| July 19, 2019

Lives on the line

Shortage of doctors

The recently announced budget aims to have at least one medical doctor in every Village Development Committee (VDC) in Nepal. There are currently 3,276 VDCs in the country. Theoretically, arranging for one MBBS-pass doctor for each VDC should not be that difficult as Nepal churns out over 1,500 such doctors a year. If there was a mandatory requirement for every MBBS graduate to serve in rural Nepal for a couple of years, then there would be enough doctors to cover all of Nepal. But today's reality is that nearly half the VDCs in Nepal have been operating without any doctor. Since the government has also been unable to procure vital medicines for past two years, the health posts in these VDCs would be running short of life-saving medicines as well. Public health in Nepal is thus in a precarious state. It could get worse. At a time health experts have been warning of possible outbreak of communicable diseases in the temporary camps in the 14 earthquake-hit districts, all medical doctors deployed there after the earthquakes have returned from their workplace. There is no plan to replace them.

The health facilities in these districts are also in disarray. The Gorkha District Hospital for example was badly damaged by last year's earthquakes. But there has been no initiative to rebuild the damaged structures. When power goes out, the hospital sends back service-seekers, even though there is a backup solar generator. The back-up generator, like much of the hospital, is kaput. The hospital has plenty of new equipments like x-ray machines and modern dental units that were donated to it after last year's earthquakes. But there isn't enough electricity to run them. And these barely functional public health institutions are supposed to ensure universal health coverage of all Nepalis in the next three years. The universal health scheme might as intended cover all Nepalis, but what will be the quality of the services they receive? Also, the Oli government, in its recent budget, committed to concentrating health resources in areas that most needed them. How does that commitment square with the recall of doctors from quake-affected regions? There is thus a big gap between commitment and action.

In case of the earthquake-affected populations in the 14 districts, the question is: How long were the doctors sent immediately after the April 25th earthquake expected to remain in their deployed areas? Surely they didn't sign up for an indefinite period. With the work of rehabilitation of earthquake victims expected to take at least a couple of more years, according to the National Reconstruction Authority, they were bound to get restless. But it appears that many of the doctors were ready to stay put if the government had again sought their help and given them time-bound new contracts. By allowing their contracts to lapse, the government has once again put nearly 770,000 families who were rendered homeless by last year's earthquakes in the harm's way. To avert another disaster it must immediately draw up new contracts for doctors to be deployed to the 14 quake-hit districts and commit to support them in every way. This is the least it can do for the long-suffering earthquake victims.

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