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Closed shutters, ‘shop on sale’ and ‘to-let’ notices are on display almost everywhere in Kathmandu. These scenes at business hubs to nooks and crannies point toward an economic crisis that started in the country after the coronavirus pandemic, only to deepen in the wake of international tensions like the Russia-Ukraine war. While traveling around Kathmandu for a field report, this journalist went a bit beyond those shut shops, ‘to-let’ and ‘shop on sale’ notices in a bid to fathom the crisis better. Be it a khaja ghar owner, a grocer, a readymade clothes seller, or a street vendor, everyone was waiting for customers. Many of them were playing games on their mobile phones, some were chatting with fellow shopkeepers, many were dozing off, while a few were calling passersby in a desperate bid to sell their goods. Many owners of these outlets have been finding it hard to pay the rent, leave alone make a decent profit. Delayed rental payment has become quite common. A message displayed on a landlord’s cellphone highlights the hardship thus: “We will probably transfer it (the rent) to your account this week. Sorry for the delay and thanks for your patience.” A brief conversation on the phone between the landlord and the tenant makes it amply clear that none of the tenants pay the rent on time. High price rise in the market Rameshwor Raam (60), a shoemaker from Sarlahi, Bagmati Municipality, has been making a living in this city for more than 30 years. Raam says eking out a living has never felt this difficult. Market prices have spiraled up, but customers need the services at earlier rates, he observes: People bargain hard…. They need to know that things have become really expensive. “Profit margins are quite low. But what option do I have other than carrying on with this profession despite a meager income? Plan for closure Shyam Shrestha (40) runs a Newari Khaja Ghar at Shantinagar. He says  daily income from his business has declined after the coronavirus pandemic. “Before the pandemic, the daily earning used to be about 10-15000 per day. Now, it has gone down to Rs 4,000/day,” Shrestha says. “The situation of the country is not good. A conducive investment climate is lacking. There’s no certainty that your investment will yield profit. Market prices have been skyrocketing making it difficult to run a business.” Shrestha, who returned home after working abroad for six years, thinks he won’t be able to give continuity to his business if the situation does not improve. What is the way out then? Heading abroad, once again. That’s what Shrestha has been thinking about, of late. “One has to take care of their family, educate their children, raise them properly…. These are not normal times…. With rising costs of living, things are getting really tough here.” Many people like Shrestha have returned to the country over the years, only to find the going tougher here. After working abroad for 14 years, Raju Dhakal (33) returned home with the aim of doing something within the country. He set up a retail shop—Jamuna Store—at Budhanilkantha. But the going has not been easy for Dhakal, what with the pandemic and the ensuing economic crisis. With the business hardly making any profit, the youth has made up his mind to sell the shop and move to Dubai. “I had planned to upgrade my shop as a wholesale store. But a grim economic situation has spoiled the plan. The business has gone down so much that I am finding it hard even to pay the rent,” Dhakal laments. ‘Shops on sale’ notices make it amply clear that a lot of shopkeepers in the city are trying hard to sell their shops for want of profit.

