Education in Sri Lanka has a long history dating back two millennia. While the Constitution of Sri Lanka does not provide for free education as a fundamental right, its section on Principles of State Policy states, "The complete elimination of illiteracy and the guarantee of the right of all people to universal and equal access to education at all levels." Sri Lanka's population had a literacy rate of 96.3% in 2015, which is above average by global and regional standards. Computer literacy was 28.3% in 2017, telephone use was 100%, and website use was 32%. In the same manner the health care Sri Lanka's health care system is free for all people. It performs better than the regional average in health care, has a high life expectancy and lower maternal and infant mortality rates than its neighbours, and is known for one of the oldest health care systems in the world with its own indigenous medical system. (Primary Health Care Reforms in Sri Lanka: Aiming at Preserving Universal Access to Health. Orient Blackswan. 2015.) (Sri Lanka tops in healthcare deliver in South Asia-UNFPA". Archived from the original on 2016-03-04.)
In medicine, Sri Lanka is divided into two parts. In the countryside, medicine is often still practiced according to old traditions. Ayurveda, the ancient art of healing for which Sri Lanka is famous, is used. In many villages there is a doctor and a midwife who take care of the primary care of the population. Serpent medicine men care for people after bites from venomous reptiles.
In contrast, in urban areas, Western teachings dominate. Medicine "English style," as it is called here. In the Asian-coloured streetscape, the "Pharmacy" signs and "Medical Center" signposts quickly catch the eye. They are called "English" because Sri Lanka's health care system is based on the pillars of the British health care system - a remnant from colonial days. This is because Sri Lanka was in British hands from 1803, with only a brief interruption. It was only after the end of the Second World War that the island, which was then still called Ceylon, became independent.
Vestiges of the British occupation can still be found everywhere in the country. In the architecture, in tea cultivation, in the education system - and also in the health care system. Access to health care is free for all citizens of the island. Sri Lankans can visit clinics and doctors without having to pay. Medication is also free. The state pays for it.
People who can afford it go to private clinics:
Modern, English conditions, however, can only be expected to a paltry extent on the island. In the big cities and the centres frequented by tourists, such as the capital Colombo on the west coast or Kandy in the mountainous centre of the island, medical care is "sufficient to good," as western officers describe it. But even here, only a few of the state facilities meet European standards.
The natives appreciate that the state takes care of them when they are ill. But they also feel that not all state hospitals are well staffed and equipped. Therefore, often the case in the rest of the world, those who can afford it go to one of the better-equipped private facilities when they have ailments. Limited of them do, however, because the country and its people have been through a difficult time of suffering.
It was not only the tsunami in 2004 that left deep wounds in the country. A long civil war also caused a lot of suffering and destroyed infrastructure, including the health care system. From 1983 to 2009, up to 100,000 people are estimated to have died in the bloody conflict between the country's different ethnic groups. The aid organization Doctors without Borders has repeatedly placed Sri Lanka on its list of countries with the most severe humanitarian crises in the past.
Given this background, it is all the more astonishing how well the country is doing today. Sri Lanka has developed very positively in recent years. Moreover, in the health sector, the country is now considered a role model for many other developing and emerging countries in the region. The country impressively demonstrates that a great deal can be achieved in the health sector, even with limited financial resources.
Tremendous progress in the fight against infectious diseases:
Although investment in the health sector is low, at just 3.2 percent of gross domestic product (as of 2012), key indicators are comparable to or even better than in more developed countries in the region. Looking at life expectancy, for example, it is clear how much progress the country is making despite its difficult history. In 1960, Sri Lankans lived to an average age of 62. By 2013, the average life expectancy was 72 for men and 78 for women. As another example, the under-five mortality rate has dropped from 38 deaths per 1,000 births to ten in 20 years.
Impressive is the density of public health facilities and clinics in the country. They are distributed in most parts of the country - unusual for developing and emerging countries, where care centres are often found only near cities. This is another reason Sri Lanka has made enormous progress in the fight against typical infectious diseases. For example, malaria has declined sharply. High rates of vaccination have made diseases such as tetanus and Japanese encephalitis controllable. Government efforts to combat tobacco consumption can also be described as a showcase success: Policies such as a ban on smoking in public places have had a significant impact - making Sri Lanka further ahead than some countries in Europe in this regard.
Not only countries like India or Thailand, where in some cases much more is invested with poorer results, are noticing Sri Lanka's positive developments. Even the international community is observing the changes on the island with goodwill. The World Health Organization (WHO), for example, has called Sri Lanka's efforts in the health sector "exemplary" and expressly praised the "great commitment" of national policy-makers. The World Bank considers Sri Lanka's development "in many respects a success story.
However: looking ahead, hurdles can already be identified for the country's health care system. «The aging of the population and the increase in non-communicable diseases (NCDs) will put increasing strain on the healthcare system," the British Economist recently analysed. WHO also warns of the already noticeable increase in NCDs such as cardiovascular disease, diabetes and cancer. Moreover, the organization sees that further strengthening of primary care is imperative. More recently, reports of an increase in the number of new HIV infections have also given cause for concern.
Advertisements for finished products, pallets with soft drinks:
That the typical widespread diseases of the West can also become a problem in Sri Lanka is quickly apparent to anyone moving around the country. Besides the many traditional fruit and vegetable stands, sales booths with Western products catch the eye, especially in the cities - and the conspicuously frequent advertising for ready-made products on large banners and posters. Besides the water bottles, which in a country with a tropical climate are a permanent fixture for locals and tourists alike, there are often pallets stacked with Coke, lemonade and the like. Sri Lanka should be warned: the country's immediate neighbour India already has a massive diabetes problem, which is already putting a massive strain on the health system there.
However, observers are generally optimistic about Sri Lanka's future development, including the health care industry: «Rising incomes should increase opportunities for the private sector and boost demand for medical equipment and drugs," wrote the Economist. A sense of optimism is palpable in many regions. However, it will be quite a while before Sri Lanka crosses the threshold of modernity.
AYURVEDA: THE MAGNETIC FOR TOURISTS:
In Sri Lanka, traditional and Western medicine are on an equal footing. The majority of doctors working on the island today, however, are Western-trained. Ayurveda is above all the healing art of the rural dwellers and the elderly. However, stressed city dwellers also like to resort to the millennia-old art of healing for everyday ailments.
Ayurveda plants grow everywhere in Sri Lanka, especially in the region around Kandy: red pineapple, cinnamon, cardamom, herbs, aloe Vera. The art of healing offers a solution for almost every problem: common colds, pain, high blood pressure, high cholesterol, gout, hair loss, kidney stones, diabetes, and allergies. Time and again, Ayurveda clinics pop up among the lush vegetation. Former Chancellor Helmut Kohl stayed in one of them several times.
Sri Lanka's reputation as an Ayurvedic paradise has suffered recently, however. There were reports of arsenic and heavy metal poisoning from Ayurvedic medicines. Therefore, it is strongly discouraged to take non-certified medicines during treatments. Such negative reports are devastating for Sri Lanka. This is because Ayurvedic tourism is one of the country's growth engines. The government therefore wants to regulate certification for Ayurveda clinics and hotels more closely in the future.