{"id":114767,"date":"2023-05-28T05:25:44","date_gmt":"2023-05-28T05:25:44","guid":{"rendered":"https:\/\/websitedesigns.com.au\/elankanew\/?p=114767"},"modified":"2023-05-28T05:25:44","modified_gmt":"2023-05-28T05:25:44","slug":"a-candid-study-and-an-action-plan-economic-and-social-development-for-sri-lanka-part-3-barriers-to-progress-healthcare-reforms-and-skill-labor-export-by-professor-sunil-j-wimalawansa","status":"publish","type":"post","link":"https:\/\/websitedesigns.com.au\/elankanew\/a-candid-study-and-an-action-plan-economic-and-social-development-for-sri-lanka-part-3-barriers-to-progress-healthcare-reforms-and-skill-labor-export-by-professor-sunil-j-wimalawansa\/","title":{"rendered":"A candid study and an action plan Economic and social development for Sri Lanka -Part 3: Barriers to Progress, Healthcare Reforms and Skill Labor Export &#8211; By Professor Sunil J. \u00a0Wimalawansa"},"content":{"rendered":"<h2 style=\"text-align: center;\"><span style=\"color: #800000;\"><strong><span class=\"article_header\">A candid study and an action plan Economic and social development for Sri Lanka -Part 3: Barriers to Progress, Healthcare Reforms and Skill Labor Export &#8211; <span style=\"color: #000000;\">By <\/span><\/span><\/strong><\/span><span style=\"color: #000000;\"><strong><em data-rich-text-format-boundary=\"true\">Professor Sunil J. \u00a0Wimalawansa<\/em><\/strong><\/span><\/h2>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\"><strong>Pre-requisites for economic development and the need for a new constitution<\/strong><\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">The stagnation of the Sri Lankan economy since gaining independence from the British is striking. \u00a0This is due to selfish politicians lacking: a vision for the country, forward-looking policies, and long-term national development plans (e.g., for clean water). \u00a0The failure to address social and economic issues and plan and implement future needs via education, agriculture, land reforms, infrastructure development, and judicial system has been a disaster for the county. \u00a0<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">It is disturbing to see the trend of focusing only on short-term policies\/projects that provide self-gain for politicians at taxpayers\u2019 expense. \u00a0In conjunction with rotten amendments, adding to the flawed 1977 constitution, opened doors for prevailing widespread corruption at each level of the government.\u00a0 No wonder the country is not progressing.\u00a0 To achieve success, each of these factors must be addressed candidly, especially replacing the constitution with the abolition of the executive presidency, without loopholes, and assuring the full independence of the judiciary from the executive branch.\u00a0<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">In addition, it is essential to replace outdated laws to improve the social condition and prevent further deterioration of values and the Hela culture.\u00a0 Politicians are eager to expand the alcohol and tobacco industries and dish out liquor licenses like new year\u2019s gifts to their cronies.\u00a0 These will not only fatten the pockets of politicians but also increase businesses\/profits for hospitals and undertakers.\u00a0 Such unscrupulous activities by ministers dramatically increase criminal activities and ill health and erode the country\u2019s culture, social, and economic status.\u00a0 Instead of expanding licenses, it should curtail importing alcohol, enact a law to stop issuing new liquor licenses and revoke 500 licenses each month. \u00a0This would allow a gradual reduction of legitimate and controlled outlets to what it had in 1970.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\"><strong>Adverse effects and increasing healthcare costs due to poor decision-making<\/strong><\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">As described above, a new vision for Sri Lanka and proper decision-making and implementation of projects will lead to major economic and social benefits.\u00a0 Besides, the positive impacts of seemingly such measures would tremendously impact the well-being of families and the country, reduce healthcare costs, improve law and order, and lessen prison burdens.\u00a0 Government must have the courage to implement these\u2014if it cannot, it should declare a general election and let others do it. \u00a0It must implement what is best for most constituents, despite the objections from conflicted officials, individuals, and groups\u2014influential stakeholders.\u00a0 The loss of revenue from the loss of liquor licenses and tobacco promotions\/advertisements will be more than offset by healthcare savings, less absenteeism and increased productivity, and improved law and order.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">Another critical area is the significant harmful effects on the population\u2019s health from the mushrooming of the fast-food (junk food) industry. \u00a0Adverse impacts of this mainly affect children from the upper-middle class.