Finding My Voice: A Journey Beyond Fear and Judgment

Finding My Voice: A Journey Beyond Fear and Judgment

- Dr. Shane Halpe 

Yesterday marked a personal milestone in my life.

No, it wasn’t about passing an exam, winning a championship, or graduating from university. Yesterday, I sang two songs in front of an audience—and to me, that was a significant achievement.

Let me explain why.

As a child, I was terrified of singing. I disliked the sound of my own voice and avoided singing during church services. Even though I began reading the Bible during Mass, I never dared join the choir. That all changed one day when the church pianist gently encouraged me to give it a try.

I joined the English Choir at Our Lady of Fatima Church in Maradana and found not just music, but friendships that have lasted to this day. Slowly, without realizing it, I began to overcome my fear. A mentor we fondly called “Neville Uncle” helped shape my confidence, urging me to sing out loud, to come closer to the mic. I began to hear something new: that maybe I had a good voice—a God-given one.

Though I continued to sing in church, I still avoided public singing. I recall once trying to sing with friends at university, only to be met with teasing. Though said in jest, those words wounded my confidence. And so, I retreated from the stage.

Years later, after passing my postgraduate Family Medicine exam, a colleague asked me to sing at a celebration. Nervously, I accepted. I practiced with YouTube karaoke tracks and sang “Quando, Quando, Quando.” To my surprise, friends praised my voice. It was amateur, yes—but it broke a barrier I’d carried for years.

That moment led to another.

Yesterday, a colleague asked if I’d sing at the Faculty of Medicine, University of Jaffna get-together. I said yes—despite not knowing many people there and navigating language barriers. I sang “Can’t Help Falling in Love” by Elvis Presley and “Master Sir,” a Sinhalese classic. Even the Acting Dean came over to commend me. I was deeply moved.

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Looking back, I am grateful.

Grateful for the chance to push past fear.

Grateful for the people—my parents, teachers, mentors, and friends—who helped me grow.

Grateful even for the critics who said I wasn’t good enough.

During my time at SAITM, I heard so much negativity. Media narratives painted us as “spoiled kids” who didn’t deserve to be doctors. A doctor once mocked me at the National Hospital, calling me a “backdoor medical student.” I was in my first year. The pain was real.

But I’ve learned this:

Society may try to break you. But if you surround yourself with people of faith, hope, and courage, you will rise.

Even your enemies can become your greatest motivators.

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So here’s my message to you:

🌟 Believe in yourself.

🌟 Enjoy what you do.

🌟 Surround yourself with good people.

Be thankful for the journey. For the battles. For the growth.

And keep striving to become the best version of who you are.

Live victoriously—every single day.

When a Wasp Delivered a Birthday Blessing

When a Wasp Delivered a Birthday Blessing

By Dr. Shane Malitha Halpe

October 2021 marked the beginning of my journey as a doctor beyond the safety net of internship. I had just completed my final rotation and was appointed as a Medical Officer (Relief) under the Regional Director of Health Services in Puttalam. My assignment? A rural divisional hospital in Kottukachchiya—about 12 kilometers inland from Puttalam town.

Kottukachchiya was quiet and unassuming. The hospital, a Type C divisional facility, had been without a doctor for nearly six months. Staff spoke of doctors who had either been transferred, gone on maternity leave, or left for postgraduate training. When I arrived, I was alone—appointed as Medical Officer-in-Charge by default. There was no nursing officer, no second doctor but a visiting a dental doctor. Just a midwife, a few attendants, a dispenser and an ambulance driver.

It was a humbling start.

Although I had trained in paediatrics and surgery, I had little experience in general practice and virtually none in administration. Every form, every protocol, every decision—I had to figure out on the spot. My daily work revolved around OPD consultations, antenatal care, and medical clinics. The pace was slow, the workload manageable. The staff were kind, though not accustomed to high-pressure situations. Most patients came with everyday complaints—coughs, joint pain, minor infections, and check-ups.

