Uttam Maharjan

Health is wealth. Access to healthcare facilities is one of the fundamental rights of the Nepali people as enshrined in the Constitution of Nepal. The Constitution has ensured health rights for every citizen. As stipulated, inter alia, in the Constitution, every citizen has rights to basic health services and that no-one will be deprived of emergency health services; every citizen has rights to seek information about their medical treatment; every citizen has equal rights to health services; and every citizen has rights to access to clean drinking water and sanitation.
Likewise, the Sustainable Development Goals (SDGs) have health as one of the components. The SDG No. 3 has set health targets for countries all over the world, such as those relating to reproductive, maternal, newborn and child health; infectious diseases; and health systems and funding. The targets are designed to increase the life expectancy of people, reduce maternal and child mortality and fight against communicable diseases, among others.
Inadequate facilities
Nepal has been working on improving the healthcare systems and has achieved headway in some aspects. But when the novel coronavirus erupted in China and spread to other countries, including the country, the country was caught off its guard. In fact, the healthcare infrastructure in the country is not up to the mark. When the disease broke out, only one laboratory, the National Public Health Laboratory, and one hospital, the Sukraraj Tropical and Infectious Disease Hospital, were there for testing and treating purposes respectively. Other government hospitals, private hospitals and pathological laboratories proved to be helpless before the coronavirus.
In view of the rapid spread of the COVID-19 all over the world, the government has taken harsh measures to curb the spread of the disease. In the meantime, the government has imported medical goods, including PCR machines and testing kits, to test cases for the disease. Now, all seven states have been equipped with such equipment, testing kits and other necessary medical goods for testing and treatment purposes. Likewise, isolation wards have been set up in various hospitals and some hospitals have been designated as COVID-19 hospitals as a step towards controlling the disease.
One of the problems with healthcare services in the country is concentration of healthcare facilities in Kathmandu and other major cities like Chitwan, Nepalgunj and Pokhara. The people living in the rural and remote areas are compelled to visit such cities for medical treatment. It is an irony that even accident victims or pregnant women have to be airlifted or carried to such cities. Due to the Kathmandu-centric development mode, it does not dawn on the rulers and leaders that healthcare facilities are also required in the rural and out-of-the-way places. Even if there are healthcare facilities in the outlying districts, such facilities are confined to the headquarters. This is one of the reasons why the people balk at returning to their villages or towns once they land in Kathmandu.
The coronavirus pandemic has taught us a lesson. For starters, there should be at least one well-equipped hospital in each state. If possible, each district should have at least one well-equipped hospital. Such an arrangement will ensure early treatment and hence death due to delay can be averted. The people can also heave a sigh of relief as they will be free from hassles and heavy expenses. The government has instructed all the seven states to build quarantine hospitals. As it seems to be out of the question right now to follow the instruction, an adequate budget should be allocated for next fiscal year and the hospitals should be built accordingly.
There should be a provision for the doctors to be deployed to hospitals outside the Valley for a certain time. In all probability, the doctors will make no bones about working in well-equipped hospitals. Now, there are health posts in outlying areas. Such health posts often have to face a dearth of medicines and health workers. When there are well-equipped hospitals all over the country, the pressure of patients on Kathmandu will be definitely lower. Viewed thus, it behoves the government to take the COVID-19 as an opportunity for improving the health sector.

Right strategy
In human history, people have faced deadly diseases: the Black Death, cholera, Spanish flu, Ebola virus, SARS, MERS and the like. There is a chance that deadly diseases may break out in the future, too. Therefore, the country should brace itself to face such disasters in the future. For this, the only way-out is to improve the healthcare infrastructure in the country. The country should collaborate with other SAARC nations at a regional level and with developed and other countries with good health facilities at a global level to improve the health sector.
The National Health Policy, 2071 seeks to promote, preserve, improve and rehabilitate the health of the people. It is also designed to tackle the existing and newly emerging challenges in the health sector. The COVID-19 is a new disease that could not be predicted to break out on such a massive scale. The world has now learnt that there should be a strategy for the timely management of unpredictable diseases. The country should also formulate its health strategy accordingly.
The effects of the COVID-19 are low in the country vis-à-vis other counties like the USA, Italy, Spain and France but the spread of the disease in the country cannot be ruled out. The government has imposed a nation-wide lockdown since March 24 and publicity about preventing the spread of the disease and avoiding contracting the disease is going on aggressively. Therefore, the people should take extra care to stay safe by practising social/physical distancing and adopting other preventive methods.

(Former banker, Maharjan has been regularly writing on contemporary issues for this daily since 2000. uttam.maharjan1964@gmail.com)