Life-threatening shortages of medicine and essential equipment 

Children on the brink of starvation due to severe food shortages

‘If we cook lunch, we don’t have dinner, and if we don’t have dinner, then there is nothing for the morning too. Some days we don’t eat at all…’ - Arun 

‘The Sri Lankan authorities and the international community must act quickly to mitigate the widespread human rights cost of [this] crisis, which has cruelly stripped away people’s rights’ - Sanhita Ambast

People in Sri Lanka face little to no access to healthcare while being driven to the brink of starvation, malnutrition and deep poverty, Amnesty International said in a new report today.

The 57-page report - “We are near total breakdown”: Protecting the rights to health, food and social security in Sri Lanka's economic crisis - explores the catastrophic impact of the economic and social crisis on the rights of people in Sri Lanka.

Sanhita Ambast, Amnesty International’s Researcher on Economic, Social and Cultural Rights, said:

“The economic crisis has led to devastating consequences for the people of Sri Lanka.

“For months, the people have been suffering from severe shortages of food and have struggled to access healthcare, while sky-high inflation has exacerbated already existing patterns of inequality. 

“The Sri Lankan authorities and the international community must act quickly to mitigate the widespread human rights cost of this crisis, which has cruelly stripped away people’s rights.

“The international community must offer all possible financial and technical support to Sri Lanka while putting measures in place to protect marginalised groups from disproportionate harm.”

The report details the recovery measures that Sri Lanka’s leaders and the international community must put in place to safeguard human rights in their responses to the situation, such as increasing the amount of international assistance, ensuring comprehensive social protection, and considering all options for debt relief, including debt cancellation.

Between June and September this year, Amnesty conducted interviews with 55 people. They include: people in precarious employment; daily wage workers; those working in the fisheries sector and plantations; people from the Malaiyaha Tamil community, who are likely to be particularly impacted; public health workers; staff members from civil society groups, humanitarian organisations and international NGOs and individual experts.

Dangerous healthcare crisis 

Life-threatening shortages of medicine and essential equipment are major concerns in Sri Lanka as the economic crisis deepens. From shortages of gauze, intravenous antibiotics and insulin to requests to re-use catheters or endotracheal tubes, the last few months have brought shocking challenges to Sri Lanka’s healthcare system.

A healthcare worker told Amnesty: 

“Nurses are drawing blood without gloves. This is dangerous for the nurse and the patient.”

In some cases, people in need of healthcare supplies were advised to purchase medicine or equipment from private pharmacies, because government hospitals had run out of supplies. One doctor told Amnesty: 

“But not everyone could afford it. Those who couldn’t just went home and came back worse.”

Fuel shortages have also rendered transport either unavailable or extremely expensive, making it difficult or impossible for people to access healthcare services, particularly those from the Malaiyaha Tamil community who live and work in plantations that are historically poorly served by essential services.

Padam, a member of the Malaiyaha Tamil community, told Amnesty that he faced difficulties when taking his mother to the nearest hospital which was 15 km away. He said:

“Before the crisis, I used my personal vehicle. Due to the fuel shortage, this became more challenging. If we use public transport, it is fully crowded nowadays and people like my mother cannot travel in the public transport because she [is] very old. Tickets [prices] also increased massively... If we have fever, we are not able to see a doctor. We are using a Panadol [acetaminophen] for our illness.”

Fuel shortages have also impacted health workers and ambulances. A doctor told Amnesty:

“People can’t come into work because they are stuck in fuel lines... I have seen ambulances parked in front of fuel stations for hours for fuel.”

Food poverty 

Rising prices driven by inflation and reduced household income mean people are increasingly unable to meet their basic food needs.

Several interviewees raised concerns over their children not having enough to eat. Aruni, who has three children, said: 

“If we cook lunch, we don’t have dinner, and if we don’t have dinner, then there is nothing for the morning too. Some days we don’t eat at all…”

Staff members of civil society organisations told Amnesty that the amount of funding from the government for school meals is no longer enough to buy food for every child.

Savita, a 39-year-old Malaiyaha Tamil woman who works in a tea estate told Amnesty:

“Last month we were without any meal for two days because we didn’t have anything to cook… my children cannot understand the problems… When they feel hungry, they ask for meals, and sometimes they cry for meals.”

Prioritisation of human rights urgently needed

The Government of Sri Lanka, donor countries, and international financial institutions are in the process of putting programs and economic reforms in place to address the economic crisis. 

Amnesty is calling on these bodies to ensure that they meet their obligations under international human rights law by safeguarding the rights to health and adequate food in all aid agreements. The government of Sri Lanka and international financial institutions must also conduct human rights impact assessments before implementing economic reforms - it remains unclear as to whether these have been or will be conducted.

The Sri Lankan authorities are also currently in discussions with creditors on restructuring the country’s debt. All options for debt relief should be considered, including debt cancellation, which would allow the Government to increase public investment in crucial healthcare and social protection systems.

Any debt relief agreements must not undermine Sri Lanka’s ability to meet its human rights obligations. Reforms of social protection systems, meanwhile, must be carried out transparently and with meaningful participation of those who will be affected by the changes. The Government should also explore all options for accessing the maximum available resources to fulfil human rights obligations, including through implementing progressive, redistributive tax reform.

Root of the economic crisis 

Sri Lanka’s economic crisis has its roots not only in government policies over several decades, but also the Covid-19 pandemic, which seriously affected the country’s economy by stripping away vital sources of tourism-related income, while payments from overseas workers also dropped.

In March this year, the Government ran out of foreign currency, which it needed to import essential items like fuel and medicine. This contributed to rising rates of inflation, price hikes on essential goods, rationing of electricity supplies, and long queues for fuel. In May this year, Sri Lanka defaulted on its debt repayments for the first time.

As the situation worsened, thousands of protesters took to the streets, calling for the Government to take responsibility for the crisis. Instead, the Sri Lankan authorities responded harshly to demonstrators, inflicting serious human rights violations previously documented by Amnesty International.

*All names changed to protect individuals’ identities.