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When we hear the word “nurse”, we think of a wom­an with an apron, mainly because the nursing profession in Nepal has been the exclusive preserve of females. But then the country does have a history of male nurses. The Institute of Medicine (IOM) under Tribhuvan University trained four batches of male nurs­es between 1986 and 1993, during which time almost 80 male nurses were produced.The enrolment of male nurses was terminated for two main rea­sons. One, it was a new profession for males and people were uncom­fortable. “The patients would not accept male nurses. They start­ed complaining about not getting proper as they would from female nurses,” says Tara Pokhrel, Presi­dent of the Nursing Association of Nepal (NAN), the umbrella body for nurses in Nepal.

“This made our jobs tough,” says Ratna Guragain, a male nurse from the first batch at the IOM. Guragain would serve as a professional nurse for 20 years before his retirement.

The other reason for the termi­nation of male enrolment was that the trained male nurses refused to serve in rural areas as they were expected to do.

So male nursing is not a com­pletely new concept in Nepal. And on June 19, Nepal Nursing Council (NNC), the main nurs­ing regulatory body in the country, once again decided to enroll male students in nursing courses starting this year in all 125 nursing colleges in Nepal. Fifteen percent seats have been reserved for male students and they will be allowed to enroll in two courses—‘Staff Nurse’ and ‘Bachelor of Science in Nursing’. If all goes according to the plan, every year 1,155 male nurses will be produced.

But what explains the NNC’s deci­sion to enroll males again, after over two- decade hiatus?

Second life

“The society has changed. Peo­ple are now more literate and understand that nursing is not an exclusive women profession. So we thought we would give it anoth­er shot,” says Goma Devi Niraula, President of NNC. “The demand is high and frankly, male nurses have become a necessity today.” The NAN played the lead role in implement­ing the decision, after almost three years of homework.

“We started to hear from Nepalis abroad that there was a huge demand for male nurses in other countries. This also made us con­sider if male nurses had become a necessity in Nepal as well,” says Pokhrel of the NAN.

There are many instances of peo­ple who have completed their Bach­elors and Masters in other streams opting to take up nursing cours­es when they went abroad. “For instance, I personally know of a doctor with an MD who left his job in Nepal to study nursing in America,” says Pokhrel.

Even though the initial enrolment for males had to be terminated par­ty because male nurses refused to serve in remote areas, Pokhrel is more hopeful this time. “The pay at remote government hospitals is good these days,” she says. She also pointed out the desperate need for male nurses during emergencies like the 2015 earthquakes.

The subtle pressure from the International Council of Nurses, a federation of over 130 nurses asso­ciation around the world including the NAN, also played a part. In fact, Nepal was the only country associ­ated with the council that did not have male nurses, and the council pressed for more gender equality.

Says Khusbu Sapkota, a profes­sional female nurse, “The inclu­sion of male nurses will make a big difference in our field. In my time in India, patients and doctors used to prefer male nurses partic­ularly in Operation Theatres and Intensive Care Units. This is because they are strongly built and can shift patients with ease during difficult medical procedures.”

According to Sapkota, many Nepali male patients also find it eas­ier to deal with male medical stuff, for instance during insertion of Foley’s catheter in the male urethra.

Challenges, old and new

Nonetheless there are many chal­lenges to male enrolment. It is pos­sible, says Pokhrel, the NAN presi­dent, the 15 percent male quota will be difficult to fill, at least initially, mainly because of lack of awareness among prospective students of the scope for male nurses. This is why the association plans many aware­ness-raising activities.

When APEX approached 50 SEE graduates this year, we found just one student who was willing to enroll in nursing. The rest said they would be embarrassed to study what was still a ‘girl’s profession’. Even Anil Thapa, the sole SEE grad­uate who intends to take up the course, says he is doing so at the instigation of his father, a medical doctor. But given a choice he would opt out. Why? “I fear being ridiculed by my friends.”

The IOM staff are, however, con­vinced that many male students will enroll as it is a job that is both financially rewarding and emotion­ally satisfying.

Other than that, there are con­cerns that male students might take this course only as a stepping stone to another health profession. “In the past, over 50 percent male nurses changed their profession, to lat­er study Bachelor Public Health or Master of Public Health,” says Pokhrel. “They wanted to serve in top positions of certain government health institutes instead of working in hospitals.”

