COI Report March 2012 - UK Border Agency - Home Office

SRI LANKA 7 MARCH 2012
―Mrs Gunesekara stated that the needs of kidney patients had increased in Sri Lanka in
recent years. She stated that there were around 250 dialysis machines and only 17
nephrologists in the entire country. There are no reliable statistics on the number of
persons suffering from kidney failure but it is currently estimated that every year a
further 10,000 people are diagnosed. This increase is directly linked to the higher
number of patients diagnosed with chronic diabetes. She said there was also a major
concern that many patients are only indentified with kidney issues at the chronic level,
where both kidneys have failed, and added that it was very rare that a patient was
diagnosed at acute level. Mrs Gunesekera gave the opinion that there are many more
people suffering from the illness who were not even aware.
―The availability of dialysis treatment is extremely limited due mainly to the extreme
demand for limited machines, but also the cost of the treatment and the fact that poor
water pressure over virtually the entire island means that hospitals offering such
treatment are limited to being in Colombo and Kandy. An added cost is the travel to and
from the hospital, given that nearly all of the hospitals offering treatment are in these
areas and a large percentage of the patients live in rural areas. Some poorer patients
without funds are often transported in vans. It was added that people often had a lack of
trust in providing funds to such patients.‖
23.19 The same BHC letter 458 continued:
―Braun & Company and Commercial Syndicate are the only suppliers of dialysis
machines. Each dialysis machine can carry out a maximum of four treatment sessions
per day. Each session lasts for 4 hours. However, because of the lack of new machines
being purchased and poor maintenance they are often limited to three. This does not
include time put aside for maintenance, plus many patients require several dialysis
sessions per week. It is estimated that Sri Lanka requires between 500 and 1000
dialysis machine to cope with demand. Doctors and nurses in Sri Lanka are reluctant to
take up nephrology due to the lack of dialysis machines and other services such as
technicians and maintenance capacities; this has created a shortage of nephrologists to
treat the growing numbers of kidney patients.
―With regard to public sector hospitals providing dialysis treatment we were told that the
main hospitals were the National Hospital in Colombo, the Teaching Hospital Colombo
South, Sri Jayewardenepura General Hospital and Kandy General Hospital. Old dialysis
machines had been donated to the Police Hospital and Badulla Hospital. The problem
with the public sector was that the Sri Lankan government simply could not afford to
increase the number of facilities. Often it is only when organisations such as the KPWS
fund and build units, or provides machines, that the government then allocate funds for
staffing and running costs.‖
23.20 The BHC letter of 30 January 2012 459 added that:
―In the private sector the following Colombo hospitals were specifically mentioned by
Mrs Gunesekera: Navaloka Hospitals, Durdans Hospitals, Asiri Hospitals, Apollo
Hospital and Asha Central Hospital. Costs for a dialysis treatment vary from Rs 6,000 –
10,000 per session (£34-£57), so for a person requiring 3 sessions a week costs could
be as high as Rs 30,000 (£170) per week. The initial dialysis treatment is available in
458 British High Commission (BHC) Colombo, letter dated 30 January 2012
459 British High Commission (BHC) Colombo, letter dated 30 January 2012
178 The main text of this COI Report contains the most up to date publicly available information as at 3 February 2012.
Further brief information on recent events and reports has been provided in the Latest News section
to 2 March 2012.