centigrade. However, what struck us most was the extreme warmth with which the airport authorities greeted our family. As my father was a diplomat, we were quickly ushered to the airport’s VIP Lounge. We were in transit on our way to Rawalpindi, the airport serving the capital of Islamabad.

We quickly realized that the word “we are from Sri Lanka” opened all doors just as saying “open sesame” gained entry to Aladdin’s cave! The broad smile, extreme courtesy, and genuine warmth we received from the Pakistani people were unbelievable.

This was all to do with Mrs Sirima Bandaranaike’s decision to allow Pakistani aircraft to land in Colombo to refuel on the way to Dhaka in East Pakistan during the military confrontation between Pakistan and India. It was a brave decision by Mrs Bandaranaike (Mrs B), and the successive governments and Sri Lanka people are still enjoying the fruits of it. Pakistan has been a steadfast and loyal supporter of our country. They have come to our assistance time and again in times of great need when many have turned their back on us. They have indeed been an “all-weather” friend of our country.

Getting back to 1972, I was an early beneficiary of Pakistani people’s love for Sri Lankans. I failed the entrance exam to gain entry to the only English medium school in Islamabad! However, when I met the Principal, along with my father, he said, “Sanjeewa, although you failed the entrance exam, I will this time make an exception as Sri Lankans are our dear friends.” After that, the joke around the family dinner table was that I owed my education in Pakistan to Mrs B!

At school, my brother and I were extended a warm welcome and always greeted “our good friends from Sri Lanka.” I felt when playing cricket for our college; our runs were cheered more loudly than of others.

One particular incident that I remember well was when the Embassy received a telex from the Foreign inistry. It requested that our High Commissioner seek an immediate meeting with the Prime Minister of Pakistan, Mr Zulifikar Ali Bhutto (ZB), and convey a message from Mrs B. The message requested that an urgent shipment of rice be dispatched to Sri Lanka as there would be an imminent rice shortage. As the Ambassador was not in the station, the responsibility devolved on my father.

It usually takes about a week or more to get an audience with the Prime Minister (PM) of a foreign country due to their busy schedule. However, given the urgency, my father spoke to the Foreign Ministry’s Permanent Sectary, who fortunately was our neighbour and sought an urgent appointment. My father received a call from the PM’s secretary around 10 P.M asking him to come over to the PM’s residence. My father met ZB around midnight. ZB was about to retire to bed and, as such, was in his pyjamas and gown enjoying a cigar! He had greeted my father and had asked, “Mr Jayaweera, what can we do for great friend Madam Bandaranaike?. My father conveyed the message from Colombo and quietly mentioned that there would be riots in the country if there is no rice!

ZB had immediately got the Food Commissioner of Pakistan on the line and said, “I want a shipload of rice to be in Colombo within the next 72 hours!” The Food Commissioner reverted within a few minutes, saying that nothing was available and the last export shipment had left the port only a few hours ago to another country. ZB had instructed to turn the ship around and send it to Colombo. This despite protests from the Food Commissioner about terms and conditions of the Letter of Credit prohibiting non-delivery. Sri Lanka got its delivery of rice!

The next was the visit of Mrs B to Pakistan. On arrival in Rawalpindi airport, she was given a hero’s welcome, which Pakistan had previously only offered to President Gaddafi of Libya, who financially backed Pakistan with his oil money. That day, I missed school and accompanied my parents to the airport. On our way, we witnessed thousands of people had gathered by the roadside to welcome Mrs B.

When we walked to the airport’s tarmac, thousands of people were standing in temporary stands waving Sri Lanka and Pakistan flags and chanting “Sri Lanka Pakistan Zindabad.” The noise emanating from the crowd was as loud and passionate as the cheering that the Pakistani cricket team received during a test match. It was electric!

I believe she was only the second head of state given the privilege of addressing both assemblies of Parliament. The other being Gaddafi. There was genuine affection from Mrs B amongst the people of Pakistan.

I always remember the indefatigable efforts of Mr Abdul Haffez Kardar, a cabinet minister and the President of the Pakistan Cricket Board. From around 1973 onwards, he passionately championed Sri Lanka’s cause to be admitted as a full member of the International Cricket Council (ICC) and granted test status. Every year, he would propose at the ICC’s annual meeting, but England and Australia’s veto kept us out until 1981.

