Sri Lanka’s financial crisis, its worst since independence, is swiftly becoming an alarming health crisis.
Sri Lanka imports more than 80% of its medical supplies. Now almost 200 medical items are in shortage, including 76 essential, life-saving drugs, from blood-thinners for heart attack and stroke patients to antibiotics, rabies vaccines and cancer chemotherapy drugs. Essential surgical equipment and anaesthesia is running out so fast that the decision was made this week for only emergency surgeries, mostly heart and cancer patients, to go ahead. Cancer drugs, which are notoriously expensive to import, have been particularly badly hit by shortages in recent weeks, and the responsibility to source them has fallen on the heads of oncologists themselves. They have been putting out global appeals for donations, and writing letters to private supporters, organisations and governments, to ensure cancer treatments are not delayed. All routine surgeries – anything from hernias to swollen appendixes – have been put on hold. Some government hospitals have been instructed to only admit emergency patients.
“Ultimately, people are definitely going to die,” said a doctor in Colombo. She described how the hospital was so low on certain drugs they had to instruct families of patients to go out to pharmacies and try to buy it themselves. The doctor said the shortages were getting worse. “I’m worried about pregnant mothers because soon I don’t know whether we will have enough drugs to perform cesarian sections,” she said.
Dr Buddhika Somawardana, an oncologist at Colombo’s largest cancer hospital, described the “great stress” he and other doctors were under as essential cancer drugs began to run out over a month ago or stopped being available at all.
“One of the drugs we give patients undergoing chemotherapy, which boosts their blood count so they aren’t liable to serious infections, is not available any more,” he said. Somawardana said the crisis was placing a huge “financial and psychological burden” on cancer patients, who were having to source and pay vast sums for their own medicines to continue their treatment, previously free and easily accessibly in hospitals under Sri Lanka’s lauded universal healthcare system.
Ruvaiz Haniffa, a doctor in Colombo, expressed his frustration that doctors had “seen this coming as early as January” but little had been done by authorities to set up backup plans to ensure no medicines ran short, even as the country’s foreign reserves began to deplete to worryingly low levels.
“We are facing great ethical dilemmas as doctors,” said Haniffa. “We used to have a very efficient health system. But at the moment, it has become ineffective. More people will die, which is not acceptable.”
He said his patients were being forced to find their own drugs and pay prices over 40% higher, if they could find them at all.
Haniffa said he feared for the long-term impacts on the life expectancy of Sri Lankans. “With the kidney disease and the diabetes and the hypertension we are not treating now, it causes long term damage,” he said. “So in five years, we will see strokes go up, heart attacks go up, neurological problems go up, cancers go up.”