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 155km (96 miles) between his home and Sri Lanka’s main cancer hospital on the outskirts of the country’s largest city, Colombo, for treatment.
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.
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 doctor’s union said.
“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 spokesman for the Government Medical Officers’ Association.
Specialist facilities like cancer and eye hospitals are running on donations, Ratnasingam said.
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 imports of fuel, food, cooking gas and medicines.
For months, the country of 22 million people faced hours-long power cuts and severe fuel shortages.
The economic hardship triggered protests, which in July led to the removal of former President Gotabaya Rajapaksa.
Currency depreciation and record inflation have pushed middle-class families like Kumarasinghe’s to the brink as they scrambled to meet higher living costs.
For decades, Sri Lankans have benefitted 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.
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 for a $2.9bn bailout but has to put its huge debt burden on a sustainable track before disbursement can begin.
The economic hardship remains crushing for many.
Sathiyaraj Silaksana, 27, is visiting her five-year-old son S Saksan suffering from leukaemia, travelling 350km (217 miles) 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, 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 jewellery.”