Rs 750m pledged, but IndiaSri Lanka ambulance service faces funding emergency

In a country where access to timely medical care was once a luxury, Suwa Seriya emerges as a beacon of hope, delivering swift and free ambulance services to those in need. Praised by the World Bank for its remarkable efficiency, Suwa Seriya stands as a testament to the power of digital innovation in revolutionising healthcare and emergency services.

The ambulance service, initially funded by the Indian Government, has played a pivotal role in providing timely medical care. The ambulances, carrying trained staff and state-of-the-art equipment, have been instrumental in saving lives during medical emergencies, terrorist attacks such as the Easter bombings, accidents, and natural disasters.

In a recent blog post, the World Bank’s Vice President for the South Asia Region, Martin Raiser lauded ‘Suwa Seriya’ for tapping into digitisation by leading digital innovation in health and emergency services. Raiser emphasised that Suwa Seriya’s success is an example of how technology can help revolutionise service delivery in developing countries.

But, this vital lifeline is grappling with a significant financial gap after Indian Government funding ended.

The service, initiated in 2016 with a generous grant from India, operated under an initial agreement stipulating that the Sri Lanka Government would assume responsibility for its operations and maintenance after one year. This arrangement was proposed by the then foreign Secretary, and the current Minister of External Affairs India, Dr. Subrahmanyam Jaishankar.

Amendments were made to the Suwa Seriya Act, ensuring Sri Lanka Government funding.

The establishment of the 1990 Suwa Seriya Foundation through Parliament Act No. 18 of 2018 initially ensured the continuity of operations, with funding provided from the consolidated fund.

The service is now exploring alternative financial sources.

The chairman of the Suwa Seriya Ambulance Service, Dumindra Ratnayaka, said the ‘Adopt an Ambulance’ project began in 2023 to garner private sector support. Commitments of up to Rs. 750 million have been received. Donors are in the process of fulfilling their pledges.

“Additionally, the service has launched a public funding initiative to cover operational costs, encouraging citizens to contribute towards maintaining ambulance services,” said Mr Ratnayaka.

Despite ongoing efforts to secure funding, the service continues to face significant challenges in meeting operating costs. There was a budget shortfall of Rs. 1.4 billion in 2023, highlighting the urgent need for support from companies and Sri lankans.

In light of these challenges, Suwa Seriya has embarked on various strategic initiatives to enhance its capabilities and reach. Plans are underway to increase ambulance coverage density nationwide, aiming to reduce average response times to within 8 minutes. Efforts to expand the fleet through partnerships with the Asian Development Bank and private donors are underway.

“Also, together with Dialog we have launched a crowd funding Programme through Karuna.lk, this is an another initiative for public participation,’’ said Mr Ratnayake.

The service is investing in staff training and development, with Programmes such as the advanced diploma Programme in paramedicine to enhance the skills of new and existing staff. Also, rials for connected ambulances are underway, with plans to roll out this innovative technology to further improve emergency response capabilities.

"We have achieved this after fighting obstacles every step of the way," said Dr. Harsha de Silva, Member of Parliament and former minister of economic reform and public distribution, who was involved in the initiative from the very beginning.

"There were times when our ambulances were denied parking space at hospitals, and our patients were denied admission during emergencies,’’ he remembered.

“Credit for this success is attributed to our exceptional team and the advanced technology we've integrated. As Dr. Harsha de Silva, rightly commends, it's the synergy of talent and technology that propels the service forward.’’

When contacted by The Sunday Times, Jathika Nidahas Peramuna leader Wimal Weerawansa, who had opposed the Suwa Seriya at its inception, asserted that the ambulance Programme was not funded, but a loan had been given. “This was the basis of our objection, as we believed that financial assistance could be obtained from other developed countries like Japan, why India, as the Sri Lankan Government would have to repay the loan anyway.’’

Responding to inquiries about his sentiments regarding the success of the service, he remarked: “Anyways, the whole world knows that our country's health sector is highly renowned. So, even though the loan was provided by the Indian Government, the staff and the health sector of Sri Lanka managed and operated it. Therefore, its success was inevitable. But the Government Medical Officers' Association (GMOA) was the one that really objected to the initiative at the start."

Indian High Commission statements show that the service began in 2016 in the Western and Southern Provinces at the request of the Government of Sri Lanka, under an Indian grant of US$7.56 million. The grant included purchase of 88 ambulances, operational expenditure for one year and setting up of an emergency response centre.

The request had first been made during Prime Minister Narendra Modi’s visit to Sri Lanka in March 2015.

Then in January 2018 in Colombo, an additional grant of US$15.02m was announced by India for extending the service to the other seven provinces.

This was following a request by the Government of Sri Lanka to the Government of India to expand the service island-wide. Mr Modi, announced during his visit to Sri Lanka in May 2017, that the service would be expanded island-wide.

Dr. de Silva confirmed that it was a generous, US$23m grant from the Indian Government.

“I am the one who asked for the first tranche of US$7.8m and the second tranche of US$15.2m, we never paid back a single cent,” he said.

Despite financial constraints and operational challenges, the Suwa Seriya remains committed to its mission of saving lives. Its dynamic and proactive team continues to explore innovative solutions to overcome obstacles and ensure high-quality emergency medical care is provided.

In light of these challenges, Suwa Seriya has embarked on various strategic initiatives to enhance its capabilities and reach. Plans are underway to increase ambulance coverage density nationwide, aiming to reduce average response times to within 8 minutes. Efforts to expand the fleet through partnerships with the Asian Development Bank and private donors are underway.