The members of Parliament raise their concerns on social and national issues. These issues range from health to education to infrastructure to policies at both national and constituency levels. It is the job of the MPs to draw attention of the government to the problems that need fixing. And in case there are some lapses and oversights on the part of the government, it is also the duty of the MPs to hold the executive to account. But are the concerns and suggestions that come out of Parliament ever reach the government? What are the procedures in place to ensure that the legislative and the executive arms of government are working together. Ekaram Giri, spokesperson for the House of Representatives, says the ministries usually send their representatives to attend the parliamentary meetings. It is the task of these representatives to report the matters discussed in meetings to their respective ministries. Besides, Giri adds, the House sessions are broadcast live for everyone to see. So, the ministers who cannot make time to show up in parliamentary meetings can always remain updated. Whether or not the ministers choose to stay in the loop is another story entirely. Speaking at a special time in the meeting of the House of Representatives on Wednesday, several lawmakers pointed out the issues of public importance and a few suggested ways to resolve them. Here is what they had to say: Arju Deuba, Nepali Congress I am suggesting ways to improve the education quality in government schools. There has been a lot of politics in the formation of school management committees. The existing guidelines should be updated to change the way these committees work. To make an environment for English medium teaching in primary schools, necessary rules, policies and resources should be ensured. It is necessary to increase the admission rate in schools. Every aspect of society should pay attention to this. Let us clarify the rights and authority of the three-tier government. Let us evaluate the performance of teachers and students. It is also necessary to regularly inspect and evaluate schools. Students and teachers should be rewarded and punished on the basis of the results. Madhav Sapkota, CPN-Maoist Center Only those who have never been in the position of privilege and profit in their life should be appointed to the Commission for Investigation of Abuse of Authority. People who have enjoyed exercising authority should not go to the commission, as they will be influenced in one way or the other. Our constitutional bodies and agencies have been turned into clubs for the retired bureaucrats. It is like people go there to enjoy power, to rest, and to spend time like aristocrats. Sumana Shrestha, Rastriya Swatantra Party Why is there an emergency postponement of parliamentary meetings? If we cannot coordinate between the Cabinet and Parliament, how will we coordinate between many ministries and agencies in  big projects? Is the taxpayers’ money so cheap? Is this because the money does not come out of our pocket? Let's call a mistake a mistake. A tendency is being set where the state resources and the precious time meant for parliamentary business are being wasted at the whims and fancies of the government. Amresh Kumar Singh, independent The citizenship bill was not passed by the government because it concerns the children of the poor. Had it been the question of the children of the prime minister or former prime ministers, it would have long been passed. The children of the poor people are suffering because they do not have citizenship documents. Every government and its leaders promise to solve the citizenship problem, but they are working in the shadows to stop its passage. I have seen such double standards when I was a member of the parliamentary committee for state administration. The previous government deliberately blocked the passage of the citizenship bill. The ruling MPs at the time put the bill on hold. The problem of citizenship is the problem of the poor, and since they do not have any power, ignoring their concern is easy. When a select community tries to run the government as per their convenience and vested interest, there is a risk of the country plunging into a crisis. If that happens, no one will be more accountable than those few individuals who have served as the prime minister of this country in the recent decades. Uday Shumsher JB Rana, Nepali Congress The government must find the short- and long-term ways to control the worsening air pollution of Kathmandu Valley. Incidence of forest fires and seemingly unending road widening projects in and around the Valley have contributed to the rising air pollution problem. Ain Bahadur Shahi Thakuri, Nepali Congress The government should open transit points along the Nepal-China border in Humla. It takes a two-day walk from Khatyad of Mugu to reach the district headquarters. Open an area administration office within the municipality. Ranju Kumari Jha, Janata Samajbadi Party The government should arrange fertilizers for farmers. There has been a government to government agreement with India to bring fertilizers in the country, so why has the Salt Trading Corporation been given the tender to bring fertilizer? Why has the government planned to bring low grade chemicals from Iran revoking the past government’s decisions? This government must give answers. Prem Suwal, Nepal Majdoor Kisan Party It will be disastrous to let Nepal’s private companies involved in hydropower generation sell the energy to India. The government should sell the green energy to India only after meeting the domestic energy requirement