Saturdays were half-days, and I looked forward to them. On one particular Saturday, I was especially eager to get home—it was my mother’s birthday. I had packed early, hoping to catch the afternoon bus to Wattala. By 11 a.m., the OPD had quieted down. I was almost ready to leave.

Then came the three-wheeler.

It rushed into the hospital compound, carrying two women—mother and daughter—surrounded by anxious villagers. They had been attacked by a swarm of wasps while riding a motorcycle. Panic filled the air as they were wheeled into the dusty, rarely used ward. I heard someone shout, “Doctor! Come quickly!”

I rushed in.

The younger woman appeared distressed but stable. The mother, however, was pale, clammy, and semi-conscious. Her pulse was thready. She was sweating and cold to the touch. Her blood pressure? Undetectable. My heart sank. I had never managed a case of anaphylaxis on my own. But amid the chaos, a lesson from my final year medicine rotation under Prof. Kolitha Sellahewa echoed in my mind:

"Anaphylaxis? Give adrenaline. Adrenaline!"

I called for the cardiac monitor—it hadn’t been used in ages, and no one knew how to operate it. I connected it myself. I asked for adrenaline—only two vials remained in the hospital, and one was expired. I took the viable vial.

With trembling hands and a pounding heart, I drew up 0.5 ml of adrenaline (1:1000) and injected it into the patient’s thigh. I prayed as I watched and waited.

Slowly, to my relief, her condition began to stabilize. Her pulse strengthened. Her blood pressure returned—120/80 mmHg. The adrenaline had worked.

Realizing the limitations of our rural facility, I arranged an immediate transfer to Puttalam Base Hospital. She was safely loaded into the ambulance, stabilized and conscious. Only then did I allow myself to breathe.

As I turned to leave, I mentioned to the midwife—half-apologetically—that I was now late for my mother’s birthday and hadn’t even bought her a present. She smiled gently and said:

“Doctor, you’ve already given her the best birthday gift. You saved a life today.”

That evening, when I finally made it home—disheveled, drained but deeply thankful—my mother met me with a warm hug. The midwife had already called to share what had happened.

With tears in her eyes, she whispered:

“Thank you, son. This birthday, you gave me the most precious gift a mother could receive.”

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Looking back, that day in Kottukachchiya was more than a clinical experience. It was a rite of passage. I stepped into responsibility, leaned on my training, and learned that even the most basic of settings can become the backdrop for life’s most profound lessons.

It reminded me that healing isn’t always about technology or titles.

Sometimes, it’s simply about being present—when it matters most.

And perhaps, that’s what Family Medicine is truly all about.

𝗣𝘂𝗿𝗽𝗼𝘀𝗲 𝗟𝗶𝘃𝗲𝘀 𝗢𝘂𝘁𝘀𝗶𝗱𝗲 𝘁𝗵𝗲 𝗖𝗼𝗺𝗳𝗼𝗿𝘁 𝗭𝗼𝗻𝗲

𝗣𝘂𝗿𝗽𝗼𝘀𝗲 𝗟𝗶𝘃𝗲𝘀 𝗢𝘂𝘁𝘀𝗶𝗱𝗲 𝘁𝗵𝗲 𝗖𝗼𝗺𝗳𝗼𝗿𝘁 𝗭𝗼𝗻𝗲

By Dr. Shane Malitha Halpe

A Sudden Shift in Plans

I still remember the day I chose Jaffna.

At the time, Family Medicine was a newly emerging discipline in Sri Lanka, and accredited training centers were few and far between. To make matters more complicated, two of the three centers near Colombo were abruptly removed from the list due to a technicality. It caused a wave of uncertainty among many trainees, narrowing our options overnight.

What felt like a setback for most, I saw as a challenge—and a chance.

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Choosing the Unfamiliar

When I heard that a Senior Registrar had begun training in Jaffna, it sparked something within me. During selection day, while many clung to the hope of remaining near Colombo, I made a different choice. I opted for Jaffna—400 kilometers away from the familiarity of home, friends, and even language.

