Gota-Go village run by protestors, in Colombo
Tue, April 12, 2022,
By Uditha Jayasinghe and Devjyot Ghoshal
COLOMBO (Reuters) - On a patch of grass near Sri Lankan President Gotabaya Rajapaksa's office in the commercial capital Colombo, around two dozen tents have been erected in a small but growing camp that is becoming the focal point of national protests.
Thousands of people have taken to the streets nearby and across the country in recent days to call for Rajapaksa to step down, venting their anger at soaring inflation and lengthy power cuts caused by the spiralling economic crisis.
On a handwritten board next to the tents, not far from the colonial-era presidential building adjoining Colombo's water front, stands the sign: "Gota-Go Village".
The slogan "Gota go back," also referring to Gotabaya, is being chanted at demonstrations sweeping Sri Lanka, in an unprecedented public outcry that has brought together people of different faiths, ethnicities and social groups.
Close to the protest camp on Monday evening, a group of Christian nuns in white habits walked past a police barricade, atop which 11 protesters sat chanting. One held a poster saying "Our Govt Failed Us".
A short distance away, three Buddhist monks in bright saffron robes stood amid the crowd.
'OUR ONLY HOPE'
At the edge of a lawn, behind some tents, around 30 Muslim men sat in two lines to break their Ramadan fast.
Farzana F. Haniffa, a professor of sociology at the University of Colombo, said the protest site had become a space where all Sri Lankans could come together in a rare show of unity.
One common cause was anger at what protesters said was economic mismanagement by the Rajapaksa family.
Mahinda Rajapaksa, the president's elder brother, serves as prime minister and their younger brother, Basil, was finance minister until recently.
The administration says it is doing what it can to drag Sri Lanka out of a crisis that has left it unable to buy fuel and medicine and struggling to pay its debts.
Some protesters said they would only leave if the Rajapaksas stepped down. Mahinda Rajapaksa said in a televised address that the protests were hampering attempts to improve the situation.
Walking around barefoot early on Tuesday, after another night of heavy rain, Mary Suwen was rearranging tents that her husband had brought in from his adventure tourism business.
"The country is in a crisis so you can't stay at home," said Suwen, 27, a civil engineer.
"We need to pressure them," she said, talking of the Rajapaksas. "They need to be accountable to the people."
Gagana Atapattu, 22, said he was part of the election campaign that brought Gotabaya Rajapaksa to power in 2019, but now regretted working for him.
"I'm now suffering for what I did," he said, as he helped to manage donations of food, water and other supplies that Sri Lankans were bringing to be stored in large open tents.
Among those donating was Y.C. Kanthi, who waited in a long queue for fuel and then drove 15 km (9 miles) to deliver a pile of buns stuffed with caramelised onions for the protesters.
"I gave a special order to a nearby bakery and had them made for these youngsters," said Kanthi, 53. "They are our future, they are our only hope out of this mess."
(Reporting by Uditha Jayasinghe and Devjyot Ghoshal; Editing by Mike Collett-White and Janet Lawrence)
INSIGHT-Drugs running out, surgeries cancelled as Sri Lanka's health system buckles
* Sri Lankan healthcare system hit hard by economic crisis
* Some patients unable to access key drugs through state hospitals
* Some medical procedures being suspended due to shortages
* Officials hope aid from India, WHO will relieve pressure
By Devjyot Ghoshal and Uditha Jayasinghe
COLOMBO, April 12 (Reuters) - Rosanne White was first diagnosed with cancer eight years ago and lost a kidney. After the cancer returned five years ago, an oncologist in Sri Lanka's commercial capital Colombo started her on Bevacizumab last May, a treatment she was responding to.
White, a 58-year-old Sri Lankan retiree, said she had received the injections free of charge as part of the country's universal government health system, which the vast majority of its 22 million people depend on.
But after 13 rounds of treatment, White said she now cannot find the injection in government hospitals.
Bevacizumab costs 113,000 Sri Lankan rupees ($359) per shot in the private market and, because she does not have insurance, 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," White told Reuters. "But what do you do when the nurses say the hospital doesn't have the medication?"
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. As well as shortages of vital drugs, some procedures and tests have been suspended.
The lack of foreign exchange has left President Gotabaya Rajapaksa's government unable to import essentials including medicines and fuel, causing crippling power cuts and bringing thousands of protesters on to the streets demanding his ouster.
Reuters spoke to two government officials, six doctors and a healthcare union leader who said they had not seen Sri Lanka's health system in such a bad way before.
An internal memo from a major state-run hospital in Colombo seen by Reuters said that only emergency, casualty and malignancy surgeries would be conducted from April 7 onwards because of a lack of surgical supplies.
Sri Lanka's health ministry did not respond to detailed questions from Reuters about the problems facing the sector.
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.
Some analysts have also criticised Rajapaksa's administration for its decision in 2019 to make deep tax cuts and delay talks with the International Monetary Fund (IMF). Those negotiations are now going ahead.