\u00a0 The grossly unwise decision by the government to approve to copy of the failed disastrous junk food system in Sri Lank is a sad story. \u00a0A few years ago, the author directly warned the government authorities and via local television discussions about the impending harmful effects of approving multi-national companies selling unhealthy fast food in Sri Lanka (and other developing countries).\u00a0 These unwholesome foods contain empty calories (loaded with high-fructose and pork fat\/lard) with no nutritional value, having a major impact on causing childhood obesity and diabetes.\u00a0<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">These harmful fast-food ingredients include fructose-corn syrup, fried in cheap oil used often, lard (saturated fats), and refried cooking oils (extremely unhealthy) containing trans fat. \u00a0These not only increase cancer risks but also obesity, diabetes, reduced immunity, and poor educational performance.\u00a0 Based on the evidence, the author predicts that mentioned harmful effects will double\u201d every five years. \u00a0Deviating from the traditional healthy, Sri Lankan balanced diet by the gullible younger generation, provided by their parents, will be a healthcare nightmare for the country.\u00a0 Children are carried away (i.e., brainwashed) by falsified television and billboard advertisements. \u00a0Parents unknowingly or knowingly feed their children into this disaster: partly to show off their status to peers and to satisfy children\u2019s na\u00efve demands.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">Unfortunately, the government and the media support this to generate revenue for themselves but accelerate the impending disaster due to short-term financial gains.\u00a0 This is conflicted by the taking commissions and bribes with the disguise of generating tax revenue.\u00a0 Politicians focused on these short-term gains by compromising our children\u2019s and grandchildren\u2019s health\u2014this is not the first time the government failed to put the country first.\u00a0<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">It is time to think about the longer-term negative public health consequences, especially regarding childhood obesity, diabetes and associated mental and physical medical disorders, escalating healthcare costs, loss of productivity, and a significant increase in morbidity and mortality and premature deaths.\u00a0 With the approval of fast-food industry licenses, the government imposed harmful effects on our children.\u00a0 It was a dangerous and short-sighted measure to increase revenue and bribes\u2014an act against the health of our children.\u00a0 One should not copy and blindly implement such harmful measures that will increase the cost of healthcare, which costs more than ten times the expected tax revenue. \u00a0The detrimental effects of this poor policy will start manifesting in our society within five years.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">It is not too late for the government to reverse this unthoughtful, damaging, and dangerous miscalculation, albeit a profitable short-term business. \u00a0Government should consider replacing the fast-food promotions with a campaign to educate the public on using local nutritious food and promote home gardening, as the author\u2019s family foundation (Wimalawansa Foundation) and others have been doing for a while. \u00a0Taking the proper actions will prevent billions of rupees from being wasted in years to come.\u00a0 Emphasis must be on preventative health, not expanding and funding acute care by building hospitals.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\"><strong>Instead of cheap labour, the country should export high-skill jobs<\/strong><\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">The country should not depend on loans from the World Bank, IMF, or any other lender. \u00a0In comparison, expanding the exportation of tea, rubber, coconut, gems, and skilled labour, alone.\u00a0 It must develop tourism and diversify exports by small and large businesses, especially the manufacturing sector and new ventures to earn more foreign exchange.\u00a0 Similarly, the country should not depend on remittance from Middle Eastern jobs and reliance on fossil fuels for its energy.\u00a0 Both these sectors have major uncertainties\u2014sudden changes could lead to a significant punch to the economy.\u00a0 Unemployment is rising with stagnant entrepreneurs and a lack of creating new jobs.\u00a0 Consequently, many professionals and skilled workers take their expertise to other countries\u2014Sri Lanka is losing talent.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">The government provides little or no assistance or guidance and neglects the welfare and safety of persons going and already serving in Middle-Eastern countries.\u00a0 Instead, it boasts about the millions of USD remittances it receives. \u00a0It has miserably failed to consider the significant negative impact of such labour exports.