Greater Reforms Needed

Narayan Upadhyay

The ongoing hunger strike of the senior orthopaedic surgeon, Dr. Govind KC, has captured the attention of whole nation. Dr. KC’s 15th round of fast-unto-death protest has obviously divided the opinion. A greater number of people including intellectuals, political party leaders and workers, professionals, civil society leaders, media persons and pro-people activists have thrown their weight behind the protesting doctor. As a result the ruling party and the government have felt tremendous pressures from Dr. KC and the support the protesting doctor’s hunger strike has generated in the past three weeks or so.
The people who have thrown their weight behind Dr. KC see genuineness of KC’s demands for bringing reforms in the nation’s medical study area, which is crucial for realising much needed reforms in the country’s ailing health sector.

The medical study in Nepal is regarded quite mediocre because of the substandard medical colleges that impart medical education across the nation. Barring few government owned medical colleges, the education imparted by the privately-run medical colleges can only be termed substandard. This is also surmised from the fact several of the students who graduate from the private medical colleges do fail their examinations conducted by Nepal Medical Council (NMC).
The number of students graduating from the medical colleges such as the Institute of Medicine (IOM), Maharajganj who pass the NMC examination is quite high. Experts say that the government owned medical college, IOM, boasts of better equipment, infrastructures, teaching faculties as well as opportunities for carrying out practices. The students can avail of greater number of patients visiting emergencies, outpatient departments for various diseases.
If one visits private medical colleges of the country, she/he will certainly find it that these medical colleges are lacking the facilities availed by a student studying at a government-run medical college. This often turns many students of the private medical colleges mediocre, lacking enough knowledge required to pass the NMC examination. Many of the private colleges are set up and run with a sole motive of earning profits through high fees.
The private medical colleges have a tendency to accept the students who have secured poor marks but have the capacity to pay exorbitant fees. These medical colleges thus have become a place to produce mediocre or inefficient future doctors, whose main objective would be to earn quick bucks at any cost, without paying attention to the well-being of patients.
Therefore, the high proliferation of private medical colleges must be stopped. On the other hand, the tendency of the universities to grant affiliation to the private medical colleges must be regulated strictly. There are many colleges in the country that not only lack equipment, infrastructure, and teaching faculties but also lack the inflow of patients. There are some colleges in the country which have been set up in rented buildings and lack sufficient health workers in them. Such a prevailing situation has led to the deterioration in the standard of medical study, which seems to be the reason that has sent Dr. KC to his 15th round of hunger strike.
The tendency of giving affiliation to the medial colleges with the KathmanduValley appears to be another vice, because many of the aspiring medical students want to study in the KathmanduValley based colleges, making better health services in other parts of country inaccessible to the local people.
Indeed, the medical study in the country is getting costlier while the standard and quality of the services have deteriorated. Besides fast deterioration of the medical study sector, the overall health sector has too deteriorated in recent years. The Nepali health sector has now appeared to gone in the hands of private sector. Owing to the poor services provided by the government-owned hospitals, the private health centres have been doing brisk business, though the patients have to pay high costs of availing health services at the private hospitals and nursing homes.
The deterioration in the government hospital is reflected not only in the services provided there but also in the behaviour of the doctors working at the government hospitals. The doctors here often refer a visiting patient to the private hospitals where they are associated with. The doctors are also ‘guilty’ of referring the patients to certain clinic for other medical tests, obviously due to their love for high commissions. The ever growing cost of availing quality health services in Nepal can only be stopped if and when the government and the concerned authority regulate medical colleges and health centres quite strictly.
There is now an urgent need for the government to make it mandatory for every medical college to have a full-fledged hospital having enough beds. A medical college must have a hospital with at least 300 beds. The medical study should be made affordable for the students hailing from middle classes while the same can be made free to the diligent and poor students. The medical colleges should be opened in various parts of the nation so that the people could avail better health services while local students will get a chance to carry out their study at their own locality or near their locality.
As the issue pertaining to reforms in medical study and health sector has become the order of the day, the talks of nationalising all existing medical colleges has also been doing the rounds. With the ever growing cost of medical study and with the deterioration in the health service quality, this appears to be a viable solution to end anomalies that have confronted our medical study and health sector. The nationalised medical colleges would be facilitated better than the private ones.

Quality matters
The government does possess enough resources to equip all the nationalised medical colleges with better equipment, infrastructure, teaching faculties with hospitals having enough number of beds. The aim of bringing such reforms in the health sector is nothing but producing skilled and talented doctors or health experts who would provide quality services to the common people at affordable prices. On the other hand, the health institutions should be made non-profit ones.
It is a fact Dr. KC’s protest has currently divided the opinion in the nation. But there can’t be two opinions on the fact that the country’s health sector is in bad shape and it needs greater reforms. Reforms in medical study sector can be one of the ways to realise the betterment in the nation’s health sector.


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