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Challenges hinder ‘mission’ to ensure safe anaesthesia and critical care for all
View(s):- COAISL gives solutions, while urging the addition of ‘critical care’ to the specialist designation
By Kumudini Hettiarachchi
A “thriving” workforce is essential for optimal patient care and this is why the College of Anaesthesiologists and Intensivists of Sri Lanka (COAISL) has turned its intent focus on them.
Addressing the inauguration of the 41st Annual Academic Congress on the theme ‘Nurturing Resilience Through Workforce Well-being’ on Friday evening, COAISL President Dr. Vinodini Wanigasekera spoke not just about the many challenges faced by her fraternity but how they could be redressed too.
These challenges include a dearth of specialists; the omission of ‘critical care’ from their designation; and the isolation and lack of facilities young specialists have to endure in remote areas.
The head-table (from the left) COAISL President Dr. Vinodini Wanigasekera; Chief Guest Dr. Chris Carey; Guest of Honour Prof. Laurence Weinberg; B.S. Perera Orator Prof. Thamasi Makuloluwa; Congress Chair Dr. Chamila Liyanage; and COAISL Secretary Dr. Anushka Senevirathna . Pix by M.A. Pushpa Kumara
Dr. Wanigasekera said a “significant” gap in specialist anaesthesia services was evident in the Health Ministry’s draft 2025 Transfer List. Of the 180 consultant posts across the country, 60 lacked board-certified (Postgraduate Institute of Medicine – PGIM-certified) specialists. Some of these vacancies – which have arisen due to overseas training and migration – were being covered by senior registrars or acting consultants.
Another disturbing statistic was that 19 ‘B Grade Base Hospitals’ had surgical facilities but no specialist for anaesthesia coverage.
Prof. Laurence Weinberg
Moving onto critical care services, she said that according to January 2024 data, there were nearly 125 Intensive Care Units (ICU) across the country, with anaesthesiologists managing 68% of them. Despite anaesthesiologists providing a major part of critical care services and their specialized training in this area, no ‘official’ recognition has been given to them primarily due to critical care being a separate specialty.
Dr. Vinodini Wanigasekera
“The omission of critical care from our designation highlights a significant discrepancy. Repeated appeals supported by statistics, to both the PGIM and the Health Ministry have been disregarded,” she said.
Ensuring safe anaesthesia and critical care for all people is our mission, reiterated Dr. Wanigasekera, pointing out that a key challenge was expanding the anaesthesia workforce to guarantee accessibility. The Health Ministry, working collaboratively with provincial administrators and professional colleges, should prioritize the development of a robust mechanism with effective retention strategies.
She said: “Retaining newly-qualified acting consultants in peripheral hospitals is crucial, as they represent the future of specialist care. These junior colleagues, often the newest members of our teams, typically holding temporary positions may receive less support from established colleagues and administrators. There are instances that they have been subjected to various forms of harassment. These challenges, combined with economic hardship and the emotional toll of the job, are pushing anaesthesiologists beyond their capacity.
“The COAISL proposes a comprehensive strategy to address this critical challenge. Key components include: prioritizing postings to hospitals based on workload demands, ensuring the effective utilization of the available workforce, providing suitable accommodation and travel incentives, enhancing administrative responsiveness to staff needs and implementing transparent and equitable placement policies. These measures are designed to improve the well-being of anaesthesiologists and ensure their retention within the Sri Lankan healthcare system.”
The COAISL recognized Dr. Mithrajee Premaratne, the first Sri Lankan to be awarded a Fellowship by the European Resuscitation Council for his contribution to resuscitation training.
Dr. Chris Carey
Looking to the future, Dr. Wanigasekera stressed that COAISL remains deeply committed to advancing safe anaesthesia care and the well-being of the anaesthesia workforce, urging that their strength lies in unity. “Let us stand together with ever-growing strength, to reach our shared goal.”
A major contribution of COAISL in the past year has been the “mammoth” undertaking to train healthcare workers under the national initiative, the ‘Oxygen Guideline Project’ implemented by the Health Ministry, UNICEF and professional colleges. The training includes capacity building in oxygen supply, maintenance, handling and usage.
Another has been the groundwork to form the multi-stakeholder National Resuscitation Council for uniform training in cardiopulmonary resuscitation (CPR) across the country, while an important goal had been the establishment of a National In-hospital Cardiac Arrest Registry. With Health Ministry approval, COAISL has funded a pilot project being implemented in several centres.
On a lighter note, there was celebration over COAISL’s grab of the Champion’s Trophy from the earlier undefeated physicians at the heavily defended netball finals.
| Oration and launch of Anaesthesia Handbook The Chief Guest at the inauguration was the Vice President of the Royal College of Anaesthetists, United Kingdom, Dr. Chris Carey, and the Guest of Honour, the Director, Department of Anaesthesia, Austin Health, Australia, Prof. Laurence Weinberg. The B.S. Perera Oration on ‘Mind-Body Interaction in Pain: Implications for Establishing a Futuristic Pain Service for Cancer Patients in Sri Lanka’ was delivered by Prof. Thamasi Makuloluwa. Meanwhile, the Sixth Edition of the Anaesthesia Handbook, considered the ‘Bible of Anaesthesia’ by juniors was also launched on Friday evening.
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