Healthcare system close to collapse as drugs run out

COLOMBO • Sri Lankan Rosanne White was first diagnosed with cancer eight years ago and lost a kidney. After the cancer returned five years ago, an oncologist started her on Bevacizumab last May, a treatment she was responding to.

Ms White, a 58-year-old retiree, said she had received the injections free of charge as part of the country's universal health system, which the vast majority of its 22 million people depend on.

But after 13 rounds of treatment, she now cannot find the injection in government hospitals.

Bevacizumab costs 113,000 Sri Lankan rupees (S$490) per shot in the private market and, because she does not have insurance, Ms White said the costs were eating into her limited savings.

"We have to call the hospital before going in for treatment to find out if our medication is available," Ms White told Reuters. "But what do you do when the nurses say the hospital doesn't have the medication?"

Ms White's struggle to find Bevacizumab in state-run facilities is an early sign of how Sri Lanka's healthcare system is close to collapse, under the weight of the island nation's worst economic crisis. In addition to shortages of vital drugs, some medical procedures and tests have also been suspended.

The lack of foreign exchange has left President Gotabaya Rajapaksa's government unable to import essentials including medicine and fuel, causing crippling power cuts and bringing thousands of protesters on to the streets demanding his ouster.

An internal memo from a major state-run hospital in the capital Colombo said that only emergency, casualty and malignancy surgical operations would be conducted from April 7 onwards because of a lack of surgical supplies.

The economy, which relies heavily on tourism, has been devastated by the Covid-19 pandemic and hit by the sharp rise in oil prices in the wake of the war in Ukraine, which has made importing enough fuel unaffordable.

The Sri Lanka Medical Association, the country's oldest professional medical body, wrote to Mr Rajapaksa last week warning him that even emergency treatments may have to be stopped in the coming days.

Out of 1,325 drugs that the government provides to state-run hospitals, three life-saving medicines have completely run out and another 140 essential ones are in short supply, said the secretary to Sri Lanka's pharmaceuticals ministry, Mr Saman Rathnayake. "This will not end in two months," he said. "The dollar crisis will go on."

In an interview with Reuters last Saturday, Sri Lanka's new Finance Minister Ali Sabry said his first priority was to stabilise the supply of essentials such as medicine.

But for patients such as Ms White, coping with the crisis is becoming increasingly difficult. Slow-release morphine tablets to manage pain are often not available, she said.

"The other day, my son went to get it and came back empty-handed," Ms White said.

"I feel very helpless... I cannot even go to a protest." REUTERS