The excitement after conceiving, dreams of being a mother, a life growing inside, hormonal changes, and difficulty with the large belly, fear of delivery…. A bundle of mixed emotions never known before… That is what a mother-to-be experiences during nine months of her pregnancy. During this period, adequate care is a must for survival and good health of both the mother-to-be and the life growing inside. The World Health Organization has recommended four antenatal visits during pregnancy. The antenatal period presents opportunities for reaching pregnant women with interventions that may be vital to their health and well-being and that of their infants. Receiving antenatal care at least four times increases the likelihood of receiving effective maternal health interventions during the antenatal period, per the UN health body. Seeking the services, at least 1,000 women visit the Paropakar Maternity and Women’s Hospital daily. Crowd everywhere New mothers standing, placing their hands on the lower abdominal area, walking slowly, holding the hands of their relatives, relatives holding newborns wrapped in warm blankets, bargaining with the taxis are some of the everyday scenes in and around the hospital. As you get in from the eastern gate you are welcomed by a large number of men using their mobile phones. Some of them are even seen sleeping on black mats. As you walk further there is a crowd to welcome you. Women from their first months of pregnancy with those in the final days of their pregnancy are seen sitting on the chairs, floors and many leaning on the walls. Had there been sufficient chairs on the waiting spaces both in the OPD counters, corridor near video X-ray room, doctor’s room, it would have been easier for the service seekers. A lack of sitting spaces in the hospital compels people to sit on the stairs. Women fanning themselves shows the lack of ventilation in the corridors. Like the new mother and her child, the hospital too needs proper care to help it grow and blossom. “There is always a crowd here. Had there been proper sitting arrangements, it would have been easier for service-seekers,” said Shanta Shrestha, 27 from Tanahu. ‘Beware of pickpockets’ signs are almost everywhere on the walls of the hospital, cautioning both the suspects and the gullible public. Brimming with patients   When this reporter visited the hospital on Wednesday morning, the hospital beds were all full of new mothers and their babies. The beds are arranged very close to one another. The wards have become less spacious. It is a tertiary central hospital supposed to have 415 beds for providing obstetrics, gynecology and neonatal services. Keeping in mind a growing number of service-seekers, the hospital has added more beds—altogether 489 to be exact. Even the extra beds do not seem to be enough. “Despite the addition, the number of beds is insufficient. Many women and their families go to other hospitals fearing that they won’t get the beds after delivery seeing the lack of beds in the hospital,” said Dr Pawan Jung Rayamajhi, director at Paropakar Maternity and Women’s Hospital. Nurses lacking The country has been coping with a shortage of nurses and this is one of the major ills plaguing this hospital as well. Only a few nurses were there in the emergency and the wards on their duty attending patients, some busy on dressing the patients, some adjusting cannulas, some taking blood from the syringes. They were seen to be running from one bed to the other measuring and recording blood pressure. The hospital has 170 nursing staff. “The number is not enough to deliver quality health services,” said Dr Rayamajhi, adding: The hospital needs at least 350 nurses immediately to provide quality services. There are 300 medical practitioners (including 170 nursing staff) and 348 administrative staffers in the hospital. Lack of ultrasound, x-ray machines, MRI   The hospital does not have sufficient ultrasound and x-ray machines to meet the demands of pregnant women seeking the services. According to the 59th Auditor General’s report for the fiscal year 2021-22, 4,200 patients were referred to other hospitals for Magnetic Resonance Imaging (MRI) and the same situation continues this year too. There is only one ultrasound machine of low capacity because of which it has been difficult to diagnose the diseases. Patients have to wait for 3-4 hours for an ultrasound. Also the high use of the machine leads to errors in the report, the report revealed. The hospital however claims that it is delivering services from six ultrasound machines. “The machines are insufficient. It is all because there is a lack of space in the hospital. If there is enough space, we can have more machines. But we don’t have enough space to extend our services,” said Dr Rayamajhi. The report also revealed that x-ray services are not available in the neonatology department. The hospital charges Rs 1,000 for the service while private hospitals take Rs 3,000 for the same service. The report has advised the hospital to manage equipment required to deliver quality services. Also, only 40 beds are available at the neonatal ward. “If the number of beds are increased at the neonatal ward and services improved, we won’t have to refer the newborns to other hospitals,” said Dr Rayamajhi. Infra improvement necessary The hospital must improve its infrastructure to deliver quality health services. All these critical services are still being delivered from an age-old building, which lacks adequate infrastructure to cater to a growing number of patients. The building’s corridors look like dark alleys for want of adequate lighting. The toilets at the post-delivery ward stink, what with the lack of running water and cleanliness. The only commode at the ward is unusable. Even usable commodes would have given women, especially those who have undergone surgery, much relief.

