Cover Story

Toying with health

May 25, 2018 09:05 AM Swasti Gautam

When he reached Norvic International Hospital in Thapathali, Kathmandu, Kanaiya Shah from Rautahat was told he would have to wait for two months even when he had booked an appointment 25 days earlier. But he still managed to see the doctor because he knew a staff who worked there.    

Another patient from Butwal at the same hospital made sure his appointment was booked three months in advance. He did so because he expected a long wait-list, and there indeed was one.  

“I wonder if everyone has to wait so long for an appointment or is it just people like us who suffer,” says the patient who didn’t wish to be named adding, “Do bureaucrats, ministers, and politicians face the same problem?”

According to most patients that this scribe spoke to at different private hospitals around the valley, difference in services and treatments could easily be seen between people who had power and connections and those who did not. And many patients at these big private hospitals were quite resentful, as they were not getting the same services even after paying a huge amount of money.

People were of the opinion that private hospitals in Kathmandu seem to be treating their patients merely as revenue generators. They say there is rampant carelessness while treating patients even at pricey hospitals. The quality and standard of care are clearly lacking. 

A patient at Grande International Hospital in Tokha, Kathmandu, who had her prescription glasses made at the hospital itself said she was given the wrong lenses. The lens power did not match the prescription. 

“The hospital boasted about having the latest technology and best services. But they messed up my lenses and I’m sure I can’t possibly be the only one,” says Sita Tamang* who was highly disappointed by the costly yet ineffective services provided by the hospital. 

When this scribe questioned Grande International Hospital about such incidents and complaints, the hospital authorities brushed it aside with seemingly very little concern about the matter. “We aren’t responsible for that kind of mistake. The spectacle shop is not a part of the hospital,” says an authority at the hospital’s eye care department. 

Over at Annapurna Neurological Institute and Allied Sciences in Maitighar, Kathmandu, the situation seems to be even worse. When Poonam Maharjan rushed her father to the emergency department when he had a seizure attack at about 8:00 am in the morning, there was no one there except the cleaning woman. 

“After having waited for more than 20 minutes, we were told that the doctors sat down for a meeting from 8:00 to 9:00 am and so there would be no one available during this time. Basically they meant it’s unfortunate someone needed them during that hour,” says Maharjan. 

At the same hospital, while her father was in the CCU, there were also some problems with the diaper and all his clothes and bed were wet. No one knew about the wet bed until Maharjan’s mother went in to feed her husband some porridge. When she informed the nurse on duty, her mother was told that the related staff would take care of it. But no one did even after an hour of the complaint. 

“When I went in the CCU, the nurse was busy using Facebook and I firmly asked her to either let my mom change the clothes and bed sheet or call for the staff right away. Only then did she go to call someone to take care of it,” says Maharjan. 

Similarly, later, after her father was discharged and was only being taken to the hospital for follow-up checkups, they were asked to consult two separate doctors—a cardiologist and a neurologist. “It so happened that both these doctors prescribed anti-cholesterol medications under different brand names and while my dad was supposed to take only five milligrams of the said medicine, he was actually taking 15 milligrams,” explains Maharjan.

“I found out about this when my father had to pee every two minutes and I googled to see if it were the side effect of any medicine he was taking,” she adds. 

These incidents compel us to raise some serious questions about the accountability and the quality of services provided by these hospitals. When questioned about it, the spokesperson at Ministry of Health said that the ministry needs to regularly monitor private hospitals but also acknowledged the fact that they haven’t been able to do so that efficiently. 

“A single ministry is expected to check all the hospitals in the country, be it private or public. That is why we are now lobbying for an Independent Quality Control Authority that is established in most countries abroad. If we are able to implement this independent body, quality control and checks will be a lot more efficient,” says spokesperson Mahendra Shrestha. 

According to Shrestha, even patients can take action when they feel a hospital’s service is substandard. He says patients play an important role in making the hospitals more accountable for their services. He says one can immediately inform the medical superintendent or the director of the hospital if they feel they have been mistreated or not been given enough information. Under any circumstances, if the hospital is not ready to address their problems, then the patient can contact the Ministry of Health who will then take further action. 

But people seemed to be unaware of the fact that they could file a complaint at the ministry and even when this scribe told them many were skeptical that it would actually amount to much. Many patients also confessed to being peeved by the frequent and unregulated rise in the prices of facilities and services at private hospitals. But, apparently, having no other option, they have been forced to put up with it.    

Bimala Sitaula from Nepaljung who frequently comes to Kathmandu for checkups says private hospitals in Kathmandu are businesses that operate with the sole motive of making money. According to her, every time she comes to Kathmandu, the prices of tests and facilities at private hospitals seem to have gone up.  

She had paid Rs 6,000 at a private hospital for a full-body checkup about five years ago. This time around, she was made to pay Rs 6,500 for three simple tests at the same hospital, the name of which she didn’t wish to disclose. 

“I don’t want to take the name of the hospital or the doctor. There are very few good hospitals in Nepal and we all depend on them. What will I do if he finds out I pointed fingers at him and refuses to treat me,” says Sitaula. Like Sitaula, many patients seem to be angry, irritated, and disappointed all at the same time by the quality of care provided by our private healthcare system.

Out of 20 patients this scribe spoke to throughout the valley, 18 of them said they have had to wait for at least two hours to see their doctor even when they arrived on time. “Why would you tell a patient to come at 10 am when the doctor doesn’t come to the OPD till noon?” questions Tina KC who doesn’t remember a time she’s gone to the hospital and not spent at least four hours there. And this is just the waiting time. She’s not factoring in time taken for tests here. 

A patient from Butwal who had lived in the United Kingdom for about a decade feels that nowhere in the world is health care system so inconvenient. He says even if you are paying hundreds of thousands in a day for healthcare in Nepal, you have to get someone along with you who has to run around the hospital for small things such as paying bills or getting food. 

“The patient’s family members are expected to be with them and take care of them the entire time. What if the patient has no one to take care of him? Why are they charging so much money when the quality of care is so poor?” he questions. He believes hospitals shouldn’t be charging so much when they clearly do not have a good system in place. 

There is also inconsistency in hospitals around the valley on the amount they charge for the same kind of services. When this scribe collected data to compare the cost of a full body checkup at 10 different private hospitals in the valley, their prices ranged from Rs 6000 to Rs 36000 per person. This large gap in the price range for almost the same kind of facilities shows how hospitals in Kathmandu are increasingly becoming profit driven corporate organizations that operate at their own free will. 

This sorry state of affairs at private hospitals in the valley demands some immediate action. Healthcare shouldn’t be a compromise but that’s how things seem to be at the moment. The government claims it’s lobbying for better monitoring by establishing an independent unit but it’s high time we take the matters into our own hands too and start questioning the system and not silently be its victims.

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