Priyantha Kumarasinghe starts his day in the small Sri Lankan town of Maharagama with a breakfast of two biscuits and a small glass of tea, followed by a round of cancer medicines.
The 32-year-old vegetable farmer was diagnosed with lung cancer in 2021 and started receiving treatment earlier this year just as Sri Lanka's economy went into free-fall.
Amid crippling fuel scarcity and weeks of unrest, Kumarasinghe said he was unable to travel the 155 km (96 miles) between his home and Sri Lanka's main cancer hospital on the outskirts of the country's largest city, Colombo, for treatment.
Priyantha Kumarasinghe, 32, who has been diagnosed with lung cancer which doctors think has spread to his neck and spine, has his head massaged by a relative at his aunt's home in Homagama, Sri Lanka, November 10, 2022. Kumarasinghe started receiving treatment earlier this year just as Sri Lanka's economy went into free fall. Amid a crippling fuel scarcity and weeks of unrest, Kumarasinghe said he was unable to travel between his home and Sri Lanka's main cancer hospital for treatment. "If I had been able to get treatment properly during June, July and August there is a good possibility I could have reduced the lung cancer," he told Reuters. "Because that was not possible that may be the reason why the cancer has grown." REUTERS/ Dinuka Liyanawatte
"If I had been able to get treatment properly during June, July and August there is a good possibility I could have reduced the lung cancer," he told Reuters.
"Because that was not possible that may be the reason why the cancer has grown."
Kumarasinghe is among hundreds of cancer patients who have had their treatment upended by Sri Lanka's worst economic crisis since independence from Britain in 1948.
Biscuits for Priyantha Kumarasinghe, 32, who has been diagnosed with lung cancer which doctors think has spread to his neck and spine, are seen on a plate at his aunt's house in Homagama, Sri Lanka, November 10, 2022. Kumarasinghe dips biscuits into his tea as they are easy for him to swallow with a painful throat. "If I had been able to get treatment properly during June, July and August there is a good possibility I could have reduced the lung cancer," he told Reuters. "Because that was not possible that may be the reason why the cancer has grown." REUTERS/ Dinuka Liyanawatte
Hospitals countrywide have struggled to contend with severe drug shortages, which have worsened over the last eight months, a representative of Sri Lanka's largest doctors union told Reuters.
"All hospitals are experiencing shortages. There is difficulty in even sourcing basics like paracetamol, vitamin C and saline for outpatient services," said Vasan Ratnasingam, a spokesperson for the Government Medical Officers' Association.
Specialist facilities like cancer and eye hospitals are running on donations, Ratnasingam said.
Priyantha Kumarasinghe, 32, who has been diagnosed with lung cancer which doctors think has spread to his neck and spine, eats food donated by a temple at a communal kitchen in a cancer care transit home near Apeksha Hospital, Colombo, Sri Lanka, August 12, 2022. Kumarasinghe started receiving treatment earlier this year just as Sri Lanka's economy went into free fall. Amid a crippling fuel scarcity and weeks of unrest, Kumarasinghe said he was unable to travel between his home and Sri Lanka's main cancer hospital for treatment. "If I had been able to get treatment properly during June, July and August there is a good possibility I could have reduced the lung cancer," he told Reuters. "Because that was not possible that may be the reason why the cancer has grown." REUTERS/Kim Kyung-Hoon
Sri Lanka's health ministry and senior health officials did not respond to calls from Reuters.
Battered by the loss of tourism and remittance earnings because of the pandemic, alongside an ill-timed tax cut, Sri Lanka slid into crisis in early 2022 after its foreign exchange reserves dried up, leaving it short of dollars to pay for fuel, food, cooking gas and medicines.
For months, the country of 22 million people faced hours-long power cuts and severe fuel shortages.
Ratnasingham Rajini, 45, watches her grandson S. Saksan, 5, who has been diagnosed with leukaemia, while he takes a nap in a corridor of a cancer care transit home near Apeksha Hospital, Colombo, Sri Lanka, August 11, 2022. "I have to give him something easy to eat like porridge every 2 hours but he doesn't eat because of the strength of the medicine and side effects of the chemotherapy." Said Rajini REUTERS/Kim Kyung-Hoon
The economic hardship triggered protests, which in July ousted former President Gotabaya Rajapaksa after thousands took to the streets and occupied his official residence.
Currency depreciation and record inflation have pushed middle-class families like Kumarasinghe's to the brink as they scrambled to meet higher living costs.
But the family has another crisis to contend with.
