Colombo, Sri Lanka – Sri Lankan doctors have warned that a catastrophic number of people could die as the country’s health care system falters on the brink of collapse amid a power outage and a shortage of life-saving drugs.
Officials and health workers across the country say there is a shortage of drugs to treat heart attacks and breathing tubes for newborns, while doctors in rural Sri Lanka are being forced to stitch wounds and treat snakebite in the dark due to the blackout.
The situation is so bad that many hospitals have stopped routine surgeries and drastically reduced the number of laboratory tests, and according to internal documents, doctors, nurses and other health workers have been forced to take to the streets in protest.
Some have also expressed support for a growing protest movement demanding the resignation of President Gotabhaya Rajapakse.
“All hospitals in Sri Lanka are on the verge of collapse,” said Dr Chanel Fernando, secretary of the Government Medical Officers’ Association. “The situation will get worse in the next two weeks. If action is not taken now, people will start dying.”
He warned that any patient death due to drug shortages would result in “riots in hospitals” and that the government had failed to acknowledge the severity of the crisis or to be transparent.
“The government is not worried. They say nothing to people.
Sri Lanka, an island nation of 22 million people, is mired in the worst financial crisis in decades. An economy plagued by the Govt-19 epidemic has been pushed to the brink of collapse, with the Rajapakse government sinking into the country’s foreign reserves to pay off its debt.
In less than two years, the reserve has fallen by more than 70 percent. It was $ 1.93bn at the end of March, according to central bank data.
Unable to pay for essential imports, including fuel and medicines, the government has sought power cuts and sought the help of the International Monetary Fund and China and India.
Doctors say the shortage of supplies and the power outage have created “a terrible situation.”
In the central Nuwara Eliya hills, a doctor at a government hospital said he was forced to treat patients seeking help with a torch light at night.
“My hospital helps the poor. Most of them are being treated for accidents and alcohol-related injuries, ”he told Al Jazeera. “Over the past few weeks, I have cleaned, medicated and stitched the wounds of more than twenty people without electricity.
“I feel like we’re back in the 19th century.”
The doctor, who did not want to be named, said he had no authority to speak to the media and that his hospital had no antibiotics and that the gas would soon be gone.
Meanwhile, in the northeastern city of Polonnaruwa, many people sought medical help for snakebite, while another doctor had to use lights during a power outage.
“But the severity of the snake bite is not easy to detect under the lamp,” he said. “People’s lives are in danger”.
The government-run hospital where he works has to send any serious injuries to the big hospital, but he said “ambulance availability is very difficult” due to the shortage of diesel.
Hospitals in Sri Lanka’s largest cities have been saved from power cuts, but due to the limited supply of anesthetics and antidotes, many have been ordered by the government to suspend routine surgeries and reduce laboratory tests.
The Karapitiya Teaching Hospital in the southwestern city of Galle told its staff in a March 29 memo that it was limiting surgery to “life-threatening conditions” due to a shortage of the drug neostigmine used by anesthesiologists.
According to local media, the Peradeniya Teaching Hospital in central Kandy also suspended routine operations at the end of March, but was reopened after Indian Foreign Secretary S Jaisankar promised assistance.
Sri Lanka’s largest hospital, the National Hospital in the country’s capital, Colombo, meanwhile, has limited laboratory investigations “until further notice”, according to a March 29 memo, due to disruptions in the delivery of chemical reactions.
Doctors are also warning about the shortage of important drugs, such as streptokinase and donectoplasmone, which are used to treat heart attack and stroke.
“If you go to the hospital with a heart attack now, your chances of dying are much higher than they were a few months ago,” said Dr. Lakumar Fernando, president of the Association of Medical Specialists. “All hospitals have been severely affected.”
The government did not say which drugs were in stock, but last week Sri Lanka faced a severe shortage of 40 essential medicines and a stockpile of 140 essential medicines, the health ministry said.
Meanwhile, neonatologists seeking international help to save newborns say they have run out of endotracheal tubes placed in the trachea through the nose or mouth to deliver oxygen to the baby’s lungs.
In a letter dated April 7, Dr. LBC, President of the Perinatal Society of Sri Lanka, addressed the gathering. Saman Kumara said the shortage was “too complicated” and that used pipes should not be disposed of, but that hospitals should no longer be ordered to clean and disinfect them. As a desperate solution we would have to reuse them.
The shortage at the Castle Street Teaching Hospital in Colombo, the capital of Sri Lanka, was felt most acutely, but Kumara told Al Jazeera that “soon all hospitals will run out of pipes.”
The health ministry said it was acting “too fast” to try to rectify the situation.
Ministry spokesman Dr Saman Ratnayake told Al Jazeera that the ministry was seeking the help of the Indian government and the World Health Organization. He added that the Sri Lankan treasury had promised to open credit links to suppliers for the purchase of some important medicines, including Donecteplace and Stroke.
“We ordered. The problem now is that it will take another one to two months to get the goods, ”he said. Ratnayake, meanwhile, said the government was asking hospitals to manage things, including postponing non-life-threatening procedures.
“Until then, you have to be patient and help us manage the situation,” he said.
Sri Lankan doctors say this is not a “sound” or “standard” policy.
In a letter sent to the president on April 7 and made public on Sunday, the Sri Lanka Medical Association (SLMA) argued that “what is considered an emergency situation could turn into life-threatening problems within hours”.
The supplies will not be filled in a hurry and the emergency treatment will have to be stopped within a few weeks, otherwise in days, the letter said.
Referring to the 2004 Indian Ocean tsunami and Sri Lanka’s 26th death toll, the letter added that “this would be a catastrophic death toll, which could be higher than the combined death toll from the Kovit, tsunami and civil war.” A year of civil war between the army and Tamil separatists.
About 31,229 people died during the tsunami, while 100,000 died in the civil conflict. The country has an epidemic number of 16,489.
The SLMA urged the President to consult with physicians, saying “the need of the hour is for you to use the country’s intellectual resources in the form of genuine, compassionate and expert advice and guidance.”
According to Sudeva Hettiarachchi, director general of the president’s media unit, Rajapakse has not yet decided on the doctors’ demands. He did not comment on allegations that the government had failed to take the situation seriously.
Health workers say the government should take immediate action.
Ravi Kumdesh, President, College of Medical Laboratory Science, said, “This is a catastrophic situation. “We call on the government to declare a medical emergency and call for international humanitarian assistance.”
Kumdesh himself was very worried and said, “We can not calculate where the end is.”
Even if the government quickly alleviates some of the major drug shortages, the severity of the economic crisis is likely to face a similar situation within a few months.
“The consequences will be very long lasting,” Kumdesh said. “We must call for international humanitarian assistance because, as a country, we can compromise on other needs, but not on health.