Bheri Zonal Hospital in a shambles
When she suffered from profuse menstrual bleeding, 22-year-old Ruma Tharu was brought to Bheri Zonal Hospital on January 5. She needed blood urgently, and was given O+. Medical attendants informed Tharu she would need another pint of blood the following morning, which her father Raju Tharu procured from a blood center run by the Nepal Red Cross Society. However, the blood that the center gave to Tharu was of B+ category. Soon after, Ruma started developing blisters all over her body. Both her kidneys stopped functioning. Ruma’s family staged a protest. The hospital suspended the nurse who had administered the blood. Ruma was brought to the capital and she survived. But she has become extremely weak.
Locals says the 150-bed Bheri Zonal Hospital is marred by political interference, staff negligence and general mismanagement. Its services are increasingly brokered by middlemen. Many are compelled to seek treatment at expensive private hospitals.
It was only a month ago that the hospital administration caught a middleman who was sweet-talking patients into seeking private medical services. But no action was taken against him. Reportedly, he was close to a senior hospital staffer.
The hospital is one of the few public hospitals in western Nepal with a cardiology department. But its echocardiogram machine, worth some Rs 8 million, has been broken for seven months. An echocardiogram examination costs Rs 850 at the hospital, but private hospitals charge over Rs 2,000 for it. Similarly, a TMT machine bought one and a half years ago for Rs 1.3 million is also kaput. Dialysis services, which the hospital was supposed to provide starting a year ago, only began two months ago.
Poor service quality owes to the carelessness of the Hospital Development Committee, alleges former committee chairman Bed Prasad Acharya. But Bir Bahadur Chand, medical superintendent at the hospital, claims that there has been steady progress. “Staff shortages have caused some problems, but specialized services have been improving. There hasn’t been any negligence.
What about the broken echocardiogram machine? “We have brought in technicians to repair it. It should be up and running a few days,” says Chand.
The hospital has had eight heads in past nine years, an apparent sign of excessive politicking. It was only in October 2016 when Chand replaced Dr Shyam Sundar Yadav, who is credited with important reforms in the hospital’s functioning. The appointment of Chand, a junior radiologist, has not gone down well with the staff and is apparently against the Health Guidelines, which stipulate that only someone from the ‘General Health’ category can be appointed medical superintendent.
Usha Shah, who currently heads the Hospital Development Committee, blames it all on lack of funds. “We are committed to quality care. We have asked the government for additional resources,” she said.
By Govinda Devkota
Not many tourists opt to stay overnight in Lumbini
Lumbini, the birthplace of Gautam Buddha, has drawn 276,620 tourists in the two months of January and February, according to the Lumbini Development Trust. This is almost 100,000 fewer tourists than in the first two months of 2017, when 376,600 visitors had come to Lumbini.Of the 276,620 tourists visiting Lumbini this year, 223,016 were Nepalis, 24,095 were Indians while 29,509 were from other countries, according to the trust’s information officer Rajan Basnet. While the number of Indian tourists increased slightly this year, the number of Nepali tourists went down considerably. The number of tourists from other countries also declined. According to Basnet, tourists from over 50 countries have already visited Lumbini this year. In this period, besides India, Thailand has sent the most number of foreign tourists (7,928) to Lumbini, followed by Myanmar (6,689), Sri Lanka (5,733), China (2,821) and South Korea (1,406).
Tourist arrival had suffered in 2016 because of the twin effects of the earthquake and the blockade. It picked up steam in 2017 only to slow down this year. “Most tourists to Lumbini come via the Nepal-India border. Although their primary destination is Lumbini, they don’t stay here overnight,” said Achyut Guragain, vice-chairman of Nepal Tour and Travels Association. “That’s because they come here with Indian guides, who tell them that although Buddha was born here, other significant places associated with his life all are in India.
As a result, local businesses haven’t been able to flourish as much as they would if the tourists stayed here longer.”
By Salman Khan
Work on Pokhara international airport moving apace
After a slow start, construction work on the international airport in Pokhara in western Nepal is moving ahead at a brisk pace. According to the Chinese government-owned construction company CMC, 6 percent of construction has been completed. In the first phase, CMC has begun leveling the land. The work picked up steam after 20 pieces of equipment such as trippers, rollers, excavators and dozers reached Pokhara from China. As many as 20 additional pieces of such equipment will soon arrive in Pokhara via the Kolkata port, according to Krishna Chapagain, CMC’s public relations officer. Earlier, 45 pieces of such equipment were being used for the construction.
