Nathan Sivagananathan of Trail Sri Lanka: “People are the key!”

If something doesn’t work out, take a step back, regroup, rethink and then try again, there is always a solution — When we were first trying to launch Trail, we kept pursuing the same formula for funding with different people and what remained the same was their response. As part of my series about “individuals and organizations […]

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If something doesn’t work out, take a step back, regroup, rethink and then try again, there is always a solution — When we were first trying to launch Trail, we kept pursuing the same formula for funding with different people and what remained the same was their response.

As part of my series about “individuals and organizations making an important social impact”, I had the pleasure of interviewing Nathan Sivagananathan.

Nathan Sivagananathan is the Co-Founder of Trail (, a walk of solidarity to honor and aid those battling cancer by bringing together communities in a previously war-torn Sri Lanka with the shared goal of developing cancer treatment infrastructure. Trail has brought forth a new era of cancer treatment in the country by creating equitable access through the construction of their first hospital, the Tellippalai Trail Cancer Hospital in the North of Sri Lanka, which to date has treated over 250,000 patients in impoverished and marginalized communities, and with another underway in the South to provide relief to thousands of patients in the vicinity anticipating treatment eagerly from months to years in waiting lists. A 2015 Eisenhower Fellow and 2018 Kauffman Fellow, member of YPO (Young Presidents Organization) and a 2021 YPO Global Impact Award Honoree, Nathan is also a successful strategist, entrepreneur, prominent investor and innovator in Sri Lanka.

Thank you so much for joining us in this interview series! Can you tell us a story about what brought you to this specific career path?

I was born in Sri Lanka but grew up and was educated in the UK. After completing my education, I returned to Sri Lanka and joined a multi-national company, MAS Holdings, South Asia’s largest apparel tech company. It was a challenging period for Sri Lanka at the time, the country was in the throes of a civil war which was causing significant upheaval and turmoil in the country driving ethnic division, stagnating economic development, and leaving countless displaced. I felt strongly however that Sri Lanka held great promise and after witnessing the effects of war, I wished to be instrumental in bringing some form of positive change to our people.

Tragically, my sister was diagnosed with cancer around the same time, at the age of 32 years, with two young children in her care. I come from a very close-knit family and my sister was my support system growing up so her diagnosis affected me greatly. My sister had been residing in the UK at the time, therefore, she was fortunate enough to receive good care and treatment while there. Despite her indomitable will and how bravely she faced every challenge, she succumbed to cancer after a 5-year long fight with the disease.

My sister’s battle against cancer changed the entire course of my life. It was then that I came to fully understand its impact, the continuum of cancer-care and the glaring deficits and inadequacies in the treatment offered in Sri Lanka. At the time, treatment was centralized with the National Cancer Institute serving as the only public treatment facility to the entire nation. Not only was this creating inequities but the growing influx of patients, coupled with ineffective national cancer-care related health systems, meant that many would have to suffer while on waiting lists, deprived of timely treatment. The hospital was struggling to accommodate and treat the increasing number of patients received, forcing patients to share beds due to lack of space and occupy hallways and public areas in desperate hope for treatment. Many who sought treatment were from disadvantaged communities without the means to afford treatment and already facing economic hardships.

I felt more had to be done to elevate the level of care and treatment facilities in Sri Lanka. With that came the determination to look for solutions to alleviate the suffering of those affected by cancer and develop treatment facilities in our country. I co-founded Colours of Courage Trust (COC), a non-profit organization dedicated to improving cancer-care in Sri Lanka, through which I was able to provide the National Cancer Institute with Medical and Surgical Intensive Care Units. With the decades long ethnic conflict in Sri Lanka reaching closure, I was able to shift my focus to patients in marginalized communities in the previously war-torn Northern region, who had given up all hope for treatment.