She says she is not confident that the same thing won’t happen again and if that is the case, “there is no point in teaching nursing to male students.” Also, even though the society has progressed, Pokhrel doubts male nurses will be accepted by female patients easily as “there is a lot of physical contact in this profession, even in sen­sitive areas of the body.”

More than 81,000 nurses are currently reg­istered with the NNC, and there is an over-pro­duction of nurses every year. Income-wise, gov­ernmental hospitals offer lucrative salaries but the offerings in private hospitals are comparably low. This is why there is always the risk that the new male nurses would rather choose to go abroad rather than serve in low-paying private hospitals, or even in well-paying government ones. Just as is happen­ing with female nurses, greener pas­tures could also lure them abroad.

Four police personnel and at least 88 militants have been killed in clashes in two Afghan provinces, authorities said Thursday. 

In eastern Paktia province, 51 Taliban militants were killed and several others wounded during a clash and ensuing airstrike in Band-e-Michalgho area of Ahmad Abad district at wee hours of Thursday, provincial police spokesman, Sardar Wali Tabasam told Xinhua. 

The clashes occurred after dozens of militants stormed security checkpoints in the area and four policemen were also killed and six others wounded during the clashes. 

In northern Jawzjan province, 28 Islamic State (IS) militants and nine militants of Taliban group were killed and 16 IS militants and 11 Taliban wounded after the two groups of militants clashed in Darzab district on Wednesday, the Afghan Defense Ministry said in a statement. 

The two rival armed groups often fight over expanding territory in parts of the conflict-hit Afghanistan. Xinhua

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The district of Bhaktapur in Kathmandu valley is one of the most concentrated human settlements in South Asia, packing in over 12,000 residents every square kilometer. And the population continues to swell, as the area absorbs more and more people lured by land prices that are comparably cheaper to what they would have to fork out inside the ring road. More people means more buildings and less open space. With the building codes lax, the human set­tlements in Bhaktapur had been getting progressively closer to the catchment areas of its three main rivers: Hanumante, Khasyangkhusung and Manohara. As a result, whenever there is a heavy rainfall, at least some areas in Bhaktapur are badly inundated by overflow­ing rivers. But the flooding on July 12 was the worst in years. Three members of the same family perished in Changu­narayan municipality when their tin hut was swept away in floods following 12 hours of non-stop rainfall. Temporary camps of earthquake victims at Jagati and Barahisthan were submerged; the landless squatters’ settlement at Jadibuti completely inundated. Similarly, settlements at Radhe Radhe and the Kamerotar land pooling project in Madhyapur Thimi were under water. Thousands of people were trapped inside their own watery homes.

This monsoon has already taken a heavy toll. Nearly 300 people have died in floods and landslides in the past three months, according to Home Ministry. “We have been unable to reduce damages despite our many programs to reduce the risk of natural disasters,” says Kedar Neupane, the chief of the ministry’s disaster management unit.

It is not clear better forecasting could have prevented the latest Bhaktapur inundation either. There was no cloudburst, nor was one predicted. Nor were there any blockades in the three main rivers, which are otherwise fast turning into dumping grounds. The culprit rather was the sheer volume of water that fell.

The only way to mitigate future damages will be to keep the settlements at a safe distance from the main water arteries. But any such effort will be met with tough resistance, espe­cially by the squatters and those displaced by recent earth­quakes. There are in fact no easy fixes. More effective would be progressive tightening of the building codes, building resettlement homes for the landless—the Dhurmus-Suntali foundation has already shown the way on cheap mass-scale housing—and greater awareness on the ever-present dangers of living so close to the unruly rivers.

The idea of men studying nurs­ing is not new to Nepal, even though the concept may now appear alien. Back in 1986, the Institute of Maharajgunj decided to begin enrolling male students in its nurs­ing programs and in the four batches produced around 80 male nurses. It then stopped taking male students.

Nepali patients at the time were skeptical. They started complaining that male nurses were unable to give the quality of service that female nurses could. The idea that male nurses would be ready to go and serve in remote areas of the coun­try also proved premature. Most male nurses wanted comfortable urban postings.

Now the nursing campuses in Nepal are again starting to enroll male students starting this year. The society is changing and so are traditional gender roles. Moreover, with lucrative salaries on offer for those who want to go serve in rural areas, more male nurses will take that route. Male nurses will also be able to do more manual bits of the profession.

That, at least, is the thinking. But will the students come and will the nursing campuses be able to fill their 15 percent male seats?

Full story on Sunday