The country has been witnessing a rise in the number of Covid-19 cases since the past week. Health experts say the rise in infections in India, with which Nepal shares an open border, is a major reason behind the rise in the number of infections. Several Indian states and territories like Delhi, Gujarat, Himachal Pradesh, Karnataka, Kerala, Maharashtra Punjab, Tamil Nadu, Uttar Pradesh and West Bengal have seen a surge in the number of coronavirus cases in the past week. The new variant XBB.1.16, the Omicron recombinant sublineage, is currently driving the new Covid-19 spike in India and is also the dominant strain spreading in the city, various Indian media have reported. “Open border with India and the lack of surveillance in land crossings have resulted in the rise in infections in Nepal,” says Dr Baburam Marasini, public health expert. He points that the people’s tendency of taking infections lightly and not bothering about preventive measures is also to blame.  The XBB.1.16 variant, however, has not been detected in the country till now. “The number of people suffering from influenza has increased in the country also because an increasing number of people are opting for medical tests,” according to Dr Anup Bastola, tropical and infectious disease expert. Experts stress the need to ramp up tests warning that infections on the rise in communities can spread further if control measures are not taken. They suggest people to practice preventive health measures such as wearing masks and frequent handwashing. But seven districts in Madhes Province—Parsa, Rautahat, Bara, Sarlahi, Mahottari, Siraha and Saptari—have stopped PCR tests as they lack human resources. The World Health Organization on Wednesday said it is monitoring XBB.1.16, an omicron subvariant that has been documented mostly in India. “We're monitoring it because it has potential changes that we need to keep a good eye out on,” Maria Van Kerkhove, WHO’s COVID-19 technical lead, said at a press conference. “The surveillance must be increased both along land crossings and international airports,” says Dr Marasini. Experts also suggest people to take the vaccine against coronavirus and its additional doses to protect themselves. A total of 12,020 people have succumbed to the infection till March 30 in the country.

As I walked past the corridors of Bir Hospital for this article, I was transported back in time. Twenty-four years ago to be precise. When I was a child back then, I would accompany my grandfather, a patient of bronchitis, to the hospital for his regular check-up. Bir Hospital has barely changed after all these years. The corridors that I walked as a child, the counters where patients and their relatives gather, and the hospital building itself look and feel the same. The only thing that seems to have changed over the years is the absence of natural lights that would pass from the windows to light up the corridors. The corridors need to be illuminated by electrical lights these days. Though Bir Hospital has constructed new wings and departments, its main building is falling into disrepair. The taps that were either broken or leaking, and windows that were without panes have not been fixed. Toilet doors that used to have bolts are gone now and the tap water is murky. The hospital bathrooms look and smell horrendous—hygiene and sanitation be damned. Long queues, lack of sitting arrangements, wheelchairs The hospital services are no better either. People holding medical reports while assisting their sick relatives to walk, elderly people sitting on the floor or wandering aimlessly wearing confused expressions on their faces, and long queues outside counters are common sights that you see here. The hospital lacks basic things like wheelchairs and sufficient seating space for patients and visitors. A hospital cleaning staff member tells me there is only one wheelchair in the emergency room. It is clear to see that the oldest hospital in the country is not functioning well. Established in 1889 by Bir Shumsher, Bir Hospital is where people who cannot afford private hospital fees come for treatment from around the country. The hospital receives around 2,000 patients in a day, but not every one of them gets the medical attention they need. The hospital boasts  multi-special care from more than 30 departments, not a single one of them is well-managed. There are long queues at the OPDs of every department, at the pharmacy, and at the laboratory. “There are queues everywhere. It is difficult getting anything done here,” laments Shreemaya Budhathoki, a 66-year-old patient who has traveled all the way from Lamjung district. Lack of nurses I have a distinct memory