ABSTRACT
The encounter between indigenous medical systems and Western medicine forms a focal point of the current debate over the nature and extent of the cultural hegemony that accompanied Western imperialism.2 The contest between these forms of medicine was, it is claimed, an unequal one from the start. For instance, as Bridie Andrews and Andrew Cunningham have argued, Western medicine was ‘both metaphorically and literally imperialist as a form of knowledge and as a practice’.3 This chapter explores this contention in relation to the historical development and current availability of healthcare services in Sri Lanka. Today the health care system of Sri Lanka is recognised as ‘a highly diversi-
fied pluralistic one’.4 Western medicine is available free in government run hospitals and clinics. According to Indrani Pieris a Western medical facility is available within 3 miles of every home. At the same time there is an indigenous facility of some sort within 0.8 miles.5 The latter includes state funded Ayurvedic clinics and hospitals staffed by professionally trained practitioners at the government colleges at which treatment is free. The other forms of indigenous medical services defined by Carolyn Nordstrom as Sinhala medicine (to distinguish them from the officially sponsored Ayurveda) are not provided free. They include vederalas who offer a general medical service with traditional treatments. These vederalas can be professionally trained at, for example, the Ayurvedic College, Gampaha Siddhayuruveda Vidyalaya (affiliated to Kelaniya University in 1995), or through a traditional and often family-based apprenticeship system. There are also healers who specialise in such things as snakebites, fracture and sinusitis. In addition, medical care services based on astrology and religious ritual, such as exorcists are available.6
