As soon as thought of top-of-the-line within the area, Sri Lanka’s healthcare system is ailing, laid low by the exodus of tons of of medical doctors and, with sufferers left languishing, consultants are calling on the federal government to behave to cease the lack of expertise.
Greater than 1,700 medical officers – an umbrella time period for medical doctors and different healthcare professionals –have left Sri Lanka over the previous two years, in response to the Authorities Medical Officers’ Affiliation commerce union, which shared information solely with Context.
This compares to the departure of round 200 medical doctors and different well being staff in 2021. The most recent exodus has dealt a heavy blow to the island nation’s much-praised common well being system on which most of its 22 million folks rely.
“It is extremely unhappy to see the shortage of medical doctors. The little assist we had is slipping away,” mentioned Srimal Nalaka, 47, who had been ready for six hours for his month-to-month diabetes checkup at a state-run hospital south of the business capital Colombo.
“The financial disaster has hit us all, however for these of us with well being points the influence is much more extreme,” mentioned Nalaka, who has a diabetic ulcer on his proper leg.
The worst could also be but to return.
A well being ministry report, additionally shared solely with Context, confirmed that 4,284 medical doctors obtained “Good Standing” certificates – thought of necessary to confirm a person’s skilled standing to international regulators – from the Medical Council between June 2022 and July 2023, indicating that they too are fascinated with leaving.
The identical report additionally revealed that greater than 5,000 medical doctors had acquired medical licences from Britain, Australia and international locations within the Center East, and an analogous quantity have reserved slots for international licensing exams this yr and in 2025.
Greater than two million Sri Lankans have left the nation to work or examine overseas since 2022, when the nation defaulted on its debt and sank into its worst monetary disaster in additional than seven many years.
And whereas the economic system is clawing its means again in the direction of restoration, the healthcare system continues to be poorly, with ever-longer ready lists and an absence of entry to high quality remedy and medicines in a rustic with 1.2 medical doctors per 1,000 folks, in response to World Financial institution information from 2021.
Chamil Wijesinghe, a Authorities Medical Officers’ Affiliation spokesperson, mentioned hospitals had been already severely strained earlier than the monetary disaster.
“We’re urging the president and the federal government to take higher accountability for the lives of harmless residents. Pressing measures and insurance policies are wanted to retain the prevailing medical doctors,” mentioned Wijesinghe.
“However the authorities is comatose.”
The federal well being ministry didn’t reply to requests for touch upon the issues raised by the Authorities Medical Officers’ Affiliation.
No cash, no remedy
President Ranil Wickremesinghe has already put ahead the concept of in search of compensation from the international locations that recruit Sri Lankan medical doctors. Final August, he requested the federal government to boost the difficulty with the World Well being Group.
When requested about progress on the president’s request, Palitha Mahipala, the secretary to the ministry of well being, mentioned the difficulty needed to be dealt with with cautious consideration and diplomacy.
Final yr, Wickremesinghe additionally reversed an earlier order that lowered the retirement age of public staff, together with medical doctors, from 65 to 60 to ease workers shortages. And in January, the cupboard authorised his proposal to double the Disturbance, Availability & Transport allowance for medical doctors.
This motion, nonetheless, triggered a strike in February after commerce unions unsuccessfully lobbied for the allowance to be prolonged to different healthcare staff as properly.
The problem of maintaining proficient, expensively skilled medical professionals at dwelling will not be distinctive to Sri Lanka. In lots of African international locations, notably Nigeria and Zimbabwe, poor pay and troublesome working circumstances have pushed medical doctors and nurses to hunt employment overseas.
Zimbabwe’s Vice President Constantino Chiwenga has even introduced plans to criminalise the international recruitment of well being workers, and says it’s incorrect that Zimbabwe spends huge sums coaching well being staff just for them to be poached by richer international locations.
In Sri Lanka, the place medical research are publicly funded, it takes seven years to turn into a medical officer and as much as 15 years to coach as a specialist physician.
Wijesinghe of the Authorities Medical Officers’ Affiliation mentioned the authorities must make it extra engaging for medical doctors to remain. The Authorities Medical Officers’ Affiliation offered an eight-point proposal to the president final October, with the important thing give attention to enhancing salaries, advantages, incentives, and amenities for medical doctors.
Within the meantime, low-income households are struggling most as a result of they can not afford personal care or more and more costly medicines.
For RS Siva, a 72-year-old retired engineer, the shortage of specialist medical doctors at a authorities hospital meant he needed to dip into his financial savings to pay for personal care to have an operation on a small bowel obstruction.
“If I had no financial savings for a medical emergency like this, I would not be alive at the moment,” he mentioned.
“The every day fee for the personal room was 100,000 rupees ($319), and the physician charged 500,000 rupees ($1,596) for the surgical procedure alone,” he mentioned as he recovered at dwelling.
Lengthy-term results
For a lot of Sri Lankans, these prices are prohibitive, leaving them depending on the general public sector, which gives almost 95% of in-patient care and about 50% of out-patient care.
Other than the rapid results on staffing at hospitals, the mind drain may also hit training.
Medical consultants warn that with extra expert healthcare staff flying out, there might be important gaps in mentoring and coaching medical college students.
A well being ministry panel, which compiled the report on these leaving, discovered that fewer medical doctors had been participating in choice examinations for postgraduate coaching, that means there can be fewer consultants sooner or later.
It added {that a} “appreciable quantity” of medical doctors, who had initially enrolled in post-graduate coaching programmes, had dropped out of their programs.
Sirimal Abeyratne, the pinnacle of the division of economics on the College of Colombo, mentioned there was no fast repair to the mind drain and its disproportionate results on the poorest.
“No in a single day coverage modifications can clear up this problem. In Sri Lanka, the exit door is open, however our entrance is closed. Our labour market will not be open to international expertise,” he mentioned.
Nalaka, who runs a small grocery retailer, mentioned medical doctors ought to give their nation a second likelihood.
“I’ve to decide on between placing meals on the desk and shopping for insulin,” he mentioned. “We want options that maintain our medical doctors right here, caring for us at dwelling.”
This article first appeared on Context, powered by the Thomson Reuters Basis.