By Ajita Rijal

Kathmandu, Dec. 20: Bir Hospital, Nepal’s oldest and arguably the best medical care providing public hospital, has been providing vital public service for the underprivileged and poor. The hospital is one of the busiest visited by a large number of patients every day.
More than 2,000 service seekers visit the hospital on Sunday and Friday while on other days up to 1,700 patients reach the hospital seeking treatment of various diseases.
When this reporter, fellow journalists and photo journalists from the sister publication of this daily, the Gorkhapatra daily, reached the hospital situated at the heart of the capital city on Thursday, hundreds of patients were standing in a serpentine queue at the ticket counter for the Out Patient Department (OPD).
The reporter found that the token system was categorised for general public, elderly and disabled people. The token system has eased the patients for getting tickets.
Upon reaching the emergency department of the hospital, the reporter found that all the beds were occupied. Most of the patients having stomach problems and chronic diseases including heart attack, kidney failure, pneumonia, diarrhea, fainting cases were found visiting the emergency department of this hospital.
Around 200 patients reach the emergency department on a daily basis. There are 32 beds at the emergency among which two of them were the disabled-friendly.
Overcrowded
Being a tertiary care hospital, it is overcrowded and do not have enough beds, and the poor patients wait for a bed in the general ward of the hospital because they cannot afford to visit the private hospitals.
The hospital is a multi-specialist one which provides all kinds of medical services, from the OPD to all major surgeries. And all these care services are provided either free of cost or taking minimal charges.
Dipendra Yadav, 37, one of the patients, said, “I am told to wait for almost six and half months to have my operation on ENT.”
Another patient, Sumitra KC, 52, a residence of Pokhara, who was at the hospital for video scanning said, “My turn came today six days after the doctor wrote his prescription.”
No matter what anyone entering the hospital should wait for getting any sorts of services and facilities due to the large number of patients, said Dr. Kedar Prasad Century director of the hospital.
The wards, including urology, gastrology, kidney dialysis, neuro ward, dental ward and the senior citizens wards were found having greater number of patients on Thursday.
Best at service in nominal price
The best part of the hospital is it cater services at low fees for beds at the general ward. Around 378 beds are in operation in the general ward, which are available at the rates that are twice as cheap as the rates of other private hospitals. The hospital charges upto only Rs. 3,000 for major surgeries like neurosurgeries and cardiac surgeries.
It charges Rs. 400 for ultrasound x-ray, the MRI which cost more than 20,000 at other hospitals costs only Rs. 7000 in this government hospital. The rate of ICU bed at the hospital is Rs. 3,000 for a night while the same bed at private hospital may cost ranging from Rs. 6,000 to Rs. 15,000.
With the free medical care services, the patients are provided with two meals a day, including a diet as per the prescription of the doctor, which incorporates, vegetables, meat, fruits, milk, biscuits, lentil, rice, roti and tea, said Dr Ceintury.
Cleanliness and management of wastes
Regarding cleanliness, the floors and toilets of the hospital were seen at satisfactory level. The floors were wiped and the toilets were cleaned. The hospitals have kept several dustbins categorising as biodegradable, non-biodegradable, papers, bottles and cans for the management of the wastes. But the public were seen putting all the wastes at a place. This seems that most of the service seekers visiting the hospital were unaware of where to put the wastes on the avail dustbins.
Unutilised medical equipment
Some of the medical equipment that was purchased in millions of rupees, like intraoperative CT- Scan machines and Tomotherapy machines were not in use. When asked about the millions worth unutilized equipment, director Dr. Ceintury said that those machines were left in dust due to the lack of appropriate spaces for their installation.
Besides the unutilsed medical equipment, many non-operational medical equipment were found left messy around the corners of the passages of the hospital. Angiogram and mammogram machines, along numerous other hi-tech equipment were also dysfunctional.
Lack of medicines at Pharmacy
Parbati Lamsal, 29, a patient at Bir Hospital, reaches the window of a pharmacy after staying a long queue to buy medicines, but she didn’t get the one prescribed by the doctor. Like Lamsal, many at the

pharmacy were found returning empty handed after standing in a long queue. Most of them who failed to get the medicines at the pharmacy were suspecting the foul play of pharmacies for commission.
Lack of human resources
The hospital’s resources are underutilised due to the lack of adequate human resources. After the earthquake of 2015, the Japan International Cooperation Agency (JICA) had constructed a new three-storey building which can accommodate 90 beds. Among the 90 beds, 40 beds were found in operation.
The hospital lacks not only consultant doctors, but also staff nurses, said Dr. Ceintury. At the duty hours also most of the senior doctors are supposed to visit for taking classes and should attend some meeting, said Dr. Ceintury. This reporter found that some of the hospital employees were found spending time on union meetings and other political events rather than fulfilling their duties.