Sri Lanka

The island country of Sri Lanka is located off the south coast of India. Known as Ceylon, it was occupied by the Dutch from the seventeenth century, and then by the British who held it until independence on February 4, 1948, In 1972 the country changed its name to Sri Lanka. It has a population of 20,743,000 (2005), and a effective healthcare system in much of the country, with 37 doctors and 103 nurses per 100,000 people.

The remains of the oldest known hospital in the world is located at Mihintale, near the city of Anuradhapura, in Sri Lanka. It was developed by King Pandukabhaya in the 4th century b.c.e., and archaeologists believe that it was the first purpose-built medical facility where people suffering from different ailments were treated in separate areas with other people with similar illnesses. The Dutch established some small hospitals for Europeans, and the British built the General Civil Hospital, the Lady Havelock Hospital and the Eye Hospital in Colombo, the capital, and other treatment centers in other cities. There were also dentists and doctors who operated at the Bristol and the Grand Oriental Hotels. At the same time, many Sri Lankans continued to use ayurveda (“traditional medicine”) using the theory [Page 1606]of the “three humors” which has the human body made up or air, fire (bile) and water (phlegm). This assumed that problems were related to an imbalance between these humors.

In 1870 the Colombo Medical School was established, making it the second oldest medical school in South Asia. It was later amalgamated with University College in Colombo to form the Faculty of Medicine at the University of Ceylon, now the University of Colombo. The Medical Research Institute in Colombo was established in 1900, and one of the major problems on the island was malaria, which still presents a problem in isolated parts of Sri Lanka. There were also medical problems with tuberculosis, typhoid and cholera. There has also been a long problem of oral cancer through the high incidence of chewing betel nut by men in the country.

After independence, the healthcare in the country considerably improved. The crude death rate which had been 19 per 1,000 in 1871 fell to 13 per 1,000 at independence, and was 6 per 1,000 by the early 1980s. There was also free state medical care provided for all people in the country, and the government operated health clinics in villages offering both European medical treatment and also traditional medicine. The main hospital in Colombo was renamed the National Hospital of Sri Lanka, and the nearby hospitals, the De Zoysa Maternity Hospital and the Lady Ridgeway Hospital for Children were both enlarged and connected to the University of Colombo. There are also Faculties of Medicine at the University of Jaffna, the University of Peradeniya, and the University of Ruhuna, at Matara.

The war in Sri Lanka during the 1980s and 1990s resulted in large numbers of deaths, in a breakdown in the infrastructure in parts of the country, especially the Tamil-dominated north. The result was a blockade on trading with the north, which developed a severe shortage of medical supplies. The gradual lessening of the fighting has allowed medical care to be provided to many more people, and the money which had been devoted to the fighting to be used to improve sanitation and hygiene.

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