How Economic and Political crisis of Sri
Lanka effects Health Care system
W.M.H.R. Weerasingha
EU/IS/2019/NUR/13
Nur438
What is Health,
State of complete physical, mental and social well-being and not
merely the absence of disease or infirmity. (WHO)
What is Economic Crisis,
A situation in which the economy of a country passes through a
sudden decrease of its force, decrease usually brought about by a
fiscal crisis.
What is Political Crisis,
A constitutional crisis is a problem or conflict in the function of a
government that the political constitution or other fundamental
governing law is perceived to be unable to resolve.
What is Sri Lankan Economic and political
crisis,
The government blamed the Covid pandemic, which severely affected
Sri Lanka's tourist trade because it is the main foreign currency earner
in Sri Lanka. And also, tourists were frightened because of deadly
bomb attacks in 2019 so this effect the tourism very badly.
However, many people blame President Rajapaksa's poor economic
mismanagement that leads to this crisis. Mr. Rajapaksa was also
criticized for big tax cuts he introduced in 2019, which lost the
government income of more than $1.4billion USD a year.
At the end of its civil war in 2009, Sri Lanka chose to focus on
providing goods to its domestic market, by importing goods from
other countries instead of focus on foreign trade. But when this going
on income from exports to other countries remained low, while the
bill for imports kept growing.
Sri Lanka now expend $3billion USD on imports more than it exports
every year, and that is why it has run out of foreign currency. At the
end of 2019, Sri Lanka had $7.6billion USD in foreign currency
reserves, which have dropped to around $250million USD.
Because of those expenses now Sri Lanka faces an unsustainable debt
and severe balance of payments crisis, which is having a negative
impact on growth and poverty. According to South Asia Economic
Focus and the Sri Lanka Development Update, Sri Lanka’s GDP
(Gross Domestic Product) will expected to fall by 9.2% in 2022 and a
further 4.2% in 2023.
Sri Lanka lost access to international financial markets in 2020
because credit rating downgrades. Without market access, Sri Lanka
continued to pay external debt and pay for imports using official
reserves and loans from the banking sector.
So, because of these action official reserves dropped from $7.6 billion
USD in 2019 to less than $400 million USD in June 2022. Net foreign
assets in the banking system also fell in June 2022. This severe forex
liquidity constraint has been affecting the whole economy,
particularly from the second quarter of 2022. And with shortages of
fuel, medicines, cooking gas, and inputs needed for economic activity.
First time since independence Sri Lanka announced an external debt
service suspension in April 2022.
Poverty will be increased in 2022 due to the contraction in the
economy. Poorer households are hardest hit.
How does this crisis affect the Health
System in Sri Lanka,
There is a life-threatening shortage of medicine and essential
equipment in Sri Lanka. Children are on the brink of starvation
Because of severe food shortages. And also, people in Sri Lanka face
a crisis of healthcare.
Health Care workers told that,
“Nurses are drawing blood without gloves. This is dangerous for the
nurse and the patient.”
So, this is a serious situation that affect most of human lives.
In some cases, people in need purchase medicine or equipment from
private pharmacies, because government hospitals had run out of
supplies even though Sri Lanka have free Health Care service. Other
main one is fuel shortages have also made transport unavailable or
expensive, so people are unable to go to a health care center because
of this.
So mainly these are,
 Reduced essential medication storage
Sri Lanka relies on imports for about 85% of its pharmaceutical needs
and about 80% of its medical supplies. The country imported $815
million USD in medicine in 2021, but by May had only about $25
million USD in foreign reserves to pay any kind of import. With the
country’s foreign reserves depleted, the nationalized healthcare
system cannot afford to import medicine and medical supplies.
So, with these effects,
“The 3,500 bed National Hospital of Sri Lanka in Columbo, which
usually has 1,300 medicines in stock, is now down to requesting only
the 60 most essential medicines.”
With anesthesia in low supply, most general surgeries in the country
have been cancelled. Cancer patients have lost access to medications.
Even diabetes patients must secure and bring their own glucose
meters for check CBS. Many hospital stocks are out of basic items
like bandages and cotton balls. So, this leads to closing rural clinics
and accessing people's medication.
 Food poverty
A recent study conducted by the Medical Research Institute (MRI) in
collaboration with the WHO and UNICEF, on the “Gaps in energy
and nutrient consumption at household level” showed that one 1/3 of
children under five surveyed have at least one nutrition problem in Sri
Lanka. Rising prices driven by inflation and low income increase
inability to meet their basic food needs. With the country’s foreign
reserves depleted system cannot afford to import food even essential
to people basic needs.

Problem to access
Due to a severe fuel shortage and the price people are unable to access
medical centers. And with the poor transportation ability the
nutritional problem and supply of medication to storages are
problematic.
 Expensive of Medications
All drugs are available in multiple brands and varying prices, which
now price gone up 30%. Unfortunately, that many pharmacies tend to
stock only the more expensive brands that bring them more profit. All
because there are no quality control data to show that a more
expensive brand is more effective than an inexpensive one. Low-cost,
yet effective generic products are available but common people do not
have any idea about that.
 Psychosocial Problems
COVID-19, and now the ongoing economic crisis, are having a
serious impact on mental well-being. The psychological impact of
COVID-19 amongst separate levels of society, children, pregnant
women and healthcare workers are high. There is also an increased
incidence of domestic violence and child abuse.
And also,
Sri Lanka is also losing clinicians as they migrate to other countries
with more opportunities and more well life hood.
What can we do,
Specially in the health sector strengthening primary care would be
essential. By getting help from foreign countries and humanitarian
organizations to solve this economic crisis and talk all the parties
coming to one stage and getting into a convention.
And also, people will find hard to travel to secondary care institutions
due to the rising cost of transport,
So, making sure that the primary care institutions, both preventive and
curative, are well-staffed and provided with adequate supplies, will
reduce the negative impact of the economic crisis.
And also educate common people what is the state of the country and
how do we want to get up and get into a common ground to face this
crisis and how to get over this crisis.
 Creating a social support network to the most
vulnerable groups
Setting up food banks in most needed areas like urban low-income
settlements, where the nutritional indicators show low standards. This
can be done with the support of individual donors, community-based
organizations (CBOs) and non-governmental organizations (NGOs)
and the private sector.
 Establishing community kitchens
Establishing community kitchens attached to pre-schools and schools
to provide a nutritious and balanced meal to under 5-year-old children
and younger students in the area.

Providing Psycho-social support
It is essential to psychosocial support systems including 24-hour help
line to respond to those who needs help. And the individuals and
families who are facing serious mental health problems and domestic
violence including gender-based violence (GBV) and violence against
children.
References
 https://www.bbc.com/news/world-61028138?zephr-modalregister
 https://www.worldbank.org/en/country/srilanka/overview
 https://www.amnesty.org.uk/press-releases/sri-lanka-economiccrisis-has-had-devastating-consequences-healthcare-andfood#:~:text=High%20contrast%20Default,Sri%20Lanka%3A%20Economic%20crisis%20has%20had%20
'devastating%20consequences'%20on,and%20food%20supplies
%20%2D%20new%20report&text=People%20in%20Sri%20La
nka%20face,in%20a%20new%20report%20today.
 https://reliefweb.int/report/sri-lanka/22-million-sri-lankans-losetheir-access-medicine
 News Letter Magazine April 2022
 THB
 Health Care Workers