Sri Lanka is spending nearly Rs 6 billion on two major cardiac centres in Anuradhapura and Trincomalee, with Japanese assistance. Eight storeys, catheterisation laboratories, coronary and critical-care units and modern diagnostics are promised. For thousands of heart patients outside the Western Province, however, the real breakthrough is simpler: specialist treatment without having to come to Colombo.
Heart disease does not check your postcode before it strikes. Sri Lanka’s health system, however, has for decades made geography rather important when patients require highly specialised treatment.
Foundation stones were laid on Wednesday for two major cardiac treatment complexes at the Teaching Hospital in Anuradhapura and the District General Hospital in Trincomalee, part of a wider attempt to take sophisticated medical treatment beyond Colombo and the country’s traditional specialist centres.
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Together, the two projects represent an investment approaching Rs 6 billion. The Anuradhapura complex is expected to cost approximately Rs 3.545 billion, while the Trincomalee facility is estimated at Rs 2.403 billion. Both are being developed with loan assistance from the Japan International Cooperation Agency.
Both are planned as eight-storey specialist complexes. The facilities are expected to include coronary-care and critical-care units, catheterisation laboratories, wards, clinics, laboratories, X-ray and ECG services and other facilities necessary for modern cardiac diagnosis and treatment.
The really important number is not billions of rupees. It is kilometres. A patient in Trincomalee requiring sophisticated cardiac investigation should not have to travel across the country merely because the technology and expertise are concentrated elsewhere.
Sri Lanka’s public health system is frequently and rightly praised for providing treatment without charging patients at the point of delivery. But healthcare is never truly free for a patient who must travel hundreds of kilometres to reach it.
Buildings do not perform angiograms. Doctors do. Machines do not repair themselves. Catheterisation laboratories require trained cardiologists, technicians and nurses. Critical-care units require round-the-clock staffing.
The success of these projects therefore cannot be measured when the ribbons are cut. It should be measured several years afterwards: how many patients are being treated, how many procedures are being performed, how long the waiting lists are, whether the machines are functioning and whether the specialists are actually stationed there.
Equality in healthcare cannot simply mean that everyone is theoretically entitled to the same treatment. It must eventually mean that people have a realistic chance of reaching it.
