Devjyot Goshal, Uditha Jayasinghe

COLOMBO (Reuters – Rosanne white was diagnosed with breast cancer in 2008, eight years after she lost a limb. Five years after the cancer had returned, an oncologist at Sri Lanka’s Colombo, the commercial capital of Sri Lanka, prescribed Bevacizumab. It was her first treatment and she is still responding well to it.

White, an elderly woman from Sri Lanka, was 58 and said that she was given the injections for free as part the universal government system. It is the main source of care for the nation’s vast majority 22 million citizens.

White stated that she could not find an injection at government hospitals after thirteen rounds of treatment.

Bevacizumab, which costs 13,000 Sri Lankan rupees ($359) each shot, is sold on the private market. White claimed that because she has no insurance, the high costs are eating into her small savings.

White explained to Reuters that before coming in to the hospital for treatment, White must call to verify if medication is on hand. What do you do if nurses don’t know if they have it?

White’s inability to locate Bevacizumab at state-run facilities shows that Sri Lanka’s healthcare system may be close to collapse under the strain of its worst economic crisis. Some procedures and tests were also suspended due to shortages in vital drugs.

Because of a lack of foreign currency, President Gotabaya Rajapaksa’s government has been unable to import vital items such as fuel and medicines. This caused crippling power outages and thousands of protestors demanding that he be removed.

Reuters spoke with six doctors, two government officials and a leader in a health union. They said that Sri Lanka’s system of healthcare was not as bad as it is now.

A memo that was sent by a state-run hospital in Colombo to inform them of a shortage of supplies meant that no emergency, casualty or malignancy surgery would take place after April 7.

Reuters asked Sri Lankan officials about their health and did not receive any responses.

Tourism is a major part of this economy. It has also been severely affected by the COVID-19 epidemic and the steep rise in oil prices following the conflict in Ukraine. This has rendered it impossible to import enough fuel.

Analysts have criticised Rajapaksa’s administration’s decision to cut taxes and defer talks with the International Monetary Fund in 2019. These negotiations continue.

The Rajapaksas’ close friend has previously stated that the tax cuts were meant to spur the economy. But COVID-19 struck.

Sri Lanka currently has only $1.93 billion worth of foreign reserves. That’s less than a month’s worth of imports. In 2022, government debt repayments will be due twice as high.

Sri Lanka Medical Association is the oldest medical professional body in Sri Lanka. It warned Rajapaksa that emergency treatment may be stopped within the next few days.

According to the association, “This will lead to a catastrophe number of death.”

CRUCIAL FIVE MINS

Late March saw a 70 year-old woman being wheeled to a Colombo suburb-based tertiary-care hospital. Due to severe hypotension, the patient had developed septic shock.

A doctor attending to the situation advised that the patient be given an injection of albumin.

The doctor said that “in this case it wasn’t possible,” but declined to identify himself because the hospital staff is not permitted to talk to the media. It means that I’ve lost five critical minutes.”

Doctor said that the patient was dead.

Three life-saving medications have run out of the 1 325 that the government gives to hospitals in state runs, and 140 other essential medicines are not available, according to the Secretary to Sri Lanka’s Pharmacology Ministry.

Saman Rathnayake stated to Reuters that “this will not stop in two months.” The dollar crisis will continue.

He also said that there could be new supply sources to alleviate any immediate shortages.

Most likely, medicines purchased through credit lines with India neighboring India would arrive in two weeks. India supplies about 80% of island’s needs.

Rathnayake stated, “If the Indian credit line is successful, then there will be no issue in six months.”

Sri Lanka also sought assistance from the World Bank, Asian Development Bank, and World Health Organization. He said, “Their stuff will come after six month.” That’s how we planned.”

Some doctors have launched public appeals to raise funds in desperate need of supplies.

The Perinatal Society of Sri Lanka ran out of ET tubes to aid newborns in respiratory distress. They have compiled a list of items that could be donated through the ministry.

In a social media-shared letter, Saman Kumara, the president of the society said that “We’ve almost used all stocks” and that no ET tubes would be available for a few weeks.

I have told staff not to throw away used ET tubes, but to sterilize and clean them as they may be needed again.

Reuters viewed a listing of items out of stock from the southern Colombo state hospital. The list included urethral tubes, various types of tubes and umbilical cord clamps.

“WE ARE FIGHTING”

A large crowd of patients waited in line on benches and plastic chairs inside the hall of a government hospital located north Colombo.

An official stated that the hospital records approximately 50,000 visits per month and has a staff just above 2,500. It is also one of the largest urban health centers in the country, serving multiple areas.

He asked that the hospital and official not be identified. “But I am not certain how long services can be maintained.”

As the signs of an impending crisis were becoming clearer, an official stated that the hospital had stopped major infrastructure renovations and planned to stop any further improvements. The money was then diverted for medical supply.

After Sri Lanka’s currency was devalued amid rising inflation, a senior official stated that the costs of medical supplies have increased by 30% to 40%. This has put additional pressure on hospital finances, which are already about 350 million rupees (1.11 million USD) indebted.

Rathnayake, the minister of pharmaceutical, stated that the total government debt to suppliers for items like gloves and reagents needed for medical testing was around 4 billion rupees.

Ravi Kumudesh (President of the Medical Laboratory Technologists Association) stated that testing has dropped 30% and some higher-end tests have been halted completely. The maintenance of equipment such as Magnetic Resonance imaging (MRI) machines was also delayed.

Kumudesh said to Reuters, “There’s a big gap between the treatment a person should get and what they’re getting.”

“Noone is held responsible. He said that even though the numbers aren’t being calculated, many people are still dying.

Interview with Reuters: Sri Lanka’s Finance Minister Ali Sabry stated that his top priority is to stabilize the supply of medicines and essentials.

White says that for many patients, it’s becoming harder to deal with their crisis. She said that slow-release morphine tablets are sometimes not readily available to treat pain.

White stated, “The other day, my son went to buy it but came back empty-handed.”

“I feel extremely helpless… It is impossible for me to even protest.

($1 = 315.0000 Sri Lankan rupees)