Sri Lanka

U of T student's global project aims to reduce drug errors in Sri Lankan pediatric ward

noreen.rasbach — Thu, 16 May 2019 19:39:03 +0000

U of T student's global project aims to reduce drug errors in Sri Lankan pediatric ward

noreen.rasbach Thu, 05/16/2019 - 15:39

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As part of his joint master's of science and MD program at the ��߲ݴ�ý, Sujen Saravanabavan has opted to conduct a quality improvement project on the pediatric ward at Jaffna Teaching Hospital

Rebecca Biason

Topic

Global Lens

Pediatrics

Institute of Health Policy Management and Evaluation

Dalla Lana School of Public Health

Faculty of Medicine

Global

Graduate Students

Sri Lanka

In the city of Jaffna located on the northern tip of Sri Lanka’s coast, a busy public hospital is making plans to reduce drug errors on its pediatric ward, where a chaotic setting combined with overworked medical staff makes for an environment prone to mistakes.

As part of his joint master's of science and MD program at the ��߲ݴ�ý, Sujen Saravanabavan, a clinician in training and a master’s student at the Institute of Health Policy, Management and Evaluation in the Dalla Lana School of Public Health, has opted to conduct an international seven-week-long quality improvement project on the pediatric ward at Jaffna Teaching Hospital, where both of his parents were treated as children. He wants to use the opportunity to make a change in a health-care setting where human resources are low.

“Drug errors are not often talked about, but they have a significant impact on patient care,” said Saravanabavan. “The perception of doctors and even patients who have a deep trust in the system is that you cannot make mistakes in a clinical setting.”

The hospital, with more than 1,200 beds, has been actively trying to improve its drug administration system and implement quality improvement measures, but it is hindered in part by its physical capacity. There are no private hospital rooms here, or wards designated by disease. High volumes of patients are admitted into the same space regardless of their current illness and a lack of a data-tracking system has made it difficult to see when and where drug errors occur.

Saravanabavan started by observing the environment and conducting interviews with stakeholders on the health-care team, from nurses to pediatricians. He quickly found that many felt uncomfortable discussing drug errors at all.

“I knew then I had to change my tactics and instead began to ask them, what makes your job hard? Delivering medications in this kind of a chaotic setting is undoubtedly hard,” said Saravanabavan.

Drug errors and patient safety issues occur in Canadian hospitals too. These include giving a continued dosage of a medication to a patient after it was supposed to be stopped or not having an appropriate plan in place for adverse reactions. These same problems were occurring on the pediatric ward at the Jaffna Teaching Hospital, but with the added dimension of a lack of resources to help streamline the drug administration process

“Unlike Canadian hospitals, there is no clinical pharmacist on site who could check on the history of patients and ensure medication errors are avoided. Here, doctors and nurses end up having to take on this pharmacist role, despite the busyness of the ward, which results in a potentially increased frequency of drug errors,” said Saravanabavan.

To assist staff, Saravanabavan wanted to implement deliverables that could amount to sustainable changes that would continue long after his seven weeks on the project were complete. He created a process map that outlined how a patient is given medications from the time of admission to the time of discharge. He facilitated group conversations about the root causes of drug errors and ran a seminar on quality improvement. He also created a drug management chart to help nurses on the job.

“It is a very simple system,” said Saravanabavan, “but it allows them to see when Nurse X is working on drug administration and thereby reduce distractions.”

Implementing changes in any hospital setting can be challenging, and for Saravanabavan, the added stressor of conducting most of his interviews in a different language was difficult, but the opportunity to support practitioners in pediatric care and intervene in an effective way is something he was drawn to.

“Pediatric medicine represents an upstream way of interacting with society’s problems – there is a real potential to intervene and positively impact or shape the trajectory of a young person’s life and health,” said Saravanabavan.

In addition to some of his other changes, Saravanabavan has also helped to create a data structure to track when drug errors occur and reinforced this by creating a common drug error guide. Senior hospital staff have now been tasked with tracking and recording drug errors when and if they occur, so that moving forward, the hospital will know what changes need to be made.

