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Hospitals out of drugs, surgeries nixed, Sri Lanka’s once-lauded health sector is in crisis

Sri Lanka’s economic crisis has had a devastating impact on the medical sector, with acute shortages and rising prices. Some hospitals even struggle to provide food for patients.

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Colombo: Faced with chronic shortages of medical equipment, antibiotics, and anaesthetics, doctors at major hospitals, especially state-run ones, across Sri Lanka have been forced to stop performing non-emergency surgeries, ThePrint has learnt.

This is just one aspect of the devastating effect that the country’s ongoing economic crisis has had on the health sector, which was once lauded for providing better medical care than its neighbours in South Asia.

Funds are so low, doctors at state hospitals say that even providing meals for inpatients has become a challenge.

Further, given that Sri Lanka imports about 86 per cent of its pharmaceutical supplies, the country’s foreign exchange crunch has led to a shortage of medical supplies and also increased the price of all generic drugs by about 30 per cent island-wide.

Patients scheduled for surgery and other medical procedures from as long as six months ago are being turned away, said Dr Haritha Aluthge, secretary of the Government Medical Officers Association, a doctors’ trade union.

He added that life-saving tests are also not being performed due to shortages of consumables like bloodglucose strips, blood gas machines, catheter tubes, cardiac stents, and ultrasound scan paper. Whatever stocks are there, he said, have been allocated for emergency surgeries.

A paediatrician at a state hospital also told ThePrint under condition of anonymity that these basic consumables were unavailable because there were no funds to purchase them.

Medicines and even food are now luxuries at government facilities, with many patients depending on the largesse of those who are financially better off, including Sri Lankans living abroad.

The paediatrician said that the document room at the hospital where he works is now basically a storeroom with milk, eggs, and dry rations piled up. “These items are donated by people because we cannot afford a nutritious meal for the children. It is so bad that we have a milk and egg fund,” he said.

In the case of medicines, too, many patients rely on acts of kindness.”What generally happens is certain patients get together and purchase [medicines] from pharmacies outside at higher prices and give it out to those who cannot afford the drug,” a paediatrician attached to the Lady Ridgeway General Hospital in Colombo said.

Also read: Charred coconut shell stoves, cycling — 5 hacks helping Sri Lankans survive economic crisis

Drugs running out

The health sector’s predicament in Sri Lanka started in parallel with the foreign exchange crisis by March this year, according to Dr Anver Hamdani, director of medical technical services at the country’s Ministry of Health.

At the time, 14 vital medical items were in short supply along with 300 essential items, he said. “Currently, about 112 drugs are still in short supply,” he said, noting that there is a sizeable shortage of reagents as well. Reagents are substances or compounds that facilitate chemical reactions, and are widely used in tests.

Certain vulnerable groups are most severely affected by drug shortages, including paediatric and cancer patients.

State sector doctors said that meropenem — an antibiotic that is often used to treat babies —  is no longer available in government hospitals, and neither is the meningococcal vaccine. The chemotherapy drug gemcitabine is also out of stock.

The All-Island Pharmacy Owners Association Private Limited (AIPOA), a body of pharmacists, is struggling with requests to supply cancer medication.

“The issue at the state sector hospitals is so acute that 95 per cent of State Pharmaceutical Corporation (SPC) drugs are not available. The cancer drugs were always brought down from abroad by the SPC. Now there are hardly any,” said G.M.C.D. Gankanda, chairman of the AIPOA.

Thilani Wijesinghe, 44, a business owner from Mulleriyawa in the heart of Colombo, said finding cancer medication for her mother is a major challenge.

“She is being treated at the (government-owned) Neville Fernando Hospital and at times we run from pillar to post looking for drugs. More often than not, we need to purchase it from outside the hospital,” Wijesinghe said.

Many cancer patients can barely afford these medicines. Adding to the issue, many expensive cancer medicines are up by more than four times in price, pharmacy owners say.

Chamat Amarasiri, 25, an office assistant, said that doctors at the National Hospital-Kandy in Sri Lanka’s highlands, where his father is being treated for blood cancer, requested them to purchase medicines from a private pharmacy for the chemotherapy treatment.

“I only managed to get two doses. I need five more. I am told it is not available in the area. It is very costly. We can hardly afford it,” Amarasiri said.

Help from foreign shores

To help tide over the healthcare crisis, expatriate Sri Lankans are stepping up with donations.

“How we manage medicines at critical times is through the College of Paediatricians Fund operated by a crisis team and funded by overseas Sri Lankans,” said the paediatrician quoted earlier.

Overseas donations such as these, sent by air freight and shipping containers, are actively sought by state sector hospitals.

“We get donations from the diaspora. So far, we have mostly got them from Australia. Some well-wishers bring it directly from overseas and hand it over to the fund/ hospital. Nobody wants to give cash to the Ministry of Health,” a government sector doctor said.

Different countries have donated about US $9 million in medicines and supplies since March, and in addition expat organisations and groups provided drugs worth almost US$1.3 million, said officials at Sri Lanka’s Ministry of Health, which oversees 1,200 healthcare institutions.

Dr Hamdani claimed that the expatriate community in the UAE was the first to start sending donations. “We are very grateful to them for starting the initiative,” he said.

Isthiaq Raziq, president of Sahana, a Sri Lankan welfare association in the UAE, said that they sent had medicines to Sri Lanka after a lot of coordination efforts with the country’s Ministry of Health.

According to Dr. Hamdani, donations have also come from the expat community in countries like Bangladesh, Indonesia, India, France, Vietnam, China, and Nepal.

International donor agencies are also providing some relief. For instance, Americares, one of the world’s leading nonprofit organisations, donated US$773,000 in medical supplies to Sri Lanka at the request of the Sri Lankan Embassy in Washington, D.C. last month.

Dr. Hamdani added that last week, too, the ministry had discussions with lending agencies that pledged sizeable donations.

Last month, the United Nations Development Programme (UNDP) in Sri Lanka announced it would procure and deliver vital and essential medicines and medical supplies for the country, “together with the World Health Organization (WHO) in Sri Lanka with the financial support of the United Nations’ Central Emergency Response Fund (CERF)”.

According to Dr Hamdani, the ministry is trying to procure medical items for three months through soft loans by donor agencies. He added: “We have also initiated a plan for sizeable security for medical drugs for the next six months, and through donor agencies, to subsequently sign agreements to procure medicines for the next year.”

(Edited by Asavari Singh)

Also read: Sri Lanka gets IMF’s provisional nod for $2.9bn loan. Tax reforms, social spend hike part of plan


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