“We are unable to find a MDGP gynecologist willing to go to Bhojpur and some other remote districts for carrying out caesarian section operations,” Director of Family Health Division (FHD) Dr Naresh Pratap KC said. He said the district hospital has been offering Rs 300,000 per month for a gynecologist since a year back but no one shows any interest in going there. The offer is 10 times higher than the salary of senior doctors at hospitals in the capital. [break]
“We published a vacancy notice in the Gorkhapatra in November and December but no one shows any interest,” chief of Bhojpur hospital Dr Naresh Kumar Jha said, adding, “We are ready to pay whatever they demand.”
Dr Jha said he personally requested then secretary of health Dr Sudha Sharma, incumbent Secretary Dr Pravin Mishra, the chief of the Department of Health Services (DHS), the regional director and the FHD chief to send a gynecologist. Dr Jha also said that he has approached various medical colleges, but to no avail.
However, the doctors have their own reasons for avoiding remote postings. Former chairman of Nepal Medical Association Dr Kedar Narshing KC said that lack of basic medical infrastructure discourages doctors from taking up responsibilities in the remote districts. Without infrastructure, including a team of associates, a doctor can do nothing, he said and added that the government should have programs for persuading doctors to serve in remote areas, including a policy of lucrative rewards.
After being unable to send doctors to the remote areas, the Ministry of Health and Population (MoHP) has provided Rs 4 million to Bhojpur hospital for hiring an MDGP gynecologist for its Community Emergency Obstretic Care. With that fund the hospital has to hire an MDGP gynecologist as well as an assistant anesthetist and a staff nurse trained to assist in the operation theatre.
Patients have to travel more than 12 hours by ambulance to reach Dharan and pay Rs 20,000. “How can a woman in labor travel 12 hours by dirt road?,” Raju Shrestha, a hospital technician, said. He said that in view of the unavailability of MDGP gynecologists, the hospital is suggesting that pregnant women facing complications should go to the regional hospital before their delivery date.
“Lots of times we have stopped a plane or chartered a helicopter to send woman in labor,” Dr Jha said, adding, “Those who cannot afford to go to the big hospitals are dying in their homes.”
The ministry provided funds for 22 districts this fiscal year for comprehensive emergency obstretic care. After the government launched a Safe Motherhood Program the ministry started to provide money for hiring doctors. Likewise, Taplejung district hospital is paying more than Rs 200,000 per month to an MDGP gynecologist. With all its infrastructure, Sankhuwasabha district hospital is still unable to bring such a service into operation. The FHD says that it is unable to send doctors to six hospitals in the remote districts.
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