VShandrapala Weerasuriya does not remember when he last took his medicine. The 67-year-old retired businessman, living in the Gampaha district of Sri Lanka, has always relied on medication to control his hereditary nervous condition, which makes him dizzy and unable to walk.
But since his prescription just ran out, he can’t get another supply. The drug is simply no longer available in Sri Lanka.
“I’m afraid of becoming paralyzed because there’s no one to take care of us,” he said worriedly. “My wife and I do everything on our own. We share household chores and manage them among ourselves. My wife has a knee problem and she can barely walk.
Sri Lanka’s financial crisis, the worst since independence, is rapidly turning into an alarming health crisis. Government coffers have fallen to their lowest levels on record and last week the country was forced to default on its international loans for the first time in its history. Without crucial foreign currency, Sri Lanka has been unable to import the essentials: food, fuel – and medicine.
Sri Lanka imports over 80% of its medical supplies. Today, nearly 200 medical items are missing, including 76 essential life-saving drugs, ranging from blood thinners for patients suffering from heart attacks and strokes to antibiotics, rabies vaccines and cancer chemotherapy drugs. Essential surgical equipment and anesthesia are running out so quickly that the decision was made this week that only emergency surgeries, mainly of heart and cancer patients, would take place. All routine surgeries – from hernias to swollen appendages – have been put on hold. Some public hospitals have been instructed to only admit emergency patients.
“At the end of the day, people are definitely going to die,” said a Colombo doctor who was told not to talk to the media.
She described how the hospital was so short of certain drugs that they had to ask families of patients to go to pharmacies and try to buy some themselves. “There were incidents where family members went to get medicine and by the time they came back with the medicine it was too late and the patient died,” she said.
The doctor said the shortages were getting worse. “I worry about pregnant women because soon I don’t know if we will have enough medicine to do caesarean sections,” she said.
Cancer drugs, which are notoriously expensive to import, have been particularly hard hit by shortages in recent weeks, and the responsibility for their supply lies with oncologists themselves. They have launched global appeals for donations and written letters to private supporters, organizations and governments, to ensure that cancer treatments are not delayed.
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 more than a century ago. a month or have ceased to be available at all.
“One of the drugs we give to patients on chemotherapy, which raises their blood counts so they don’t get serious infections, is no longer available,” he said. “So far, we have managed to secure a donation of 80,000 vials. But it won’t last very long.
He added: “One way or another, thanks to the donations, we have generally managed without major problems. But we have had to postpone some chemotherapy, which can have adverse effects on the evolution of cancer.
Somawardana said the crisis was placing a huge “financial and psychological burden” on cancer patients, who had to procure and pay huge sums for their own drugs to continue their previously free and easily accessible treatment in hospitals across the country. praised universal health system of Sri Lanka. .
Cancer doctors, too, felt the pressure of being the ones to both appeal for global drug donations and treat their patients. “I didn’t know how long we could go on like this,” he said.
Ruvaiz Haniffa, a doctor in Colombo, expressed frustration that doctors had “seen this happening as early as January”, but authorities had done little to put in place back-up plans to ensure that no one medicine was in short supply, even as the country’s foreign exchange reserves began to dwindle. deplete to worrying levels.
“We face great ethical dilemmas as doctors,” Haniffa said. “Before, we had a very efficient healthcare system. But for now, it has become ineffective. More people will die, which is not acceptable.
He said his patients were forced to find their own drugs and pay more than 40% higher prices, if they could find any. Haniffa said many of his patients had to choose between medication or paying school fees for their children or fuel to get them to work.
Haniffa said he feared the long-term impacts on the life expectancy of Sri Lankans. “With kidney disease, diabetes and hypertension that we don’t currently treat, it does long-term damage,” he said. “So five years from now we will see increases in strokes, heart attacks, neurological problems, cancers.”
While newly appointed Prime Minister Ranil Wickremesinghe recently warned that the situation “will only get worse” and that Sri Lankans face difficult months, those without medicine said they were facing an uncertain future. India on Sunday delivered 25 tonnes of medical supplies to the country while France donated some essential equipment, but most health system workers say Sri Lanka will not be able to count on the donations forever.
Among those anxious was Sushantha Weerasuriya, 42, who struggled to get hold of her epilepsy medication, traveling long distances to track down some pills. Even when he manages to find the drugs, they have become almost impossible for him to afford, totaling 10,000 rupees (£22) in May.
But as soon as he stops taking the drug, he starts having regular seizures, which knocks him unconscious and prevents him from working.
“If I go without it for five days, then the condition will come back and continue non-stop, which I really fear,” he said. “I am the main breadwinner in my family and have to support my wife and four-year-old daughter. But when the condition comes, I can’t work. If the medication stops completely, my family’s livelihood is at risk,” he said.