Along with new equipment, 35 workers have also been added. Although construction started seven months ago, it has only been four months since work on the main site began, and in those four months, 35 percent of the annual construction target has been met, says Vinesh Munankarmi, chief of the Pokhara Regional International Airport Project.
“During the monsoon, we worked on the terminal building and the runway; now land leveling is going on at a swift pace,” said Chapagain. He claims that the pro-activeness shown by the local government and local residents has expedited the construction and that 80 percent of the work will be completed by Jeth (May/June). “Barring mishaps, the airport will be built and handed over to the Nepal government before the 2021 deadline,” he said.
Model for success?
The government had awarded the contract to CMC in May 2014 under an EPC (Engineering, Procurement and Construction) model. It stipulates that the construction must be completed by July 10, 2021, failing which CMC will have to pay a fine to the government. KP Sharma Oli, during his first term as prime minister, had laid the foundation of the airport on the first day of the Nepali year 2073 (April 13, 2016). He had signed a bilateral loan agreement on the airport’s construction during his visit to China in February 2016. The work on the airport began after the Exim Bank of China loaned Rs 22 billion to Nepal government for its construction.
The international airport is being built over 3,700 ropanis (462.5 acres) of land at Chhinedanda. The government undertook land acquisition in two phases. It will start paying compensation for 60 ropanis of land starting next week, for which it has already allocated Rs 1.5 billion, according to Munankarmi.
The 4D model airport, which will have a 2,500m-long runway and which will meet ICAO standards, will be able to accommodate medium category aircraft like Boeing 757 and Airbus 320 that can carry up to 200 passengers.
By Krishnamani Baral
Women’s empowerment is a public health imperative: WHO
In the WHO South-East Asia Region and beyond, more than half the population—women—face what is often egregious discrimination. Discrimination in education and the opportunity to learn to read and write. Discrimination in access to nutrition and the chance to grow healthy and strong. And discrimination in the workplace, where women can be subjected to unwanted advances or have their work undervalued or unpaid.
Gender-based discrimination in these and countless other forms is a persistent problem across the South-East Asia Region and throughout women’s lives. But as much as gender-based prejudice and inequality violates human rights, stymies social and economic development, and crushes the hopes and dreams of millions of young girls and women, it also has a grave impact on public health and wellbeing.
Examples abound.
The Region-wide practice of early marriage and pregnancy, for instance, is a direct threat to the health of young women and their children, especially in rural areas. Around six million girls aged 15-19 years give birth in our Region every year, while in four of the Region’s countries the adolescent birth rate is more than 50 per 1000 women aged 15-19 years. This provides immense dangers to the health of young women—dangers that can be avoided via rapid social empowerment (including access to contraception) and the implementation of laws against early marriage.
Gender-based inequities likewise impede women’s access to essential health services, causing a range of adverse outcomes. Start with childbirth: Many deliveries still occur in the home, often in the presence of a birth attendant who is unskilled. This occurs partly as a result of women’s inadequate access to health-related knowledge and a lack of decision-making power, and partly due to ongoing service gaps. Though during the Millennium Development Goal era the Region made world-beating progress in reducing maternal and child mortality, further gains are needed to bring the maternal mortality rate to below 70 per 100 000 births, as per the Sustainable Development Goal target.
Still, there is room for optimism: The Region-wide struggle to end gender-based discrimination and advance women’s empowerment—particularly for rural women and girls—has never been stronger. WHO South-East Asia is proud to champion this cause, reflecting as it does our core values and commitment to human rights, as well as our evidence-based conviction that empowered women create healthier, happier communities that produce transformative change, both locally and globally.
Until full equality is achieved, however, WHO will continue to work with our Member countries to promote and support the health of women and girls. That means continuing to train skilled birth attendants able to provide life-saving services when childbirth becomes complicated. It means continuing to advocate for increased access to contraceptives and the provision of adolescent sexual and reproductive health services. And it means continuing to actively campaign against gender-based violence and harmful practices such as female genital mutilation that can cause life-threatening injuries to young girls and adolescents.
This International Women’s Day, let us acknowledge that gender-based discrimination exists and is a daily occurrence in each of the South-East Asia Region’s countries. Let us understand that it needn’t be this way, and that gender equality can be rapidly achieved with sincere, society-wide resolve. And let us take full stock of the fact that women’s empowerment is more than a tool to advance social or economic ends—that it is a public health imperative, and one that demands our most strident pursuit.
By World Health Organization
