After serving for two years at the Gandaki Province Communicable and Infectious Disease Hospital in Lekhnath, Pokhara, pediatrician Dr. Prakash Bhattarai quit his full-time job and moved into private practice.
He now runs two polyclinics at Shishuwa and Talchowk in Lekhnath.
Dr. Bhattarai says he was compelled to switch careers because he saw no hope of recovering the tens of millions of rupees he had invested in his medical education.
“Becoming a doctor costs millions, but the government pay scale is the same for everyone,” he says. “On top of that, doctors working in local public hospitals are not even allowed to work elsewhere. How is a doctor supposed to make a living?”
Dr Bhattarai represents many doctors who want to work locally but cannot survive on full-time jobs in local hospitals alone. His bitter-sweet experiences reflect not only the struggles of doctors but also of local hospitals established to serve communities and of residents who genuinely care about the development of their local area.
Last year, youth entrepreneur Kapil Paudel personally experienced the value of having a local hospital when he helped save the life of a seriously injured man.
A bus had hit a motorcycle on the Talchowk–Dandakonak road.
Some youths rushed the severely injured rider toward Pokhara in a taxi. But they were trapped in a traffic jam at Bijayapur.
Kapil, who happened to be riding his motorcycle nearby, saw the bleeding victim gasping for life through the taxi window. With no sign of traffic clearing, he immediately stopped, informed the taxi driver that a hospital was very close by, turned the taxi around, and accompanied the group to Lekhnath City Hospital in Budhibazar, Pokhara-26.
“That incident was engraved in my mind and heart. That day, I understood the true importance of local health services,” Kapil says.
His feelings reflect the experience of most people in Lekhnath. Once an independent municipality, Lekhnath was merged into Pokhara about a decade ago, but many locals still feel it has been sidelined in development and services.
The incident Kapil describes, and the hospital he led the victim to, perfectly illustrate this sentiment.
Low trust in local hospital
Established in 2018 (2075 BS) as the first private hospital in the area, Lekhnath City Hospital was built with an investment of over Rs 40m by local youth and social activists. Yet the hospital has never been able to earn enough to cover its expenses.
“Somehow locals haven’t given it the attention we expected. So the hospital hasn’t grown as we had planned,” says founding chairman Udeep Raj Dhungana.
Managing Director Akash Basnet adds that the hospital struggles to bring in doctors—and when doctors are available, there are not enough patients.
“Even patients who know us personally often pass by and go to hospitals in central Pokhara,” he says. “Distrust of local hospitals is like a disease here.”
According to Basnet, the hospital recently added gynecology and pediatrics services.
It already offered orthopedics, general physician services, ENT, dermatology, laboratory services, and more. About 400 patients come monthly, but Basnet says this is still far too few to sustain the hospital. The management has been running community outreach and social responsibility campaigns to raise awareness.
Public hospitals face the same story
Shishuwa Hospital, one of the oldest and one of the only two government hospitals in the former Lekhnath Municipality, offers only basic primary-level services. Local health workers say people hesitate to visit nearby hospitals because they think they will be referred elsewhere due to lack of services.
“Because of the low patient flow, authorities also show little interest in upgrading the hospital,” says Shishuwa Hospital Chief Dr Suman Khaniya.
Other hospitals in Lekhnath share similar struggles. Pokhara University Teaching Hospital, which started services last year, has 100 beds, which are mostly empty.
On average, only 50 patients visit daily, according to Chief Dr Madan Khadka. Eleven doctors serve daily, but the hospital is facing procedural difficulties in starting ICU, NICU, maternity, and other critical services.
A growing population but lagging health infrastructure
Lekhnath is geographically larger than central Pokhara, and its population is rapidly approaching similar levels. But residents say it still struggles to establish itself institutionally and in policy terms as a functional part of the metropolis.
According to the Urban Health Division of Pokhara Metropolitan City, Pokhara has more than two dozen hospitals, with about half a dozen—both public and private—located in Lekhnath. Public Health Officer Subash Bastola says patient flow in Lekhnath hospitals is comparatively very low.
“It is very difficult to retain doctors in the local area,” says Dr Khaniya. “If doctors can work only in one or two small hospitals, they cannot sustain their livelihood. So getting doctors for local hospitals is extremely challenging.”
Experts say that the government must provide special subsidies and incentives to both public and private hospitals in local areas if they are to retain doctors and improve services.
