Sri Lanka’s remarkable healthcare services did not flourish overnight

Our public health midwives travel long distances to deliver health advise to expectant mothers and parents

It is very important to re-establish the trust our patients had on the health system. Encouraging them to seek medical attention, as before is crucial

The number of deaths in Sri Lanka due to coronary artery/ heart disease back in 2017 was 28,554. More than 118,000 of our patients died in 2016 due to non-communicable diseases. It was 83 per cent out of all documented deaths in Sri Lanka. The fact that non-communicable diseases are the leading cause of mortality worldwide is no secret. COVID-19 has completely disrupted the excellent “Health seeking behaviour” we had a few weeks ago.

The number of deaths due to non-accessibility of essential health requirements or drugs is hardly discussed in media these days. Home-bound deaths will become a norm unless we launch a large-scale initiative to medicate patients, who are drug dependent. 

It has been described in certain research papers that a “Second wave of deaths due to resource restriction in non-COVID conditions” will be of a larger magnitude than the virus itself. The “Third wave of morbidities due to disrupted care in long term conditions” will follow this second wave

It has been described in certain research papers that a “Second wave of deaths due to resource restriction in non-COVID conditions” will be of a larger magnitude than the virus itself. The “Third wave of morbidities due to disrupted care in long term conditions” will follow this second wave. Only a few countries have launched proper mechanisms to counteract these deaths. 

I practice rheumatology and rehabilitation in a rural setting. Although arthritis does not cause mortality, it creates devastating disability.  A large proportion of our patients have various other illnesses like diabetes, high blood pressure, asthma and heart disease. Even though my patients are rural folk, we had an excellent health-seeking behaviour. There were many reasons for this. 

Sri Lanka boasts of a good road network, one of the cheapest public transport systems in Asia, an outstanding rural hospital network and dedicated health care staff at grassroots level. Our public health midwives travel long distances to deliver health advise to expectant mothers and parents. The free health care system delivers to patients of all social classes while medical consultants who come back after foreign training with a wealth of experience pass on the benefit of modern medicinal practices to these rural patients and our neonatal death rate, maternal death rate at birth of a child or our immunisation schedule is of world class standard. 

The Ministry of Health has launched a reliable drug delivery system through the department of posts. Assisting in the continuation of essential life-saving drugs is the main aim of this programme

Sri Lanka’s remarkable healthcare services did not flourish overnight. This system from its slow start since the launch of the Malaria eradication campaign back in 1911, became stabilised over a course of a few decades. Patients’ perspective and faith in western medicine also proved to be a significant supportive factor. 

The preventive campaigns of COVID-19 rely heavily on social distancing and a stay-at-home campaign. It’s of paramount importance that we adhere to these safety campaigns to curb the virus once and for all. But do we have to ultimately pay the price through the second wave of non-COVID related deaths is a question that remains unanswered worldwide. 

The ministry of health has launched a reliable drug delivery system through the department of posts. Assisting in the continuation of essential life-saving drugs is the main aim of this programme. I propose that we swiftly move forward from this initiative to counteract the second wave of deaths. It is very important to re-establish the trust our patients had on the health system. Encouraging them to seek medical attention, as before is crucial. The hospital setup which was deemed taboo because of infection risk should be modified to welcome non-COVID-19 patients. Patient cooperation and honesty are also salient factors in this scheme of treatment. Utilising our public transportation system to safely escort non-COVID patients for a nominal fee will also work wonders. 

Repeating the same medication for months does not align with correct medical practices. The drug doses need constant adjustments. With adequate protective gear the doctor should meet the patient as before. I sincerely hope that the right course of action is taken immediately to prevent the “Second wave of deaths” which will otherwise cause an immense economic and grief response like never before.