My colleagues were surprised. “Why Jaffna?” they asked, some even feeling sorry for me. I didn’t speak a word of Tamil, had never lived that far from home, and couldn’t even cook a basic meal.

But deep down, I knew I was ready to grow.

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The Long Journey North

It was Easter Sunday in 2024, when I left Katugastota, where I had just completed my last posting, and headed north. The vehicle was packed to the brim—with bags, books, and even my bicycle.

In Jaffna, I moved into a small hostel near the university, sharing space with a senior colleague. It wasn’t luxurious by any means, but it marked the start of something remarkable.

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Baptism by Fire (and Sun)

In the morning, I cycled to the Family Health Centre in Kondavil, under the relentless northern sun. The heat was unforgiving, but the sea breeze carried some relief. My supervisor—firm, punctual, and no-nonsense—believed in tough training to ensure smooth exams. His motto: "Training should be hard, so the exam is easy." In time, I saw the truth in those words.

We saw patients in clinics, went on home visits, taught medical students, and engaged in field work. Despite the intensity, I found a rhythm. I began to adapt. Slowly, Jaffna stopped being foreign and started feeling like purpose.

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Discovering Myself in the North

What began as a reluctant assignment became a rediscovery of self.

I forged new friendships, immersed myself in the culture of the north, and began writing—something I hadn’t done in years. I published my reflections, presented my work at the WONCA academic sessions, and even addressed the Sri Lanka Medical Association. I saw myself differently, not just as a trainee, but as a contributor to the field of Family Medicine.

When I passed the MD in Family Medicine, I realized that this journey had transformed me.

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Return to Jaffna—By Choice

Now, as a Senior Registrar, I’ve chosen to return to Jaffna, this time with a few fellow colleagues. Once again, I heard the familiar surprise: “Why go there again, bro? Colombo is easier!” Some teased, “You’re single—maybe that’s why!”

Yes, perhaps being unattached made it easier. But the truth? I felt I still had something to give—and something to learn.

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Hard Roads, Strong Spirits

This second phase had its own challenges. No fan. No air conditioning. No water supply in the hostel. Traveling was expensive, and I missed the comfort of home-cooked meals, a cool room, and neatly washed clothes and even water to drink . But strangely, I felt content. I found great places to eat to nutritious and healthy meals for surprisingly cheap places. Got myself a fan from a local electronics store which cooled me down. Got into the habit of washing my clothes with washing powder and a bucket of water. Also found places to which provide filtered drinking water 1 litre for Rupees - which helped me realise the value of good drinking water. 

I felt peace. I felt strength.

I had developed something I never truly understood before—resilience.

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From Struggle to Strength

As I continue my journey toward becoming a specialist, I reflect often on the choices that brought me here. In a world obsessed with convenience and comfort, I’m grateful I chose discomfort—because that’s where I grew the most.

I’m reminded of Nelson Mandela, who endured 27 years of imprisonment before leading a nation to freedom. That image reminds me: greatness often grows in the soil of adversity.

And so I write this today, not just as a doctor, but as someone who chose the long road, the hot sun, the hard days—and found a deeper joy on the other side.

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Have you ever stepped out of your comfort zone and discovered a part of yourself you didn’t know existed? I’d love to hear your thoughts in the comments below.

📍 #FamilyMedicine #JaffnaJourney #MedicalReflections #OutOfComfortZone #SriLankaHealthcare

In Their Words: Discovering Humanity Through Language and Loss

In Their Words: Discovering Humanity Through Language and Loss

By Dr. Shane Halpe | Reflections from the Clinic | Myliddy, Sri Lanka

Above: The sun rising over the clinic at Myliddy – a new beginning for an old land.

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Learning to Listen

Today in Myliddy, a quiet fishing village slowly finding its rhythm after decades of conflict, I stepped into more than just a clinic—I stepped into the lives and languages of a community with untold stories.