of following my mom around the hospital, looking for a nurse whenever my grandfather’s health deteriorated or his saline drip needed to be adjusted or replaced. The experience is the same for patients and their relatives who visit Bir Hospital these days. In a medical ward filled with more than 20 patients, I observed there were only two nurses to attend to their needs. My suspicion was confirmed by Dr Bhupendra Basnet, former acting executive director of the hospital, who told me that Bir Hospital requires over 500 nurses to provide smooth services to the patients. “If the hospital can recruit the required number of nurses, it could run the 500 beds in its new building,” says Basnet. “But there is a severe dearth of nursing staff.” A lack of nurses has also affected the hospital services. Out of 15 operation theaters, only nine are running. “There are only two trained nurses in our department. If we can recruit specialized nurses the service delivery can be increased,” says Dr Robin Bahadur Basnet, head of the Urology Department. Old equipment Outdated machines and equipment have also hindered services at Bir Hospital. Some of the equipment is so old that in case they are broken, services will be indefinitely halted. Dr Basnet says the hospital has not bought new equipment in a long time. “Every now and then we have to replace parts of the machines to make them work. We are still relying on old equipment to provide services,” he adds. But it is not enough that the hospital added new equipment, it also needs to train its staff to use them correctly. A UroDynamic machine, which was bought by the hospital five years ago, has still not been installed.  The machine detects whether the urine leakage in a patient is because of a neurological or prostate issue. The hospital staff are not trained and incentivized to carry out their duty effectively. “For the hospital to deliver quality services, the government must increase the budget,” says Dr Basnet, the former executive director of Bir Hospital. Wait list for surgery Despite its crumbling infrastructure, poor services and  lack of equipment and human resources, Bir Hospital continues to draw a large number of patients every day. This is where the people with poor economic backgrounds come to seek medical help. And large patient volume often means delayed services. Take the Urology Deparment for example, where patients in need of surgery have been put on a wait list for up to nine months. It’s the same for other departments as well. The Urology Department runs outpatient services for three days in a week, during which over 600 patients are offered medical help and consultation. Its surgery department is one of the busiest and performs 15-20 operations daily. Dr Basnet, the head of Urology Department, says patients are waitlisted based on three categories: emergency, semi emergency and elective. “We can lower the waitlist period if the hospital hires more nurses,” he says, once again pointing out the problem of insufficient nursing staff. Lack of information While Bir Hospital staff members blame the lack of human resources and equipment for poor service delivery, they seem to overlook the common problems faced by the patients that could be fixed just with better management skills. Issues such as long queues, scheduling appointments and setting up a proper information center call all be resolved without the need for a big budget or equipment. Patients like Budhathoki from Lamjung, visiting the hospital for the first time, do not know where to go, because the hospital doesn’t have a proper information desk. “After getting the ticket for OPD I didn’t know where to go for the service,” she says. “Some of us have traveled far away for treatment and when the services are delayed, it all adds up in our expenses.” Radhika Khadka, a resident of Betrawati, Nuwakot, says when she entered the hospital, she was overwhelmed by the crowd and chaos. She has come to Kathmandu to treat her son’s fractured arm. “I don’t know how the services can be taken here,” she says. Hari Bahadur Rai, another resident of Nuwakot, says for the past one week he has been running around the hospital waiting and collecting medical reports of his wife, who is suffering from fever and chest pain. “We are still in the process. The actual treatment has not even started,” he says. Doctors and other health professionals at Bir Hospital say part of the reason why the hospital is overcrowded is because many patients refuse to visit their local health facilities. If people were to take available health services and medical tests in their home districts, they claim the hospital would not be so crowded and unmanageable.

