Koshi Province Health Minister Bhupendra Rai inaugurated the District Hospital in Diktel, the headquarters of Khotang, on July 6 with much fanfare, announcing its upgrade to a 50-bed facility. At the inauguration, he declared, “Khotang residents will no longer have to travel to the capital by helicopter for treatment. Services with specialist doctors will be available here.”
However, his assurance has proven to be little more than an empty promise. The hospital lacks specialist doctors, and residents still depend on Kathmandu for critical care, often forced to travel by helicopter.
Khotang, an eastern hill district about 270 kilometers from Kathmandu, faces not just geographic isolation but also deep disparities in healthcare. The District Hospital in Diktel has a building, beds, and some basic equipment, but without specialist doctors it functions more as a referral center than a treatment facility. Patients in critical condition must either charter helicopters to reach Kathmandu or endure costly ambulance journeys to Dharan or Biratnagar.
According to hospital chief Dr. Rupesh Sangraula, more than 50,000 patients seek treatment at the hospital annually. Yet, in the absence of surgeons, gynecologists, pediatricians, neurologists, and cardiologists, serious cases must be referred elsewhere.
Ram Kumar Rai (Pasang), a House of Representatives member from Khotang, says, “The situation where citizens must risk their lives in helicopters due to the lack of health facilities is inhuman. I have repeatedly raised my voice in parliament, but the government has yet to implement the policy of permanently posting specialists.” He has demanded immediate deployment of specialist doctors to Khotang.
The human toll is stark. Bed Prasad Acharya of Diktel-1 was admitted with a fever but, unable to be treated locally, was referred to Kathmandu. He died in an ambulance en route. His brother, Jeevan Acharya, lamented, “My brother died unnecessarily without treatment. When our father also needed care, we had to charter a helicopter to Kathmandu to save him.”
Similarly, 27-year-old Maiti Kala Rai of Buipa died at Diktel Hospital during pregnancy complications. According to local ward chairperson Dinesh Rai, her weak financial condition prevented her from reaching Kathmandu.
Such tragedies have become a collective pain for the district. With helicopter charters costing Rs 300,000–500,000, farming families often fall into lifelong debt. The premature loss of labor further reduces village productivity, while locals say their trust in the state is eroding.
Daman Rai, former president of the Federation of Nepali Journalists, Khotang, explains, “Residents here must keep Rs 500,000 standby in case they need to fly to Kathmandu. Otherwise, they risk dying.” Nagendra Dhakal of Diktel Rupakot Majhuwagadhi-15 adds, “For poor people like us, hospitals are just buildings. The rich survive by helicopter, the poor die on the way.”
Local leaders echo the frustration. Maoist Center Khotang Chair Deepak Pandey remarks, “While five-star hospitals are built in the capital, citizens here die without basic care. Specialists need incentives and a safe environment to come here.”
Municipality Mayor Tirtha Bhattarai says, “We have arranged a rescue fund, ambulances, and health workers. But this is not enough. The problem will persist until the provincial and federal governments expand Diktel Hospital into a provincial hospital.”
Despite longstanding government policy to post specialists in every district, Khotang has yet to receive permanent appointments. Even doctors who arrive on temporary contracts rarely stay. Although the Koshi provincial government has announced plans to upgrade Diktel Hospital to provincial-level, little progress has been made.
Locals are demanding an emergency fund for free air rescues for the poor and an immediate upgrade of Diktel Hospital. Chandra Budhathoki of Dorpa, who lost his wife without treatment, says, “Those with money survive in Kathmandu, while poor people like us are ignored. I feel the state has abandoned us.”
Currently, despite its 50-bed designation, the hospital has only 30 posts—including one MD physician and six MBBS doctors—leaving it far short of meeting the people’s needs.
