Thursday, 25 April, 2024

Public Health In Dangerous State

Prem Khatry

Whether it is God or Mother Nature, Nepal has been blessed eternally for her beautiful landscape, vertically and horizontally stretched landmass, cool air, blue sky and 6000 small to big rivers as clean water sources. Yet, when it comes to public health hazards, the ground situation is not always pleasant. There was a time when active mosquito in Terai caused extreme health problems such as anemia, malaria and host of other problems.

Continuous spray of DDT in the mid and late 1950s at least controlled malaria for decades. Indian Railways, growth of farming communities alongside the indigenous Tharus, access to modern health facilities further improved the health conditions in the plains. Then migration from the hills and other side of the border took decisive turn in the habitation of the fertile Terai.

Lower valleys and river beds of the hill regions also suffered from malaria. There was a belief in Nepal that malaria us caused by the blooming flowers of shorea robusta and hill valleys had plenty of such forests. Slowly malaria began to be reported in the beginning of the new, 21st century.

This was the worst news coming from the region. The tiny animal began to move upwards in the hills and valleys and now one can find the mosquito all over the hills. There was a time when mosquito was not a problem in the Kathmandu Valley. But now it is a domestic animal here as well. The small animal has caused a big problem.

The latest 'bout' the insect is showing is proving to be dangerous to fatal. The scourge of the much despised dengue fever has caused not only concerned in the public countrywide, it is getting 'out of control' the news says. Never before a dangerous situation like this one was heard in the recent past.

As far as Kathmandu is concerned, this is a new experience in recent years after the much feared 'bird flu'. When the bird flu risk is still on, the dengue's dangerous bout has caused extra concern in the public.
The latest news of dengue moving from the hot Terai plains to the hill areas and the Kathmandu Valley has alerted the public to be extra cautious.

This was the second worst news to arrive in Kathmandu after the flood and landslide disasters during the peak hours of monsoon - 2019. The smallest animal now has caused big concerns as the figure of the affected population has reportedly reached 70 thousand. This apart, dengue has grown to the extent that the wisdom is: Nobody is safe, News of doctors treating patients in the Teku Infectious Disease Control center are themselves reported to be the latest victims. What will happen to the patients in such a situation? It is a grave national concern.

How the government is bracing its staff is nowhere to be heard. The sad news came from the Eye Hospital, Til Ganga where the iconic Dr Sanduk Ruit along with his son are reported to be infected. The worst still came when Minister Chakrapani Khanal and his son were also infected and admitted to hospital where they are reported to be recuperating.The question now is: Is it all because the killer mosquito is getting powerful and we humans are rendered to be helpless? Or, is it because we have not been careful enough to keep our living and working environs clean enough to live and work enjoying good sanitary condition, or both?


We do our best to stay safe in our house, but as soon as we reach our workplace, the standard there is totally different. In many cases, the employees take the job lightly unless they are sensitized to keep the standard.

Their professional organizations are more powerful than the Chief of the workplace. It has been seen time and again. Visit any hospital, to take a look of the sanitary condition, you will be surprised.

When one visits a hospital the normal scenario is that toilets are broken, gardens do not exist, foul smells govern the floors and rooms of the doctors, the patients, and the visitors alike. You can spare some for the sake of prestige but very few maintain minimum standard of the code, if there is any.

The lesson is: Build a health code and employ someone to monitor the condition on daily basis. Twice a day is even better for the sake of life. One must not save the life of an insect at the cost of precious human life. But this is happening. Big name hospitals are not doing enough to maintain minimum standard although the docs are fully aware of what the premise and the interior must look like.

There is no doubt they make rounds not only in beds, aisle and hallways, but also of the world outside the country. Like heads of states, ministers and MPs, the Doctors and Mayors also make a team in terms of world tour but when they come home they become regular Nepalis and like the government school students, they flunk together. It is a sad situation. Following or preceding the doctor.

The fact of the matter is: Nepal's national health is ailing. Often we hear about prolonged battle for a chair of the Secretary in the Ministry of Health. News of understaffing in health centres around the country are regular and unchanged. Doctors opening clinics next to the government hospitals, theft and transfer of equipment is also reported in the media.

Procuring unnecessary equipment and storing till its 'death' is also now a common phenomenon in the health sector because Nepal fails flatly in terms of permanent and dependable monitoring mechanism.

Yet sincere doctors are at work with less complaint and level of satisfaction.

(Former Dean of Humanities & Social Sciences, TU and Fulbright scholar from University of California, Khatry writes on cultural issues)