Who will become Nepal Police’s 30th IG? Will the chief of the law enforcement agency be a female this time around? If that happens, the country will get a first woman IG.  Five recently-promoted Additional Inspector Generals (AIGs) are in the fray for the top police job. They are: Basanta Bahadur Kunwar, Tek Prasad Rai, Deepak Thapa, Shyamalal Gyawali and Kiran Bajracharya.  On Wednesday, the incumbent Inspector General of Police Dhiraj Pratap Singh decorated the five senior officers with insignias at the police headquarters in Naxal, two days after their promotion on the basis of recommendations from the Promotion Recommendation Committee of the Ministry of Home Affairs.  These promotions follow mandatory retirement of AIGs Bishwo Raj Pokharel, Mukunda Acharya, Arun BC, Rabindra Bahadur Dhanuk and Puja Singh upon completion of 30-year service.  According to Nepal Police Regulations, a police officer has to mandatorily retire upon completing 30 years of service or upon turning 56.  If this rule holds, IGP Singh will retire on March 25, having completed 30 years of service. From among the promoted officers, Kunwar is posted in Dhanusha, Rai in Dang, Thapa in Makwanpur, Gyawali in Morang and Bajracharya at the police headquarters in Naxal.  The government can appoint IGPs from among the AIGs on five grounds, including seniority, efficiency and leadership qualities. Earlier, seniority was considered the top criterion for promotion. But a Supreme Court verdict on a petition challenging Singh’s appointment as IGP has set a precedent, giving the government the authority to decide on whom to promote from among the equals (AIGs). The senior officers now have an equal chance to land the top job after Ashok Singh, considered a strong contender for the position, resigned in the wake of a legal case over his citizenship. “Women in the police force can lead the entire team. They are as competitive as men,” says Hemant Malla, former DIG. Malla says it is difficult to predict who will be the next IG. “Things keep changing till the last moment.”  He says: “The appointment to the top job is made on the basis of rules, but then the rules keep changing.” A proper evaluation system should be in place, Malla argues, adding: The appointment should be fair and transparent.  Know the contenders Bajracharya is the only female candidate recommended as the top cop. She has investigated crimes against women and children, including human trafficking. She received the Prabal Janasewa Shree medal from the President in 2016 for her outstanding performance as District Police Chief of Bhaktapur. Rai has worked as Chief of the Anti-Human trafficking Bureau, Kunwar as spokesperson at Nepal Police, Thapa has worked in the field of change management, risk management, strategic planning and risk assessment, whereas Gyawali has previously led the Metropolitan Police Range, Kathmandu. 

A beam of red light falling on one of the walls where a 12 horned deer’s head is stuck on makes the audience feel that the house belongs to a rich person. The audience is not wrong. This is an apartment where a colonel’s wife Muma Hajur (Saguna Shah) lives. Red light has been purposefully used in the play. Explanation later. Muma Hajur is in bed, a patient of asthma and lives in support of oxygen but likes smoking.   The play begins with Deep (Ghimire Yubaraj) and Muma Hajur’s meeting after 25 years. They have an  age old relationship. Muma Hajur, then Rashmidevi was 45 and Deep a 19 year old teenager. He was not Deep but was Kamal Ghimire. Deep is a ‘Dalit’ but has concealed his original caste and lives as Kamal Ghimire to avoid caste based discrimination. He has rented one of the rooms in Rashmidevi’s house. The layers of the past start unfolding as the two characters start talking. Muma Hajur wants to recall all the sweet memories she had with Deep but Deep wants to forget. Rashmidevi, married to Colonel Shyam Kumar Basnet recalls how she was trapped inside the four walls of her house. She expresses her suffocation living in the house. Later her husband is abducted and killed during war. She is later informed that her husband has married another woman and has a child with her. After her husband’s death she feels that she has now become free. It reminds the audience of the story by Kate Chopin “The Story of an Hour.” Though Mrs Mallard in the story feels free after hearing her husband’s death for a short time Rashmidevi’s happiness and experience of freedom lasts lifelong. She becomes closer to Kamal both physically and spiritually. Has Deep regarded Rashmidevi’s love the same way? One needs to watch the play till the end. The play tries to show the love relationship between the two characters who have differences in their class and caste. With the relationship between the two characters the playwright tries to show the deeply rooted caste based discrimination across the country. “Had Deep not concealed his surname, would he ever have been able to get the room in Rashmidevi’s house, in her heart?” The question raised by Deep makes the audience think deep on caste based discrimination. His question “You purify your home worshiping deities but how can you purify your body?” is thought provoking. The young Deep’s role is played by Sagar Khati Kami while Pabitra Khadka has fit in the role of Rashmidevi. Khadka is bold in her role. The sensual roles she has played is a brilliant watch on stage. The chemistry between Kami and Khadka goes well in the play till the end.   