Narahenpita Military Hospital, an establishment critical in providing a backbone to the military forces during the civil conflict, is now facing multitudes of crises, from drug shortages to systemic failures and brain drain.
A ‘brain drain’ of over 1,000 medical specialists and one million skilled individuals has left military healthcare critically understaffed
85% of drugs and 80% of medical supplies are imported; their scarcity has forced reliance on costly or substandard substitutes
The Narahenpita crisis is not merely a welfare issue; it is a strategic vulnerability that threatens morale, retention, and the nation’s defence readiness
This article provides a critical assessment of the profound challenges facing the Sri Lanka Army’s premier medical facility, the Narahenpita Military Hospital. For sixteen years since the conclusion of the civil conflict, this institution has served as the vital medical hub for thousands of serving and retired service members, upholding a national commitment to those who sacrificed for the country. However, a detailed analysis reveals that this central pillar of military welfare is at a breaking point due to a convergence of systemic failures, a severe and accelerating shortage of medical professionals, a critical collapse in the supply of essential medicines and equipment, and a fundamental misalignment in fiscal priorities. These issues, while symptomatic of a broader national crisis, pose a direct and escalating threat to the morale, retention, and long-term operational readiness of the armed forces.
The report identifies three primary vulnerabilities: first, a “brain drain” of skilled medical personnel, a problem exacerbated by a failure to provide basic incentives and infrastructure, such as dedicated quarters for intern house officers. Second, a crippled supply chain, where a national economic crisis has left hospitals devoid of life-saving medications and medical supplies, forcing a dangerous reliance on costly, or at times, substandard alternatives. Third, a budgetary paradox, where a significant increase in the overall defence budget has not translated into sufficient, ring-fenced funding for military healthcare, creating a resource scarcity for urgent and critical needs. Addressing these issues is not merely a matter of social responsibility; it is a strategic imperative for the Commander-in-Chief. This article outlines a three-tiered framework for reform, proposing immediate, mid-term, and long-term interventions to restore the integrity of the military medical system and, in doing so, to reassert the nation’s unwavering commitment to its protectors.
The Legacy and Role of the SLAMC
The Sri Lanka Army Medical Corps (SLAMC) possesses a rich and commendable history, from its origins in 1881 to its formal establishment as a regular force in 1950. The Corps’ evolution culminated in a period of unprecedented service during the prolonged civil conflict, where it forged a formidable, integrated medical system meticulously organised into “echelons of care”. This tiered approach allowed for the rapid medical evacuation of battle-injured personnel from the point of injury to definitive care facilities, an operational model that saved countless lives. The wartime success of the SLAMC was not a matter of chance; it was a result of a comprehensive, integrated system of both military and civilian health assets, orchestrated at the highest administrative levels to achieve a singular objective.
In the post-conflict era, the role of the SLAMC and the Narahenpita Military Hospital has undergone a significant yet challenging pivot. Sixteen years after the cessation of hostilities, the hospital has transitioned from a primary trauma centre to the central hub for long-term care, rehabilitation, and management of non-communicable diseases for serving personnel and a vast population of disabled and retired veterans. This ongoing commitment is evidenced by the Sri Lanka Army’s continuous organisation of island-wide medical camps for disabled and retired personnel, a programme that has reached over 10,000 beneficiaries and their families. These efforts underscore the Army’s enduring commitment to its veterans. However, while these initiatives are commendable, their ad-hoc nature highlights a critical vulnerability: they are not a sustainable substitute for a robust, permanently funded central medical institution. The current crisis at the Narahenpita Military Hospital suggests that the integrated, high-capability system of the war years has been allowed to deteriorate, leaving the core medical facility ill-equipped to meet the complex, long-term healthcare needs of its constituency.
Analysis of the Multi-faceted Challenges
The difficulties facing the Narahenpita Military Hospital are not isolated but are a direct manifestation of wider systemic and economic pressures. An analysis of the current situation reveals a confluence of factors that threaten the very foundation of military healthcare.
The Erosion of Human Capital
The most immediate and critical threat to the military medical system is the severe shortage of skilled personnel, a problem that mirrors a devastating nationwide trend. Sri Lanka is currently grappling with a “huge brain drain,” with over 1,000 medical specialists and an estimated one million skilled individuals having left the country during the past few years. This mass migration is driven by uncompetitive wages, high taxation, and the spiralling cost of living, which have made professional life unsustainable for many.