\u00a0 These include but are not limited to abuses of men and women, mutilation, deaths, particularly of women, and the significant destruction of their families left behind.\u00a0 No government organisation, including foreign embassies, are properly monitoring this vulnerable group and taking any tangible actions to prevent destructive practices (e.g., destruction of family units and social destruction) and protect against the abuse of our citizens.\u00a0 However, while doing nothing to protect this workforce, the government is happy to enjoy the benefits from remittances, disregarding the victimisation of these families.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">Many people who had gone for these low-paid jobs in the Middle East had been harassed and abused (physically, sexually, and mentally) and were not fed properly or paid their salaries before returning home. \u00a0Despite thousands of complaints, none of the successive governments addressed these serious irregularities and crimes against humanity.\u00a0 Despite not being paid the agreed amounts for slavery, many had to buy their way out of the misery to come home alive. \u00a0Despite these miseries, agents and go-betweens continue exploiting these poor folks to the maximum without protecting them.\u00a0 What justice!<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">People who go to Middle East countries under such difficult conditions risk their lives and let their families at home get devastated. \u00a0As discussed above, the Sri Lankan government should create skills training opportunities and let the industry generate suitable jobs within Sri Lanka for their employment with reasonable wages.\u00a0 That will eventually negate the urge to go to the Middle East. \u00a0The government has the moral, ethical, and legal responsibility to take substantive steps to do the above, monitor these ill fates, and fix this tremendous problem harming our society.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\"><strong>Exporting higher paid jobs<\/strong><strong>\u2014e.g.,\u00a0<\/strong><strong>allied health to the West<\/strong><\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">New ways of thinking are necessary to break the vicious cycle of slavery mentality and dependence.\u00a0 For example, instead of exporting low-wage unskilled (i.e., domestic help and construction work) and semi-skilled labour to middle-east as described above, Sri Lanka should establish training highly skilled labour centres as described across the country.\u00a0 Highly trained nurses are one example of great demand in Western countries.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">Creating specific programs to properly train nurses, a few thousand per year, with high-end skills, like intensive care units and emergency room (ER) experience, so that they can be employed in these counties with over ten times guaranteed salaries than otherwise received in the Middle East.\u00a0 These higher-paying jobs also come with much respect and safety.\u00a0 For example, the US alone is currently short of 130,000 trained nurses required annually\u2014the demand continues to increase.\u00a0 Such training with high-end nursing skills can be accomplished between two to four years of structured, standardised training programs. \u00a0This concept is not different from the value-added exports of commodities.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">In contrast, the current unskilled labour export to the Middle East with high risks and meagre wages only benefits the intermediaries and the government, not their families.\u00a0 The above-mentioned proactive measures will provide a window of opportunity for the transition from the current misery to success, minimising social disruptions, improving safety, and overcoming poverty with marked improvement of earning capacities (i.e., over 10-fold higher guaranteed salaries).\u00a0 These would also benefit the foreign exchange inflow, reduce the deficits, and allow debt servicing without taking additional loans.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\"><strong>Why is Sri Lanka not progressing as expected?<\/strong><\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">Apart from cheap labour, good weather, and a reasonable percentage of the population\u2019s ability to communicate in English or another foreign language, the Sri Lankan government offers nothing unique to attract FDIC\u2014foreign firms to invest in Sri Lanka. \u00a0Despite this, more wealth\u201d and resources are available in Sri Lanka that have not been realised and marketed.\u00a0 Consequently, investors are hearing only rampant red tape and corruption at a high level, lack of appropriate infrastructure, bureaucratic delays, etc., that reduce the enthusiasm of potential investors. \u00a0The Sri Lankan approach had been backward, and must change the negative attitudes and be proactive in messages and offerings to attract FDIC.\u00a0 These would eventually result in higher-end jobs and more taxes.