Health service has always figured as the top priority of the state in its policies and legal framework. The framers of our constitution wisely wrote: “Every citizen shall have the right to free basic health services from the State, and no one shall be deprived of emergency health services.” “Every citizen shall have equal access to health services,” says the constitution. But this promissory note on health service has remained limited to paper when it comes to the common people of Nepal. This is because our public health facilities are poorly equipped, even non-functional in some cases, forcing the commoners to go to private health facilities which charge exorbitant amount of fees that are beyond affordability of the common people. Those to suffer this state neglect have been the citizens of Province 1 in recent times. People in hill districts of Province 1 are forced to go to expensive hospitals in Tarai for most of their medical needs because local facilities can provide only basic medication. Hospitals in hill districts of this Province lack specialist doctors, equipment, knowhow and medicines. Here, again, constitutional promise on health has not materialized.
The government policy says district government hospitals need to provide 70 types of medicines free of cost and primary health centers and health posts should provide 58 and 40 types of medicines for free. District hospitals and other health facilities have failed to provide such services. Their roles are basically limited to referring patients to other hospitals, mostly private. So the residents of the hill areas have no choice but to come down to the plains or other major cities for treating even ordinary ailments but private hospitals there charge exorbitantly forcing people to even sell their property to meet the expenses. District hospitals in Panchthar, Taplejung, Ilam, Terhathum and Dhankuta provide only basic medical services. The 50-bed hospital in Ilam, for example, lacks enough specialist doctors. There are 15-bed hospitals each in Taplejung, Terhathum, Dhankuta and Sankhuwasabha but these hospitals are also poorly equipped. In lack of doctors, they depend on their medical officers for medication. The list of affliction on public health facilities runs long.
Troublingly, what is happening in public health facilities of Province 1 is happening across the the country including in big hospitals like Bir and TU Teaching of the capital city. Either there are no enough doctors, or hospital beds are too few to accommodate growing number of patients or they are struggling in lack of lab equipments. This affliction must be cured and it can be cured only when the political leaders in the government take the initiative. But as a matter of fact, improving services at public health facilities has never become the priority issue for them. Prime minister and ministers themselves tend to fly to posh locations like Singapore, Thailand and America even for treating minor ailments. If they ever go to hospitals within the country, it is usually expensive private hospitals. When they do not have to rely on public hospitals for treatment they naturally ignore public hospitals. This has become a norm, rather than an exception and this norm must be broken. The government does not have to do much for this. If it ensures that public health facilities have required human resources, if medicines and equipment are procured and supplied to these hospitals on time, it could go a long way in changing the situation in these public hospitals. Most of all, there must be a realization among political class that Nepali people must not be deprived of right to health at affordable price. The nation cannot allow public health facilities to remain ailing anymore.