News
Heart trouble for Lanka’s children with doctor exodus
View(s):By Kumudini Hettiarachchi
The children of Sri Lanka are in trouble. The statistics with regard to the brain drain from niche paediatric specialties are chilling.
Taking the specialty of Paediatric Cardiology, the Sunday Times found that the projected cadre requirement for 2024/2025 (the next two years) is 18.
But the ground situation right now is that in August 2023, Sri Lanka has only 4 Paediatric Cardiologists.
An analysis of the dire situation in Sri Lanka has found that: 
Of 4 Paediatric Cardiologists [board-certified by the Postgraduate Institute of Medicine (PGIM)] –
- The premier child health centre which is the Lady Ridgeway Hospital (LRH) for Children, Colombo, which should be a 5-man station has only – 2 while 3 have joined the brain drain
- The Sirimavo Bandaranaike Children’s Hospital, Peradeniya, which should be a 2-man station has only – 1 left while 1 has joined the brain drain
- The Kurunegala Teaching Hospital has – 1 (with this Consultant also going up to Peradeniya to help with the workload there)
- The Karapitiya Teaching Hospital, Galle, which should be a 2-man station has – none, as they have joined the brain drain Paediatric Cardiologists who have completed both their local and foreign training and are awaiting board-certification –
- The Jaffna Teaching Hospital – 1 (in an ‘Acting’ capacity)
Paediatric Cardiologists who have completed their local training and are awaiting their foreign training, even though there had been 6 –
- LRH, Colombo – 2
- Ratnapura Teaching Hospital – none
- Anuradhapura & Batticaloa Teaching Hospitals and Badulla Hospital – 3 on the verge of leaving
- Karapitiya Hospital – 1
Paediatric Cardiologists who are currently undergoing foreign training –
- 2 who are unlikely to return, many predict
When taking the spread of Paediatric Cardiologists across the country to diagnose and manage the heart troubles of little ones on a province-by-province basis, the gravity hits home further.
- Western Province – just 2 where there should be 5
- Central Province – just 1 where there should be 2
- Southern Province – none when there should have been 2
- Uva Province – none where there should be 1
- Sabaragamuwa Province – none where there should be 1
- North Central Province – none where there should be 1
- North Western Province – 1
- Eastern Province – none where there should be 1
- Northern Province – none where there should be 1
(Please see the graphic for other paediatric specialties.)
Meanwhile, the likely retirement of medical specialists at 60 years, some say is the other side of the same coin which would aggravate the dearth of specialists.
They questioned whether the issue raised by the Association of Medical Specialists (AMS) then under the leadership of President Dr. LakKumar Fernando in September 2022, was an early warning of the imminent danger to the state health sector.
Taking up cudgels over the proposed ‘en bloc’ retirement of a large number of medical specialists (around 300) in a single day, Dr. Fernando had pointed out the severe fallout of such a move a year ago.
He had predicted then that there were only 33 Transfusion Specialists in the country and 8 would retire with the proposed rule, while 2 had already retired, 5 had migrated and 4 were in the process of leaving the country. This would bring down the number to only 14.
“Even before this, the waiting list for bone marrow transplantation at the Maharagama Cancer Hospital was extending to 2025 and one can imagine the effect of further prolonging the waiting time. Many patients would die while waiting,” he had pointed out.
With regard to Histopathologists needing to report on biopsies, Dr. Fernando had explained that the country needs at least 80 but had only 60. While 5 had been on overseas leave, 10 others were in the process of migrating and 5 were to retire if the new rule was implemented. The dearth would increase the waiting time for biopsy reporting and impact the outcome of patients with conditions like cancer.
He also analysed the data about the number of consultants retiring from major institutions if the new rule was made effective – 43 from the National Hospital of Sri Lanka (NHSL), Colombo; 30 from the Kandy National Hospital; 17 from the Karapitiya Teaching Hospital; 15 from the LRH, Colombo; and 9 from the Maharagama Cancer Hospital. This year it would be more.
Looking at a hidden angle, the then AMS President had also stressed that the potential retirement of experienced senior consultants from teaching hospitals suddenly in large numbers would place in jeopardy, the medical training programmes and post-graduate examinations. These major hospitals would have new consultants who may not be eligibleto train the trainees due to PGIM requirements and this would have an adverse impact.
This is why the en bloc retirement of medical specialists would have a “huge” impact on the maintenance of health
services, Dr. Fernando still maintains.
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