Politics-health nexus
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Issues were the same one year ago. Dr Govinda KC wanted a strict policy to regulate private medical colleges. He wanted them in rural hinterlands, within the reach of the poor. He is fighting for the same now. He led a Satyagraha to push this agenda last year; he has put his life on the line again (as of this writing, there is no sign of government addressing all of Dr KC's demands). It's going to be a tough battle for Dr KC and his supporters. In the corporate state, state actors only understand language of monetary gains. Humanity does not count.
Like in the past, his Satyagraha has brought out some disturbing secrets of medical mafias. The bid to grant affiliations to four medical colleges concerned a bribe amounting to at least Rs 600 million, Nepali Congress Central Committee member Dr Sashank Koirala had disclosed last year. We were told then that politicians, TU officials and members of council of ministers were involved in the scam. Now new details have emerged. Dr KC's supporters claim that Minister of Education received millions in bribe money to grant affiliations to the controversial medical colleges. Perhaps. It needs a great pressure to act against one's conscience and (perhaps) a great monetary incentive to break the promise made with a Satyagrahi just in a matter of one year. Entire lobby of CPN-UML (which has its penetration in private health and education institutes) and big section of ruling establishment are against him.
It is about bringing private health and education institutes under government control. It is about dismantling politics-business-crime nexus vis-à-vis health and education. Thus having a national policy on health and medical education and halting affiliation process will only solve a part of the problem at the moment. It will only cure one symptom of the chronic disease. Unless education and health are freed from 'only-for-profit-private-sector' things will remain the same.
Dangers, risks and irregularities are so high in health and education sector. We won't be able to realize its intensity without putting some instances into the context. 'Renowned' institutions are in the frontline of committing and abetting medical malpractices.
Recently, Republica's health correspondent Arjun Poudel shared some hard-to-believe facts regarding a private hospital based in Bansbari. They bear repeating here. A man met with a motorbike accident and was rushed to this particular hospital. He was put under ventilation care. When the patient's relatives ran out of all money (about 2.5 million had already been spent), he was declared dead and discharged without issuing death certificate. But he was still pulsating even when he had been taken to Aryaghat for the last rites. The case was reported but no action was taken against the all-powerful hospital.
In yet another case, a middle-aged patient killed himself by jumping off the same hospital building because the hospital bills had grown enormous and he would not be freed unless the accounts were settled. Arjun says there are a number of cases where private hospitals even lock up patients for payment. It is common for directors of government hospitals to own and operate private hospitals, says Arjun. These private hospitals embody all the ills Dr KC is fighting against.
Our health facilities have hardly benefited the poor and the needy. Extremely rich do not trust hospitals here (they have no reason to) and go abroad for treatment. This cohort has increased with political upstarts joining the fray. Upper middleclass and desperate middle-class go to India for treatment. Lower middleclass turns to private hospitals in Kathmandu because public health institutions are in a mess. You lose significant amount of your hard-earned money in these hospitals but there is no guarantee of treatment. The rest turn to public institutions such as Bir and Tribhuvan University Teaching hospitals. Dr KC's battle is concerned with the right to medical care of the poor. It would not be wrong to say he is leading a socialist movement for health and education.
This hierarchy of inequality in health services has its visible parallels in the output of our education system as well. This system produces two distinct classes of people. First, those who are educated in expensive private schools, who are well-versed in English and who leave for Uncle Sam's shores right after graduation, perhaps never to return. Second, there are products of public education system which imparts nothing more than literacy and who do not qualify for anything more than manual jobs in the Middle-East and the Gulf. It is the second group that is sustaining country's economy through their blood and sweat but state cares a little about their health and education. Dr KC wants to alter this situation.
All this, however, is the result of state actors allowing profit mongers to do business with public health and education. As a result, health and education are neither under government control, nor within the reach of the common people. It has become mere commodity goods which can be bought, sold and put in auction for profit. Problems have gone worse since state actors themselves are stakeholders in this business.
The problems listed above are only symptoms of the disease called privatization of education and health that started in the mid 1990s. Private hospitals and schools began to mushroom. But there were no regulatory bodies to check their excesses. We began to worry only after the private sector brazenly began to fleece the general public. Despite being part and parcel of profit sector, educationists, doctors and professionals agree that vital services like health and education should never have been given to private sector, and that economic libertarianism should have been kept limited to other services. So what should be done?
Profit sector has developed an empire of its own. Politicians, businesspeople, educationists and professionals are into it. Mere government intervention won't be enough because government actors are themselves partners of this empire. To free health and education from profit sector, we need to review and revoke (if needed) our privatization policy. We need to stop putting health and education on sale. This would have been possible if the "socialist" Nepali Congress had not sold out the soul of its ideology to market capitalism in the 1990s. It would have been different if the revolutionaries of the 2000s had not defaulted on their promise of health and education for all. It is harder now because free market fundamentalists are at the helm, because the entire regime is against Dr KC's call for reform.
But this won't and should not stop people from supporting the noble soul. He has the blessings from the poor whom the state has left at the mercy of profit sector. He has the blessings from those who have not sold out their soul and conscience. The rest can rise up to the moment or formally declare themselves votaries of crony capitalism.
mahabirpaudyal@gmail.com
