Country Policy and Information Note Sri Lanka: Medical treatment and healthcare Version 1.0 July 2020 Preface Purpose This note provides country of origin information (COI) for decision makers handling cases where a person claims that to remove them from the UK would be a breach Articles 3 and / or 8 of the European Convention on Human Rights (ECHR) because of an ongoing health condition. It is not intended to be an exhaustive survey of healthcare in Jamaica. Country of origin information The country information in this note has been carefully selected in accordance with the general principles of COI research as set out in the Common EU [European Union] Guidelines for Processing Country of Origin Information (COI), dated April 2008, and the Austrian Centre for Country of Origin and Asylum Research and Documentation’s (ACCORD), Researching Country Origin Information – Training Manual, 2013. Namely, taking into account the COI’s relevance, reliability, accuracy, balance, currency, transparency and traceability. The structure and content of the country information section follows a terms of reference which sets out the general and specific topics relevant to this note. All information included in the note was published or made publicly available on or before the ‘cut-off’ date(s) in the country information section. Any event taking place or report/article published after these date(s) is not included. All information is publicly accessible or can be made publicly available, and is from generally reliable sources. Sources and the information they provide are carefully considered before inclusion. Factors relevant to the assessment of the reliability of sources and information include: • the motivation, purpose, knowledge and experience of the source • how the information was obtained, including specific methodologies used • the currency and detail of information, and • whether the COI is consistent with and/or corroborated by other sources. Multiple sourcing is used to ensure that the information is accurate, balanced and corroborated, so that a comprehensive and up-to-date picture at the time of publication is provided of the issues relevant to this note. Information is compared and contrasted, whenever possible, to provide a range of views and opinions. The inclusion of a source, however, is not an endorsement of it or any view(s) expressed. Each piece of information is referenced in a brief footnote; full details of all sources cited and consulted in compiling the note are listed alphabetically in the bibliography. Page 2 of 143 MedCOI MedCOI is an Asylum and Migration Integration Fund financed project to obtain medical country of origin information. The project allows 11 European Union member states plus Denmark, Norway and Switzerland to make use of the services of the ‘MedCOI’ team in the Netherlands and Belgium. The MedCOI team makes enquiries with qualified doctors and other experts working in countries of origin. The information obtained is reviewed by the MedCOI project team before it is forwarded to the UK or other national COI teams. Previous MedCOI responses are stored on its database which participating states are able to access. Feedback Our goal is to continuously improve our material. Therefore, if you would like to comment on this note, please email the Country Policy and Information Team. Page 3 of 143 Contents Assessment 6 Guidance on medical claims .................................................................................... 6 Country information 7 1. Overview of the healthcare system .................................................................... 7 2. Primary (Public) healthcare ................................................................................ 9 2.2 Referral facilities ..................................................................................... 11 2.3 Private sector healthcare ........................................................................ 12 3. Discrimination in accessing health care ........................................................... 13 4. Communicable diseases .................................................................................. 15 5. Pharmaceutical sector ..................................................................................... 16 6. Treatment and medication for specific conditions ............................................ 18 6.1 Tuberculosis (TB) ................................................................................... 18 6.2 HIV/AIDS and sexually transmitted diseases (STD) ............................... 19 6.3 Cancer .................................................................................................... 21 6.4 Renal failure/chronic kidney disease (CKD) ........................................... 23 6.5 Hepatitis, liver disease and transplants .................................................. 24 6.6 Diabetes ................................................................................................. 24 6.7 Neurological conditions .......................................................................... 27 6.8 Coronary heart disease (CHD) ............................................................... 27 6.9 Gastroenterological conditions ............................................................... 29 6.10 Gynaecological conditions ...................................................................... 29 6.11 Reproductive health ............................................................................... 30 6.12 Dengue fever .......................................................................................... 30 6.13 Palliative care ......................................................................................... 31 7. Paediatrics ....................................................................................................... 32 7.2 Ear, nose and throat (ENT), audiology and speech therapy ................... 33 7.3 Support and care for children with disabilities ........................................ 33 8. Mental health ................................................................................................... 34 8.1 Overview of mental health care .............................................................. 34 8.2 Schizophrenia and other psychotic disorders ......................................... 37 8.3 Mood disorders: depressive disorders and bipolar disorder ................... 37 8.4 Stress related disorders.......................................................................... 38 8.5 Anxiety spectrum disorders .................................................................... 38 8.6 Substance abuse .................................................................................... 39 8.7 Other services ........................................................................................ 39 Page 4 of 143 8.8 Helplines ................................................................................................. 40 8.9 Medication .............................................................................................. 40 9. People living with disabilities ............................................................................ 41 10. COVID-19 ........................................................................................................ 42 Annex A 43 Sri Lanka: Medical treatment and healthcare, February 2020 ....................... 43 Annex B 74 Alphabetical list of available medication, February 2020 ............................... 74 Annex C 90 List of hospitals in Sri Lanka, ......................................................................... 90 Terms of Reference 138 Bibliography 140 Sources cited ...................................................................................................... 140 Sources consulted but not cited ....................................................................... 142 Version control 143 Page 5 of 143 Assessment Updated: 29 June 2020 Guidance on medical claims For general guidance on considering cases where a person claims that to remove them from the UK would be a breach Articles 3 and / or 8 of the European Convention on Human Rights (ECHR) because of an ongoing health condition, see the instruction on Human rights claims on medical grounds. Back to Contents Page 6 of 143 Country information Section 1 updated: 29 June 2020 1. Overview of the healthcare system 1.1.1 All Sri Lankans benefit from free health care1 financed through government funding, generated through taxation2. The healthcare system also receives contributions from both donors and the private sector3. 1.1.2 The Ministry of Health, Nutrition and Indigenous Medicine (MoHNIM), Sri Lanka Essential Health Services Package 2019, stated: ‘Sri Lanka has a well-established public health system dating back to the establishment of the first health unit in the 1920s. The well-planned network of Medical Officer of Health units provide a comprehensive, quality, and evidence-based package of services covering reproductive, maternal, new born and child care, disease surveillance, prevention and control, as well as other promotive and preventive services. Grass-root level public health workers (Public Health Midwives and Public Health Inspectors) cover the entire country at household level and provide strategic interventions as per the national guidelines. Supervising officers at the field, regional and national level provide supportive supervision and feedback to the field officers. The high standards of the integrated