Lone Crusader Of Nepal’s Health Education
Hunger strike was a weapon used by Mahatma Gandhi as part of his philosophy of non-violence. During India’s freedom struggle Mahatma Gandhi undertook 17 fasts and his longest fasts lasted 21 days. Through his fasts Mahatma Gandhi shook the foundations of British Raj in India and ultimately India became independent country. Similarly Anna Hazare, a Gandhi disciple, staged fast-unto-death for Jan Lokpal bill during India against corruption (IAC) campaign which sent ripples across the world. Even though politicians in Nepal have also staged hunger strike for political cause many times in the past but fast-unto- death undertaken by Dr. Govinda KC, senior orthopaedic surgeon at Tribhuwan University Teaching Hospital (TUTH), has received wide media coverage as well as public support. Thousands of people, especially youths participated in rally in support of Dr. Govinda KC.
Dr. Govinda KC, a lone crusader who has been fighting for reforms in the country’s medical education sector for the past five years, has again staged his 11th hunger strike for the endorsement of Heath Profession Education Policy (HPE) a Bill which is languishing in parliament for more than one year due to the hindrance created by handful of parliamentarians. Lawmakers have filed a total of 276 amendments to the Health Profession Bill with a majority seeking removal of 10 year moratorium on establishing nursing and medical colleges. Amendments registered by lawmaker reveal their interest on operating medical colleges as some of them have invested in the sector.
The number of MPs registering the amendments is 54. For instance, MPs Rajendra Pandey has requested removal of clause 12(A) of HPE that bars the opening of new college in the valley for a decade. Similarly, Dr. Bansidhar Mishra has filed for the removal of Clause 12, sub clause (B) which requires a 300 bed facility to qualify for running a medical college. Both Pandey and Mishra had stakes in the Manmohan Memorial Academy of Health Sciences MBBS which government decided to acquire following a series of hunger strikes by Dr. Govinda KC. They both are accused of using their political clout to obtain permission to run MBBS classes in the capital. But Kedar Bhakta Mathema, who led the committee that drafted the Health Profession Education Policy, says provisions in HPE were proposed after rigorous discussions among experts and it is necessary to honour the expertise.
Until and unless the nexus between the politicians and medical mafias remain, unethical practices in Nepal’s medical sector will continue. Dr. KC believes that implementation of HPE will eradicate the anarchy prevailing in the medical education sector of Nepal. Along with the endorsement of HPE Bill his other key demands include slashing fees of postgraduate studies from Rs. 3.1 million to Rs. 2.2 million, revoking Tribhuvan University decision regarding medical education, appointing four assistant deans of Institute of Medicine (IOM) and campus chief, and probing into irregularities of TU officials.
Dr. KC had ended his three-week-long hunger strike last year after government signed a 12- point agreement on December 4, 2016. But as government failed to implement the agreements signed with him, he again staged 11th round of hunger strike
It is true that Nepal’s medical sector is marred with many ill practices which have lowered the trust of common people. Last year operation quack, launched by Central Bureau of Investigation (CIB), arrested 36 doctors possessing forged academic certificates which came as a shock to many but it is only the tip of iceberg as medical sector has widespread malpractices. In Nepal, anyone can be a doctor if they are willing to pay huge amount as a donation to medical colleges. Investigation in past has found out that many colleges have been taking donations for admitting foreign students without taking qualifying exams. Even it has been found that Nepali students have also been admitted as Indian students to avoid the entrance exams.
Though government has fixed the fee ceiling of Rs. 3.5 million to study MBBS, medical colleges have been exploiting the students charging millions more than fixed ceiling. In medical sector students should have been admitted by evaluating their capacity rather than amount of donation they pay to medical colleges but due to web of medical mafias, corrupt officials and flow of money later has been the case in Nepal which is very unfortunate for the country in long run.
Even though many medical colleges lacked adequate infrastructure and faculties but were given affiliation letters in the past due to the false report submitted by the officials of Nepal Medical Council (NMC). Colleges were found to have bribed the NMC officials and showed fake infrastructure and faculties to get affiliation. Many colleges hire facilities from India on temporary basis which are known as Khade Baba and patients during college inspection by NMC officials. As a result understaffed and ill equipped medical colleges have increased across the country producing under qualified doctors and putting millions of lives at risks.
Another problem of Nepal’s medical sector is high density of medical colleges inside the Kathmandu Valley. At least one medical college should be established in all the federal provinces but currently majority of the medical colleges are established within the valley which has compelled common people to visit the valley for the treatment from the far-flung areas as well so that people’s basic right to get timely treatment be addressed.