Despite this, many people are deprived of health services because many medical staffs don’t stay at their appointed health facilities regularly.
A few days ago, irate locals at Lele VDC of Lalipur thronged the Lele PHC (Primary Health Center) in a fury and nearly thrashed its health workers, citing regular absenteeism of the staffs. The management committee intervened and saved the doctors and other staffs from being beaten.
Kameshwori Shrestha, Hospital Nursing Inspector, had gone to attend a training without informing the PHC in-charge. As a result, the services were halted. As the patients didn’t receive the services, the locals gathered and went to take stern action against the irregularity of the health workers because this wasn’t the first time it had happened.
When asked about the irregularity of the health workers, Dr Milan Khadka, the PHC-In-Charge, said, “Since the PHC is located far from our residential areas and doesn’t have secure residential infrastructure, we’ve maintained rotational duty hours. If we stay here for three days, we stay on leave for the remaining days (of the week).”
Since the doctor irregularly visits the PHC, many patients don’t receive treatment even though the PHC is well equipped to provide the health services.
“We only admit cases related to delivery. Other cases are referred to nearby hospitals because we don’t have doctors stationed here most of the time. Patients are under the supervision of paramedics and a nurse,” said Kameshwori Shrestha.
The PHC has stories of poor performances in the past as well. The position of a lab assistant also remained vacant for two years, meaning the laboratory was dysfunctional.
“He didn’t tender his resignation letter but forwarded an unpaid leave application, so it wasn’t possible for concerned authorities to fulfill the position,” replied Dr Khadka.
Similarly, Ram Naresh Mahola, Senior Auxiliary Health Worker, complained, “Providing services is problematic here because there aren’t enough medicines and the microscope doesn’t work properly.”
However, Bal Krishna Bhushal, District Public Health Officer, said. “It’s their mistake for not lodging a report about the lack of equipments. They would have been made available if they’d filed a report,” adding, “The National Tuberculosis Center has continuously announced their commitment to provide necessary equipments. But if the PHC doesn’t report about it, what can be done?”
The district authority has now committed to take stern actions against the staffs working at the PHC.
Bhushal said in effect, “The PHC staffers have been disregarding the management committee’s rules for a long time. So this time I’ve asked the committee to mark with red the false attendance made by such staffs,” adding, “I won’t approve the salary for those falsified attendance dates, and even more stern actions will be taken if repeated.”
According to an operational research conducted by SOLID Nepal with Merlin Nepal, only 62% of doctors’ positions are filled in the country followed by nurses (90%), paramedics (94%), and technicians (79%). That means a total of 14% of positions are still vacant.
Chapter 10 of the Health Service Act, 1997, has defined different levels of punishment for staffs breaching the law. Accordingly, if an employee frequently commits breach of discipline, he is subjected to his promotion being withheld for up to five years, or withholding of a maximum of five salary increments, or demoting to the basic scale of the post held by him. Also, an employee may be removed from service without being disqualified for the health service in the future if he is frequently found violating rules relating to conduct and if he fails to perform the assigned duties or responsibilities.
Nepal is among 57 countries to have critical shortage of health workers. Nepal had developed the National Health Policy in 1991, and as of now, there has been 45% growth in the country’s population but only 3.4% of positions for health workers have been increased.
In addition, if such incidence continuously occurs where there is need of more doctors committed to providing better health services, how will the people of the next generation receive quality health services?
The writer is Media Monitor at Society for Local Integrated Development Nepal.
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