Sickness In Health

The Kathmandu Valley that also comprises Lalitpur and Bhaktapur has a population of an estimated 2 million people. And with countless people constantly swelling its ranks every year, the demand on the city's health infrastructure is enormous and really difficult. In the existing scenario, there is an overwhelmingly negative and unpleasant ratio between the frighteningly large number of patients demanding medical treatment and the availability of commensurate medical infrastructure and back up.

Budgetary support
There are, in fact, no official estimates of the exact number of people from outside Kathmandu who come to the city for treatment. Officials put it at several thousands at least.
As people's health needs have risen exponentially over the years, increase in the size of the valley's health department has remained virtually stuck in stasis in the face of thinning budgetary support.

The need of the hour is to open more hospitals in the primary, secondary and tertiary sectors in different areas of the Kathmandu Valley to address the growing demand for a diverse range of medical services. No concrete steps have been taken in the past few years to strengthen and expand health infrastructure of the valley for more advanced health services and better accessibility.

The increase in the average life expectancy of the people, though marginal, has brought with it its own problems in a typical way. Another important preventive aspect is to ensure quick investigation and treatment of the infected person so that complications arising out of the disease can be arrested, and further damage by the disease can be prevented. For instance, the number of confirmed cases of HIV/AIDS has been increasing at an alarming rate in the country; the menace dangerously looms large and real over the valley.

In order to create a better response to the mounting challenges, the health department has to join hands with several non-governmental organisations, including international non-governmental organisations working to ameliorate the menace of AIDS in the country. The gradual development of special methods and means to counter fearsome diseases has now become critical in the fight against dreaded diseased like AIDS.

Moreover, the health department has to take the necessary initiative to set up a voluntary counseling and testing centre for HIV/AIDS at appropriate places in the valley. Installing advertisement hoardings is a good movement indeed. But in a country with a low literacy rate, one can easily guess how much of the desired results that will yield.

Our strategy against infectious disease and their fallout should hinge on taking proactive measures and timely actions that are precautionary in nature but can be immensely useful in preempting the genesis and incidence of communicable diseases. For certain types of communicable diseases, the concerned authorities are expected to make available appropriate vaccines to the people for immunisation as an ounce of prevention is better than a pound of cure.

Also, the introduction of evening out-patient blocks at the Bir Hospital and Patan Hospital would be an ideal step to helping the poor and marginalised section of the population who cannot afford the astronomical service charges asked by private-run hospitals and clinics.

Needless to say, the government has to make a plan to formulate an appropriate disaster management centre for the city to cope with any unpredictable contingency, calamity or catastrophe, which may include arrangements to make available more than 5,000 beds at short notice besides ensuring that the department has a stock of medicines to last more than six months at any given time.

Medical equipment like mobile x-ray machines and electrocardiograms as well as other provisions, meant to act as buffer in the event of an emergency, will not be used in the routine course, but should be stocked as reserve and used only during a crisis.

Registration act
To streamline and improve the quality of health services in the private sector, the government should propose to modify the registration act for running private nursing homes and clinics in the valley and make it more stringent. Similarly, the government should also evolve guidelines to regulate the functioning of paramedical services, i.e., pathological labs and blood banks in the valley. The government will have to formulate plans to strengthen and expand the health infrastructure of the valley for more advanced health services and better accessibility to taxpayers.