I was supported by a demonstrator who helped translate between Tamil and Sinhala. In between patient consultations, we shared something beautiful: I practised basic Tamil, and in turn, taught him a few Sinhalese phrases. It felt joyful—liberating even. Language, I’ve come to realise, isn’t just about communication; it’s about connection.

Tamil in Translation

I tried using Tamil as patients arrived. I asked their names, ages, and about their symptoms. But when I ventured into open-ended questions like “What made you come today?”, the replies were long, emotional, and—for now—beyond me. It sounded like Greek!

Thankfully, my assistant filled in the gaps. I kept referring to my notes, scribbled with Tamil phrases in English letters. It was a humble start, but every word felt like a step toward something larger—a bridge across difference.

To my surprise, patients responded warmly. A simple “Eppadi irukkeenga?” (How are you?) brought a smile. Even broken Tamil was better than silence. It reminded me that when we make the slightest effort to understand, people open up.

Stories That Stay With You

Two of my patients that day shared more than symptoms. Both were middle-aged mothers of one child. Both had husbands who had left for France and never returned—remarried, unreachable, offering no support. They weren’t legally divorced, just abandoned.

I gently asked about their mental health. Their responses were calm, grounded. They had learned to carry on—alone, with strength and quiet dignity. I realised then how deeply personal struggles can remain unseen in a typical clinical encounter unless we create space to hear them.

Myliddy: A Town Reclaimed

Later, I learned that Myliddy had once been under military control—its residents displaced, its homes empty. Only in recent years have families returned. The town is rebuilding itself, stone by stone, story by story. It’s a place of resilience, shaped by conflict but determined to heal.

A Doctor’s Reflection

Medicine often teaches us how to diagnose, prescribe, and treat. But today taught me something different: to listen, to learn, and to care in the language that matters most—the patient's own.

Healing begins long before a prescription is written. Sometimes, it starts with the courage to ask simple questions… and the humility to hear long answers.

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🌿 Have you had moments when language became a bridge—or a barrier—in your own life? Share your thoughts in the comments below.

Follow this blog for more reflections from the field, stories from the clinic, and insights into community-based care in Sri Lanka.

𝗔 𝗗𝗮𝘆 𝗼𝗳 𝗛𝗼𝗽𝗲, 𝗪𝗶𝘀𝗱𝗼𝗺, 𝗮𝗻𝗱 𝗟𝗲𝗴𝗮𝗰𝘆 𝗶𝗻 𝗞𝗶𝗹𝗶𝗻𝗼𝗰𝗵𝗰𝗵𝗶: 𝗥𝗲𝗳𝗹𝗲𝗰𝘁𝗶𝗼𝗻𝘀 𝗳𝗿𝗼𝗺 𝘁𝗵𝗲 𝗢𝗽𝗲𝗻𝗶𝗻𝗴 𝗼𝗳 𝘁𝗵𝗲 𝗗𝗶𝘀𝗮𝗯𝗶𝗹𝗶𝘁𝘆 𝗥𝗲𝗵𝗮𝗯𝗶𝗹𝗶𝘁𝗮𝘁𝗶𝗼𝗻 𝗖𝗲𝗻𝘁𝗿𝗲 – 𝗝𝘂𝗻𝗲 𝟲𝘁𝗵, 𝟮𝟬𝟮𝟱

Last Friday, I had the honour of attending the ceremonial opening of the Centre for Disability Rehabilitation – Kilinochchi, a collaborative initiative by the Manitha Neyam Trust and the Mettha Rehabilitation Foundation. This centre, situated in the heart of the Vanni, offers prosthetic limb services and physical rehabilitation for persons with disabilities — a vital service in a region still healing from the deep scars of war.

I attended with my consultant, Dr. S. Kumaran, and our team from the Department of Family Medicine. The morning sun fell warmly over the newly painted green walls of the centre as chairs were arranged, speeches prepared, and guests began to arrive. But among all the meaningful encounters that day, one left a lasting imprint on my heart — my conversation with Professor Sreeharan Nadarajah.

