But how long should one have to wait? Neither the doctors nor the hospital administration has an answer.[break]
"We do not have any other option. If the case is not an emergency, patients have to wait," said Dr Bulanda Thapa, director of the hospital. However, patients with political access do not have to wait in queue, nor do they have to pay for the treatment. The hospital offers them free treatment.
Balaram Awasthi of Sindhuli waited one whole year for kidney stone surgery but the doctors asked him to wait some more, citing lack of any vacant bed. "I thus feel compelled to go to a private medical centre for treatment," he complained.
According to Awasthi, the cost of the treatment is nothing compared to the living expenses for the patients and relatives while staying in the capital.
Indigent patients from the far flung districts visit Bir Hospital for quality service at affordable cost but their real troubles start once they reach there.
They have to wait at least two weeks for an ultra sound test at the hospital, and the difference between the ultra sound fees charged by Bir and private hospitals is not very big.
The radiology department at Bir says the hospital has a limited number of machines and manpower. And the flow of patients is very high.
Though all the doctors at the hospital receive an additional 100 percent of salary as academic allowance for teaching medical students and another 50 percent for the various expanded services, the doctors do not shoulder any additional responsibility.
Director Dr Thapa concedes that he is struggling to hold doctors to their duty hours at the hospital. Senior doctors skip off to private centers after attendance. Some of them used to lure patients away to the private centers and charge them exorbitant amounts.
Moreover, doctors prescribe medicines under the influence of medical sales representatives.
Needy patients are in no position to question the doctors and have become tools for their tests. They have to bear the cost of expensive gifts that the pharmaceutical companies offer doctors in return for prescribing their brands.
The hospital, which is the country´s oldest and largest, does not even have a standard treatment guideline. Taking advantage of these shortcomings, the doctors used to prescribe medicines foisted on them by the pharmaceutical companies.
The doctors do not know whether the drugs they prescribe actually work or not. "Patients do not return and so we don´t know whether the medicines work," Bhupendra Bahadur Thapa, a drugs expert, told Republica. He said patients go elsewhere if the medicine does not work.
The government provides a huge grant to the hospital for providing quality treatment at an affordable price. The hospital provides free treatment to the poor, but are the genuine poor benefitting? Hospital authorities and officials at the Ministry of Health and Population have their doubts. "The real poor cannot get the benefits," a health worker at the hospital said.
Moreover, the hospital has handed over the responsibility for sanitation to a non-governmental organization, after questions over hygiene were raised.
About 1,500 employees work at the hospital, but the authorities always complain about a manpower crunch.
"In fact senior as well as junior staffers do not obey the authorities," an employee at the accounts section said. There are 28 trade unions at the hospital and the authorities are helpless. Care of the patients is not a priority.
More beds needed for better service: Dr Bulanda Thapa, Director, Bir Hospital
What are the measures that you have taken to mitigate the ongoing problems?
Following my appointment as director of the hospital, I have been taking several measures to mitigate the chronic problems under which the hospital has been reeling for years. But the task has not been easy. I had launched a ´clean hospital campaign´ and we met with some success. If you are a regular follower of developments at the hospital, you can compare the overall changes that have taken place.
Patients have to wait months to get treatment and being admission to the hospital is like winning a lottery. Aren´t you bothered about such problems?
Yes, we have problems in some departments. We have a limited numbers of beds and limited manpower and resources, and the flow of patients is very high. To respond to these problems, we have to increase the number of beds. Without expanding the beds, I can do nothing. Unfortunately, only 300 beds have been added to our hospital in the last 100 years while the flow of patients has increased 100-fold. I am helpless.
Patients from far flung districts come to Bir for quality care at affordable cost but due to the misdemeanors of some employees they have been compelled to go to the nursing homes. Are you aware of this?
Of course, I am well aware of the problem. To check such wrong practices at our hospital, I am going to form a probe team that will report to me about such practices. Stringent action will be taken against those found guilty. I have heard that such practices are rampant at the Emergency and Out Patient Departments. I will not tolerate such practices.
Is there any obstacle in implementing your improvement measures?
It is needless to say how many obstacles I have been facing. But I hope I will be able to overcome them all. I expect greater cooperation from colleagues and staff to fight the anomalies that have severely sapped this institution. Through collective effort we shall improve its image.
Vox-pop:
Bir is first choice
I have a kidney stone problem. Doctors at Bir Hospital have suggested that I undergo surgery. For middleclass people like me, Bir is the first choice. All kinds of treatment are available here. And, more than that, the service is not very expensive.
Sharmila Biswokarma
Naikap, Kathmandu
Toilets are filthy
I am a security guard at Chhauni Housing. I came to Bir Hospital after suffering from leg cramps. I was unable to walk properly. I always prefer this hospital because doctors here are experienced and the service is also cheap. But the problem is that we can´t get service on time. We have to wait hours. At times, even a whole day. And the hospital is not sanitary either. The toilets are filty. People may get infected with other diseases. I hope the hospital management solves this problem.
Bhab Prasad Lamichhane
Chhauni, Kathmandu
No help desk
I am suffering from asthma. I came to this hospital as people told me that the medical service here is cheap. But I do not know where to get the ticket. Nobody is around to help me. I am an old man and I can´t understand the procedures. I think old and uneducated people like me would have gotten quicker and better service if the hospital management had set up a help desk. As there is no help desk, this hospital has been user-friendly only for the young and educated.
Lal Bdr Gautam Khatri, 69
Rukum
By Pratibha Rawal
Related story
PM directs NAMS to provide complaint-free services at Bir Hospi...