A close aide to the Rajapaksas has said previously that the tax cuts had been designed to boost the economy, but that COVID-19 then struck.
Sri Lanka now has just $1.93 billion in foreign exchange reserves, the equivalent of less than a month's imports, while government debt repayments of twice that amount are due in 2022.
The Sri Lanka Medical Association, the country's oldest professional medical body, wrote to Rajapaksa last week warning him that even emergency treatments may have to be stopped in the coming days.
"This will result in a catastrophic number of deaths," the association said.
'CRUCIAL FIVE MINUTES'
In late March, a 70-year-old woman was wheeled into a government-backed tertiary care hospital in a Colombo suburb. The patient was in septic shock, leading to dangerously low blood pressure.
The doctor dealing with the emergency said the patient ideally needed to be injected with albumin.
"In this case, it wasn't available," said the doctor, who declined to be identified because hospital medical staff are not authorised to speak to the media. "Which means I lost a crucial five minutes."
The patient died, the doctor said.
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, the secretary to Sri Lanka's pharmaceuticals ministry said.
"This will not end in two months," Saman Rathnayake told Reuters. "The dollar crisis will go on."
But he added that new sources of supply could help alleviate immediate shortages.
Some medicines ordered through a credit line with neighbouring India, which supplies 80% of the island's requirement, would likely arrive within two weeks.
"If this Indian credit line works, there won't be an issue for the next six months," Rathnayake said.
Beyond that, Sri Lanka has sought help from the World Health Organization, the World Bank and the Asian Development Bank. "Their things will come after six months," he said. "That is how we've planned."
Desperate for supplies, some doctors' groups have made public appeals for donations.
Running out of endotracheal (ET) tubes used to help newborn infants with respiratory distress, the Perinatal Society of Sri Lanka issued a list of supplies that can be donated via the health ministry.
"We have almost used all the stocks and no ET tubes will be available in few weeks," the society's president Saman Kumara said in a letter shared on social media.
"I have instructed (staff) not to discard used ET tubes but to clean and sterilize them from now onwards as we may have to reuse them."
A list of out-of-stock supplies from the major state-run hospital in southern Colombo seen by Reuters featured more than 40 items, including urethral catheters, different types of tubes, umbilical cord clamps and glucose test strips used for checking blood sugar levels.
'WE ARE FIGHTING'
A crowd of patients waited on plastic chairs and wooden benches inside a large, brightly lit hall at a major government hospital in northern Colombo late last week.
The hospital, which records around 50,000 patient visits every month with a staff of just over 2,500, is one of the country's major urban health facilities that serves multiple districts, an official said.
"We are still fighting," the official said, asking that he and the hospital not be named. "But I don't know how long we can maintain services."
Last August, as early signs of a brewing crisis became clear, the official said the hospital stopped infrastructure improvements and major renovations, diverting the money to shore up medical supplies.
In recent weeks, after Sri Lanka devalued its currency amid soaring inflation, the official said the cost of medical supplies had increased by 30-40% and put further pressure on the finances of the hospital, already some 350 million rupees ($1.11 million) in debt.
Overall, the government owed around 4 billion rupees ($12.70 million) to suppliers of items such as gloves and reagents used for medical testing, said Rathnayake from the pharmaceutical ministry.
Ravi Kumudesh, president of the Medical Laboratory Technologists Association, said testing had dropped by 30%, with some high-end tests completely stopped. Maintenance of equipment like Magnetic Resonance Imaging (MRI) machines has also been delaye
"There is a gap between the treatment a patient should be getting and what they are getting," Kumudesh told Reuters.
"No one is being held accountable. Even though we are not calculating the numbers, people are dying," he said.
In an interview with Reuters on Saturday, Sri Lanka's new Finance Minister Ali Sabry said his first priority was to stabilise the supply of essentials such as medicines.
But for patients like 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," White said.
"I feel very helpless ... I cannot even go to a protest." ($1 = 315.0000 Sri Lankan rupees) (Reporting by Devjyot Ghoshal and Uditha Jayasinghe; Editing by Mike Collett-White and Raju Gopalakrishnan)
* Sri Lankan healthcare system hit hard by economic crisis
* Some patients unable to access key drugs through state hospitals
* Some medical procedures being suspended due to shortages
* Officials hope aid from India, WHO will relieve pressure
By Devjyot Ghoshal and Uditha Jayasinghe
COLOMBO, April 12 (Reuters) - Rosanne White was first diagnosed with cancer eight years ago and lost a kidney. After the cancer returned five years ago, an oncologist in Sri Lanka's commercial capital Colombo started her on Bevacizumab last May, a treatment she was responding to.
White, a 58-year-old Sri Lankan retiree, said she had received the injections free of charge as part of the country's universal government health system, which the vast majority of its 22 million people depend on.
But after 13 rounds of treatment, White said she now cannot find the injection in government hospitals.
Bevacizumab costs 113,000 Sri Lankan rupees ($359) per shot in the private market and, because she does not have insurance, 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," White told Reuters. "But what do you do when the nurses say the hospital doesn't have the medication?"