Customers stand in line to buy medicine at a pharmacy near Apeksha Hospital, Colombo, Sri Lanka, August 16, 2022. Hundreds of cancer patients have had their treatment upended by Sri Lanka's worst economic crisis since independence from Britain in 1948. Hospitals countrywide have struggled to contend with severe drug shortages, which have worsened over the last eight months, a representative of Sri Lanka's largest doctors union told Reuters. "All hospitals are experiencing shortages. There is difficulty in even sourcing basics like paracetamol, vitamin C and saline for outpatient services," said Vasan Ratnasingam, a spokesperson for the Government Medical Officers' Association. REUTERS/Kim Kyung-Hoon
Doctors are now worried the cancer has spread to Kumarasinghe's neck and spine, said his wife, Shashini Chamilka Maduhansi, 23.
The couple are awaiting results of an MRI scan that will direct future treatment, and have temporarily moved in with Kumarasinghe's aunt whose rented home is close to the hospital.
Their five-year-old son has been left in the care of other family members.
Shashini Chamilka Maduhansi, 23, prepares tea for her husband, Priyantha Kumarasinghe, 32, who has been diagnosed with lung cancer which doctors think has spread to his neck and spine, at his aunt's home in Homagama, Sri Lanka, November 10, 2022. Kumarasinghe started receiving treatment earlier this year just as Sri Lanka's economy went into free fall. Amid a crippling fuel scarcity and weeks of unrest, Kumarasinghe said he was unable to travel between his home and Sri Lanka's main cancer hospital for treatment. "If I had been able to get treatment properly during June, July and August there is a good possibility I could have reduced the lung cancer," he told Reuters. "Because that was not possible that may be the reason why the cancer has grown." REUTERS/ Dinuka Liyanawatte
Kumarasinghe used to make a living growing leeks, carrots and cabbages, which are now being tended to by his parents.
Besides inflation, his income has been badly hit by a chemical fertiliser ban implemented last year, which has since been reversed, but led to the price of fertilisers jumping to about 30,000 Sri Lankan rupee ($82.64) a bag from about 1,600 rupees previously, Kumarasinghe said.
"Every month I need about 70,000 rupees for expenses but it is hard to meet the costs," he said.
Medical workers walk past graffiti protesting against Sri Lanka’s former President Gotabaya Rajapaksa, on a wall Apeksha Hospital, Colombo, Sri Lanka, August 16, 2022. Hundreds of cancer patients have had their treatment upended by Sri Lanka's worst economic crisis since independence from Britain in 1948. Hospitals countrywide have struggled to contend with severe drug shortages, which have worsened over the last eight months, a representative of Sri Lanka's largest doctors union told Reuters. "All hospitals are experiencing shortages. There is difficulty in even sourcing basics like paracetamol, vitamin C and saline for outpatient services," said Vasan Ratnasingam, a spokesperson for the Government Medical Officers' Association. REUTERS/Kim Kyung-Hoon
"Medicine is not available at the hospital so it has to be bought from pharmacies. Every single type of medication is over 1000 rupees. I'm doing my best but it's very hard."
For decades Sri Lankans have benefited from a universal public healthcare system that subsidises treatment, including medicine for serious illnesses.
But services have been hampered by the dollar shortage, which has restricted imports of medicines, and limited public funds available to hospitals to provide care.
Shashini Chamilka Maduhansi, 23, prepares medicine for her husband, Priyantha Kumarasinghe, 32, who has been diagnosed with lung cancer which doctors think has spread to his neck and spine, at his aunt's home in Homagama, Sri Lanka, November 10, 2022. Kumarasinghe started receiving treatment earlier this year just as Sri Lanka's economy went into free fall. Amid a crippling fuel scarcity and weeks of unrest, Kumarasinghe said he was unable to travel between his home and Sri Lanka's main cancer hospital for treatment. "If I had been able to get treatment properly during June, July and August there is a good possibility I could have reduced the lung cancer," he told Reuters. "Because that was not possible that may be the reason why the cancer has grown." REUTERS/ Dinuka Liyanawatte
President Ranil Wickremesinghe has pledged to restore economic stability but has warned reforms will be painful as the country strives to increase taxes to put its public finances in order and work with creditors including India, Japan and China to restructure debt.
In September, the country entered a preliminary agreement with the International Monetary Fund (IMF) for a $2.9 billion bailout but has to put its huge debt burden on a sustainable track before disbursement can begin.
The economic hardship remains crushing for many.