Prof. Sreeharan carried with him a calm dignity and a presence that was quietly commanding. In our brief but deeply enriching interaction, I found not just a senior physician, but a true mentor. He was humble, kind, and full of wisdom — the sort that doesn’t lecture, but gently invites you to think more deeply about your purpose.

As we spoke, he shared something profoundly simple yet powerful:

"𝙀𝙫𝙚𝙧𝙮𝙩𝙝𝙞𝙣𝙜 𝙬𝙚 𝙙𝙤 𝙨𝙝𝙤𝙪𝙡𝙙 𝙪𝙡𝙩𝙞𝙢𝙖𝙩𝙚𝙡𝙮 𝙡𝙚𝙖𝙙 𝙩𝙤 𝙩𝙝𝙚 𝙝𝙖𝙥𝙥𝙞𝙣𝙚𝙨𝙨 𝙖𝙣𝙙 𝙬𝙚𝙡𝙡𝙗𝙚𝙞𝙣𝙜 𝙤𝙛 𝙤𝙪𝙧𝙨𝙚𝙡𝙫𝙚𝙨 𝙖𝙣𝙙 𝙤𝙩𝙝𝙚𝙧𝙨."

That sentiment, he explained, is at the heart of the Manitha Neyam Trust — an organisation dedicated to serving war-affected and underserved communities in the North, regardless of race or religion. It resonated with the very meaning of the name Manitha Neyam — "Love for Humanity."

To my surprise, he revealed that he, too, was a Josephian — an alumnus of St. Joseph’s College, Colombo 10, just like me. He had topped his A/L batch and entered the Colombo Medical Faculty, later rising to prominence in his field. Yet despite being a boy from Colombo, he chose to go to Jaffna during the most difficult of times to establish the Department of Medicine at the University of Jaffna — a true act of courage, conviction, and service.

He encouraged me to continue pursuing Family Medicine, reminding me of the value of working in rural areas and underserved communities.

“𝙒𝙝𝙞𝙡𝙚 𝙬𝙚 𝙣𝙚𝙚𝙙 𝙨𝙥𝙚𝙘𝙞𝙖𝙡𝙞𝙨𝙩𝙨,” 𝙝𝙚 𝙨𝙖𝙞𝙙, “𝙞𝙩 𝙞𝙨 𝙩𝙝𝙚 𝙜𝙚𝙣𝙚𝙧𝙖𝙡𝙞𝙨𝙩𝙨 — 𝙩𝙝𝙚 𝙛𝙖𝙢𝙞𝙡𝙮 𝙥𝙝𝙮𝙨𝙞𝙘𝙞𝙖𝙣𝙨, 𝙩𝙝𝙚 𝙘𝙤𝙢𝙢𝙪𝙣𝙞𝙩𝙮 𝙙𝙤𝙘𝙩𝙤𝙧𝙨 — 𝙬𝙝𝙤 𝙘𝙖𝙣 𝙩𝙧𝙪𝙡𝙮 𝙩𝙧𝙖𝙣𝙨𝙛𝙤𝙧𝙢 𝙡𝙞𝙫𝙚𝙨, 𝙘𝙤𝙢𝙢𝙪𝙣𝙞𝙩𝙞𝙚𝙨, 𝙖𝙣𝙙 𝙚𝙫𝙚𝙣 𝙣𝙖𝙩𝙞𝙤𝙣𝙨. 𝙊𝙣𝙚 𝙨𝙩𝙚𝙥 𝙖𝙩 𝙖 𝙩𝙞𝙢𝙚.”

He also spoke about the importance of collaboration — between races, religions, languages, and even across national borders — in building a better world. “We must learn to work with others, not dominate them,” he told me. “That is the path to peace and progress.”

