BY D. M. THAPA
Like many people all over the world, I too have had to visit hospitals for different reasons, mostly in Kathmandu. On most occasions, I have gone to hospitals not because I am a doctor, but to visit near and dear ones, relatives and friends among others who have been hospitalized.
Every time I go to these places where they come for treatment of various diseases, some serious and some not that serious, I feel very sorry for the sick individuals I see and also the appalling conditions in which they have to stay. If such is the case in the well equipped hospitals of Kathmandu, the capital City of Nepal, one can imagine the state of affairs in the far flung areas, where proper health care is just a myth which is out of bounds for many.
As everyone knows, though very small in size, Nepal has a most difficult terrain and the people are compelled to live in the most difficult areas, whether along the mountain terrains, the hilly districts or even the plain Terai Belt, which has better road facilities. But even there, floods create havoc in every Monsoon season like it is doing now and dozens of people have already lost their lives, still the government seems most ill-equipped to deal with this regular problem. Instead we hear of tall promises and also about the way political leaders in the Parliament and other local bodies are taking huge amounts of money in the name of development. In fact it is reported that a minimum of development works take place and the funds allocated for one fiscal year are spent on unproductive things by officials, just to finish the budget!
But to come back to healthcare in the country, Kathmandu has some good hospitals with well trained doctors, but still our leaders tend to go abroad for treatment of minor ailments as well. That means they have the constant craving to go abroad even if they are ill and more importantly they don’t have faith in the treatment facilities within the country. But the majority of the people cannot do what the political leaders do, though some rich people go abroad for treatment and other lesser ones go to neighbouring countries which costs less for medical treatment. Mostly, the savings of the middle class people are gone if one member of the family gets ill and he or she has to be taken outside Nepal for treatment. Many even sell their houses and other property, including land, for the good health of their loved ones. But the political leaders just take funds from the government coffers and the super rich can afford to go to even America or Europe for treatment.
Now imagine life in the remote and harsh areas of the country, where there are no hospitals and small ill-manned and ill-equipped health posts that are there for whatever ailments people living there suffer from. Some places in rural areas don’t even have such facilities and walking too far off health posts are a common thing. Sometimes a patient has to also be carried to these ill-equipped health posts.
There are thousands of doctors, well trained nurses and other medical hands in the country, but no one wants to go to such far flung areas for the meager salary paid to them by the government. The government has tried to enforce strong regulations, specially for those medical doctors and nurses who have been funded by the government for their studies, but still such doctors, nurses and medical hands can be found only in the district headquarters where there are better basic facilities and transport connections as well. There have been hundreds of reports of how a health post is manned by an untrained office boy and that also he or she does not have any basic medicines to provide relief to those who come there for even minor ailments.
The doctors, nurses and other medical hands, want to stay only in Kathmandu or other bigger townships like Biratnagar, Pokhara, Nepalgunj, Bhairahawa, Chitwan and a few other populated areas with people willing to pay for better health facilities.
It is said the doctors take an oath to cure the ill people before they take up their study of medical science. But in the five plus years it takes them to become a full fledged doctors, it seems they forget their solemn oath and see only money in front of their eyes whenever they come across a sick person needing their advice. The doctors normally work in government offices, if they have the right connections and then they put in more efforts in lucrative private practices or work for well paying private hospitals. This is the same for others like nurses and those who are trained to do essential medical works. But at least some leaders decades ago had the vision of not only in providing medical education within the country to those who deserved the same and also setting up health posts all over the country with the aim of reaching the services of at least one doctor and one nurse with other helping hands in such remote areas. But all such plans were flaunted by doctors and others for the greed of making money.
With the mushrooming of private medical colleges in providing more home educated medical professionals, the fate of those who unfortunately become ill has even become worse. The political leaders, wise planners and policy makers seem least bothered as long as they make money with owners of the private colleges which charge millions of rupees for a person to become a doctor, but provide bad services.
Perhaps this is the reason why we hear of doctors getting beaten up by irate crowds and hospitals getting shut down at frequent intervals.
There are some good hospitals, including government ones, but they are carelessly run and the doctors and others who work in such health institutions are not concerned at all about cleanliness, proper medical waste management, hygiene and their behaviour towards patients, without whose money, they would be unemployed!
But at the same time, we have to agree that students have to pay a hopping amount of money to become doctors and even nurses. They have to also work long hours and specially the nurses have to tend to more patients than that is stipulated per nurse in hospital regulations. It is said they are not well paid as well, but it has also been reported of how many poorly qualified individuals are getting admissions in training institutions just because they want to be doctors or nurses. This no good, as it is the patients who have to suffer because of such medical personnel who have studied in colleges with a bad track record or nurses who just want to go abroad to make more money. I have personally seen such so called medical professionals, who could not even draw out blood from a patient for some tests. At the same time there are reports of how locally made drugs are not of good standard because of poor supervision and careless pharmacists and of how some drugs, also those imported from India, are not up to the standards endorsed by the government. “Such drugs could be not only useless for patients but they could also be seriously harmful,” a medical doctor said while being interviewed by a TV anchor.
Wise people said it was a curse to be ill in a country like Nepal and this seems to be quite true except for influential political leaders and the super rich. For others, we have to depend on God and hope the doctors treating you are well qualified and others are more well behaved after all the money that has been spent for your treatment.