Miru has a malignant brain tumor that causes him to have frequent epileptic seizures and faint for minutes. The only thing that helps is a cure for seizures, but with the financial crisis in Sri Lanka hitting drug imports, Miru’s father, Upul Chandana, is struggling to find a cure everywhere.
“This is no longer available at the hospital. Even the nearby pharmacies are exhausted,” Chandana said as his only son played on the thin mattress behind him. “Now, even with money, we can’t find the cure.
Now, with the depletion of medical drugs and equipment, the country is facing what the Singapore Red Cross describes as an “unprecedented humanitarian crisis”.
Doctors report washing and reusing medical equipment – and even performing surgery on cell phone lights. Authorities have so far not confirmed drug-related deaths – but experts warn that the number of crises could exceed more than 16,000 deaths in the country from Covid.
“This is a crisis, we can’t predict how bad it will be,” said Atula Amarasena, secretary of the State Pharmaceutical Association of Sri Lanka, which represents pharmacies across the country. “But we are aware that we are heading for a new crisis.
Miru’s parents are worried about giving him the medicine he needs. Credit: Upendra Herat / CNN
Difficult situation in hospitals
Every day, Vasanta Seneviratne goes from pharmacy to pharmacy in the Sri Lankan capital, Colombo, desperate to find topotecan, the chemotherapy drug his 7-year-old daughter needs to stay alive.
And in the hospital where his daughter was admitted on April 7, and in every pharmacy she visits, the answer is the same: The drug is not available anywhere in the country.
“There is no government hospital, pharmacy or importer. It is not available anywhere in Sri Lanka,” he said of the drug his daughter needs to treat neuroblastoma, a form of cancer. “What can I do? My child may not live long if he does not receive the medicine.”
Just a few weeks ago, Topotecan was offered for free by hospitals, but patients’ families are now tasked with procuring it themselves from private pharmacies, Seneviratne said.
Even that feels impossible. And the problem is much bigger than Seneviratne.
According to a letter published by the Medical Association of Sri Lanka (SLMA), not all hospitals across the country have access to emergency medicines and medical equipment. Several government hospitals have been ordered to suspend routine operations and reduce laboratory tests due to limited supplies of anesthetics and reagents used for testing, the SLMA said.
And medical equipment is also in short supply. The president of the Sri Lanka Perinatal Society, for example, has ordered hospitals to sterilize and reuse endotracheal tubes used to deliver oxygen to the lungs of newborn babies as tube shortages become “extremely critical,” according to a letter to the ministry. of Public Health earlier this month and provided to CNN.
Hospitals in Sri Lanka are short of supplies. Credit: Upendra Herat / CNN
An intensive care surgeon, who asked not to be named for fear of losing her job, said vital drugs used to treat strokes and heart attacks were now critically in short supply and her hospital was forced to reuse catheters.
“I know I’m endangering the next patient’s life. “I feel hopeless and completely helpless,” she told CNN this week, adding that she now spends much of her time disinfecting equipment that can be reused. “It goes against everything we’ve been taught to do.”
Although hospitals were spared mostly from power outages, the doctor told CNN they had a power outage while she and others operated on a young child for heart disease. They were forced to continue working with torches on their mobile phones held by other medical workers until the generators were powered.
“Although at least two mobile phones are held, it is not easy to perform procedures or stitches in such light,” she said.
A doctor from a government hospital in the central city of Kandy, who asked not to be named for fear of losing her job, said in the hospital’s intensive care unit that their anesthesia was low and she was worried about how the hospitals would perform operations without pain relief. Her hospital reduced her planned operations.
Like the unnamed surgeon, she has been told to reuse patients’ catheters and tubes – and although she knows this could harm patients, she says she has no choice.
Her team faces a difficult choice of who needs the medicine the most.
“We had to make difficult choices these days, especially in the intensive care unit, such as who will live and who will not,” she said. “We may continue to accept patients, but we will not have a way to treat them.”
