While the health care market of its capital city is almost oversaturated with 99 hospitals, only 64 other districts (out of 75) in Nepal have hospitals, and many of them just a single one. Even fewer are well equipped: only 14 district hospitals can perform surgeries.
Due to lack of equipment to diagnose and treat serious ailments, rural hospitals are used to referring patients to bigger hospitals, but research shows that the rate of patients following up on referrals is quite low. This is partly because of transportation problems in rural areas: in the absence of motor vehicles, it might take days to walk from one hospital to another. If the patient is very ill, caretakers may have to carry the ailing person for days at a time, which deters many from seeking medical care. The problem is compounded by the fact that due to lack of facilities, few doctors want to live in rural areas. [break]
The consequences of our inequitably distributed health care system became amply clear last week, when a flood in the Mahakali river inundated entire settlements in the hilly district of Darchula. Among the buildings swept away were buildings of the lone government hospital in the district. Since most houses are already filled with displaced people, the hospital has since been providing services from a nearby under-construction house. Most patients have had to sleep under the open sky, and are troubled by insects at night. Predictably, the number of patients has increased after the disaster, but the hospital is struggling to provide even basic services because most of its equipments have been swept away. The staff has been making do with a few equipments which were salvaged and stored at the local army barrack and other government offices, but with electricity from the local power house interrupted, they are unable to provide X-ray services.
More than a week after the flood, the government has taken no initiative to build an embankment to contain the raging Mahakali, due to which locals live in perpetual fear of another flood.
The team at Darchula hospital has bravely shouldered on despite their dwindled resources and diminished manpower, even making eight deliveries in the week since the flood. However, it does not relieve the government of its responsibility emergency relief in the short term, and providing for buildings and equipment and deploying needed medical professionals in the long run. Under pressure from locals, the government did declare Darchula a crisis-hit district, but the aid itself has not been so prompt.
Darchula hospital had demanded medicines and a medical team from the government, but they have been slow in coming. While some medicines reached Darchula, with the rest stuck at Dhangadhi airport, the medical team never arrived. According to the doctors at the hospital, if the team does not arrive soon, a large number of patients at the understaffed hospital could be deprived of vital services. The disruption of services at Darchula hospital should serve as a lesson. There ought to be a mechanism for immediate deployment of vital medical aid in case of emergencies. A little more political will to improve the pathetic health infrastructure in the mofussil would certainly help as well.
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