Sunday, 31 May, 2020
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OPINION

Health Sector Needs Overhaul



Mukti Rijal

 

Coronavirus pandemic has hit Nepal though the scale and intensity of its invasion yet far appears not very large and comprehensive. Only five persons are confirmed of having contracted coronavirus so far. Anyway, timely decision to implement some relevant measures to limit the damage is welcomed from all quarters. The prompt steps taken by the government especially to enforce lockdown is said to be one of the reasons why the virus pandemic is halted to spread further with disastrous consequences though undetected cases could be more than meets the eye.
The much appreciated lockdown has, of course, caused seen and unseen hardships to the people. This is particularly due to the lack of concomitant preparedness on the part of the government agencies to mitigate the risks that have ensued following the clamping of the lockdown. The acute shortage of facilities, logistics and equipment needed to test the probable cases of infections has posed greater challenge and dilemma. The people who are suspected or have to undergo pathological test for determining or ruling out the probability of infection have to go through the ordeal of isolation or quarantine for considerable length of time due to lack of kits and lab facilities at the convenient locations. Many people especially coming from abroad especially India, Europe and Gulf countries are reportedly confined into isolation waiting for their turn of lab testing and investigation.
It is said that fifty plus thousand people are listed needing investigation to squash the fear of infection or contagious effect. Many more are yet to be spotted, identified and admitted into the isolation facilities. Reports have indicated that some sub-national and local governments have been active to help locate people coming from the countries hit by the coronavirus, build quarantine facilities using public schools and community places and provide needed support to them. However, such facilities are said to be very shabby, like makeshift structures generally said to be unfit t for sick people to stay and recuperate. Moreover, the plight of the people coming from India who are stranded and left to fend off for themselves in major entry points of Nepal-India border is reported to be very pathetic and therefore needs prompt attention. Due to lockdown enforced stringently in Nepal these people are not allowed to enter. A situation that the people coming from India are forced to risk their life jumping into the Mahakali river to swim across to Nepal to elude the lockdown clamped in the border points is heart rending and shows the gravity of the situation.
Mention in this context needs to be made of the role of the state (Pradesh) governments. They have failed to respond to the critical emergency gripping the nation. No state (Pradesh) capital or major city outside the Teku Hospital in Kathmandu has set up the facilities to take diagnostic lab test on corona virus. Chitwan, Butwal, Nepalgunj and Biratnagar have been the major cities outside Kathmandu where such facilities would have long provided. Though with the test kits and equipment supplied by China, the facilities are reportedly being propped up in all the states. But these facilities are reportedly to come into shape yet though the situation is very critical, demanding immediate and hands-on action.
Furthermore, the sordid state of services characterised by negligence and irresponsiveness in private and public hospitals should not escape scrutiny. The patients who arrive in the hospital for medical services have been turned back in a blanket and random manner or sent for quarantine or isolation without examination. As a result, those who are affected due to other seasonal infections and diseases than corona virus are denied medical care and reportedly succumbed to illnesses. A case of death in Butwal the other day is said to be of that nature. The lack of Personal Protective Equipment (PPE) is argued to be the reason why the medical personnel have been compelled to shirk their responsibility. As the government has geared up for making these gears available at the needy hospitals and service centers, this should not be an excuse for evading services.
Generally, if one takes into account the situation of public hospitals, doctors and nursing staff working for them, they are found not attending to their duties on a regular basis. What is dismaying is the fact that the basic diagnostic equipment and appliances like X-ray have been allowed to go dysfunctional rendering the hospital assets non-performing and their services go almost bust. Not only at the districts, public hospitals like Bir Hospital, Teaching Hospital and Chitwan Cancer Hospital have not been doing well. The services in Bir Hospital and Chitwan Cancer Hospital have come under sharper public scrutiny time and again. The ugly face of the medical community does come to the fore time and again. The chief of the prestigious hospitals and institutes have been accused of misusing resources while procuring medical equipment, vital supplies and medicines.
Practicing medical doctors were caught in the past for allegedly possessing fake academic certificates. Medical community is respected in the society. If those who are trusted as the savior of the life of the people are themselves found indulging in abominable practices, there cannot be severer breach of ethics than this. The Medical Council as it is headed by respected Dr. Bhagawan Koirala, it should not limit its action only to issuing caution order but should take stringent measures to ensure that hospitals, doctors and nursing staff both in public and private sectors rise to the occasion to respond to the challenges facing the country due to Covid-19.

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

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