Nepalese Woman, Kamala Makes Her Way to the Hospital
Life in a Nepalese Hospital Without a Doctor
If the stories told in the Himalayan mountains about Dr. Gunaraj Lohani are true, then he should be wearing a long red cape and have a large ‘S’ on his chest. To his patients and colleagues, he is little short of a superhero.
"Dr. Lohani is a great surgeon. He’s cured everyone sent to him from our village".... "He is a perfect man — a great hospital manager and a great doctor"... "Dr. Lohani walked to every village to meet the people."
These were some of the comments heard on a visit to the remote hills of the Panchtar District in eastern Nepal. Here, Dr. Lohani has almost God–like status. Or rather, had. Dr. Lohani has left.
A government doctor who was posted to Panchtar temporarily, Dr. Lohani, as is the practice, has since been transferred to another district. Unfortunately, Dr. Lohani’s replacement is not qualified to perform surgery.
This means any pregnant woman requiring a caesarian section has to be referred to another hospital. In other parts of the world, this might not matter so much. The referral hospital might be fairly nearby.
But here it can have devastating consequences — as a 23–year–old pregnant woman called Kamala recently discovered.
When she arrived at Phidim Hospital, her baby was suffering from fetal distress. Kamala was told she needed a caesarian section. The nearest hospital — a private facility beyond the limited means of the family — was three hours away by ambulance. The nearest government hospital was nine hours away. As a result, Kamala’s baby was born without a caesarian section. He died within 24 hours.
No one knows for sure if Dr. Lohani could have saved Kamala’s baby had he, or a similarly qualified doctor, been on hand. But at the least a caesarian section could have taken place.
Kamala’s own personal tragedy illustrates a much larger problem. Even as Nepal and partners like UNICEF are making efforts to slash maternal mortality, the country’s shortage of doctors continues to endanger communities that remain underserved. Indeed, official statistics show just over half of Nepal’s government doctors’ posts are vacant nationwide.
This is not because the country isn’t producing enough doctors. But government employee salaries are very low. Many doctors complete their training, and then immediately apply for well–paid jobs overseas. And posts like the one in Panchtar often remain vacant or are filled by less qualified staff because doctors do not want to live in remote areas.
The lack of doctors remains a serious problem, says Dr. Geetha Rana, who works with UNICEF in Kathmandu. Millions of dollars are being spent in the creation of new hospitals, but they are useless if there are not enough doctors to work in.