Our problem in Sri Lanka is the long waiting list for cardiac surgical intervention in the non-fee-levying Government hospitals – often one year or more at the NHSL and two years or more in Kandy, Galle and Jaffna. The long waiting list in the Government sector for cardiac surgery where timely surgical intervention is of the essence is the outcome of a combination of three factors – an inadequate number of ICU beds and operating theatres for cardiac surgeons and catheterization laboratories (Cath Labs) for cardiologists to perform percutaneous interventions such as stent placement (stenting), placement of artificial pacemakers and a highly inadequate number of cardiothoracic surgeons – a mere 13 in the whole Government sector. In Australia, which has a population similar to that of Sri Lanka, there are about 200 qualified cardiac surgeons while of course in many developing countries there are none at all.

Hence, when a long date is given to a heart patient where fast and timely intervention is of the essence to win the battle between life and death, the only available option then is to seek treatment in a fee levying hospital. In such in­stances, the cost to the patient – depending on the technique used in the case of surgery (key­hole/off pump/on pump) and post operative clinical complications if any - could roughly be anything between 550,000 rupees and 900,000 rupees in a private hospital, the comparative cost to the patient in the fee-levying semi-Govern­ment Sri Jayewadenepura General Hospital (SJGH) could be lower - varying between 350,000 rupees and 550,000 rupees on average in most cases.

The better off patients then naturally go to the private healthcare sector which has seven cardiac surgeons (including Indian surgeons) working full-time in addition to the Government sector cardiac surgeons who work in private hospitals in their non working hours after 4pm. To settle for this option and save their lives, fi­nancially impoverished patients can access as­sistance amounting to 200,000 rupees from the President’s Fund after going through a long and tiresome application procedure.

And this is where the Heart to Heart Trust Fund comes in. We provide financial support of another 150,000 rupees to 200,000 rupees and sometimes even more to patients who are sup­ported by the President’s Fund as this will en­able them to mobilize where possible the required balance from their own meagre resources.