S. Saksan, 5, who has been diagnosed with leukaemia, rests at a cancer care transit home near Apeksha Hospital, Colombo, Sri Lanka, August 16, 2022. "Due to the current crisis in Sri Lanka, we are facing severe problems in transport and food," said his mother Sathiyaraj Silaksana, "I have no option but to pay for my son's needs. My husband, is a construction worker. In order to pay for all these expenses we pawned our jewellery." REUTERS/Kim Kyung-Hoon
Sathiyaraj Silaksana 27, has come to visit her five-year-old son S. Saksan suffering from leukemia, travelling 350 km with her husband to feed him.
"Due to the current crisis in Sri Lanka, we are facing severe problems in transport and food," said Silaksana, 27, who is pregnant with her second child.
“I have no option but to pay for my son's needs. My husband, is a construction worker. In order to pay for all these expenses we pawned our jewelry."
Kesakarasa Sathiyaraj, 34, shows food stored in a cupboard for his son S. Saksan, 5, who has been diagnosed with leukaemia, at a cancer care transit home near Apeksha Hospital, Colombo, Sri Lanka, August 16, 2022. Kesakarasa travelled 350km with his wife Sathiyaraj Silaksana, to visit their son. "Due to the current crisis in Sri Lanka, we are facing severe problems in transport and food," said Silaksana. "I have no option but to pay for my son's needs. My husband, is a construction worker. In order to pay for all these expenses we pawned our jewellery." REUTERS/Kim Kyung-Hoon
($1 = 363.0000 Sri Lankan rupees)
(Reporting by Uditha Jayasinghe and Kim Kyung-hoon; Editing by Devjyot Ghoshal and Stephen Coates)
Needle marks are seen on the wrist of S. Saksan, 5, who has been diagnosed with leukaemia, while he takes a nap after receiving cancer treatment at Apeksha Hospital, at a cancer care transit home, Colombo, Sri Lanka, August 16, 2022. "Due to the current crisis in Sri Lanka, we are facing severe problems in transport and food," said his mother Sathiyaraj Silaksana, "I have no option but to pay for my son's needs. My husband, is a construction worker. In order to pay for all these expenses we pawned our jewellery." REUTERS/Kim Kyung-Hoon
S. Saksan, 5, who has been diagnosed with leukaemia, takes a nap in a corridor of a cancer care transit home near Apeksha Hospital, Colombo, Sri Lanka, August 16, 2022. "Due to the current crisis in Sri Lanka, we are facing severe problems in transport and food," said his mother Sathiyaraj Silaksana, "I have no option but to pay for my son's needs. My husband, is a construction worker. In order to pay for all these expenses we pawned our jewellery." REUTERS/Kim Kyung-Hoon
Rathis Supiksa, 7, who has been diagnosed with both blood cancer and bone cancer in her leg, has lunch on a bed at a cancer care transit home near Apeksha Hospital, Colombo, Sri Lanka, August 15, 2022. "We never, ever faced a situation like this before. Even during the war period we ate well. but with the current situation in Sri Lanka, it is difficult to live." Said her father, Periyathambi Rathis, "I will definitely have to take out a loan from a loan shark to meet the child's expenses in the future." REUTERS/Kim Kyung-Hoon
Rathis Supiksa, 7, who has been diagnosed with both blood cancer and bone cancer in her leg, is carried by her aunt as they follow her father, Periyathambi Rathis, 32, towards Apeksha Hospital for cancer treatment, in Colombo, Sri Lanka, August 15, 2022. "We never, ever faced a situation like this before. Even during the war period we ate well. but with the current situation in Sri Lanka, it is difficult to live." Said Periyathambi "I will definitely have to take out a loan from a loan shark to meet the child's expenses in the future."