In 2011, I co-founded ‘Trail’, a walk of solidarity, through COC with my colleague and good friend, Sarinda Unamboowe, following the conclusion of the civil war, as an initiative to reframe issues surrounding ethnic division and bring our people together for the shared purpose of developing the country’s cancer-care landscape. In 2014, after raising over 2.6 million USD in funding, we built our first hospital, the Tellippalai Trail Cancer Hospital, in the North of Sri Lanka which to date has treated over 250,000 patients from impoverished and marginalized communities.

The success of ‘Trail 2011’ gave us the confidence to take one step further and in 2016, we continued our journey with ‘Trail 2016’ to raise USD 5 million to build our second hospital, the Karapitiya Trail Cancer Hospital in the South of the country.

The story that led me down this path over a decade ago may have begun with a tragedy but it was also what made me determined to do all that I could to improve the lives of others.

Can you share the most interesting story that happened to you since you began leading your company or organization?

Despite our best intentions, the initiation of Trail was mired in people’s skepticism and lack of confidence in our idea and we were forced to postpone our walk and rethink our whole approach and channels of fundraising. We believed so strongly in the potential of our idea and that Sri Lanka was poised for change, with people reorienting themselves from the antagonistic relations of war to more respect-based relations of cooperation, that we thought it was worth the effort to go ahead with the walk, even though there was so much uncertainty surrounding us. In 2011, during our first walk, we had more and more people join us every day and were humbled to receive the support of over 30,000 joining our cause enduring the sweltering heat and tackling the grueling trek with us to improve the lives of others. We had children run up to us with their piggy banks, giving to our cause all that they had. We had road-side vendors selling fruits and snacks giving them to us freely, insisting that we accept their gift so we had the strength to carry on with our walk. There were people who donated their daily wages and the roads were lined with people cheering us on, encouraging us to keep going. In the unforgiving heat of Sri Lanka, with blisters upon blisters, that encouragement was very welcome. It was a moving experience to see people give so selflessly with no expectation of reward or praise and connected solely by human experience and the hope of making the world a better place for someone else.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

This story is possibly more funny ironically than humorous. When we started out, we were certain that our initiative would be supported by corporates — after all Sarinda and I were part of an established, reputable and one of the most profitable companies in Sri Lanka and had built flourishing careers ourselves and we were confident that we would receive the financial backing we had hoped for from our networks and peers in the professional world of business. I was sure that corporate would identify the opportunity to give back to our community and would receive the financial support to launch Trail. We relied on that assumption and designed a format based on that. It was a rude awakening when our idea and requests were met with a resounding no — the bubble we had been living in had officially been burst and we had landed with a thud.

Considering the wounds left behind by an overdrawn conflict that had only recently been concluded and the nation-wide scale of the project we were aiming for, many regarded our efforts as an unachievable feat and one that would not progress beyond a mere idea, let alone succeed. We then took a step back to rethink our approach. It was then we realized that the support we were looking for could be found in those who had the greatest stake, the everyday you and I, who would benefit from our efforts and to whom the initiative would carry most significance. Our greatest supporters were the very community we wished to serve. Hence, we looked in to crowdfunding and crowdsourcing as a fundraising mechanism to carry the project forward. I was eager to create positive change in my community and it dawned on me that it was also important to empower someone else to make that change too, to sustain dynamism in fundraising. We were supported by donors from all over the world joining our walk as virtual walkers and fundraising on our behalf and people fundraising within their capacity through various means. I also learnt that sometimes rethinking your course is the best course of action and to persist no matter how many times you get knocked down.

Can you describe how you or your organization is making a significant social impact?

When Trail was initiated in 2011, Sri Lanka was just emerging from the end of a civil war that has spanned nearly three decades. Though the effects of the war permeated every corner of society, most of the violence took place in the Northern region leaving the territory ravaged with extensive damage to infrastructure and with little to no room for economic or social development. Impoverished amidst adverse conditions and struggling with the psychological trauma and effects of a brutal civil war, patients battling or diagnosed with cancer in the North were forced to travel over 400km by both sea and land if they hoped to receive any treatment at the country’s sole treatment facility, the National Cancer Institute. As a result, many opted to remain untreated, unwilling to and oft times unable to make the challenging journey across the country.