The play is more dialogue centric. Shah’s powerful dialogues satire on gender based violence. Long form of dialogues, punches, both comic and satire makes the audience serious and laugh out loud. The design of the stage is captivating. Two storeyed design of the stage where the past events are shown on the top and the present are shown on the ground floor is apt to show how we are triggered by our memories. The characters in the upper storey and lower storey communicating in the last scenes makes one feel the character analyzing and thinking to give an exit to the past incidents. The use of music and poem add colors in the play. Nepali Translation of the poem “Traveling through the Dark” by William E. Stafford is symbolic as it reflects the speaker’s inability to make a critical decision. As the speaker in the poem undergoes a dilemma to take the decision the character Deep too is in dilemma to conclude whether his relation with Rashmidevi was an erotic or pragmatic. Directed by Prabin Khatiwada and written by Ghimire Yubaraj the play Bimoksha: The salvation is the perfect title given to question on being free from the past events. One of the interesting things to watch on Shilpee Theatre’s production is stage design and use of props. The stage is designed in the shape of vagina giving a symbolic impression of female sexuality. A portrait of Colonel Shyam Kumar Basnet. A cosy sofa, medals won by the colonel, book racks and a double sized bed gives the homely impression. Shah has judged the role of an elderly woman with her role and dialogues. There is a use of bright colors on the second storey while showing the romances between Deep and Rashmidevi. Light colors are used in the conversations between Deep and Muma Hajur The play of the red colors has been more symbolic in the play. A color of protest and a color to show one’s love both have been well depicted with the play of the light in the set. A must watch play. The play Bimoksha is staged every day at 5:30 pm except Tuesdays but with additional shows on Saturdays at 1:00 pm at Shilpee Theatre, Battisputali. It's on stage till April 1. 

As you enter the main entrance of Civil Service Hospital and take a right turn, you are welcomed by rows upon rows of bikes parked by visitors. There is a guard managing the parking space, but it is beyond his control. He blows the whistle to remind visitors to park their vehicles at the designated parking lot. Not everyone heeds his instructions. As a result of haphazard parking, it is difficult to find a parking space at the hospital. On this particular day, I was lucky to find a slot after much hassle. I managed to squeeze my bike in among the sea of motorbikes. The story of the crowd doesn't end here, though. A long queue greets you at the entrance counter of the hospital. Walking inside, you feel like you are taking part in a fair. Located at a prime location in Min Bhawan, Kathmandu, the hospital draws hundreds of people seeking the services from the Kathmandu Valley and beyond every day. Also, the hospital, as its name suggests, is primarily meant for the treatment of civil servants, at discounted rates. On the first floor, a large group consisting of both patients and visitors is awaiting its turn. There are parents carrying babies, pregnant mothers, and elderly citizens. The seating area is packed and some of them are sitting on the floor. The 112-bed hospital has been serving more than 1,000 people daily. And the number of patients is rising. "The hospital lacks infrastructure to cater to a growing number of patients and visitors," says Prof Dr Bidhan Nidhi Paudel, executive director of the hospital. “Insufficient infrastructure and human resources are hindering our efforts to deliver quality health services." Dr Paudel says the hospital plans to extend the hospital and its services. The plan includes a 10-storey building with 1,000 beds. Once the government approves the budget, the construction work will begin. The hospital is hopeful of an early approval. "If we could shift the OPD to a new building, managing this kind of crowd will be no problem,” says Dr Paudel. For now, patients and visitors at the hospital will have to contend with the crowd, and service delays that come with it. Minimum two months waiting list for surgery The waiting list of patients needing surgery is serpentine, literally. “Some patients have been waiting for eight months. It takes a minimum of two months for surgery, depending upon your case,” says Dr Paudel. Though compiled data is unavailable, a large number of patients have been waiting for treatment from ENT, orthopedic and other surgery departments. The reason for the delay of surgical cases is the ongoing repair of four operation theaters. This could take another one-and-a-half months. "Once the operation theaters become operational, the number of patients on the waiting list will go down by half," says Dr Paudel. Right now, the hospital is performing emergency surgeries. Limited services Lack of infrastructure has made the hospital unable to provide multi-specialty services as well. Many patients are referred to other hospitals, as services related to spine, kidney and neuro, among others, are not available. The hospital has been offering MRI services with the 0.35T MRI machine, which cannot perform brain imaging. “If we had enough space and resources, we could have met the public’s demands to deliver multi-care services,” says Dr Paudel. Online registration, limited But there is a lot the hospital needs to improve on. It's not just the infrastructure it lacks. The hospital has an online registration system for patients.  