Before we parted, he blessed me and offered one last encouragement — to keep writing, to keep learning, and to keep striving to make a difference.

As I left the ceremony, watching him blend back into the crowd with quiet grace, I knew I had encountered someone whose legacy wasn’t just in medicine, but in mentorship, humanity, and hope.

He left behind no grand gesture — just a few words, a warm smile, and a heart stirred to do more.

📍 Location: Centre for Disability Rehabilitation, 9th Farm, Kanagapuram, Kilinochchi
🤝 Organisers: Manitha Neyam Trust & Mettha Rehabilitation Foundation
🎤 Chief Guest: Hon. Nagalingam Vethanayahan, Governor of the Northern Province

Tags: #FamilyMedicine #Kilinochchi #ManithaNeyam #DisabilityRehabilitation #SriLankaHealth #MedicalMentors #RuralHealth #ProfSreeharan #CommunityCare #VanniHealing

https://www.med.jfn.ac.lk/personnel/prof-nadarajah-sreeharan/

When a Stomach Ache Wasn’t Just a Stomach Ache: Reflections from the Family Medicine Clinic in Kondavil

Today was another busy day at the Family Medical Clinic in Kondavil. Together with the registrar in Family Medicine, I was seeing the usual stream of patients—headaches, backaches, follow-ups for chronic illnesses, and plenty of medication adjustments. Just another day in primary care—or so I thought.

Among the patients was a 16-year-old schoolgirl, accompanied by her warden. Dressed in her school uniform, she looked visibly anxious. Her stated complaint was dysmenorrhoea—period pain. Two of our medical students had already begun taking her history and were presenting the case in the consultation room, which was bustling. Including myself, the registrar, the two medical students, and the patient, the room felt quite full. The warden waited outside in the reception area.

Sensing that the environment might be overwhelming for her, I quietly stepped out and asked the registrar and the two female students to continue the consultation in a more comfortable and private manner. I felt instinctively that she would be more at ease speaking with female caregivers.

Shortly afterward, the registrar updated me. The girl had no significant physical symptoms of dysmenorrhoea. It turned out that her refusal to attend school had little to do with her periods. Underneath this seemingly routine complaint was a much deeper and more troubling picture.

She had a history of severe low mood, expressed a loss of interest in daily activities, and, alarmingly, had previously attempted to take her own life—once by ingesting pills and another time by cutting herself. The scars on her forearm told their own story. She was apparently very unhappy staying at the boarding house. Her background was marked by hardship—she came from Pungudutivu, from a family struggling with poverty, and her sister too was attending the same school.

When I later spoke with the warden, she described the girl as quiet, non-violent, and withdrawn. She frequently refused to eat or attend school and would sometimes go home and not return, citing financial reasons.

Recognizing the gravity of the situation, I discussed it with my team. There was no time to delay—we made an urgent referral to the Consultant Psychiatrist. I personally contacted the psychiatrist, who kindly agreed to see the girl immediately. We ensured she left with a proper referral and followed up with her warden to confirm she had made it to the clinic.

What began as a vague complaint of abdominal pain turned out to be something far more serious—a cry for help. We may never fully know the impact of that consultation, but I believe we may have helped save her life that day.

As a family physician, I am reminded again and again that our role extends beyond the symptom checklist. We are here not just to diagnose and prescribe, but to listen, to probe gently when things don’t add up, and to care for the whole person—and often their family too. Adolescent depression is a growing issue, both in Sri Lanka and globally, and it is frequently missed.

This time, we caught it. And I am grateful.