“To implement any kind of quality improvement initiative in health care, you need to be able to see and measure whether there has been any improvement,” he said.

While Saravanabavan encourages other students to consider international experiences, he also wants them to be mindful and ethical in their approach to interacting with international health systems.

“I’m a lifelong learner,” said Saravanabavan, “and this opportunity has changed the way I look at the health systems reminding me of the thoughtful conversations that need to take place especially in international systems, to ensure that quality improvement projects are ethical and considerate of cultural elements.

"I have no doubt that this will benefit my clinical expertise in the years to come.”

'Something that should be shared internationally': How an ancient Tamil epic was given new life at U of T Scarborough

Christopher.Sorensen — Thu, 09 May 2019 20:51:34 +0000

'Something that should be shared internationally': How an ancient Tamil epic was given new life at U of T Scarborough

Christopher.Sorensen Thu, 05/09/2019 - 16:51

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U of T's anthropologist Brenda Beck first discovered The Legend of Ponnivala in the 1960s. She has since turned the folk epic into a book, graphic novels and, with the help of a U of T employee, live performances (photo by Joseph Burrell)

Alexa Battler

Topic

City & Culture

Anthropolgy

Faculty of Arts & Science

��߲ݴ�ý anthropologist Brenda Beck first heard the story that would change her life in Olappalayam, a village in India.

The year was 1965 and Beck was doing research for her doctoral studies when two bards sung The Legend of Ponnivala, an ancient, oral folk epic from South India. With permission, she recorded the epic, which took 38 hours to sing over 18 nights.

“It’s a very rich and interesting story, which is totally unknown in the world of literature,” says Beck, who is an adjunct professor in U of T’s department of anthropology. “It is something that should be shared internationally, and it’s something that Tamils can be proud of.”

At U of T Scarborough’s first Tamil Heritage Month celebration earlier this year, 18 performers made history by illustrating parts of the legend. It was the first time two ancient Tamil arts came together – an ancient tale told in a musical storytelling form too old to accurately date.

The U of T Scarborough performance was the first time the legend had been performed as a Villu Paattu, or bow-song, an ancient musical technique that combines narration and a 10-foot bow-string struck for rhythm.

The legend is as difficult to summarize as the Iliad or Beowulf. The story spans roughly two centuries, set in the post-Sangam era in the Kongu region, now part of modern-day South India.

The story begins with the Goddess Parvati, who created nine farmers and told them to cultivate a vast, forested land. It follows these men and their families across three generations – through victory, defeat, famines, curses, power struggles and interfering gods.

Beck first published the tale in 1992 as a two-volume book in Tamil with English translations on alternate pages. She later decided to convert the story into modern mediums and found an animator from a village not far from where she first heard the story. Together, Beck and the artist, whose own grandfather had sung the legend, created a 13-hour animated series.

She went on to turn the story into graphic novels, in English and Tamil, and taught parts of it in local Toronto schools.

“I believe folklore and related story traditions can be used culturally, and applied to new situations,” she says. “I want to see this story grow and become meaningful here.”

A match made in Canada

Shanmugananthan Ramaneekaran, a caretaker at Hart House and University College, wrote, directed and acted portions of the legend at a street festival in Markham, Ont. (photo by Joseph Burrell)

Fast-forward almost half a century, to 2009 – the year Shanmugananthan Ramaneekaran came to Canada as a refugee, fleeing Sri Lanka’s civil war.

Ramaneekaran was a celebrated performer in Tamil folk arts and worked training teachers for Sri Lanka’s ministry of education. Upon coming to Canada, he became a caretaker at U of T’s Hart House and University College. After years of saving, he brought his wife and children to Canada in 2012.

He continued to perform for the GTA’s Tamil community and taught his children to do the same.

“Our community is a very ancient one, we have so much culture and tradition,” Ramaneekaran says. “Whatever I have, I want to share it with communities and other people.”

A few years ago, Beck watched Ramaneekaran on stage at a Tamil folk performance. Struck by his talent, she knew she had to meet him. They have been friends ever since.

