KATHMANDU, Nov 26: Anomalies prevail in the medical sector because of the government's weakness, said Dr Dinesh Binod Pokhrel, former president of the Professors Association at Tribhuvan University Teaching Hospital (TUTH).
Talking to Republica about medical education in relation to the anarchy in the medical sector and Dr Govinda KC's hunger strike, Dr Pokhrel said, “Dr KC's demands are rational. The government grants permission to the private sector to open medical colleges without subjecting the applying colleges to detailed scrutiny.”
There are altogether 20 medical colleges in Nepal, including eight inside Kathmandu Valley and 12 outside. At a time when Dr KC has staged 10 hunger strikes demanding an end to medical sector anarchy, Dr Pokhrel has stressed the need for strong policy and good guidelines for opening new medical colleges.
“Although the opening of new medical colleges is necessary for the students and for the country, the government has failed to enforce the rules and standards required for good medical colleges,” he said. “As a result, the number of medical colleges is increasing on the basis of giving and taking [of bribes].”
According to Dr Pokhrel, 2,500 to 3,000 students go for medical studies in foreign universities every year although some of the foreign medical colleges are no better than the ones in Nepal. “Domestic medical colleges enroll about 2,000 students annually. We need more colleges of merit and quality, with adequate faculty, infrastructure and equipment,” he added.
The Nepal Medical Council has lowered the number of seats for students at private colleges from 150 to 115 per college. “This does not auger well for producing doctors as per our needs,” said Dr Pokhrel.
There are more than 17,000 registered doctors in the country. Out of the total of approximately 54,177 health personnel in Nepal, 32,809 are involved in the public sector and 21,368 in private sector.
Nepal has only 0.67 doctors and nurses per 1,000 population as against the WHO recommendation of 2.3 health workers per 1,000 population. “We have only 0.17 doctors per 1,000 people. We have to think where we are heading in terms of health manpower,” said Dr Pokhrel. “The government should open a good medical college in every federal province and ensure quality education that is free or low-cost,” he suggested.
Dr Pokhrel argues that political intervention in the education sector has worsened the situation. “Deans should be appointed as per quality, vision and seniority. Seniority alone as demanded by Dr Govinda KC cannot improve medical education,” he said. “We need to review the rules to better manage the medical sector. Strict standards and a strong implementing body are indispensable.”
Dr Pokhrel, who is a dermatologist and venereologist at TUTH, also said that the incidence of skin disease in Nepal is increasing rapidly due to unhelpful dietary habits, pollution, cosmetics, internal diseases, smoking and drinking. “Out of the 23,750 skin patients at TUTH in one year, the most prevalent skin diseases are infections (22 percent), eczema (12 percent), pigmentary disorders (12 percent) and acne (10 percent),” he said.