The Ceylon National Association for the Prevention of Tuberculosis was the brainchild of Dr. J. H. F. Jayasuriya. He realized the need for a voluntary organization to assist the efforts of the government to control the disease. He initially conceived the idea, implemented it and eventually built and nurtured the CNAPT it into a very effective organization.
CNAPT is a community organization with a strong determination to achieve TB control in the quickest possible time. The CNAPT represents a promise that public awareness will be kept high, the people educated and the state assisted in the control of this disease. In all countries, success has been achieved largely through the work of the National TB Associations.
On the 17th June 1948 the first National Voluntary Organization was formed, and its aim was to conquer the specific disease - Tuberculosis.
The inaugural meeting was held at the Town Hall with the Governor - General Sir Henry Monk Mason Moor presiding. The distinguished gathering included S. W. R. D. Bandaranaike, Minister of Health, Dr. S. E. Chellappah, the Director of Medical and Sanitary Services. A Committee was elected with Dr. J. H. F. Jayasuriya as Chairman. The newly formed Association was assured of Government and public support. The CNAPT was incorporated by an act of Parliament in 1957.
A poignant issue at the time was to find a suitable place somehow. The CNAPT stepped into remedy the situation by building three wards. Welisara Children's Ward (1952), Clarence Nathani Memorial Ward at Welisara (1960) and Hawke Memorial Ward at Kandana (1955) provided a total of 165 beds exclusively for children. The entire cost was raised through the efforts of the CNAPT. Also proposed and got funds to constrict Colombo chest clinic building which is now functioning as a Ministry of Health.
Another commitment of the CNAPT to the cause of affected children was the running of a home for children of tuberculosis parents. The objective was to isolate the children and thereby preventing the spread of tuberculosis from their infected parents. The Sir Frank Gunasekera Trust owned a house in spacious ground overlooking the scenic Bolgoda Lake. The CNAPT took over the running of a prevention which provided a home for the children till their parents became noninfectious.
In the 1950's there was hardly an established system of home visits by personnel from the Department of Health for the purpose of educating patients and their families about the disease. CNAPT conceived the idea of organizing visits to homes in Colombo to create tuberculosis awareness. It was estimated that there were around 20,000 homes in Colombo alone. The home visiting service was inaugurated by the Prime Minister, Hon. Dudley Senanayake on the 25th of February 1953. During the first 13 years of the scheme, over 2000 homes were visited by CNAPT teams. The teams distributed dhal, dried sprats, milk foods and cod liver oil to under nourished children. They also provided advice regarding family planning. Children were also taken to Chest Clinics for examination and BCG vaccination.
Provincial chest clinics as a means of controlling the disease in the provinces, were first conceived of by the CNAPT at a time when only Colombo had such facilities. The first such clinic outside Colombo was built in Galle at the insistence of CNAPT. The Thassim Chest Clinic was named after the Mayor of Galle and the President of the Galle branch of the CNAPT, Mr. A R M Thassim. It was declared open on the 28th of June 1953 .The government scheme of financial assistance for tuberculosis patients was started in 1953. However, in 1950 the CNAPT solicited regarding the hardships undergone by tuberculosis patients and CNAPT granted financial assistance to selected patients and their families.
In the early 1950's patients discharged from hospital found difficulty obtaining employment, one reason being the stigma attached to the disease. The CNAPT embarked on a programme to boost self-employment as an answer to this problem. Accordingly the CNAPT decided to provide vocational training, and tailoring was selected for the purpose. Messrs. Hirdramani Ltd, gifted a large building with spacious grounds while CNAPT provided furniture and machines for the inmates residing in the premises. Training in tailoring was started in 1959 for selected men discharged from hospital. The idea was to have a quick turnover of trainees so that as many as possible would derive the benefits of such skills. A Co-operative society was established to look after their interests. After some years, the original concept of the society was defeated when one batch of trainees become permanent residents of the premises without relinquishing their places to the new batch. A few years ago, the co-operative society was disbanded at the request of the members themselves and the sewing machines were gifted to them.