Beck says The Legend of Ponnivala made its way to Sri Lanka, as families from the Indian continent were taken as labourers to tea plantations in Sri Lanka’s hill country decades ago. But Ramaneekaran had never heard it. Throughout their friendship, he grew to appreciate the story – just as Beck had almost 50 years earlier, no more than 1,000 kilometres from where he grew up.

This is how The Legend of Ponnivala found a new home, on a new continent, in a new century, and how, through Beck and Ramaneekaran, found a way to become something new.

The epic retold

At U of T Scarborough’s first Tamil Heritage Month celebration earlier this year, 18 performers made history by illustrating parts of the legend (photo by Joseph Burrell)

In 2015, at Markham Ont.’s first Tamil Street Festival, Ramaneekaran wrote, directed and acted portions of the legend in a solo performance. He told it as a koothu, an artform from early Tamil country (circa 200 BC), in which performers tell epic stories by singing, playing music and dancing.

But at U of T Scarborough, it was Ramaneekaran’s daughter Tharscika Ramaneekaran (a current student and now the family’s second generation of Tamil-Canadians) that sat centre stage. At the Tamil Heritage Month celebration, she struck a 10-foot bow-string with two wooden rods, singing and acting with 16 other young Tamil-Canadians for the 40-minute performance.

“Through my daughter, I continue to tell these stories to the younger generation, that is my dream,” says Ramaneekaran, who wrote and directed the performance. “She’s very talented. Whatever I had, she has now.”

Ramaneekaran was also able to bring more youth into the performance by having them mime portions of the story.

“We are a very ancient history and traditional culture,” Ramaneekaran says. “We have it with us – that’s why we try to keep it alive.”

Vigil held at U of T Scarborough to mourn victims of terrorist attack in Sri Lanka

noreen.rasbach — Fri, 26 Apr 2019 20:23:47 +0000

Vigil held at U of T Scarborough to mourn victims of terrorist attack in Sri Lanka

noreen.rasbach Fri, 04/26/2019 - 16:23

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Chemi Lhamo of the Scarborough Campus Students’ Union holds up a picture of victims of Sunday's attack in Sri Lanka during Friday's vigil (photo by Don Campbell)

Topic

Undergraduate Students

Vigil

Tharscika Ramaneekaran spent her childhood surviving Sri Lanka’s 26-year civil war.

“Since the war ended, people at least had hope, they had confidence to dream about a peaceful life, and that’s being shaken again because of [Sunday's] attack,” said Ramaneekaran, a third-year student and culture director of the ��߲ݴ�ý Scarborough’s Tamil Students’ Association (TSA).

“I don’t want that division to happen again, so this is like a nightmare for me.”

U of T Scarborough hosted a vigil Friday for victims of the attack in Colombo, which left at least 253 dead and hundreds more injured. The event was organized by the TSA and the Scarborough Campus Students’ Union (SCSU).

“It is important that we come together to share our combined condemnation of this atrocious attack on individuals who were in places that you would hope to find sanctuary,” Wisdom Tettey, vice-president and principal of U of T Scarborough, told the crowd.

“This pain does not just end with this service and this day. Members of our community will continue to feel the impact of this and it behooves all of us to be there with them, supporting them.”

Terrorists detonated a series of bombs in Sri Lanka on Easter Sunday. Three churches across Sri Lanka – two Catholic and one Protestant – and several hotels were attacked.

Third-year student Kayona Karunakumar was born in Colombo and attended the vigil on behalf of U of T Scarborough’s branch of Power to Change, an interdenominational Christian organization. She says the attack brought back tragic and painful memories, but she hopes students left the vigil feeling loved.

“I do not grieve as someone who has no hope, because I believe that I will see those Christians one day in heaven,” she says.

Vigil participants sign a solidarity banner with messages of love and support (photo by Alex Wong)

Gary Anandasangaree, member of Parliament for Scarborough-Rouge Park, condemned the attacks and offered condolences on behalf of the Canadian government at the vigil. Anandasangaree was born in Sri Lanka and came to Canada as a refugee at age 10.