I always felt that our Cricket Board made a mistake by not inviting Pakistan to play our inaugural test match. We should have appreciated Mr Kardar and Pakistan’s efforts. In 1974 the Pakistan board invited our team for a tour involving three test matches and a few first-class games. Most of those who played in our first test match was part of that tour, and no doubt gained significant exposure playing against a highly talented Pakistani team.

Several Pakistani greats were part of the Pakistan and India team that played a match soon after the Central Bank bomb in Colombo to prove that it was safe to play cricket in Colombo. It was a magnificent gesture by both Pakistan and India. Our greatest cricket triumph was in Pakistan when we won the World Cup in 1996. I am sure the players and those who watched the match on TV will remember the passionate support our team received that night from the Pakistani crowd. It was like playing at home!

I also recall reading about how the Pakistani government air freighted several Multi Barrell artillery guns and ammunition to Sri Lanka when the A rmy camp in Jaffna was under severe threat from the LTTE. This was even more important than the shipload of rice that ZB sent. This was crucial as most other countries refused to sell arms to our country during the war.

Time and again, Pakistan has steadfastly supported our country’s cause at the UNHCR. No doubt this year, too, their diplomats will work tirelessly to assist our country.

We extend a warm welcome to Mr Imran Khan, the Prime Minister of Pakistan. He is a truly inspirational individual who was undoubtedly an excellent cricketer. Since retirement from cricket, he has decided to get involved in politics, and after several years of patiently building up his support base, he won the last parliamentary elections. I hope that just as much as he galvanized Sri Lankan cricketers, his political journey would act as a catalyst for people like Kumar Sangakkara and Mahela Jayawardene to get involved in politics. Cricket has been called a “gentleman’s game.” Whilst politics is far from it!.

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Covid-19 health rules disregarded at entertainment venues?

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Believe me, seeing certain videos, on social media, depicting action, on the dance floor, at some of these entertainment venues, got me wondering whether this Coronavirus pandemic is REAL!

To those having a good time, at these particular venues, and, I guess, the management, as well, what the world is experiencing now doesn’t seem to be their concerned.

Obviously, such irresponsible behaviour could create more problems for those who are battling to halt the spread of Covid-19, and the new viriant of Covid, in our part of the world.

The videos, on display, on social media, show certain venues, packed to capacity – with hardly anyone wearing a mask, and social distancing…only a dream..

How can one think of social distancing while gyrating, on a dance floor, that is over crowded!

If this trend continues, it wouldn’t be a surprise if Coronavirus makes its presence felt…at such venues.

And, then, what happens to the entertainment scene, and those involved in this field, especially the musicians? No work, whatsoever!

Lots of countries have closed nightclubs, and venues, where people gather, in order to curtail the spread of this deadly virus that has already claimed the lives of thousands.

Thailand did it and the country is still having lots of restrictions, where entertainment is concerned, and that is probably the reason why Thailand has been able to control the spread of the Coronavirus.

With a population of over 69 million, they have had (so far), a little over 25,000 cases, and 83 deaths, while we, with a population of around 21 million, have over 80,000 cases, and more than 450 deaths.

I’m not saying we should do away with entertainment – totally – but we need to follow a format, connected with the ‘new normal,’ where masks and social distancing are mandatory requirements at these venues. And, dancing, I believe, should be banned, at least temporarily, as one can’t maintain the required social distance, while on the dance floor, especially after drinks.

Police spokesman DIG Ajith Rohana keeps emphasising, on TV, radio, and in the newspapers, the need to adhere to the health regulations, now in force, and that those who fail to do so would be penalised.

He has also stated that plainclothes officers would move around to apprehend such offenders.

Perhaps, he should instruct his officers to pay surprise visits to some of these entertainment venues.

He would certainly have more than a bus load of offenders to be whisked off for PCR/Rapid Antigen tests!

I need to quote what Dr. H.T. Wickremasinghe said in his article, published in The Island of Tuesday, February 16th, 2021:

“…let me conclude, while emphasising the need to continue our general public health measures, such as wearing masks, social distancing, and avoiding crowded gatherings, to reduce the risk of contact with an infected person.

“There is no science to beat common sense.”

But…do some of our folks have this thing called COMMON SENSE!

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