1) Massive investments in public hospitals.
2) Development of a decentralized, federal healthcare system.
3) Better management of qualified human resources.
Every citizen must have access to adequate health facilities as provided in the constitution. But there are clear disparities in healthcare regarding both access and quality of health services.
This inequality in our health system fuels poverty as well. We have laws that say people have the right to basic healthcare, but they are seldom implemented. It has hence become necessary to bridge the chasm between policies and their implementation.
To fulfill my vision of ensuring health facilities for every citizen, we need a collective approach of private and public sectors. Our country has adopted a federal system of governance, but unfortunately, our health system is yet to be decentralized. All three levels of government should work together to federalize the health system too.
This will improve people’s access to healthcare regardless of their location in Nepal. Private hospitals have been shouldering an immense burden in our health system. So they should collaborate with the government and expand their branches to remote places to provide services at affordable rates.
Implementation of federalism in the health system requires massive investment. A health post as it exists today cannot even meet people’s basic healthcare needs. There should be hospitals with necessary equipment and human resources: tropical and infectious disease hospitals, trauma centers, and maternity and women’s hospitals. As our transport facilities are also poor, it takes a lot of time for people from rural areas to reach the hospital, which often leads to the patient’s death.
We have to list out the needs of our citizens in health, and all those things should be made available at every place. For example, the ERIG vaccine, used to treat third-degree wounds from dog-bite is available only in some hospitals. Why can’t we make it available everywhere? These things don’t take much effort, and yet we haven’t done them.
Management of trained and qualified human resources is another big challenge in our health system. We trained many health personnel on covid-related problems. But what will they do after the end of the covid crisis? We should be able to utilize their qualifications in the future as well.
For that, we should look at how and where they can fit, as there are plenty of other tropical and infectious diseases in Nepal. Managing them is important. We have to better manage equipment too. We have gone from having a handful of PCR machines and ventilators all over the country to now having them at 90 different locations. This is progress. Yet these equipment need to be looked after and properly utilized post-pandemic too, which is only possible via a goal-oriented approach.
Negligent people are the ones who suffer. But the negligence we see in Nepal is because of illiteracy. That means we are behind on education, too. As health is intertwined with other sectors, collaboration is a must.
Our government has provided health insurance to the public, but most people don’t know about it. The concerned body should collect data and target the people of backward areas. The vulnerable groups are always the last to benefit, so we should prioritize their participation.
The next important thing is our approach to disease-prevention. For instance, a large number of the youth smoke these days. Hence the number of patients with cardiovascular pulmonary infections may increase in the next decade. So, we have to work on preventing them. Yes, our government and other NGOs and INGOs are working on reducing cigarette consumption among the youth, but the results are yet to be seen.
If our approach is not providing results, we need to look for alternatives. We keep repeating the same failed approach time and again, hoping it might work this time. This might sound rather simplistic, but these things matter in health.
The condition and facilities for doctors also play a part. If the doctors can’t sustain themselves, they will just leave the country. Many doctors who graduated from Nepal are serving abroad because we didn’t try to stop them. They never ask for luxury. They just want proper labs and research centers. If they don’t get to utilize their expertise, they will serve others for sure. We need to solve this problem too.
In the end, as in other sectors, everything boils down to politics as it controls everything. So our political leadership must take the initiative to deliver quality healthcare to each and every Nepali citizen.
When do you see the corona epidemic in Nepal ending?
We can’t say. There is no way to foretell if new variants will emerge. The Delta variant won’t harm us anymore, but anything can happen if there are newer variants.
What is the best part of your job?
I love people and getting to know them. My job gives me this opportunity every single day.
A quote you live by.
“The best way to find yourself is to lose yourself in the service of others” - Mahatma Gandhi