“It’s a country where racial and religious harmony isn’t being fostered, and it’s a message for us as Canadians, because we’re living in an era where we too are facing these challenges, where we too are being asked a question of who we are as a people,” he said.

Anandasangaree encouraged attendees to leave “with the resolve that we will not tolerate division, or the sense of hatred that’s permeating around the world.”

TSA president Kanitha Uthayakumar says this is why she prayed for the safety of Christians and Muslims, and the recovery of everyone affected.

“Because it is also exam time, we want to support all students who were impacted and have an open space to pray and come together,” says Uthayakumar, who came to Canada from Sri Lanka as a child.

Two of U of T Scarborough’s chaplains, Pastor Mark Devanathan and Pastor Johnson Hsu, also addressed the crowd. Devanathan, lead pastor of U of T Scarborough’s Campus Church, was born in northern Sri Lanka and recounted his family’s terrified attempts to contact relatives in Colombo after the attacks. Thankfully, they were all safe.

But he said he is “broken that many did not hear back.”

After the speeches, attendees signed a solidarity banner with messages of love and support. The banner is hanging in the Student Centre, where a decompression space was also offered to students.

“No matter what, UTSC will continue to show up and continue to pledge to work together for a better world until there is no need for these vigils,” said Chemi Lhamo, vice-president of equity at the SCSU.

Read U of T President Meric Gertler's statement on Sri Lanka

U of T President Meric Gertler offers 'deepest condolences' after terrorist attacks in Sri Lanka on Easter Sunday

geoff.vendeville — Mon, 22 Apr 2019 19:54:02 +0000

U of T President Meric Gertler offers 'deepest condolences' after terrorist attacks in Sri Lanka on Easter Sunday

geoff.vendeville Mon, 04/22/2019 - 15:54

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A woman prays at St. Sebastian's Church in Negombo on April 22, a day after the building was hit as part of a series of bomb blasts targeting churches and luxury hotels in Sri Lanka (photo by Jewel Samad/ AFP via Getty Images)

Topic

University of Toronto President Meric Gertler has condemned the string of bombings in Sri Lanka on Easter Sunday that left nearly 300 people dead and hundreds more injured.

“The ��߲ݴ�ý community shares in the shock and sadness felt around the world in response to the terrorist attacks in Sri Lanka yesterday,” President Gertler said in a statement on Monday.

“These despicable atrocities were orchestrated on Easter Sunday, the holiest day in the Christian calendar, in a country with a long history of religious pluralism and a culture that is welcoming to foreigners.

“Like all such attacks, they were meant to divide and weaken. We join the Sri Lankan community at U of T and in the Toronto region in hoping that Sri Lanka will only grow in unity and strength as a result.”

Read President Gertler's full statement

The co-ordinated bombings on three churches and three luxury hotels represented the deadliest attack in Sri Lanka since the end of the country's civil war in 2009, and drew condemnations from leaders around the world. Mangala Samaraweera, Sri Lanka's finance minister, called the attacks “an attempt to create murder, mayhem and anarchy.”

Global Affairs Canada told CBC in a statement that it has no reports of “Canadian citizens being affected” by the attacks.

“On behalf of the university, I extend our deepest condolences to those whose loved ones were killed or injured, and to the people of Sri Lanka,” President Gertler said.

“I offer our full support to members of our community who are grieving or worried about family and friends. I also encourage all those who are in need of assistance in the wake of this terrible news to access the chaplaincy and health and wellness services available on our campuses.”

There are vigils planned at churches in Scarborough and Brampton tonight. Liberal MP Gary Anandasangaree, who represents the riding of Scarborough-Rouge Park, said members of the local Sri Lankan community can pay their respects at an inter-faith vigil at Malvern Methodist Church near Morningside Avenue and Sheppard Avenue East, starting at 7 p.m. Another memorial is planned in Gage Park in Brampton at 7 p.m.

Another vigil, hosted by the Tamil Students' Association, is to be held at U of T Scarborough on Friday in the Instructional Centre atrium from 12 to 2 p.m.