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">Achieving long-term benefits would not come automatically (i.e., no free lunch). \u00a0Ad-hoc measures to solve problems will not work for a better future for Sri Lanka.\u00a0 The country must carefully plan and implement reasonable measures and sustainable and income-generating programs propagated by its foreign missions.\u00a0 One example in the recent past is the protracted delays and inefficiency (and pilferage) in implementing the post-tsunami reconstructions in Sri Lanka and the lack of accountability for donated funds.\u00a0 Anyone visiting the affected areas (even now, after 16 months) realises that the small NGOs, charities, and individuals genuinely contribute to the recovery process, housing, job creation, and rehabilitation.\u00a0 However, the government and large NGOs are taking credit with self-publicity but providing minimal assistance to needy people (<strong>N<\/strong>o\u00a0<strong>A<\/strong>ction,\u00a0<strong>T<\/strong>alking\u00a0<strong>O<\/strong>nly\u2014like NATO).<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\"><strong>Status of the tsunami funds<\/strong><\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">Most tsunami relief funds went to the government or international organisations (I-NGOs) like the Red Cross. \u00a0Both groups did little work, and the remaining money failed to reach the intended destinations. \u00a0Furthermore, some economically-advanced (large) donor countries like the USA, which pledged financial assistance for tsunami relief, never made that promise a reality.\u00a0 Even after 16 months, it has been estimated that approximately 20% of the needed tsunami reconstruction has been achieved.\u00a0 Individual donors and small local charities accomplished more than two-thirds of it. \u00a0Meanwhile, the government received more than USD 100 million in donations\u2014what happened to that fund is unclear.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">Furthermore, the recent exposure of several scandals and investigations highlighted large-scale corruption at high levels of administration\u2014government organisations and large NGOs. \u00a0Unfortunately, they failed to implement a practical, cost-effective tsunami reconstruction plan in the country.\u00a0 This conflicted and unwise decision led to a significant loss of opportunity for the country to construct a series of brand new model cities\u2014e.g., constructing energy-efficient clean cities that Prof PA de Silva and we proposed immediately after the tsunami.\u00a0 We provided the government with specific ideas and drawings with cost estimates: it did nothing. \u00a0Although committees were appointed, little was achieved due to ego-centred thinking, inexperienced committee members, and political bickering and giving construction contracts to cronies without bidding or following.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">We estimated that with the money pledged for tsunami reconstruction (assuming it was used correctly), entire tsunami-affected southern and eastern coastal regions would have been rebuilt with energy-efficient, environment-friendly, planned cities by now, without accessing governmental funds. \u00a0Yet the governmental organisations failed to consider any of these out-of-the-box, highly cost-effective novel alternative development plans\u2014since there were no commissions, they buried them. \u00a0<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">Instead, the current government opted to do nothing.\u00a0 It relies on individuals and charities to rebuild homes and villages in the exact locations without future expansion plans, modernisations, or embedding any safety considerations.\u00a0 In contrast, a well-planned semi-urban development approach that we proposed would have provided comprehensive housing structures and all needs for these self-sufficient mini-cities (including power), given long-term self-sustainable employment, and improved the livelihood and economy.\u00a0 So, why aren\u2019t these happening and what happened to tsunami funds?<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\"><strong>What kind of economy are we referring to?<\/strong><\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">Sri Lanka must develop more innovative ways of improving its economy.\u00a0 The hard fact is that many big lenders are not interested in developing the country but focus on the return for themselves.\u00a0 Their motives for lending money to Sri Lanka and other developing countries contradict what one would expect from them\u2014there is no compassion or philanthropy in lending money.\u00a0 The condition the IMF is imposing is to push their masters\u2019 globalisation and marketing agenda and ensure they can get the money back.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">Ironically, due to heavy pilferage and high overhead costs, only a tiny proportion of the loans or donated funds reach the earmarked projects or go to the intended beneficiaries.