In Sri Lanka, the infiltration of “quacks” who practice medicine illegally without proper medical education or recognition from the Sri Lanka Medical Council (SLMC) has now become a serious danger. These unqualified people, operating widely across the country, pose a huge threat to innocent lives. Many die without proper treatment, while many others suffer long-term physical complications.
The key points raised are on the reasons behind this problem, the damage to the health services, and the immediate actions that the Health Ministry has to take on controlling.
Who are quacks?
The SLMC is the Statutory Body that registers qualified doctors in Sri Lanka. All doctors practicing Western medicine must register with it. Those who practice Western medicine without such registration are identified as quacks. Even if they have completed a medical degree, they cannot serve without SLMC registration.
Meanwhile, Ayurveda, Unani and indigenous medical graduates (Bachelor of Unani Medicine and Surgery/Bachelor of Ayurvedic Medicine and Surgery) registered with the SLMC may provide only services within their purview. They cannot provide Western medical treatment.
Infiltration of quacks and the reasons
Most of the quacks are personnel who have worked for a long period as assistants to a doctor, as medicine packers, or in pharmacies. When the doctor leaves the area due to some reason, they begin issuing medicines on their own, using his name and reputation.
Main factors paving the way for their infiltration
They easily take root in rural areas and areas where small communities live without adequate pharmacies and hospital facilities. It is very rare for the public to question doctors about their qualifications or experience. These people misuse the trust and respect that people have on doctors. Such persons operate even in areas near Police stations and Courts in Colombo.
Their illegal activities continue because of a lack of proper monitoring by the Ministry, the SLMC, the National Medicines Regulatory Authority (NMRA), the Medical Officer of Health (MOH) Divisions, the Provincial Director of Health Services (PDHS) offices and the Police. Doctors registered with the SLMC must renew their registration every five years. Those serving with expired registration are also considered as quacks under the law.
Nurses, hospital staff and pharmacy workers give medicines that they know of without a doctor’s prescription when people describe their symptoms. Such serious incidents are also common in the country.
How to identify genuine doctors?
The public can confirm genuine doctors in Sri Lanka in the following ways: Every doctor registered with the SLMC is given a unique registration number. Doctors in the Government service or private practice must display that registration number and their educational qualifications on their name board.; and the public can directly verify registered genuine doctors by visiting the SLMC’s official website.
Dominance of quacks in the private sector
Since all educational and professional qualifications are strictly checked before Government recruitment, quacks cannot work in Government hospitals. Therefore, such illegal activities are seen more in the private sector.
Although a Government institution called the Private Health Services Regulatory Council exists to monitor private health services, quacks also register themselves there and serve without hindrance in private hospitals and pharmacies. Because this Institution is not properly managed, Government doctors and general practitioners are not interested in registering with it.
In cosmetology too, the number of quacks is rising significantly and without any
qualification or training, they advertise themselves through social media and provide dangerous treatments.
According to the available data, more than 40,000 quacks are operating in the country, on average. Accurate official data on this can be collected only with the help of the Police and Military Intelligence.
Warning and accountability placed before the Govt
The Government Medical Officers’ Association (GMOA) pointed out this issue to the responsible officials, including the Ministry, many years ago. In the current Government, although President Anura Kumara Dissanayake, the Health Minister (Dr Walakada Appuhamilage Nalinda Wajiramal Jayatissa), the Ministry Secretary (Dr Anil Jasinghe), the Director-General of Health Services (Dr Asela Gunawardena) and the Inspector General of Police (attorney Weerasooriya Liyanaarachchige Saman Priyantha Weerasooriya) were informed by letter, no action has been taken so far.
Under the Penal Code (Sections 399–405), there are legal procedures to punish illegal medical practices. The Police, the NMRA, MOHs and Ministry investigation units can act together to take a necessary action.
There is a risk that an allergy caused by an unqualified doctor giving the wrong medicine could affect a family or even a Province. Officials who fail to act despite prior warnings will have to face accountability before the law, as after the Easter Sunday attacks. This negligent attitude of officials is a criminal act.
Dangers caused by fake doctors and current harm
Rather than calling them “fake doctors”, “illegal medical practitioners” is more appropriate. They see medicine not as a service but as a business.
Severity of dengue fever
During the peak of dengue in recent months, it was found that patients suffered more due to side effects of medicines given by such illegal medical practitioners.
Deaths and serious illnesses
Deaths have been recorded due to wrong treatments, and dangers such as illness worsening in children and unidentified new physical complications are also emerging.
Affected areas
Their presence is seen more in areas under the Colombo Municipal Council, especially among certain communities, and at the District level in Batticaloa, Mannar and plantation areas.
Illegal medicines
Because they give expired and illegal medicines, side effects appear only after a long time. This also creates problems for the affected party in taking legal action.
Spread of ringworm (Tinea)
The main reason why ringworm, widely seen in the Colombo District, cannot be controlled is that pharmacies directly give high-end medicines without a qualified doctor’s prescription.
The GMOA is currently preparing a comprehensive plan to control such illegal medical practices. Once the proposal is ready, it will be officially handed over to the Ministry.
The writer is an Executive Committee Member of the GMOA
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The views and opinions expressed in this column are those of the writer, and do not necessarily reflect those of this publication