Impending Disaster in Health Sector

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By Dr. Vasan Ratnasingam 

The economic crisis facing the country has forced people to demonstrate and protest against the Government for its poor financial management leading to the present fuel crisis and increasing cost of living.

Another calamity resulting from the insufficient foreign reserves in the Central Bank is the country’s inability to import essential drugs, surgical consumables, and medical equipment, which is the cornerstone of healthcare delivery in the country. As the proverb goes ‘health is wealth,’ authorities should pay attention in allocating sufficient funds to run the healthcare system uninterrupted.

The Sri Lankan healthcare system, which was efficient and, on par with the Western world, is now on the verge of collapse due to poor financial management on the part of the Government.

The Government Medical Officers’ Association (GMOA), representing 95 per cent of the Medical Officers in the country, has identified the imminent disaster in the health system. Convening its General Committee members scattered through 130 branch unions, it studied the dearth of essential drugs and surgical consumables. It was found that a significant amount of essential drugs are in short supply in several healthcare institutions, including major hospitals in Colombo and supplies are sufficient only for a couple of weeks. 

The GMOA understood the internal crisis and requested the Ministry of Health to declare a state of emergency in the health sector. Subsequently, State Minister of Production, Supply and Regulation of Pharmaceuticals, Prof.  Channa Jayasumana invited the GMOA for a discussion to formulate a contingency plan to defuse the imminent crisis. Health authorities who participated in the discussion said the Medical Supplies Division (MSD) was short of five life-saving and 180 essential drugs.

An action committee was set up at every branch union comprising the head of the institution, representatives from other trade unions, members from civil society and other welfare organisations.

Further, failure to declare an emergency in the health sector on the part of health authorities pushed the GMOA to announce the disaster in healthcare delivery to seek assistance from Sri Lankans living overseas. The GMOA is coordinating this process presently in collaboration with the Health Ministry via digital channels and social media.

Further, the GMOA requested the Director General of Health Services (DGHS) to appoint a committee to facilitate the process of donating essential drugs and surgical consumables by Sri Lankans living overseas and the international community.

Approximately 1,500 donors have responded, expressing their willingness to help the health system.

This is organised to bring donations to the MSD by coordinating the technical process through the National Medicines Regulatory Authority (NMRA) and Customs. While the GMOA, Ministry officials and other well-wishers are effectively performing the task to keep the health sector operational, the Government issues contradictory statements with regard to the scarcity of essential drugs. Firstly, it denied the shortage in essential drugs, as was declared by the Government Information Department, while the strategies to mitigate the shortage were announced the following day in an irresponsible manner. We were in a dilemma as to whether the Government had a genuine interest in the well-being of citizens or if it was a move to sabotage the timely leadership shown by the GMOA. Instead of assisting leadership in the health sector, the Gazette was released with the inclusion of health as an essential service without ensuring the basic amenities needed for healthcare workers such as fuel, gas and electricity.

It is obvious that the fuel crisis has serious repercussions and adverse outcomes in healthcare delivery. Although the hospitals receive patients from surrounding areas, healthcare workers have to report for duty from distant areas, which have resulted in the hindrance of timely management of critically ill patients. Staying in the queue for fuel and restrictions imposed on the quantity also burdened the health staff and will adversely affect the productivity of a healthcare institution.

Also, the restrictions to pump fuel for only Rs 5,000 will restrict delivery of healthcare services in equity manner and will surely affect health delivery at peripheral stations, as doctors at peripheral hospitals depend mainly on their personal vehicles rather than public transport. The public transport service is also disrupted and is unable to deliver their routine services with the fuel shortage. It is inevitable that authorities should pay urgent attention in view of heeding aforementioned crisis for the betterment of needy patients at this juncture.

There are agitations by the GMOA membership against the present situation. The Union is bent on protecting the people’s right to live and right to health. The shortage of drugs in healthcare institutions has gone to the extent of halting routine surgeries and transferring patients to other healthcare institutions, which is disturbing the routine operations of the hospital system.

The GMOA Executive Committee has decided to request the Governor of the Central Bank to exercise his power to utilise the Itukama Covid-19 Healthcare and Social Security Fund to alleviate the acute crisis faced by the health sector. Only Rs 36 million of aforesaid fund has been utilised for Covid testing from the total of Rs 2 billion that was collected.

The GMOA observed the threat of the present economic crisis transforming into a political crisis due to the continuous protests calling on the President and his Government to stand down. It clearly shows the necessity of providing solutions to causes which has led to the aforementioned crisis, such as failure to make timely decisions, poor fiscal management, and non-occupancy of suitable personal at government institutions. 

Hence, it is high time to gather a formidable alliance comprising other professional associations to formulate short-term, intermediate and long-term strategies to overcome the crisis. The GMOA has already initiated negotiations with a few professional associations such as the Sri Lanka Administrative Service Association, Government Dental Surgeons’ Association, Sri Lanka Accounting Service Association, and Professionals’ National Front and invited other associations to join hands with us to lead the country on the right path for the betterment of all Sri Lankans. 

About the author:

Dr. Vasan Ratnasingam is a General Committee and Media Committee Member of the Government Medical Officers’ Association (GMOA).