Local level hospitals attracting service seekers

BY HARI PRASAD KOIRALA,Urlabari, July 24: The local-level hospitals in Morang district have been bearing the pressure of patients as the people find it difficult to get medical services in the federal and provincial hospitals because of a lack of required manpower there.

In Morang, Koshi Hospital in Biratnagar is operated by the federal government and Madan Bhandari Hospital and Trauma Centre in Urlabari by the provincial government. However, due to a lack of doctor vacancies, patients often face difficulties in receiving services in these two hospitals. 

Since the establishment of local government, Sundarharaicha, Belbari, Pathari Shanishchare, Ratuwamai and Rangeli municipalities, and  Kanepokhari, Kerabari and Miklajung rural municipalities have been running local-level hospitals in the district. 

Except for Sundarharaicha Municipality, there are no vacancies for federal and provincial level health workers in any hospitals of these municipalities or rural municipalities.

According to Leelamani Dahal, an employee at the Health Department of Sundarharaicha Municipality, four doctors are providing services at the municipal hospital. Among them, one receives pay and allowance from the conditional grant provided by the federal government, another one receives pay from the conditional grant provided by the provincial government and the remaining two are paid by the municipality.

The municipal hospital in Haraicha of Ward No. 1 of Sundarharaicha municipality offers general practice services three days a week. According to Dahal, more than 200 patients visit the hospital daily for treatment.

Pathari Shanishchare Municipal Hospital is the top contributor to health services in the district. 

According to Murari Acharya, the head of the municipality's health department, the municipality has appointed three medical officers. 

Additionally, the hospital provides weekly morning sessions with two orthopaedic specialists, along with services such as primary care, gynaecology, sexology, dermatology, paediatrics, mental health, surgery and radiology.

Acharya said, "The hospital has been the best service provider in the district in terms of infrastructure, medicine availability and equipment.” 

According to him, more than 400 patients visit the hospital daily. 

Similarly, two medical officers have been providing health services at Belbari Municipal Hospital. According to Mahendra Khadka, information officer at the municipality, the hospital has been providing services from general physicians, orthopaedic surgeons and gynaecologists on a weekly basis.

Kanepokhari Hospital, operated by Kanepokhari Rural Municipality, is also facing pressure of patients. The municipality has approved two vacancies and appointed two medical officers. However, after one medical officer resigned for higher studies, the hospital has been running with just one. 

The hospital's chief, Dr. Abhijit Khadka, said, "The municipality advertised the vacancy three months ago, but it has not yet appointed any manpower."

Kerabari Hospital, operated by Kerabari Rural Municipality, has been providing health facilities to the people in the north-western part of Morang, including those from Dhankuta. However, it has been providing services with a single medical officer. 

According to the head of the Health Department, Tom Prasad Chaulagai, the hospital receives around 150-200 patients every day. A 15-bed hospital building is under construction in Kerabari, but the construction has been delayed due to a lack of budget assurance from the government.

Miklajung Rural Municipality in northeast Morang has been operating Madhumalla Hospital. 

According to the head of the Health Department, Chintamani Pokhrel, the municipality has employed two health workers including one medical officer and one MD from its resources. Patients from Ilam's Chulachuli and Jhapa's Damak also visit Madhumalla Hospital, where more than 200 people receive services daily.

Despite frequent requests from local governments for the arrangement of doctors from the federal and provincial governments, no doctors have been sent till now.  As a result, local governments are appointing doctors on their own and are providing effective health services. 

However, after the Office of the Auditor General flagged the salaries and allowances paid to these doctors as arrears expenditures, local governments have also faced legal challenges. 

Chief Administrative Officer of Kanepokhari Rural Municipality, Hira Kumari Yadav, said, "The government builds the hospital but does not send doctors. When we ensure the resources and appoint doctors, the salaries and allowances are flagged as arrears expenditures." She said that due to legal issues, many initiatives by the local government had been hampered.