This national crisis has a particularly acute impact on military healthcare. The user query highlights a severe shortage of medical officers and a specific lack of intern house officers, which it attributes to the “non-availability of quarters”. While the research does not provide direct evidence of a complete absence of such facilities, it does indicate that the Army manages a variety of residential quarters for officers of different ranks in the Narahenpita area. This suggests that the problem is not a simple lack of physical infrastructure, but a more complex failure in administrative prioritisation and allocation. Intern house officers are the first point of contact for patients and are vital to the smooth, round-the-clock operation of any hospital. The inability to retain this critical cohort due to a solvable, administrative issue, rather than an insurmountable economic one, is a strategic vulnerability that directly draws the attention of military leadership to address. The inability to attract and retain these entry-level professionals undermines the entire medical hierarchy and the quality of care it can provide.
The Shortage of Essential Medicines and Equipment
The second major pillar of the crisis is the breakdown of the medical supply chain. Sri Lanka’s economic downturn and the suspension of foreign debt repayment have left the country with severely limited foreign reserves. This has had a catastrophic effect on a healthcare system that relies on imports for an overwhelming majority of its pharmaceutical and medical supplies; 85% of drugs and 80% of supplies are imported. The consequences are dire: hospitals across the country are facing shortages of everything from basic painkillers and antibiotics to life-saving drugs for chronic diseases like cancer and diabetes.
This instability has a cascading effect. The lack of reliable supplies forces clinicians to use less effective substitute medicines or, in some cases, to halt essential therapies altogether, which raises long-term public health concerns such as the rise of antibiotic resistance. Furthermore, the scarcity of materials for medical tests forces patients to seek and pay for these services at costly private laboratories, leading to a rise in “out-of-pocket expenditure” (OOPE). For many veterans and their families who lack the financial means, this results in delayed diagnoses and postponed treatments for potentially life-threatening conditions. The government’s ad-hoc reliance on donations and credit purchases from countries like India has been necessary, but the quality of these donated drugs is now a point of national concern. This dangerous stopgap highlights the urgent need for a resilient, sustainable, and transparent procurement strategy.
A Disconnect Between Budget and Need
The user query raises the critical issue of a lack of funds to acquire urgent medical necessities. However, a deeper look into the national budget reveals a profound paradox. Sri Lanka’s 2025 defence budget is estimated at a staggering LKR 437 billion to LKR 442 billion, a significant increase over the previous year. The Sri Lanka Army, which manages the Narahenpita hospital, receives the largest portion of this allocation. This robust funding is intended for recurrent expenditures, including a notable pay increase for military personnel, and for capital investments in modernising the armed forces.
This financial scenario presents a glaring contradiction: how can a sector with a rapidly expanding budget face a critical lack of funds for its core medical services? A lack of publicly available, detailed breakdowns of how the defence budget is allocated to healthcare prevents a precise answer, but it points to a significant strategic misprioritisation. A large budget for troop salaries and equipment is meaningless for soldier welfare if it does not translate into high-quality medical services when they are most needed. The paradox suggests that a large portion of the military budget is being directed away from the very support services that are essential to maintaining the long-term well-being and confidence of the troops. The issue is not the absence of funds in the defence sector, but the lack of a transparent and targeted allocation for medical services.
Military Healthcare, Morale, and National Security
Providing for the health and welfare of serving and retired service members is a non-negotiable responsibility of the state. This is not merely a moral obligation but a strategic imperative that directly impacts national security. The health and well-being of a nation’s military are inextricably linked to its operational readiness and its ability to project a credible defence posture.
A robust, reliable, and accessible healthcare system is a fundamental pillar of soldier morale. If serving members and retired veterans face frustration and “agony” in seeking care, as the user query suggests, it sends a powerful negative signal throughout the ranks. It erodes the confidence of those currently in service and discourages new recruits, thereby undermining the military’s long-term ability to attract and retain the best talent. This has a direct impact on the nation’s “soft power projection,” as a country’s ability to care for its own stands as a testament to its strength and values.