‘Trail 2011’, was a trek along the entire 670km length of Sri Lanka, from its Southernmost point to the Northernmost, over 27 days, to raise funds to build a cancer treatment center in Jaffna, located in the previously war-torn Northern region of Sri Lanka. ‘Trail 2011’ was the largest crowdfunding initiative in Sri Lanka at the time, amassing over 30,000 supporters en-route and raising USD 2.6 million to construct the Tellippalai Trail Cancer Hospital which has treated over 250,000 patients since opening its doors in 2014 and employs over 100 locals as medical and support staff. We are also heavily involved in the maintenance of the hospital and expansion of its facilities to provide quality care. It brings me great joy to say that at present the Tellippalai Trail Cancer Hospital is viewed as an integral element in the healthcare system in the country and has transformed lives of those who had given up hope for a better life.

Seeing the difference we were able to make against all odds, Sarinda and I decided to step up our efforts further. In 2016, we hit the 670km course yet again, this time in reverse, from the Northernmost point of the country to the Southernmost, over 28 days, to raise USD 5 million to build a cancer-care center in the South of the country, the Karapitiya Trail Cancer Hospital. ‘Trail 2016’ was testimony to the power of people coming together to bring about positive change — we were joined by over 2.5 million people from various communities across Sri Lanka to support through donations and in kind and have raised over USD 4 million at present. We continue to fundraise to build the 10-story fully equipped cancer treatment center complete with 160-bed adult wards, a pediatric ward, MRI and CT scanning facilities, Bone Marrow Transplant Unit, operating theaters, surgical ICU, out-patient facilities and an auditorium for medical conferences. Construction of the Karapitiya Trail Cancer Hospital commenced in November 2019 and upon completion it will provide immense relief to thousands of patients in the vicinity eagerly anticipating treatment.

Can you tell us a story about a particular individual who was impacted or helped by your cause?

There have been so many and I don’t mean it as an exaggeration of my efforts as it is more a reflection of how dire the need was. For people in the North at the time, the diagnosis of cancer, regardless of the stage it was at, seemed like a death sentence due to the lack of access to treatment and facilities. Not only did they have to travel over 400km to receive treatment but their families would have to uproot themselves to support them because the journey was a strenuous one by sea and over land taking nearly a day, while the treatment takes a toll on the body and would often require overnight stays. This would result in loss of employment for patients and their families and possible relocation so they could receive treatment.

When we built the first hospital in Tellippalai, we assumed high bed-occupancy as patients had been denied treatment for so long. However, when I visited the hospital a year or so later, I was stunned to notice several empty beds and that wards were not crowded with patients. Upon querying, I was informed by the doctors that this was in fact a positive result for this meant that patients now had the chance to receive treatment, resume their lives afterwards and get back to their daily activities and that cancer wasn’t stopping their lives in its tracks. For people in the North whose lives had been interrupted irreversibly and unfairly by conflict and violence and who are still struggling due to its aftermath, having one less hurdle to overcome meant a renewed chance at life.

Are there three things the community/society/politicians can do to help you address the root of the problem you are trying to solve?

Politicians can directly influence the development of treatment infrastructure by creating conducive conditions for government action, be it as policy makers or through the dedication of funds based on the needs of the people. The most significant problem preventing such development is a lack of or misdirection of funds. Additionally, bureaucratic procedures can at times stretch over long periods which in turn delays progress. Politicians with prominent roles within ministries can help advance plans by expediting these processes. Our goal is to develop treatment infrastructure and increase access to specialized cancer care in Sri Lanka. I believe that this is only part of the solution: community awareness of cancer, especially of early detection, plays a crucial role and state officials promoting public awareness can contribute to prevention and remove the stigma associated with cancer.

Sometimes governments fail to provide timely and efficient solutions. As a community we need to understand the role we can play in bringing about change in their stead and be the agency of change and social progress. Despite the role that philanthropic and charitable foundations play, it must also be understood that their efforts are auxiliary and not a substitute for government responsibility. I believe that the exemption of taxes levied would help redirect more funds back to charitable causes, helping to sustain their initiatives and achieve their goals.

