Nearly 200,000 people across four districts are deprived of quality healthcare due to the lack of standard facilities at the 50-bed Rampur Hospital.
Located in Rampur Municipality of Palpa district, Rampur Hospital serves as the primary referral center for residents of four local levels in Palpa, two in Nawalpur, one in Syangja, and one in Tanahu districts.
According to the hospital administration, around 200,000 people from Rampur Municipality, Nisdi, Purvakhola and Rambha rural municipalities of Palpa, Chapakot Municipality of Syangja, Ghiring Rural Municipality of Tanahu, and Baudikali and Bulingtar rural municipalities of Nawalpur depend on Rampur Hospital for basic healthcare services.
However, the hospital faces a severe shortage of doctors and essential medical equipment required to diagnose and treat patients effectively. Of the sanctioned eight consultant posts and four medical officer positions, only three consultants and four medical officers are currently serving at the hospital.
The hospital registers around 300 to 400 OPD patients daily. Despite the shortage of doctors, hospital officials say that patients arriving on time are generally able to receive treatment. Hospital records show that during the first 11 months of the current fiscal year, the hospital served 70,714 patients, including 57,094 OPD cases, 13,660 emergency cases and 63,133 health insurance beneficiaries.
All 13 sanctioned laboratory technician posts have been filled, while 25 nursing staff are providing services. However, ultrasound services are frequently disrupted due to the absence of a radiologist, and the ICU remains non-operational.
“We urgently need a general surgeon, a gynecologist, an anesthesiologist, a nephrologist and a pediatrician,” said Dr. Shant Bahadur Roka, consultant in internal medicine. He said the hospital also lacks an HDU, ICU, CT scan, MRI and other essential diagnostic facilities. “We also need a trauma center and a fully equipped operation theatre,” he added.
“We have faced these problems repeatedly,” said 65-year-old Maijun Miya of Rampur Municipality-4. “There are not enough doctors. They often tell us to seek treatment elsewhere.” She also complained that essential medicines are often unavailable.
Shyam Bahadur Bote, 61, of Rampur Municipality-3, shared a similar experience. “I have been admitted here many times, but even for minor treatments we are referred to other hospitals,” he said. “Not all necessary tests are available here.”
Hospital staff say doctors are regularly posted to Rampur Hospital under government rules but often seek early transfers or move to larger cities. “The hospital has rarely been fully staffed. Doctors do not stay long because there are fewer opportunities to earn additional income and, at times, they face threats from locals,” a hospital staff member said.
Hospital officials said doctors sometimes face intimidation when treatment outcomes are unsuccessful. “If a patient dies or treatment fails, locals may threaten doctors. Some have even pelted stones at the hospital. Neither local authorities nor the community has taken adequate steps to ensure doctors' safety,” the official said. “This is one of the reasons doctors do not want to stay here.”
If patients cannot receive treatment at Rampur Hospital, they must travel about 70 km to Tansen, 70 km to Pokhara, or nearly 100 km to either Narayanghat or Butwal for further care.
Hospital records show that during the first 11 months of the current fiscal year, the top 10 OPD morbidities included 1,550 cardiovascular and hypertension-related cases, 1,377 diabetes cases, 948 acid peptic disease (APD) cases, 745 periodontitis cases, 493 COPD cases, 318 orthopedic problems, 220 fractures, 211 arthritis cases, 184 chest pain cases and 181 urinary tract infection (UTI) cases.
Although the hospital has a capacity of 50 beds, only 40 are currently in operation. These include 15 beds in the inpatient ward, six in the emergency ward, two for antenatal care (ANC), three in the operation theatre and nine maternity beds.
Despite the shortages, the hospital has been providing comparatively better orthopedic and dialysis services. It currently offers dialysis services to 31 patients every week. During the first 11 months of the current fiscal year, 153 road traffic accident victims—48 females and 105 males—received treatment at the hospital.
Rampur Hospital is operated under the Lumbini Provincial Government. Hospital officials say neither the provincial nor local governments have done enough to strengthen the hospital's infrastructure and services. “There are plenty of promises from elected representatives, but little action,” they said.
The government allocated Rs 45m to the hospital in the current fiscal year. However, around 75 percent of the budget is spent on salaries and administrative expenses.
“We are facing serious shortages of human resources and infrastructure to provide smooth and quality healthcare services,” said Govind Bahadur Gyawali, the hospital's senior administrative officer.
Rampur Hospital was established 31 years ago in 1995 as a Primary Health Centre. It was upgraded to a 15-bed hospital in 2012 and later to a 50-bed provincial hospital in 2015.