The strategic nature of Narahenpita Military Hospital
Its failure would create a cascading crisis, impacting not only the Army but also the Navy, Air Force, and Police, who also maintain their own medical facilities. A collapse in military healthcare would also contribute to a broader public health crisis, as it could lead to widespread dissatisfaction and potential social instability. Therefore, the President, as the Commander-in-Chief, must recognise that the crisis at the Narahenpita Military Hospital is a strategic threat that requires an urgent and comprehensive response.
Actionable Recommendations
To address this multifaceted crisis, a clear, phased, and actionable framework for reform is proposed, based on the analysis of the current challenges. The plan is designed to move from immediate, targeted relief to a fundamental, long-term restructuring of military healthcare.
Propose a direct, ring-fenced allocation from the overall defence budget specifically for military healthcare, bypassing traditional bureaucratic bottlenecks. Swift acquisition of urgent necessities and stabilisation of the most critical shortages.
Short term: Implement an emergency procurement plan using the new funds to acquire essential medicines and medical accessories that are critically low. Resumption of life-saving treatments and reduction in patient out-of-pocket expenses.
- Retaining Key Personnel:- Address the critical shortage of intern house officers by immediately renovating and designating quarters for them at the Narahenpita hospital. Improved staff morale, enhanced hospital operations, and better patient care.
- Midterm: A New Retention Policy for Specialists, implement a new, formal retention strategy for specialist doctors and other healthcare professionals, including improved working conditions and a clear career path, such as the proposed MSc in Military Medicine. Reduction in the “brain drain” of skilled medical professionals from the military sector.
- Enhancing the Suwasahana Scheme:- Conducting a comprehensive audit of the scheme to identify and address administrative inefficiencies and targeting errors, proposing a move toward a fully digitised system with direct bank deposits. Increased transparency and equitable, timely access to benefits for all eligible service members.
- Fostering Public-Private Partnerships:- Expand partnerships with private hospitals on a national level with clear oversight, ensuring a wider range of services are available to military personnel. Diversified access to care, reducing the burden on military facilities and providing broader access to specialised services.
- Long term: Dedicated Military Healthcare Budget – Advocate for the creation of a dedicated, separate, and ring-fenced budget for military healthcare within the Ministry of Defence’s overall allocation. Ensures consistent funding for medical services, preventing diversion of funds to other military expenditures.
- A National Medical Technology Assessment Unit:- Establish a unit to assess the necessity and cost-effectiveness of new medical equipment and construction, ensuring sustainable, evidence-based investments. Prevention of unnecessary expenses and a strategic allocation of resources.
- Integrated Civil-Military Healthcare Strategy:- Develop a national strategy that formally integrates military and civilian healthcare systems to build long-term resilience against future health crises and economic shocks. Creates a more robust and responsive national healthcare infrastructure.
The Army Commander’s Commitment to Soldiers’ Welfare
The writer, being a veteran and in addition to being one of the beneficiaries of the Narahenpita Military Hospital, spoke on behalf of both active and retired soldiers, presenting key concerns to the current commander of the army. The commander listened patiently and responded that many of the issues had already been addressed with the Commander-in-Chief, with remedial actions underway. This effort is noteworthy and deserves commendation.
Conclusion: A Nation’s Unspoken Debt
The findings of this report demonstrate that the crisis at the Narahenpita Military Hospital is more than an operational failure; it is a strategic vulnerability that threatens to undermine the morale and integrity of the Sri Lankan Armed Forces. The nation’s profound debt to its service members, who risked their lives to secure its future, is not simply a matter of historical gratitude. It is a continuing obligation to provide them with the highest standard of care in times of peace. The paradox of a massive defence budget coexisting with a struggling medical infrastructure points to a critical need for transparent, targeted, and accountable fiscal management. By implementing the recommendations outlined in this report, the President, as Commander-in-Chief, can take decisive action to rectify these failures, honour the unspoken debt to the armed forces, and ensure that the Narahenpita Military Hospital remains a source of pride and a pillar of national strength for generations to come.
The writer is an Infantry officer who served the Sri Lanka Army for over 36 years, a former Security Forces Commander of the Wanni Region and Eastern Province, and he holds a PhD in economics. He can be reached at: [email protected]
