People's Review Weekly

Poverty and health services in Nepal

- BY NARAYAN PRASAD MISHRA The writer can be reached at narayansha­ The views expressed in this article are the author’s own and do not necessaril­y reflect People’s Review’s editorial stance.

We all know no one in the world would like to be sick, unhealthy, or in bed without doing anything. People get sick for reasons or deficienci­es beyond their control. Sickness is not your choice. It comes to you, and you cannot prevent it. In this context, free health treatment seems essential to human rights.

When I was 16, around 1960, we had very few hospitals in Nepal. There were only four prominent hospitals in the Kathmandu Valley - Bir Hospital, Kathmandu, Patan Hospital, Bhaktapur Hospital, and Shanta Bhawan Hospital at Sanepa, Patan. The health services were free, including the surgery. People went to the hospitals when they got sick. I remember my younger brother Punya

Prasad Mishra had a gallstone operation in Bir Hospital. Dr. Anjali Kumar Sharma, the well-known surgeon of the time, relieved him of his pain by removing the big stone from the gallbladde­r. We did not have to pay a single rupee. However, the available medicines in hospitals were limited. The doctor asked the patient's caretaker to bring the medicine by buying from the outside with their prescripti­on when the medicine needed for the purpose was not in the hospital stock. That, too, happened seldom. Medical shops selling medicines had an attendant doctor in a limited hour - around 6-8 pm daily. There were two prominent medical shops in Kathmandu - one named Drug Store at Indrachok, Kathmandu, and the other one was in the south and east corner of Jana Sewa Cinema Hall (present Bishal Bazar) in New Road north of the Bhugol Park. The consulting doctor was free. The medical shop expected you to buy medicine from the same shop prescribed by that doctor, but it was not compulsory. So people with minor health

problems like colds or fevers went to medical shops for treatment just as they went to hospitals. You could easily imagine how easy and beautiful that free health system would have been for the poor and underprivi­leged. With the changing times and modern developmen­t, the country's free health system slowly disappeare­d. Even the

government's hospitals started to charge people for treatment. The country's unlimited number of private hospitals appeared as business centers and industries. They are there for the business and profit rather than for service. Low-income people cannot meet the expenditur­e charged by the government or the costly private hospitals. But when people are seriously sick, and their lives are at risk, they need to go to these places even by selling their property - land or house. What a great tragedy it is.

One can imagine how people think and feel when someone's dear one is seriously sick and is afraid of losing their life, but you are not economical­ly strong and do not have money for the treatment to take the loved one to the hospital. Most people feel they can easily die if needed, but they cannot bear losing their dear ones. They may have no choice but to watch the unbearable tragedy. I have several times experience­d this kind of situation of suffering in several families.

In this context, I always think our healthcare service for people was much better in those days, even though we did not have as many hospitals and facilities as we have now. We now have so many government and private hospitals with all the modern equipment and highly qualified doctors. However, healthcare services are so expensive and beyond the capacity of the poor and middle-class people. The facilities are there, but they are there only for the rich.

It should not be like this in a civilized and benevolent society. If the political system and the government are for the welfare of the people, at least health care and education should be free. Even if they cannot be made accessible for all, they must be free for poor and middleclas­s people. We have often had government­s under the leadership of Communist leaders. I wonder why they cannot think about this important healthcare issue rather than mislead the people into communal federalism and divide them by caste, creed, and color.

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Old Bir Hospital building in Kathmandu

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