After earthquake, Nepal’s medical education in jeopardy
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.
Bir Hospital in Nepal is seen in this photo provided by The Kathmandu Post.