With more than two decades of experience as a pediatrician, Dr Kulesh Thapa is the medical director at Chhetrapati Free Clinic, Gangalal Marga, Kathmandu. After completing his MD from Moscow from Peoples’ Friendship University in 1985, he returned to Nepal and joined Nepal Police Hospital. He has earned a Diploma in Child Health (DCH) from Tribhuvan University Teaching Hospital in 1990 and worked as an instructor of medical first responder (MFR) training, disaster preparedness, etc. He has been engaged as a pediatrician and trainer in different medical institutions of Nepal.

In an interview with My City, Thapa talked about his experience and setbacks that he witnessed in his professional journey.

Has the scenario of health services improved over the decades in rural areas of Nepal?
The scenario is definitely improving but the pace of improvements is quite slow. Although the neo-natal mortality has decreased to a good extent in the urban areas, the rate is very challenging in rural areas of Nepal. Scarce number of medical posts, human resource and experienced staff and doctors has been making the situation vulnerable. Furthermore, following the lack of medical equipments and awareness among the rural people, the neo-natal mortality rate is likely to escalate every year.

What are the challenges to sustain in the field?
Every sector including the medical sector has numerous bureaucratic hassles to go through. The medical sector being a sensitive area demands immediate outcomes and resolutions but the concerned authorities are not quick enough to take necessary action. The frequent change in government invites changes in policies. Although many progressive policies are introduced, they have not been implemented properly. We have received aids and funds from numerous countries after the 2015 earthquake, but a viable outcome could not be observed in many parts of the rural areas yet. 

How can the scope of pediatric sector be enhanced in Nepal?
Like in medical services for adults, there is an good scope in the pediatric sector. The factors that we need to consider in the first place is building strong human resource and allocating ample investments in the sector. The idea of sub-specialization in the medical sector is important therefore; the sub-specialization like pediatric cardiology, pediatric pulmonarology, and pediatric gastroenterology should be developed to enhance overall medical and health sector. It takes infrastructures to make things operate. Moreover, institutionalized and managerial development is essential to invite additional advancements in the pediatric sector. 

To what extent do you think are the parents informed and aware about child’s health condition when they visit hospital?
It depends on the geography, level of awareness and economic status of the parents to help acknowledge the health condition of their children. With little geographical barrier and improved awareness level, pediatric health is prioritized in the urban areas. However, it is the opposite in most of the cases of the rural areas. Apart from that, people from both the areas are guided by superstitious beliefs which in most of the cases invite immature fatalities in the child’s health. Moreover, people may get myriad of information online which could mislead them so it is important to follow authentic sources of information for less serious health conditions.

Would you like to convey any word of advice to our readers?
Health condition in the childhood plays a crucial role to determine physical and mental well-being in the adulthood. Thus it is high time we focus on pediatric health awareness and work for its advancements. Every district should have a good number of pediatricians working accordingly with an improved infrastructure. As quality gradually emerges from a whole lot of quantity, the increase in number of service providers shall be highly encouraged in the first place. It is then we can better tackle outer factors hindering the growth in the sector.