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. As well as shortages of vital drugs, some procedures and tests have been suspended.
The lack of foreign exchange has left President Gotabaya Rajapaksa's government unable to import essentials including medicines and fuel, causing crippling power cuts and bringing thousands of protesters on to the streets demanding his ouster.
Reuters spoke to two government officials, six doctors and a healthcare union leader who said they had not seen Sri Lanka's health system in such a bad way before.
An internal memo from a major state-run hospital in Colombo seen by Reuters said that only emergency, casualty and malignancy surgeries would be conducted from April 7 onwards because of a lack of surgical supplies.
Sri Lanka's health ministry did not respond to detailed questions from Reuters about the problems facing the sector.
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.
Some analysts have also criticised Rajapaksa's administration for its decision in 2019 to make deep tax cuts and delay talks with the International Monetary Fund (IMF). Those negotiations are now going ahead.
A close aide to the Rajapaksas has said previously that the tax cuts had been designed to boost the economy, but that COVID-19 then struck.
Sri Lanka now has just $1.93 billion in foreign exchange reserves, the equivalent of less than a month's imports, while government debt repayments of twice that amount are due in 2022.
The Sri Lanka Medical Association, the country's oldest professional medical body, wrote to Rajapaksa last week warning him that even emergency treatments may have to be stopped in the coming days.
"This will result in a catastrophic number of deaths," the association said.
'CRUCIAL FIVE MINUTES'
In late March, a 70-year-old woman was wheeled into a government-backed tertiary care hospital in a Colombo suburb. The patient was in septic shock, leading to dangerously low blood pressure.
The doctor dealing with the emergency said the patient ideally needed to be injected with albumin.
"In this case, it wasn't available," said the doctor, who declined to be identified because hospital medical staff are not authorised to speak to the media. "Which means I lost a crucial five minutes."
The patient died, the doctor said.
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, the secretary to Sri Lanka's pharmaceuticals ministry said.
"This will not end in two months," Saman Rathnayake told Reuters. "The dollar crisis will go on."
But he added that new sources of supply could help alleviate immediate shortages.
Some medicines ordered through a credit line with neighbouring India, which supplies 80% of the island's requirement, would likely arrive within two weeks.
"If this Indian credit line works, there won't be an issue for the next six months," Rathnayake said.
Beyond that, Sri Lanka has sought help from the World Health Organization, the World Bank and the Asian Development Bank. "Their things will come after six months," he said. "That is how we've planned."
Desperate for supplies, some doctors' groups have made public appeals for donations.
Running out of endotracheal (ET) tubes used to help newborn infants with respiratory distress, the Perinatal Society of Sri Lanka issued a list of supplies that can be donated via the health ministry.
"We have almost used all the stocks and no ET tubes will be available in few weeks," the society's president Saman Kumara said in a letter shared on social media.
"I have instructed (staff) not to discard used ET tubes but to clean and sterilize them from now onwards as we may have to reuse them."
A list of out-of-stock supplies from the major state-run hospital in southern Colombo seen by Reuters featured more than 40 items, including urethral catheters, different types of tubes, umbilical cord clamps and glucose test strips used for checking blood sugar levels.
'WE ARE FIGHTING'
A crowd of patients waited on plastic chairs and wooden benches inside a large, brightly lit hall at a major government hospital in northern Colombo late last week.
The hospital, which records around 50,000 patient visits every month with a staff of just over 2,500, is one of the country's major urban health facilities that serves multiple districts, an official said.
"We are still fighting," the official said, asking that he and the hospital not be named. "But I don't know how long we can maintain services."
Last August, as early signs of a brewing crisis became clear, the official said the hospital stopped infrastructure improvements and major renovations, diverting the money to shore up medical supplies.
In recent weeks, after Sri Lanka devalued its currency amid soaring inflation, the official said the cost of medical supplies had increased by 30-40% and put further pressure on the finances of the hospital, already some 350 million rupees ($1.11 million) in debt.
Overall, the government owed around 4 billion rupees ($12.70 million) to suppliers of items such as gloves and reagents used for medical testing, said Rathnayake from the pharmaceutical ministry.
Ravi Kumudesh, president of the Medical Laboratory Technologists Association, said testing had dropped by 30%, with some high-end tests completely stopped. Maintenance of equipment like Magnetic Resonance Imaging (MRI) machines has also been delaye
"There is a gap between the treatment a patient should be getting and what they are getting," Kumudesh told Reuters.
"No one is being held accountable. Even though we are not calculating the numbers, people are dying," he said.
In an interview with Reuters on Saturday, Sri Lanka's new Finance Minister Ali Sabry said his first priority was to stabilise the supply of essentials such as medicines.
But for patients like 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," White said.
"I feel very helpless ... I cannot even go to a protest." ($1 = 315.0000 Sri Lankan rupees) (Reporting by Devjyot Ghoshal and Uditha Jayasinghe; Editing by Mike Collett-White and Raju Gopalakrishnan)
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