Health is a key component of an individual and social well-being and also the health sector has a huge impact on the economy. The people of this country were fortunate enough to survive a pandemic. However, with the economic crisis, each and every individual is facing hardship in their day-to-day lives. While every sector of the country is affected by the forex crisis, the health sector is also going through its fair share of difficulties. However, the main reason the Government should give priority to the health sector is because it is the lives of the people that would be in jeopardy if issues related to the health sector are neglected. Citizens are the essence of a country. They should be healthy and strong people to contribute to the economy of the country. Hence the reason why the Government should be more responsible and meet the basic needs of the health sector.
Cancer is taking its toll and the Health sector is unable to cope with the situation, on the one hand due to a severe lack of vital equipment and on the other a dearth of vital drugs.
Professor Chrishantha Abeysena, member of the National Intellectuals Organisation (NIO) said the rate of recovery of cancer patients has dropped to 10 per cent due to the lack of proper radiotherapy for patients.
He said for some cancer patients, radiotherapy was the only treatment for their recovery and due to the lack of equipment, most patients were on the waiting list awaiting their turn for over three months.
He told the media recently that although the rate of recovery of these patients in foreign countries was 45 per cent, in Sri Lanka, it was a mere 10 per cent.
What is radiotherapy
According to the National Cancer Institute (NCI) radiation therapy also called radiotherapy is a cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumours. When used to treat cancer, radiation therapy can cure cancer, prevent it from returning, or stop or slow its growth. At high doses, radiation therapy kills cancer cells or slows their growth by damaging their DNA. Cancer cells whose DNA is damaged beyond repair stop dividing or die. When the damaged cells die, they are broken down and removed by the body. Radiation therapy does not kill cancer cells right away. It takes days or weeks of treatment before the DNA is damaged enough for cancer cells to die. Then, cancer cells keep dying for weeks or months after radiation therapy ends.
Ceylon Today contacted Professor Chrishantha Abeysena to elaborate on the subject.
He said there were three ways to treat cancer patients. The first being surgery.
“Surgeries can be carried out if the cancer is in stage one of the disease. If the cancer has spread through the body, it is difficult to carry out surgeries. Therefore, doctors can carry out a surgery, remove the cancer and cure the patient if it is in stage one of the disease”.
He said the second method was radiotherapy while the third was chemotherapy. For chemotherapy there are drugs, injections and tablets to treat the cancer, he said.
As far as the subject of cancer is concerned, ‘radiotherapy’ is the most important method because for over 60 per cent of cancer patients, radiotherapy was the vital form of treatment. There are some types of cancers where surgeries cannot be carried out and the only way to treat such cancers is radiotherapy, he said.
“For example in the cases of head and neck cancers, radiotherapy is the only way to treat the patient. Also, there are some types of cancers where we need both radiotherapy and chemotherapy”, he said.
Professor Abeysena said one way to give radiotherapy is through a machine called ‘Cobalt’ and it is an old version.
“Actually, some developed countries have stopped using Cobalt machines to cure cancer whereas in Sri Lanka this type of machine is in use in numerous places. The required amount of radiation cannot be given by the Cobalt machine. Sometimes the amount of radiation that is provided by that machine can be decreased. In some cases, the radiation could be provided to unwanted areas which could result in injuries”, he stressed.
He said the best machine to provide radiotherapy is called Linear Accelerators (LINAC). There are only a little over 10 machines in the country. There are only five LINAC machines at the Apeksha Hospital in Colombo. There are two machines in Kandy and one each in Karapitiya, Jaffna and Batticaloa, he claimed.
“There are also places in the country where there is not even a single Cobalt machine to treat patients. Therefore, if patients require radiotherapy, they have to travel either to Anuradhapura or Colombo”.
The shortage of these machines has resulted in patients facing so many difficulties. However, if the treatment is carried out properly, the cancer can be cured in most cases. Also, patients face less side effects. That is why advanced technology should be used, he said.
He pointed out that there is also another form of treatment known as ‘Brachytherapy’ and it is used to treat cervical cancer. Unfortunately, there are only two machines in Sri Lanka that can be used to provide brachytherapy for patients. There is one at Apeksha Hospital and the other is in Kandy, he said.
“In fact, if a patient needs brachytherapy, they have to travel to one of these places to obtain the required treatment. Such patients have to be referred to the hospital concerned and most of the time there is a long waiting list since there is a shortage. Even to obtain radiotherapy from the LINEC machine a patient has to wait for roughly 30 days in the waiting list”, he said.
The major issues in the cancer sector is that there is a huge shortage of instruments and equipment and also the instruments that are in the country are outdated, he said.
While claiming that there are oncologists in every district hospital, he said that the facilities that they need to treat patients must be provided to them. Because it is very hard for the patients to travel here and there and wait for days to receive treatment. If the cancer is not treated right, there can be a recurrence hence the reason why the cure rate in Sri Lanka has decreased compared to other countries. The economic crisis in the country has only exacerbated the situation further, he said.
Shortage of equipment and machines were issues that were persistent over a long period of time. Even before there was a forex crisis in the country there was a shortage. “The crisis in the cancer sector has been discussed for over 10 years and even though there are projects to right the wrong we can see that they are also paused at the moment,” Prof. Abeysena said.
“It is very visible that the health sector is not being prioritised. Only 1.7 per cent of the GDP has been allocated for the health sector. In other countries they allocate an increased percentage for the health sector. Patients not only have to face difficulties when it comes to radiotherapy treatment but also medicines that need to be obtained are very expensive. Also, there are not enough drugs in State sector hospitals. When chemotherapy is administered, there is a valve that costs around Rs 109,000 which could be used to treat certain types of cancer and for a patient 17 valves are needed. Basically, over Rs 2 million is required for a patient to afford the relevant treatment. An ordinary family cannot afford these types of treatment. This is only one product we are talking about. All the other medicines are also unaffordable following the economic and the forex crisis in Sri Lanka”, he said.
It is not like a patient can wait for a very long time to collect money because cancer is something that must be treated immediately since it spreads fast, he said.
BY Aloka Kasturiarachchi