Af­ter earth­quake, Nepal’s med­i­cal ed­u­ca­tion in jeop­ardy

The China Post - - COMICS - BY MAN­ISH GAU­TAM

Five months af­ter the earth­quakes, it is now the ed­u­ca­tional ser­vices pro­vided by hos­pi­tals that are tak­ing a hit: in­sti­tu­tions with dam­aged in­fra­struc­ture are re­duc­ing stu­dent- in­take num­bers.

In the im­me­di­ate af­ter­math of the earth­quakes, which oc­curred ear­lier this year, the hos­pi­tals in the coun­try strug­gled to cope with pro­vid­ing ser­vices. Five months on, it’s now the ed­u­ca­tional ser­vices pro­vided by hos­pi­tals that are tak­ing a hit: many hos­pi­tals are mak­ing do with in­fras­truc­turethat hasn’t been re­paired, and they have thus had to cut down on stu­dent-in­take num­bers. Med­i­cal ed­u­ca­tion is un­der­pinned by strict guide­lines that take into ac­count over­all hos­pi­tal fa­cil­i­ties as a salient cri­te­rion.

Fol­low­ing the earth­quakes of April 25 and May 12, the Patan Academy of Health Sciences’ (PAHS) build­ings, for ex­am­ple, suf­fered quite a bit of dam­age. All the hos­pi­tal beds were dragged out­side and all the med­i­cal ser­vices were pro­vided in­side tem­po­rary tents. Five of its op­er­a­tion the­aters were ren­dered dys­func­tional and many other units were run­ning out of triage units. The PAHS still has not fully re­cov­ered to its early state, and there is still re­con­struc­tion work go­ing on in the hos­pi­tal.

Re­cently, even as the hos­pi­tal was try­ing to find its legs, a group from the Nepal Med­i­cal Coun­cil (NMC), the gov­ern­ment body that regu- lates doc­tors and med­i­cal col­leges, de­cided to pay the hos­pi­tal a visit. Through such vis­its, the NMC mon­i­tors the work­ings of med­i­cal col­leges to en­sure that med­i­cal stu­dents are be­ing trained un­der ex­ceed­ingly strict pro­to­cols. Not sur­pris­ingly, PAHS could not pass muster.

On Thurs­day, the NMC made public the de­ci­sion of the visit, in a state­ment that said the coun­cil had cut five med­i­cal seats at PAHS, cap­ping its en­rol­ment at 55 stu­dents for the up­com­ing Jan­uary aca­demic ses­sion. Be­sides run­ning a unique pro­gram that takes in sub­stan­tial num­bers of schol­ar­ship stu­dents on the ba­sis of merit, the PAHS also takes in stu­dents from dis­ad­van­taged com­mu­ni­ties. The hos­pi­tal’s pro­gram was cre­ated with the hope that its prod­ucts would go on to serve in the public sec­tor, and that many who hailed from out­ly­ing dis­tricts would re­turn to serve in their home­towns. With the cuts in seat num­bers, med­i­cal ex­perts fear that Nepal, a coun­try al­ready fac­ing a short­fall of doc­tors will now be even more hard-pressed to bridge the num­bers-gap.

Of­fi­cials at the PAHS say that if only the NMC were to loosen their strin­gent ed­u­ca­tional cri­te­ria — to take the earth­quakes’ ef­fects into con­sid­er­a­tion — they could go on pro­duc­ing doc­tors as they used to do ear­lier. But such pro­vi­sions will not help bur­nish the im­age of a sec­tor that has been tainted by al­le­ga­tions, many of them true, of the sec­tor’s run­ning ed­u­ca­tional in­sti­tu­tions of ques­tion­able char­ac­ter.

As with the PAHS, other medi- cal in­sti­tu­tions too have not been able to get back on track. Even the Na­tional Academy of Med­i­cal Sciences (NAMS), Kathmandu, which gov­erns Bir Hos­pi­tal, the coun­try’s old­est hos­pi­tal, is strug­gling to re­sume its fa­cil­i­ties at full ca­pac­ity. The build­ings of the academy that used to house the can­cer wards and in­ten­sive care units still need mas­sive re­pairs. Visi­tors to the hos­pi­tal are met with a stair­well whose cracks still have not been plas­tered over and in­stead of the hun­dred plus beds that used to have pa­tients on them, to­day, there are sig­nif­i­cantly fewer beds in the wards. The in­spec­tion team from NMC vis­ited NAMS re­cently and de­cided to sus­pend for this aca­demic year the su­per-spe­cial­ity course the academy runs, while also re­duc­ing the stu­dent num­bers in its post­grad­u­ate de­gree pro­grams. NAMS is the main in­sti­tu­tion in the coun­try that pro­duces doc­tors and spe­cial­ists who will go on to work in gov­ern­ment hos­pi­tals: It has spe­cial quo­tas in place for doc­tors who are prac­tic­ing in the public sec­tor, and the Min­istry of Health and Pop­u­la­tion of­ten asks NAMS to pro­duce a cer­tain num­ber of doc­tors to work in public hos­pi­tals ev­ery year.

This year, for in­stance, the gov­ern­ment had asked NAMS to pro­duce at least 20 gen­eral physi­cians, gyne­col­o­gists and anes­the­si­ol­o­gists, but be­cause of the ru­ined in­fra­struc­ture, the NMC al­lowed much fewer stu­dents to en­rol at the in­sti­tu­tion.

The Kathmandu Post/Asia News Net­work

Bir Hos­pi­tal in Nepal is seen in this photo pro­vided by The Kathmandu Post.

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