Public health institutions in the country often make headlines for the wrong reasons. Frequent strikes by doctors, untimely and low payments to staff, wrong diagnosis, extreme politicization, referral of patients to private clinics by the medicos, and so on. The list is long. Only in December of last year, Patan Academy of Health Sciences (PAHS) had become a battleground between the doctors and the hospital management over the appointment of a Rector, halting regular services.
The largest hospital of the country, Tribhuvan University Teaching Hospital, could be rescued from chronic political meddling only after Dr Gobinda KC resorted to fast-unto-death, risking his life. The country’s oldest public health institute, Bir Hospital, is virtually crippled by extreme politicization. To add to the troubles, private health establishments are extremely expensive for commoners. Amidst such chaos, however, there is news to cheer us all: Great many things have improved at Kathmandu’s Tribhuvan University Teaching Hospital (TUTH), thanks to the recently appointed director Dr Bhagwan Koirala and his unflinching commitment to reforms and dedication to selfless service.
Within two months of Koirala’s appointment, a lot has changed in TUTH, and the hospital is virtually out of its past mess. For one, operating loss has come down to zero. The hospital, which until two months ago was unable to pay salaries to its staff on time, now boasts of enough funds for that purpose. The bed occupancy rate has reached almost 100 percent from the 60 to 70 percent before, contributing to the earning of the hospital’s laboratory. Doctors move patients to other wards within two hours of their admission in emergency unit, and the ticket counter is not closed even during lunch hours.
However, Koirala has brought about these reforms not with a magic wand. He did what was long overdue. He repeated the steps with which he had successfully developed Shahid Gangalal National Heart Center into an international-standard cardiac center. He stopped paying unnecessary overtime to the staff, and made it mandatory for doctors on duty to attend to the patients and refer them to private institutions only in the most unavoidable conditions. He instituted the system of putting up the hospital’s own dispensary, something that he had tried at Manmohan Cardiothoracic, Vascular and Transplant Center while he was the acting director of the institution. Now, the TUTH boasts of its own dispensary that sells medicines at much cheaper rates than the drug stores outside.
With proven credential of being a man of action, Dr Koirala has established through his action that given the will, it is not impossible the clean the muck in public institutions. He has proven that nothing deters a person from doing well—the only thing required is commitment and dedication towards one’s profession. Of course, there is much to replicate from Koirala’s management practices at TUTH. We believe that if other public health institutions follow Koirala’s suit, it won’t be long before Nepal’s health institutions regain their long lost credibility and trust. We support Dr Koirala for taking such bold initiatives. We believe his reform initiatives will go a long way towards restoring people’s faith in public health institutions.
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