How do you define “Leadership”? Can you explain what you mean or give an example?

For me ‘leadership’ simply refers to leading by example. I believe a leader creates change by using their unique capabilities, experiences and advantages to help make a difference in the lives of others and that not only motivates but also empowers someone else to make a difference. Trail was initiated by just two people but it has now transformed into a movement supported by millions of people, each acting as an advocate for change.

What are your “5 things I wish someone told me when I first started” and why. Please share a story or example for each.

  1. If something doesn’t work out, take a step back, regroup, rethink and then try again, there is always a solution — When we were first trying to launch Trail, we kept pursuing the same formula for funding with different people and what remained the same was their response. Beating at the problem with no change in perspective was not only frustrating but caused us to postpone the launch three times. Taking a step back and approaching the issue with a fresh perspective finally enabled us to get it off ground.
  2. People are the key! As institutes reaping profits by the millions, we had initially thought that the answer for financial support laid at the doors of corporates. However, bound by reservations of the perceived practicality and feasibility of the initiative, measured against the investment of their funds and time, many corporates were not willing to sponsor our efforts. It was then that I realized the potential of community involvement, that it should be an effort by the community rather than corporates because they had the biggest stake in the endeavour and were more willing than corporates to be part of something that would help fellow citizens. Corporates understand numbers but people understand the importance of coming together for the betterment of society. Rethinking our strategy helped us harness the power of crowdfunding and look to our communities for funding, with each donation bringing us one step closer to our goal.
  3. Failure is sometimes not the worst outcome — As daunting an initiative as Trail was, given its scale and reach, failing to get if off ground in our first attempt was possibly more impactful for me than succeeding as I learnt more; more about all the moving parts to make it effective, the importance of perseverance and that there are no ‘one-size-fits-all’ solutions. This valuable insight helped me fine tune my efforts and improve myself.
  4. Collaboration is a powerful tool — Recognizing the shortcomings in the national cancer-care system and the lack of government action to fulfil such deficits is what spurred me to initiate Trail. I soon learnt that lack of government action in that aspect didn’t mean that their involvement in another aspect couldn’t help advance my efforts to achieve our goals. This realization also helped me look in to other partnerships and the potential involvement of many other parties from corporates in the private sector, to ministries in the state sector, to youth groups in communities and everything in between. Assessing the benefits and gaps of the provision and where each party would add the most value, presented innovative solutions to problems, highlighting the significance of building partnerships in the right way to achieve a common goal.
  5. A little bit of humility goes a long way — At the time of co-founding Trail, both Sarinda and I were corporate leaders in charge of tens of thousands of staff and with a prominent standing in the corporate sphere. Asking for funds, purely for charity, was an entirely new experience and we basically went hat in hand to individuals and companies looking for funds. You have to consider the bigger picture and have a certain sense of humility to be able to ask others to help you and looking back on the support our pleas received, it shows that humility can increase your impact on society.

You are a person of enormous influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

I would say exactly as I am doing now.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

“Life’s most persistent and urgent question is: ‘What are you doing for others?’

Martin Luther King Jr

From a very young age my father had instilled in us a sense of purpose and responsibility to uplift those less privileged and he always led by example through random acts of kindness and selflessness and without discrimination. Martin Luther King’s simple but thought-provoking words were an extension of my father’s teachings and have guided me to this day and led me to initiate Trail.

Is there a person in the world, or in the US with whom you would like to have a private breakfast or lunch with, and why? He or she might just see this, especially if we tag them. 🙂

Bill Gates. He is possibly one of the most significant personalities in his generation and not only because of his contributions to the tech world but to me more so because of his astounding generosity. Being an entrepreneur and tech enthusiast myself, this would be doubly special.

How can our readers follow you on social media?

Facebook — Nathan Sivagananathan —

Instagram — nathanceylon —

Twitter — @Sivagananathan —

This was very meaningful, thank you so much. We wish you only continued success on your great work!

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