Campus resources for students, staff and faculty include:

St. George, Health & Wellness Centre

U of T Scarborough, Health & Wellness Centre

U of T Mississauga, Health & Counselling Centre

St. George, Campus Chaplains Association

U of T Scarborough, Campus Chaplains Association

U of T Mississauga, Student Engagement Centre, Interfaith

Employee & Family Assistance Program

Scarborough business owner donates $2 million to U of T for Tamil studies

ullahnor — Fri, 13 Jan 2017 22:47:00 +0000

Scarborough business owner donates $2 million to U of T for Tamil studies

ullahnor Fri, 01/13/2017 - 17:47

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Sinhala and Tamil New Year in Sri Lanka (photo by Amila Tennakoon via Flickr)

Berton Woodward

Author legacy

Berton Woodward

Topic

One of U of T’s earliest Tamil alumni has given a historic donation of $2 million to support Tamil studies program.

The gift from Ravi Gukathasan, who is CEO of Digital Specialty Chemicals Ltd. in Scarborough, is the largest single cash gift from an alumnus in U of T Scarborough's history. It will fund an annual post-doctoral fellowship in Tamil studies as well as scholarships, event programming and digital archiving.

“I want UTSC to be a star when it comes to the Sri Lankan Tamil diaspora, its culture, its language, its perspective in the world,” says Gukathasan. “We have the biggest Tamil diaspora in the world in Scarborough. They need to be proud.”

Read CBC story on donation

UTSC alumnus Ravi Gukathasan's gift to the university will fund an annual post-doctoral fellowship in Tamil studies as well as scholarships, event programming and digital archiving (photo by Ken Jones)

He also sees his gift as a leadership example for other members of the Tamil community to follow.

“I applaud Dr. Gukathasan’s initiative and passionate support of UTSC and am confident that his generous example will stimulate other alumni, not just alumni from the Tamil community, to step forward with game-changing donations,” says U of T Scarborough Principal Bruce Kidd.

The 10-year commitment will fund the $1.25 million Ethan and Leah Schweitzer Gukathasan Fellowship, named for Gukathasan’s two teenage children as well as provide $500,000 for a programming fund, $150,000 for a digital fund and $100,000 for scholarships.

“The gift will add hugely to our ability to expose our campus to what’s going on in Tamil worlds,” says Bhavani Raman, associate professor in the department of historical and cultural studies and chair of the tri-campus Tamil Worlds Initiative programming committee. “We will be able to support young and upcoming scholars from all over the world with the postdoctoral fellowship as well as other visitors.”

She notes that a previous substantial gift from Gukathasan has already allowed U of T Scarborough to sponsor a Tamil studies conference, hold regular public programming on Tamil subjects and work with the U of T Scarborough Library to enhance its Tamil-language collection. She expects to be able to greatly expand such initiatives including the digitization of Sri Lankan Tamil works for global access.

“Beyond U of T, the gift will be a big resource for Tamil studies because there are very few post-doctoral fellowships dedicated to this field,” she says. “My guess is we’ll get many applicants from outside Canada.”

Gukathasan grew up outside Jaffna in Sri Lanka’s Tamil north, then left with the family for the U.K. in 1974. They later re-emigrated to Canada, settling in northern Scarborough, and in 1978, Gukathasan entered what was then Scarborough College, founded just 13 years earlier.

“I was one of only two Tamils in the whole school,” he says.

After gaining his PhD in chemistry at U of T, Gukathasan founded Digital Specialty Chemicals, a highly successful enterprise located on Coronation Drive in southeastern Scarborough, where he has also created a small park and decorated the lobby with Indigenous art.

He’s very proud of his two children with fellow chemist and alumna Caroline Schweitzer whose names are on the gift. Ethan, 18, recently entered chemical engineering at U of T, while Leah, 17 and in Grade 12, wants to study at U of T in evolutionary anthropology.

Gukathasan sees his gift as just the start. “I’m hoping others will follow suit with more money,” he says. “I hope we can keep building this program and make it very, very well-funded and well-rounded.”