Fuel crisis: Health sector on the brink of a standstill

• Rural hospitals worse off, particularly Anuradhapura and Polonnaruwa
• Medical staff including specialists unable to get to hospitals
• Fuel supply mechanism and quota for health sector inadequate
• Routine surgeries have been postponed

By Maheesha Mudugamuwa The ongoing fuel scarcity has threatened the smooth functioning of hospitals around the country as health services struggle to respond to medical emergencies due to the lack of transportation for the health staff. The worst affected are the hospitals in rural areas, where public transportation is either very limited or is not functioning due to fuel scarcity. Speaking to The Sunday Morning, All Ceylon Nurses’ Union (ACNU) President S.B. Mediwatte stressed that specialists were travelling by bus to the National Hospital of Sri Lanka (NHSL) situated in the heart of Colombo. “Some staff members travel by bicycle. Some find it difficult to come to work. The services at NHSL are severely affected by the ongoing fuel shortage. We have to work with very limited staff and some specialists find it difficult to come to the hospital even for emergencies,” he stressed. Rural areas hit hardest Mediwatte, elaborating on the situation in rural areas at present, said as per the information he had received from union members around the country, a number of hospitals were either scaling down operations or were about to do so due to the fuel shortage. “In the past several weeks, the hospital staff has been severely affected by the fuel shortage. Some are staying in long queues for days. This has affected the hospital functions too,” he shared. According to Mediwatte, almost all hospitals in the country have been affected by the ongoing fuel shortage. “The situation is worse in rural areas. We were informed that the hospitals in Polonnaruwa and Anuradhapura are severely affected. In some areas, health workers are facing threats from elephants too. In Colombo some people can be seen cycling to offices, but in rural areas this is not an option. In some areas only emergency services are in operation at present,” he added. Fuel woes Meanwhile, demonstrations have been conducted by the staff of some hospitals demanding adequate fuel for hospital staff. The country is currently experiencing its worst economic crisis since independence mainly due to the shortage of foreign exchange. As a result, imports have been affected and fuel is among the essential imports that are severely affected by the current crisis.  The country’s fuel supply has been limited since May, but in recent weeks the shortage has aggravated. At the end of last month, the Government announced that the country had very limited fuel stocks and reserved supplies for essential services such as public transport and the health sector, restricting it for others. Speaking to The Sunday Morning, Government Medical Officers’ Association (GMOA) Secretary Dr. Haritha Aluthge stressed that hospitals had been badly affected by the ongoing fuel shortage and even though the health sector had been declared an essential service and allocated several depots, there was no central level prioritisation given to the sector. “The daily fuel allocation has been somewhat successful in some areas, but it did not function well in most areas. There was vehement opposition from the public too and at the same time only around 80 depots were allocated for the health sector out of the total of around 1,200 owned by the Ceylon Petroleum Corporation (CPC),” Dr. Aluthage said, adding that there had been numerous practical difficulties faced by health sector staff in obtaining the essential service fuel allocation. “There are instances where some doctors have to travel around 80 km up and down to get fuel for their vehicles. Also, the allocated quota is not adequate for some hospitals,” he explained. Further elaborating on the fuel distribution for the health sector, Dr. Aluthge stressed that the medical staff had been given admirable support from the Army but there were a few issues relating to the conduct of the Police. “We have already written to the IGP too,” he said.      The fuel shortage has forced a number of hospitals to limit services for emergencies and routine surgeries too have been postponed to manage staff shortages. Minister’s stance Meanwhile, when contacted by The Sunday Morning, Health Minister Keheliya Rambukwella acknowledged the demands of the health workers that the health sector should be given the priority when distributing fuel so as to continue the health services without any hindrance. “I have been discussing this matter with Power and Energy Minister Kanchana Wijesekera. I feel that the health sector has to be given the priority. There are many sectors that are asking for priority. We had a programme every Friday with 100 stations dedicated for health staff, but during the last few days I feel that it has not taken place and people were not cooperative with the health staff. Some organised groups tried to disrupt that programme. On Monday, I’ll try to find a way out. I feel that the health sector should function without any kind of hindrances,” he said. Pharma shortages easing The medical drug shortage that prevailed in the country two weeks ago has now improved following foreign donations and at present there are no serious shortages. In response to the pleas made by doctors, Sri Lanka has received considerable stocks of essential life-saving drugs and other essential medicines as donations, but around 50% of the essential drugs are still in short supply. Explaining the current drug shortage, Dr. Haritha Aluthge stressed that all life-saving drugs were currently available in the country but out of around 122 essential drugs, some 50% were in short supply. “We haven’t reached out-of-stock margins. The situation that prevailed two weeks ago has now improved due to foreign donations, but we can’t always rely only on donations,” he stressed. According to Dr. Aluthge, even though the country received essential drugs as donations, the distribution has been severely affected by the ongoing fuel shortage. “Drug distribution too was affected by the fuel shortage. We suggested using trains and ambulances coming from distant areas to distribute these drugs,” he added. All-Island Private Pharmacy Owners’ Association (AIPPOA) President Chandika Gankanda said that the shortages had now improved as the stocks were returning to pharmacies. “The situation that prevailed a few months ago has now improved and we don’t see a severe shortage. Drugs are coming to the market following the price revision. After the last revision months ago, the prices were not revised,” Gankanda said. Earlier the association stressed that around 20-25% of drugs were out of stock. Mainly paediatric antibiotics and other syrups as well as drugs used to treat hypothyroidism were out of stock. Commenting on the current drug situation in the country, Health Minister Keheliya Rambukwella told The Sunday Morning that even though there were issues with regard to the availability of certain drugs, the situation was still manageable. “If one drug is not available in a hospital, they come out and say ‘we don’t have drugs’. There is an issue, but it is still manageable. Even if we don’t have a certain drug at one place and it’s available at another place, we can share it. Earlier we had excess stocks in all hospitals, but now we don’t have any. What happens is when a doctor in a hospital finds that his prescription has not been taken, then he says drugs are not available in the country, but that’s not the case,” Rambukwella said.