CHD in Sri Lanka

Medical Facilities for Children with Heart Diseases in Sri Lanka

Sri Lanka is one of the few countries which provide free health care. Even though there is a well-developed private sector, most of the patients seek services through government health facilities due to financial constraints. Until the proper paediatric cardiology program commenced at Lady Ridgeway Hospital, children with heart diseases were treated at Cardiology units at other government hospitals which were mainly treating adults with coronary artery disease. Because of the complex nature of heart diseases in children and difficulty in handling children in adult facilities with limited resources, most of these children were not operated on a timely and appropriate manner. Moreover, mass killers like diarrhoea and mosquito born disease got priority and heart diseases had to stand at the back of the queue when money is disbursed. As a result most of the children born with heart diseases succumbed to their illness even before they could reach the first birthday.

 

However, with the establishment of a dedicated cardiac program at Lady Ridgeway Hospital during early years of this millennium, there has been a rapid improvement of services provided for such children.

 

Milestones in development of heart care at LRH

1999 - Paediatric Cardiology unit established with one consultant cardiologist, a medical officer and an attendant.
2001 - Cardiology ward
2005 - Catheterisation laboratory
2007 - Cardiothoracic operating theatres and a 6bedded cardiothoracic ICU
2010 - Cardiothoracic ICU II with 12 beds

 

Infrastructure, manpower and workload

  Current Projected
Cardiology ward 24 beds 48 beds
Cardiothoracic ward 24 beds 48 beds
Cardiac catheterisation laboratory 01 01
Cardiothoracic operating theatres 02 04
Cardiac ICU 18 40
Consultant Cardiologists 03 04
Consultant Cardiothoracic Surgeons 03 06
Consultant Cardiac Anaesthesiologists/ Intensivists 04 10
Cardiac catheter interventions 700 1000
Cardiac Surgeries 900 2000
Percentage of children with CHD covered 55% 100%


Statistics – number of children with heart diseases treated by catheter interventions or surgery

Success of a paediatric cardiac program is measured by the number of children treated during the first year of life and by the mortality rate. At Lady Ridgeway Hospital most of the children undergo surgery within first year of life and if indicated even within first few days after birth. Cardiac surgery is taken as high risk surgery. Mortality after cardiac surgery is around 6% which is in par with most of the similar centres even in the developed countries.

 


Eventhough we have improve over time we are still able to treat only 50% of the children with heart diseases in Sri Lanka. Therefore, we need to increase the number of procedures done every year to clear the long waiting list. In order to achieve this goal we need to develop infrastructure and manpower, have a ready supply of consumables and improve efficiency through training and encouragement of staff. The main target of CHP is to support the government funded program at LRH as it is the most cost effective way of providing services to children with heart diseases in Sri Lanka.