Mukti Rijal

The other day Dr. Govinda KC has ended his 19th hunger strike that had lasted for almost a month. It is a welcome development as the government responded to Dr. KC’s concerns that finally persuaded him to end his hunger strike. It is a sigh of relief for the civic community, as his health was getting worse. Though such agreements had been signed in the past also, Dr. KC has accused that the government dishonored the terms of the agreements entered during the previous years. Now the question can be raised as to why Dr. KC has to go for hunger strike time and again? Why his well-accepted demands to reform medical education have not been met despite commitment and agreements with the governments in the past? But this time it is expected that the terms agreed with Dr. KC will be implemented.

Radical reform
Undoubtedly, even the government ministers admit that save his stubborn and position based approach, Dr. KC has championed the cause of radical reform in medical sector. And his demands appear to be directed at bringing about the constructive changes in medical education in particular. According to the reports including the one produced by much highlighted Mathema panel to which Dr. KC basically takes cues from, medical education is rapaciously abused and exploited by a coterie at the cost of the students seeking to study medicines in particular and general people in general.
In this context mention can be made of the fact that medical students have not been able to secure the reimbursement of the amount unduly charged and extracted from them in violation of the fee structure set and prescribed by the government. According to the media reports, a hefty sum of rupees had been collected unduly and illegitimately by the private medical college operators to the detriment of the interests of students who have ventilated their grievances against the cost prohibitive medical education in the country. Though the education minister had ordered the medical colleges to refund the amount unduly collected from the students, many private college operators have evaded respecting it.
Whenever Dr. KC goes for hunger strike, it grabs the attention of all civic stakeholders and public spirited individuals. However, some political parties even try to take advantage of the popular sentiments that tend to support Dr. KC’s hunger strike. Dr. KC and those throwing their weight behind him have not been found to be aware lest the political parties upset by the popular disinterest and discontent due to their dismal show to impress the people take advantage of the situation to incite and foment the trouble. In fact, as the country is badly mauled by coronavirus infection taking a heavy toll on the life of the people, the hunger strike launched by Dr. KC was indeed ill-suited and ill-timed despite the fact that the issues raised by him are genuine and well appreciated.
Needless to repeat, coronavirus pandemic has hit Nepal for long and the scale and intensity of its invasion has gone out of control now. Kathmandu valley has already turned out to be the hotspot for corona infections. The shortage of facilities, logistics and equipment needed to test the probable and suspected cases of infections have posed problems. It is reported that the people who are suspected or have to undergo pathological test for scrutinising or ruling out the probability of corona infection have to wait for a considerable length of time probably due to lack of kits and lab facilities at the convenient and accessible locations. Since over one hundred thousand people have been already infected, it is feared that corona infection would be difficult to control if the present level of surge goes unabated. The scarcity of ICUs and ventilators is said to be severe in the hospital.
Furthermore, the sordid state of services characterised by negligence and irresponsiveness both in private and public hospitals should not escape scrutiny. The patients who arrive in the hospital for medical care and services have been turned back in a blanket and random manner or sent summarily for quarantine or isolation without proper examination and diagnosis. As a result, those who are affected due to other morbidity than coronavirus are denied medical care and reportedly do succumb. The short supply of Personal Protective Equipment (PPEs) and other logistics is argued to be the reason why the medical personnel have not been able to perform effectively.

Skewed pattern
However, complaints have been aired pointing out discrimination and skewed pattern in the provision of health service delivery. Political leaders and the higher-ups are given undue favours at the expense of the state’s coffers, but the poor people are not taken care and thus compelled to fend for themselves. The poor people who land in the hospitals for medical services have not only to face hassles but are made to pay fees for the tests that are declared to be free on behalf of the state considering the situation of pandemic.
The medicines supposed to be distributed to the common people for free in line with welfare health services of the government have been allegedly swindled and sold out through private medical outlets in the market. Not only the district hospitals but the performance of hospitals run by state (Pradesh) government is tardy and poor. Against this backdrop, the demands put forth by Dr. KC to reform health sector are in line with the egalitarian spirit of the constitution of Nepal. The government should learn lessons from the experiences obtained from the COVID-19 management and restructure and revamp health delivery services in the country which will be tantamount to honouring the agreement with Dr. KC.

(Rijal, PhD, contributes regularly to TRN and writes on contemporary political, economic and governance issues. rijalmukti@gmail.com)