The surgeon is facing a similar problem.
“I don’t know if half of the patients we have in the intensive care unit will be alive in the coming weeks if this shortage of drugs continues,” she said.
How did this happen
Some say the government should have seen the situation.
According to experts, the economic crisis in Sri Lanka is caused by a combination of bad governance and government misery, including the Covid-19 pandemic, which has hurt the country’s tourism industry. Tax cuts and economic downturns have affected government revenues, prompting rating agencies to downgrade Sri Lanka’s credit rating to near default levels – meaning the country has lost access to overseas markets. Sri Lanka has given up its foreign exchange reserves to pay off government debt, shrinking its reserves from $ 6.9 billion in 2018 to $ 2.2 billion this year, according to an IMF briefing.
The money cut affected imports of fuels and other basic goods – including medical equipment and medicines.
For months, medical workers warned of the impending crisis, and doctors and nurses took to the streets to protest government inaction.
On Wednesday, after downplaying fears and saying there was no shortage, the country’s health ministry acknowledged that Sri Lanka was facing a shortage of certain drugs and surgical equipment. According to the ministry, the government has received $ 10 million from the World Bank to buy drugs, although it is unclear when that should arrive.
“I would call it a challenge rather than a crisis,” Dr. Anver Hamdani, coordinator of the Ministry of Health and donor activities and medical supplies, told CNN this week.
There is no reason for the problem, he said, adding that the government will solve the problem behind the shortage before the end of the month.
However, others argue that scarcity is a man-made problem that can be prevented.
According to Dr. Rukshan Belana, president of the Forum of Public Health Officials (GMOF) and administrator of a public hospital in Colombo, the government cannot pay on credit lines for supplies.
He told CNN that there were 2,500 listed pharmaceutical items approved by the government, and 60 of them were in short supply.
“The president is ignoring calls for action, so what has happened is that the situation is getting worse and worse every day,” Bellana said.
What next
The government says it is dealing with both the economic and medical crises. In a statement this week, the Ministry of Health said it was in temporary talks with the World Health Organization and the Asian Development Bank to receive funds or drugs and was working to receive donations from Sri Lankan foreigners.
But doctors say urgent help is needed.
In a letter to the president on April 7 and made public on Sunday, the Sri Lankan Medical Association said health problems, which are not usually considered emergencies, could become life-threatening.
“Without urgent replenishment, emergency treatment may also need to be stopped within a few weeks, if not days,” the letter said.
“This will lead to a catastrophic number of deaths.”
Amarasena of the State Pharmaceutical Association says the problem will get worse before it gets better. Even if Sri Lanka receives help from international organizations or other countries, it may take weeks or months for shipments to arrive – and some suppliers will only start producing medicines once an order has been placed. And the country does not even have a health minister at the moment – a number of cabinet ministers have resigned over the crisis.
“The appointee in charge is not empowered enough to make quick decisions,” Amarasena said. “We don’t have enough time.”
Earlier this month, Seneviratne and his family arrived in the capital of Kandy province, hoping they would have a better chance of helping their daughter.
“We come to the hospitals hoping we can find a good cure, so when we find that there aren’t even any drugs, we’re helpless,” he said.
For Seneviratne, he can do little to help his daughter. The economic crisis has left him without a permanent job, which means there is no way to import drugs from abroad.
“There are many more (parents) who are also deeply saddened because they cannot find this medicine, even if they have (enough money) in their hands,” he said. “We are in a lot of pain and sorrow. We don’t have the money to take our daughter abroad for treatment.”
Back in the small room in Colombo, Peace’s father, Chandana, has similar fears. The family left their rice farm and moved to Colombo so that Miru could be treated. When he bought his last bottle of medicine, the pharmacist who sold it to him said it was his last bottle in stock.
But now he has only a few days of medicine left. His only hope is to keep looking for a way to find more.
Add Comment