For several years since its inception, the CNAPT was managed from Dr. J. H. F Jayasuriya's home. Realizing the need for a suitable headquarters, he started search for an appropriate site. His efforts were successful and Money for the construction of the building was collected from friends and well wishes. The two storied building at 51 Edinburgh Crescent (now, Sir Marcus Fernando Mawatha) was declared open by the Prime Minister Hon. S W R D Bandaranaike on the 7th of June 1957. The building has since been the epicenter of all CNAPT activities including recruitment of staff.
The work of the CNAPT was decentralized by the opening of branch associations around the country. The intention was to reach the public outside Colombo. The branches were expected to perform all the activities which were being carried out by the main association. At one stage, there were 44 such branch association.
One of the main activities of the CNAPT since its inception, is in the area of health education. Sixty years ago, there was gross public ignorance about the disease Therefore, the main objectives of the Association was to communicate to the public that tuberculosis was a disease that could be cured, that patients must take treatment as prescribed and that people with suggestive symptoms should be screened for the disease. The program of health education included lectures to specifically targeted groups, talks on the electronic media, participation at exhibitions which attracted the public and the distribution of suitably designed pamphlets and posters which drew public attraction. Health education activities were further strengthened by the appointment of full time health educationists.
It was one of Dr. J. H. F. Jayasuriya's cherished aims to build a permanent center where exhibits for the promotion of health education could be displayed. He was successful in collecting sufficient funds to construct one. The proximity of the spacious two storied, Health Education Centre to the Colombo Museum is of special advantage, since school children from all regions of the country who visit the museum could opt to visit the center as well.
Advances in the medical treatment of tuberculosis over the years have basically changed the strategies required to control the disease. The incidence of tuberculosis in the country has declined dramatically the recent administration of the BCG vaccination at birth has made tuberculosis in children a negligible factor, which resulted is the closure of the children's wards built by CNAPT. It is the regular administration of drugs and not the provision of nutrients to patients that is the important factor now. Duration of the treatment, which originally dragged on for 4 years has now been reduced to 6 months, thus enabling patients to continue their employment with only a short break-. As a result, rehabilitation has little place in today's context. The stigma against the disease is now a minor factor and does not appear to influence patient’s behavior to any significant extent.
In view of these changes, the CNAPT has officially been entrusted with the task of promoting health education. The medium term plan for the control of tuberculosis is Sri Lanka, as formulated by the Ministry of Health in the late 1980's envisages a special role for the CNAPT. As a result, the CNAPT was allocated the official task of attending to all the measures relating to health education in the plan. Accordingly the Association provided the Respiratory Control Programme Also CNAPT is one of the pioneer members of International Union of Tuberculosis and Lung Diseases.(IUTLD)
The Global Fund against Tuberculosis and Malaria, (GFATM) has allocated to the CNAPT the functions of implementing a project. National Level Study on Knowledge, Attitude and Practice (KAP) of the Public in Relation to Tuberculosis.
This national field survey was carried out by the Centre for Social Survey with the participation of the undergraduates of the Sri Jayawardenapura University. Specialist Medical personnel from the Reparatory Disease Control Programme of the Ministry of Health were assigned to ascertain the knowledge of TB, the attitude and practices relating to TB patients of the general public, caretakers and service providers. As this is the only research document of its kind undertaken on TB in Sri Lanka, Medical personnel are using this document for their research studies as well as for drawing up a Social Marketing Programme on Prevention of Tuberculosis Sri Lanka.
School awareness programme on prevention of TB has to be carried out in six stages. The CNAPT has completed the 1st and 2nd stages of the programme covering the schools in the Western and Southern Provinces. Steps are being taken to extend to the other Districts and to continue the National Coverage based on the availability of required resources from GFATM.
At present CNAPT planned to conduct TB and Chest Diseases prevention programmes in cooperation with Colombo Municipality. Also preparing to establish a system on disseminating of Health awareness to the entire country.