Rathis Supiksa, 7, who has been diagnosed with both blood cancer and bone cancer in her leg, puts on a face mask at a cancer care transit home before heading to Apeksha Hospital for cancer treatment, in Colombo, Sri Lanka, August 15, 2022. "We never, ever faced a situation like this before. Even during the war period we ate well. but with the current situation in Sri Lanka, it is difficult to live." Said her father, Periyathambi Rathis, "I will definitely have to take out a loan from a loan shark to meet the child's expenses in the future." REUTERS/Kim Kyung-Hoon
Periyathambi Rathis, 32, gives water to his daughter Rathis Supiksa, 7, who has been diagnosed with both blood cancer and bone cancer in her leg, at a cancer care transit home near Apeksha Hospital, Colombo, Sri Lanka, August 15, 2022. "We never, ever faced a situation like this before. Even during the war period we ate well. but with the current situation in Sri Lanka, it is difficult to live." Said Periyathambi "I will definitely have to take out a loan from a loan shark to meet the child's expenses in the future." REUTERS/Kim Kyung-Hoon
Chamindu Dissanayake, 4, who has been diagnosed with acute myeloid leukaemia, sits in a rickshaw with his father Sisira Kumara Dissanayake, 35, as they prepare to travel back to their home after being discharged from Apeksha Hospital, in Colombo, Sri Lanka, August 15, 2022. "It takes between 8 and 10 hours to get here. We can't come by bus because the doctors said exposing him to strangers and outside environment was dangerous for his health. But since we can't afford a car or van we have no other option but to take him in my rickshaw." REUTERS/Kim Kyung-Hoon
Rathis Supiksa, 7, who has been diagnosed with both blood cancer and bone cancer in her leg, sits on a table in a communal kitchen while her aunt cooks food at a cancer care transit home near Apeksha Hospital, Colombo, Sri Lanka, August 15, 2022. "We never, ever faced a situation like this before. Even during the war period we ate well. but with the current situation in Sri Lanka, it is difficult to live." Said her father, Periyathambi Rathis, "I will definitely have to take out a loan from a loan shark to meet the child's expenses in the future." REUTERS/Kim Kyung-Hoon
Sisira Kumara Dissanayake, 35, shows a heart surgery scar on his son Chamindu Dissanayake, 4, who has been diagnosed with acute myeloid leukaemia, as they prepare to travel back to their home after being discharged from Apeksha Hospital, in Colombo, Sri Lanka, August 15, 2022. "It takes between 8 and 10 hours to get here. We can't come by bus because the doctors said exposing him to strangers and outside environment was dangerous for his health. But since we can't afford a car or van we have no other option but to take him in my rickshaw." REUTERS/Kim Kyung-Hoon
Sudhagaran Sadurshana, 9, who has been diagnosed with acute myeloid leukaemia, and her mother Sudhagaran Punawadee, 30, ride a bus as they travel home after being discharged from Apeksha Hospital, in Colombo, Sri Lanka, August 12, 2022. "We have to go there by bus, we know that's not comfortable for our child but what else can we do? We have no other choice." Punawadee Said. "Currently, increases of transport and food prices are the biggest problems for us. Most medicines are given by the hospital but but some medicines we need to buy from the pharmacy." REUTERS/Kim Kyung-Hoon
Sudhagaran Sadurshana, 9, who has been diagnosed with acute myeloid leukaemia, and her mother Sudhagaran Punawadee, 30, ride a bus as they travel home after being discharged from Apeksha Hospital, in Colombo, Sri Lanka, August 12, 2022. "We have to go there by bus, we know that's not comfortable for our child but what else can we do? We have no other choice." Punawadee Said. "Currently, increases of transport and food prices are the biggest problems for us. Most medicines are given by the hospital but but some medicines we need to buy from the pharmacy." REUTERS/Kim Kyung-Hoon
Sathiyaraj Silaksana, 27, gives a massage to her son S. Saksan, 5, who has been diagnosed with leukaemia, at a cancer care transit home near Apeksha Hospital, Colombo, Sri Lanka, August 12, 2022. "Due to the current crisis in Sri Lanka, we are facing severe problems in transport and food," said Silaksana, "I have no option but to pay for my son's needs. My husband, is a construction worker. In order to pay for all these expenses we pawned our jewellery." REUTERS/Kim Kyung-Hoon
S. Saksan, 5, who has been diagnosed with leukaemia, refuses to eat food fed to him by his mother, Sathiyaraj Silaskana, 27, at a cancer care transit home near Apeksha Hospital, Colombo, Sri Lanka, August 12, 2022. "Due to the current crisis in Sri Lanka, we are facing severe problems in transport and food," said Silaksana, "I have no option but to pay for my son's needs. My husband, is a construction worker. In order to pay for all these expenses we pawned our jewellery." REUTERS/Kim Kyung-Hoon