\u00a0 Sometimes, the donor country takes back more than a third of the funds donated or a grant to cover their expert consultation. \u00a0Another third is wasted on commissions, luxury travel, and hotel costs for them and their paid consultants. \u00a0The situation is similar with most international non-governmental organisations (I-NGOs) that are supposed to help developing countries\u2014many of these are scams to enrich themselves with donated funds.\u00a0<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">Sri Lanka is not different: it has been estimated that these NGOs, less than 20% of the donated funds and 40% of the grant funding used for the intended purposes.\u00a0 The rest goes into their expenses, administrative and overhead costs (including business class flights and hotel bills for their officials, acquiring expensive high-consumption vehicles and other luxury items, air-conditioned travel, etc.), and for unaccounted\u00a0<em>itemised<\/em>\u00a0as \u2018other costs\u2019.\u00a0 In some instances, money raised from the public was siphoned to do unrelated and unapproved activities like unethical religious conversions. \u00a0One example is some I-NGOs\u2019 widespread, ongoing efforts on forceful religious conversion.<\/span><\/p>\n<p style=\"text-align: justify;\"><em><span style=\"font-size: 16px; color: #000000;\">Part four addresses loan traps, the inability to service loans, and the possibility of future bankruptcy in Sri Lanka.<\/span><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A candid study and an action plan Economic and social development for Sri Lanka -Part 3: Barriers to Progress, Healthcare Reforms and Skill Labor Export &#8211; By Professor Sunil J. \u00a0Wimalawansa Pre-requisites for economic development and the need for a new constitution The stagnation of the Sri Lankan economy since gaining independence from the British [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":114768,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"aside","meta":{"footnotes":""},"categories":[20],"tags":[43335,52986,687,633],"class_list":{"0":"post-114767","1":"post","2":"type-post","3":"status-publish","4":"format-aside","5":"has-post-thumbnail","7":"category-articles","8":"tag-healthcare","9":"tag-loans","10":"tag-sri-lanka","11":"tag-sri-lankan-economy","12":"post_format-post-format-aside"},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v25.7.1 (Yoast SEO v25.9) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>A candid study and an action plan Economic and social development for Sri Lanka -Part 3: Barriers to Progress, Healthcare Reforms and Skill Labor Export - By Professor Sunil J. \u00a0Wimalawansa - eLanka<\/title>\n<meta name=\"description\" content=\"A candid study and an action plan Economic and social development for Sri Lanka -Part 3: Barriers to Progress, Healthcare Reforms and Skill Labor Export\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"A candid study and an action plan Economic and social development for Sri Lanka -Part 3: Barriers to Progress, Healthcare Reforms and Skill Labor Export - By Professor Sunil J. \u00a0Wimalawansa\" \/>\n<meta property=\"og:description\" content=\"A candid study and an action plan Economic and social development for Sri Lanka -Part 3: Barriers to Progress, Healthcare Reforms and Skill Labor Export\" \/>\n<meta property=\"og:url\" content=\"https:\/\/websitedesigns.com.au\/elankanew\/a-candid-study-and-an-action-plan-economic-and-social-development-for-sri-lanka-part-3-barriers-to-progress-healthcare-reforms-and-skill-labor-export-by-professor-sunil-j-wimalawansa\/\" \/>\n<meta property=\"og:site_name\" content=\"eLanka\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/eLanka.com.au\/\" \/>\n<meta property=\"article:published_time\" content=\"2023-05-28T05:25:44+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/websitedesigns.com.au\/elankanew\/wp-content\/uploads\/2023\/05\/Economy-elanka.png\" \/>\n\t<meta property=\"og:image:width\" content=\"600\" \/>\n\t<meta property=\"og:image:height\" content=\"400\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"eLanka admin\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"eLanka admin\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"12 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/websitedesigns.com.au\/elankanew\/a-candid-study-and-an-action-plan-economic-and-social-development-for-sri-lanka-part-3-barriers-to-progress-healthcare-reforms-and-skill-labor-export-by-professor-sunil-j-wimalawansa\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/websitedesigns.com.au\/elankanew\/a-candid-study-and-an-action-plan-economic-and-social-development-for-sri-lanka-part-3-barriers-to-progress-healthcare-reforms-and-skill-labor-export-by-professor-sunil-j-wimalawansa\/\"},\"author\":{\"name\":\"eLanka admin\",\"@id\":\"https:\/\/websitedesigns.com.au\/elankanew\/#\/schema\/person\/f6e635b74ab35ef88a68a9973cacc5bd\"},\"headline\":\"A candid study and an action plan Economic and social development for Sri Lanka -Part 3: Barriers to Progress, Healthcare Reforms and Skill Labor Export &#8211; 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