It’s a welcome initiative meant to serve the public better, but the service is pretty much limited. “According to the rules of the hospital, patients can buy tickets from 12:00 pm to 11:59 pm. For today, the hospital has already distributed a limited number of online tickets,” reads the hospital’s pre-registration page when this reporter tried accessing it. This means one thing: The hospital has run out of tickets for today. Try your luck tomorrow between the designated hours. “Online booking are meant to save your money and time. But you can only book ten tickets in a day,” says Santosh Bastola, who has come all the way from Khotang to get his grandparents Renuka Devi Bastola (81) and Namo Narayan Bastola (83) checked. "How is this helpful?" Limited online booking service means people queuing up from early morning, crowding the hospital counter and the parking space outside. “I stood in the line for more than three hours to get the token,” laments Sunita Shah, a resident of Lokanthali. But her struggle is nothing compared to those people who have come to the hospital from outside Kathmandu Valley. Service seekers wish the hospital increased the number of online tokens, so they could make appointments easily. “There were different lines for the civil servants and the public earlier. But now they are in the same lines, making the lines longer,” says Bastola. Service seekers also want the hospital to give priority to the elderly and disabled while delivering services. Open drainages and a dog on the loose It would also do well for the hospital if it put some effort to keep its building and surrounding clean. Open drainages on the hospital premises pose a huge health risk. The hospital staff do not seem to care that they are breeding centers for germs, especially during the summer. The hospital corridors and other sections also need some serious cleaning job. Old beds, couches and discarded stuff litter the building. And don’t be surprised if you encounter a stray dog walking idly by in the corridors. Vacancies announced, protest began The hospital needs consultants and experts to deliver quality health services. Treatment services need to be expanded covering spine and kidney diseases. For this, the hospital has announced vacancies—to be filled internally and externally. Amid all this, a group of employees have launched a protest demanding resignation of the hospital’s executive director and scrapping of the vacancy announcement. “The employees and doctors are hindering the process for fulfilling vacancies because they know it is a cut-throat competition and they don't want to sit in the exams fearing that they will fail. The vacancy has been announced after a decade and it will be fulfilled through examination and interview. Deserving candidates should come forward to improve the services. ,” added Dr Paudel. Crunch of medics in Nepal: WHO The World Health Organization has said that there is a shortage of medical practitioners in Nepal. In a recently released WHO health workforce support and safeguards list 2023, the UN health body has identified 55 countries as vulnerable for availability of health workers required to achieve the UN Sustainable Development Goal target for universal health coverage (UHC) by 2030. The UN health body has enlisted Nepal in the list along with Bangladesh and Timor-Leste from the Southeast Asia region. No less than 55 countries are struggling with serious health worker shortages as they continue to seek better paid opportunities in wealthier nations that have stepped up efforts to recruit them amid the COVID-19 pandemic, it has said. “Health workers are the backbone of every health system, and yet 55 countries with some of the world’s most fragile health systems do not have enough and many are losing their health workers to international migration,” said Dr Tedros Adhanom Ghebreyesus, WHO director-general. The countries included in the WHO health workforce support and safeguards list 2023 have a UHC service coverage index below 55 and health workforce density below the global median: 49 medical doctors, nursing and midwifery personnel per 10,000 people. These countries require priority support for health workforce development and health system strengthening, along with additional safeguards that limit active international recruitment. The WHO does not prohibit international recruitment, but recommends that government-to-government health worker migration agreements be informed by health labor market analysis and the adoption of measures to ensure adequate supply of health workers in the source countries; engage Ministries of Health in the negotiation and implementation of agreements; and specify the health system benefits of the arrangement to both source and destination countries. The health body noted that the negative health, economic and social impact of COVID-19, coupled with the increasing demand for health and care workers in high-income countries, might be increasing vulnerabilities within countries already suffering from low health workforce densities. According to Nepal Medical Council, there are 10,080 specialized doctors, 27,805 MBBS and 4,413 BDS registered doctors in the country. According to Nepal Nursing Council, there are 73,889 nurses registered in the country. The medical practitioners have been migrating to developed countries seeking better pay and facilities.