Sudhagaran Sadurshana, 9, who has been diagnosed with acute myeloid leukaemia, talks with her mother at a cancer care transit home before traveling home after being discharged from Apeksha Hospital, in Colombo, Sri Lanka, August 12, 2022. "We have to go there by bus, we know that's not comfortable for our child but what else can we do? We have no other choice." Punawadee Said. "Currently, increases of transport and food prices are the biggest problems for us. Most medicines are given by the hospital but but some medicines we need to buy from the pharmacy." REUTERS/Kim Kyung-Hoon
Sudhagaran Punawadee, 30, shows a pack of medicine prescribed to her daughter Sudhagaran Sadurshana, 9, who has been diagnosed with acute myeloid leukaemia, as they pack their belongings before travelling home after being discharged from Apeksha Hospital, at a cancer care transit home, Colombo, Sri Lanka, August 12, 2022. "We have to go there by bus, we know that's not comfortable for our child but what else can we do? We have no other choice." Punawadee Said. "Currently, increases of transport and food prices are the biggest problems for us. Most medicines are given by the hospital but but some medicines we need to buy from the pharmacy." REUTERS/Kim Kyung-Hoon
A medical worker talks to a vendor selling household goods and food for patients and their family members, outside Apeksha Hospital, Colombo, Sri Lanka, August 11, 2022. Hundreds of cancer patients have had their treatment upended by Sri Lanka's worst economic crisis since independence from Britain in 1948. Hospitals countrywide have struggled to contend with severe drug shortages, which have worsened over the last eight months, a representative of Sri Lanka's largest doctors union told Reuters. "All hospitals are experiencing shortages. There is difficulty in even sourcing basics like paracetamol, vitamin C and saline for outpatient services," said Vasan Ratnasingam, a spokesperson for the Government Medical Officers' Association. REUTERS/Kim Kyung-Hoon
Sathiyaraj Silaksana, 27, cries as her husband Kesakarasa Sathiyaraj, 34, hugs their son, S. Saksan, 5, who has been diagnosed with leukaemia, at a cancer care transit home, near Apeksha Hospital, Colombo, Sri Lanka, August 12, 2022. "Due to the current crisis in Sri Lanka, we are facing severe problems in transport and food," said Silaksana, "I have no option but to pay for my son's needs. My husband, is a construction worker. In order to pay for all these expenses we pawned our jewellery." REUTERS/Kim Kyung-Hoon
Priyantha Kumarasinghe, 32, who has been diagnosed with lung cancer which doctors think has spread to his neck and spine, poses at a cancer care transit home where he is staying near Apeksha Hospital, Colombo, Sri Lanka, August 11, 2022. Kumarasinghe started receiving treatment earlier this year just as Sri Lanka's economy went into free fall. Amid a crippling fuel scarcity and weeks of unrest, Kumarasinghe said he was unable to travel between his home and Sri Lanka's main cancer hospital for treatment. "If I had been able to get treatment properly during June, July and August there is a good possibility I could have reduced the lung cancer," he told Reuters. "Because that was not possible that may be the reason why the cancer has grown." REUTERS/Kim Kyung-Hoon
S. Saksan, 5, who has been diagnosed with leukaemia, laughs as he talks with his mother Sathiyaraj Silaksana, 27, on a video call on his grandmother Ratnasingham Rajini's, 45, phone, at a cancer care transit home near Apeksha Hospital, Colombo, Sri Lanka, August 11, 2022. "Due to the current crisis in Sri Lanka, we are facing severe problems in transport and food," said Silaksana, "I have no option but to pay for my son's needs. My husband, is a construction worker. In order to pay for all these expenses we pawned our jewellery." REUTERS/Kim Kyung-Hoon
S. Saksan, 5, who has been diagnosed with leukaemia, plays with a toy car at a cancer care transit home near Apeksha Hospital, Colombo, Sri Lanka, August 11, 2022. "Due to the current crisis in Sri Lanka, we are facing severe problems in transport and food," said his mother Sathiyaraj Silaksana, "I have no option but to pay for my son's needs. My husband, is a construction worker. In order to pay for all these expenses we pawned our jewellery." REUTERS/Kim Kyung-Hoon
S. Saksan, 5, who has been diagnosed with leukaemia, sits with his two grandmothers K. Wimalesvari, 63, and Ratnasingham Rajini, 45, at a cancer care transit home near Apeksha Hospital, Colombo, Sri Lanka, August 11, 2022. "I have to give him something easy to eat like porridge every 2 hours but he doesn't eat because of the strength of the medicine and side effects of the chemotherapy." Said Rajini. REUTERS/Kim Kyung-Hoon
Priyantha Kumarasinghe, 32, who has been diagnosed with lung cancer which doctors think has spread to his neck and spine, plays a video game as he rests at a cancer care transit home near Apeksha Hospital, Colombo, Sri Lanka, August 11, 2022. Kumarasinghe started receiving treatment earlier this year just as Sri Lanka's economy went into free fall. Amid a crippling fuel scarcity and weeks of unrest, Kumarasinghe said he was unable to travel between his home and Sri Lanka's main cancer hospital for treatment. "If I had been able to get treatment properly during June, July and August there is a good possibility I could have reduced the lung cancer," he told Reuters. "Because that was not possible that may be the reason why the cancer has grown." REUTERS/Kim Kyung-Hoon