KATHMANDU: In December of last year, Padma Tiruwa, a 21-year-old resident of Dwari in Pancheshwar Rural Municipality-3, Baitadi, suffered a serious injury after falling off a cliff. She was immediately taken to a local health post, but the health workers were unable to treat her. So, she was rushed to Nisarga Hospital in Dhangadhi for treatment. Although she could be saved, she lost one of her eyes due to the delay in receiving treatment.
To ensure that nobody has to be in a situation like Padma, the government has implemented a policy to establish a basic hospital in each local unit. The main objective of these hospitals under the charge of at least one MBBS doctor is to provide emergency health treatment for the local people. Altogether 396 hospitals, with capacities ranging from five to 15 beds, were initiated simultaneously on November 30, 2020.
Two years ago, a budget of Rs 10 million was allocated to build a 10-bed hospital in Pancheshwar Rural Municipality. But, there has been no progress in the construction.
The government has advised local units to construct hospitals near the administrative center to ensure accessibility and efficient delivery of healthcare services. The administrative center of the Pancheshwar Rural Municipality is in Ward 4. The residents of Ward 4 have even expressed their willingness to donate land for the hospital. However, the chairperson and vice-chairperson of the rural municipality are both insistent on building the hospital in Ward 3, where they reside.
The administrative center of the Pancheshwar Rural Municipality is in Ward 4. The residents of Ward 4 have even expressed their willingness to donate land for the hospital. However, the chairperson and vice-chairperson of the rural municipality are both insistent on building the hospital in Ward 3, where they reside.
The construction of the much-needed hospital in Pancheshwar Rural Municipality has been delayed due to the ulterior motives of the elected representatives. This has resulted in the government withdrawing the budget that was allocated for the project.
Unfortunately, Pancheshwar is not the only rural municipality that has faced delays in hospital construction. According to the Ministry of Health and Population, out of the 396 hospitals initiated in the first phase by former Prime Minister KP Sharma Oli, only 347 have begun the construction process. While 329 local units have prepared detailed project report, 327 local units have begun the procurement process to upgrade their health posts into basic hospitals. Likewise, 327 of them have already awarded tenders for the same.
The Ministry has stated that budgets have already been released for local units that have awarded contracts for the construction of the crucial health infrastructure.
Similarly, of the 259 hospitals initiated in 2021/22, 184 are in different stages of construction. All of them have prepared their detailed project report, while 107 have already awarded contracts for construction or upgradation.
The government has already spent Rs 10.36 billion for the construction of basic hospitals in fiscal years 2020/21 and 2021/22. Local units spent Rs 2.39 billion in 2020/21 and Rs 6.96 billion in 2021/22. It had made Rs 16.06 billion for the local units for the purpose in the two fiscal years.
The government has allocated Rs 5.33 billion for basic hospitals in the current fiscal year.
Ministry officials have cited the local units themselves as the cause of the delay in the development of crucial infrastructure despite the availability of the budget.
According to Dr. Samirmani Adhikari, the deputy spokesperson for the ministry, the lack of land and problems in land acquisition are among the factors causing delays in the construction of basic hospitals at local units. “In some local units, construction is not progressing as the new office-bearers are attempting to change the location selected by the previous office-bearers,” he added.
Ministry officials have cited the local units themselves as the cause of the delay in the development of crucial infrastructure despite the availability of the budget.
Dr. Laxmiraj Pathak, former Director General of the Department of Health Services, said the problem arose as the government laid foundation stones without proper planning and preparation. “There is a lack of clarity on whether a basic hospital means the upgrade of an existing health facility or the construction of a new hospital altogether,” he added.
Health ministry officials say the main problem behind the delay in the construction of basic hospitals is the vested interests of elected representatives who want the hospitals to be built in their own localities. Dr. Adhikari emphasized that the responsibility lies with the local units to ensure that health institutions are built above individual and partisan interests. “The Ministry cannot do anything in this situation. The local units themselves should resolve the matter,” he added.
Dr. Pathak also emphasized the need for local units to take the initiative and coordinate with the federal government to build basic hospitals. He suggested that local people should also press their local representatives to prioritize the construction of these vital health facilities.