Grateful for the opportunity to serve. Grateful for the training that helps us look beyond the obvious. And grateful for the chance to practice a kind of medicine that touches lives in ways the textbooks don’t always teach.
Dr. Shane Halpe - SR Family Medicine 
05.06.2025

#FamilyMedicine #AdolescentMentalHealth #PrimaryCareStories #RuralHealth #SriLankaHealth #CompassionateCare #MedicalReflections #YouthDepression #HiddenStoriesInHealthcare #KondavilClinic

Healing at the Edge: A Day at Myliddy’s Rural Clinic

Nestled along the windswept coastal road from Kankesanthurai to Point Pedro, with the glimmering northern sea to one side and parched, palm-fringed fields to the other, lies the quiet village of Myliddy. Here, away from the hum of busy towns and the spotlight of health policy debates, a small team continues to deliver care at the Myliddy Primary Medical Care Unit (PMCU)—an under-resourced but vital outpost of Sri Lanka’s public health system.

On Wednesday dated 21st May, 2025, my colleague and I, both Senior Registrars in Family Medicine, journeyed to this rural clinic as part of our ongoing commitment to community-based care. Our purpose was simple: to see patients attending the outpatient department and offer what help we could with the tools at hand.

Assisting us was a young demonstrator from the Department of Family Medicine at the University of Jaffna. Acting as both interpreter and eager learner, he facilitated communication with patients who spoke only Tamil, while also engaging with the family medicine consultation model we employed—an approach rooted in empathy, continuity, and whole-person care.

Consultations were held in a humble hall within a separate building, outfitted with just a table, a few plastic chairs, and a waiting area. There was no examination bed, and privacy for sensitive cases was minimal. Yet, the spirit of service was unmistakable. Despite the language barriers and material constraints, the patients—ranging in age from 30 to 70, mostly from economically struggling households—shared their stories with openness and trust.

Many of the elderly lived alone, their children having migrated for work or resettled abroad. It became clear that this community, like many others across the country, is grappling not only with illness but with the social consequences of migration, economic hardship, and aging.

Musculoskeletal complaints dominated the day—aching backs, frozen shoulders, stiff necks—likely the result of years of manual labor and poor ergonomics. Without access to even basic analgesic ointments, we leaned on physiotherapy advice, posture correction, and traditional home-based remedies. Our approach was less about prescriptions and more about empowering patients with knowledge they could act on.

We took the opportunity to screen for non-communicable diseases and provided preventive education, especially regarding cancers—breast, cervical, and oral. Chronic habits like betel and areca nut chewing had left telltale signs in some, and we promptly referred these patients to Base Hospital Tellippalai for further care.

Two female patients stood out—one suffering from vaginal candidiasis, another with a history of recurrent miscarriages. Without private space or examination facilities, managing their care respectfully and effectively was challenging. It was a stark reminder that dignity in healthcare often begins with infrastructure.

The Medical Officer in Charge, a committed and compassionate doctor, worked alongside us with quiet determination. She shared her frustrations: the absence of essential drugs, an overburdened team of just four—including a dispenser, two health assistants (one on prolonged medical leave), and a security guard. She spoke candidly about the endless uphill battle with authorities for more staff and resources—pleas that too often fall on deaf ears.

Even as she contemplates postgraduate studies to become a consultant, she worries aloud about who will hold the fort in her absence. Her words echoed in my mind later in the day as I read a headline quoting the Health Minister at the 78th World Health Assembly of World Health Organization: over 4,600 Sri Lankan healthcare professionals have migrated abroad. The consequences—deepening shortages, overworked staff, and underserved patients—are painfully evident in places like Myliddy.

Our visit offered a sobering yet inspiring glimpse into the realities of rural healthcare. It reaffirmed our belief in the value of primary care, but also raised troubling questions: Can facilities like this remain sustainable in the face of migration, resource scarcity, and an aging population? Can digital solutions like telemedicine bridge the gap? Could artificial intelligence play a role in triaging and managing care where human resources are few?

These are not hypothetical questions anymore—they are the pressing challenges that must be addressed if we are to protect the fabric of our healthcare system.

As the sun dipped low over the northern coast and we made our way back from Myliddy, I carried with me not just the clinical cases of the day, but the faces, stories, and unspoken hopes of a community that deserves better.

Points to ponder, indeed.

By Dr. Shane Halpe - Senior Registrar in Family Medicine