Sri Lanka faces worsening health crisis

Alarmed doctors and other health workers across Sri Lanka are issuing serious warnings about severe shortages of vital drugs, vaccines and medical equipment caused by the country’s deepening economic crisis.

Sri Lankan government medical officers protest outside the national hospital in Colombo, Sri Lanka, Thursday, April 7, 2022. [AP Photo/Eranga Jayawardena]

While this has most heavily impacted on the country’s run down and underfunded free public health system on which most Sri Lankans rely, both services—public and private—are suffering major shortages of basic medical items.

Reuters reported on May 23 that doctors, health workers and patients at Apeksha Hospital, Sri Lanka’s premier cancer treatment centre, said that the situation was becoming desperate with doctors forced to suspend tests and postpone important medical procedures, including critical surgery.

Dr. Roshan Amaratunga told the news agency: “It is very bad for cancer patients. Sometimes, in the morning we plan for some surgeries [but] we may not be able to do them on that particular day because supplies are not there.” If the situation is not improved quickly, he said, some patients faced a “virtual death sentence.”

Another Apeksha Hospital doctor told the World Socialist Web Site (WSWS) that shortages of certain drugs were impacting on other departments. Leukemia treatment doctors, he said, were lacking G-CSF (granulocyte colony-stimulating factor) drugs and antibiotics. Relatives of some patients are also having to find and purchase external supplies of potassium saline vials.

A doctor from the Kandy National Hospital told the WSWS that it had been over a week since the hospital’s last supplies of clips used to send cameras into the mouths of patients suffering from oral evictions of blood due to liver failure had been exhausted.

These life-threatening problems have emerged at every Sri Lankan hospital over the past five months as the country’s financial crisis, precipitated by the COVID-19 pandemic and more recently the US-NATO instigated war against Russia, has worsened.

In a desperate attempt to deal with falling foreign currency reserves, President Gotabhaya Rajapakse’s government has slashed key imports, including essential food items, medicines and fuels, leading to extended power cuts.

The resulting social crisis has precipitated mass protests demanding the ouster of President Rajapakse and his regime, and an end to the shortages. Health workers, including doctors, nurses, paramedical staff and other medical workers have been in the forefront of these struggles.

Sri Lanka has to import over 80 percent of its pharmaceuticals and other medical supplies. While the health ministry says it has opened a Letter of Credit for imports, the banks say they have no US dollars.

On May 16, former Health Ministry Secretary Sanjeewa Munasinghe told a special committee that 188, or almost a third of the 646 of the basic medicines required by patients, were not available in the ministry’s medical supplies division. Fourteen of these drugs, including one for heart patients, were essential, he said. Surgical equipment was also in short supply.

Munasinghe admitted that the ministry had been unable to pay 34 billion rupees ($US100 million) to pharmaceutical and surgical equipment suppliers.

The Rajapakse government in recent months has sharply increased the price of various pharmaceuticals by nearly 90 percent. The cost of drugs rose by 29 percent on March 11, 20 percent on April 11 and another 40 percent on April 30.

This dire situation is not restricted to state-run public hospitals. Private sector hospitals have revealed that over 70 vital medicines, including anaesthetics, were in short supply at their facilities, forcing them to use less effective substitute medicines.

Doctors have repeatedly warned about the developing catastrophe. Early last month, the Sri Lanka Medical Association (SLMA) declared: “Already decisions have been made to curtail some services, such as routine surgical operations, and even limit the usage of available material to life-threatening illnesses. This is not at all a sound policy because what are considered non-emergency situations could turn into life-threatening problems within a few hours.”

It warned if the situation was not rectified within weeks “emergency treatment will also not be possible. This will result in a catastrophic number of deaths, which is likely to be in excess of the combined death toll of COVID, Tsunami and the Civil War.”

These estimates are unprecedented. The country’s vastly underestimated COVID-19 death toll is currently over 16,500, the December 2004 tsunami resulted in the death of over 30,000 Sri Lankans, and Colombo’s bloody 26-year, anti-Tamil war killed at least 150,000 people, the majority of them Tamil civilians.

These warnings by Sri Lanka’s premier medical association point to the extent of the health catastrophe created by the shortage of pharmaceuticals and medical equipment.

This situation, combined with the looming starvation caused by rampant inflation, is producing a social disaster for millions of people in the coming days and weeks. Last month, the annualised National Consumer Price Index showed a rise of 33.8 percent and the food index was up 45.1 percent.

In a recent special address to the nation, Sri Lankan Prime Minister Ranil Wickremesinghe warned, “the next couple of months will be the most difficult in the lives of all citizens.” The population must prepare to “make some sacrifices,” he declared.

Last week, Wickremesinghe declared that the government had no money and that state spending had to be “cut to the bone.”

The ruthless attitude of the Sri Lankan ruling elite is demonstrated by comparing Ministry of Defence and Health expenditure over the past three years, amid the ongoing COVID-19 pandemic.

The budget allocation for defence in 2020 was 290 billion rupees, while health spending was just 254 billion rupees; in 2021 defence received 380 billion rupees with 286 billion rupees for health. This year, 373 billion rupees were allocated for defence and 225 billion rupees for health, the lowest amount for health sector in the past three years.

These figures make clear that Sri Lankan capitalism will never provide the funds necessary to provide adequate health service and other basic social needs to the working class, youth and the urban and rural masses.

That is why the only way to overcome the worsening social crisis is for the working class to take control of all essential production and distribution by nationalising large companies, estates and other major economic centres and repudiating all foreign loans. The allies of the Sri Lankan workers in this struggle are their international class brothers and sisters who are facing the similar attacks around the world.

The Socialist Equality Party urges workers to build action committees in every workplace, factory and working-class suburbs, independent of the trade unions and all capitalist parties, and to fight for a workers’ and peasants’ government to implement these urgently required socialist policies.