Doc-less hospital turns away hundreds

[Love Nepal]

Yo FREE PRESS ko kura pani achamma cha.You can hardly do anything to the newspapers unless and until there is a grave national risk involved with its publication.Remember how the Royal gov.tried to hurt Kantipur but couldnt.Thats what is good and bad about democracy.And while u fight with them they will publish 100 diff things about u.
I once was working in NORVIC and one magazine wrote such stupid things about it that it was actually laughable.It said Norvic is acutally being used as a Brothel by some nurses and docs and amazingly many ppl believed it!! And u know why the news was published,the magazine was owned by another marwari who had once been a partner in NORVIC but had been sidelined by the current owners.But there is limits to taking revenge right!!

Ya,why dont we come up with how to correct the ILLS OF OUR MEDICAL system.Lets come out with something like a master plan.I will also think about it,lets everyone think about it.We know the obvious things of political will and nepotism and all that but lets make a plan,good workable plan.

[Rajiv]

In my opinion, only a massive protest by health workers with support of people and media can give them pressure to work on Health reform. Because must learn to work finally. A privatisation of health service in nepal is not possible, at least until the country's economy is sufficient and stabil. It can only be dream for current time.
NMA should be more active and attack the government as soon as there is some Ignorance. Since the health sector is also widely financed by foreign Aids, those sponsor should also support such action and exert pressure on government. There must be a higher body that can demand clearification of any Ignorance by both government and health worker. That could be NMA with more power, it should represent health worker and fight for better working environment for them.

[Oak]

I still remeber one of my senior was in the remote area not far remote but we can say its remote. Time to time he used to be in the newspapers, since media attract the people when he came to Ktm we said well done dai your in the news paper these days...

You would be amazed what he reveal afterwards.

He had a journalist friend I don't want to say to the news paper to whom he belong... well and there was my senior working occasionally my senior used to offer him for the evening drink.. you know what that journalist used to do.. since he couldn't get any news to be sent... he used to praise my senior and used to give him a man of example and regularly he used to be in the newspaper.

Can you imagine a pack of drink can change the mind of a journalist.

I am not trying to say that Pal's post is not worth, I am just saying that as love nepal said journalism has to be professional.

[pathakom]

guys i love ur spirit...........its really aN IMP issue. yes there r lots to be done, from both govn and medical professionals also. i also agree that the situation is frustrating but still......who will think if we donot?

what i think is it is good 2 send medical officer( rather than interns) 2 remote areas but there are lots of issues with it.
there should be at least cetamol, other essential drugs n basic faciliyties so that a mo can do what he knows.........
and if govn is making it compulsory 2 go 2 remote area for 2 years, it has 2 offer some facility to the mo....eg.for future studies coz no one want 2 lag behind their collegues(who do not go 2 remote areas)
govn should have a real intention developing the health sector of country.
and also medical students and professionals should have positive attitude and should feel responsibilities towards the society

may be we r having a discussion program on these issues in few weeks. we should raise our voice in unison 4 positive change

[Hero]

who will work in such area where there is no single xray machine. what do u think? docs are not God, and a doc like me never wants to treat a patient without having full investigation. How do u diagnose a case of AMI where there is no ECG machine? Certainly I don wanna be the second "Dr Srikrishna Giri" of butwal hospital.

[JNUS]

Originally Posted by Hero

who will work in such area where there is no single xray machine. what do u think? docs are not God, and a doc like me never wants to treat a patient without having full investigation. How do u diagnose a case of AMI where there is no ECG machine? Certainly I don wanna be the second "Dr Srikrishna Giri" of butwal hospital.

U are writing about zonal hospital, its not bad how you are implying. In all district hospital there are X-ray, ECG machine. And in some hospitals even they have USG, like in a community hospital of Dolkha, they have X-ray, ECG, USG, all routine investigations but except Na/K. Being an intern/ Medical officer what are the things you are intending to do. Clinically and with all those investigations mentioned above you can manage most of the medical problems as well. All minor surgical procedures can be performed. But of course you can't be doing any intraabdominal surgery over those hospitals, but at least you can suspect and can refer to higher centre from the small community hospital /PHC / disctrict hospital to Zonal Hospital or tertiary centre.

I will be doing my posting for 6 weeks and can be extended to 3 mths in Dolkha hospital , run by pHECT. It is a community hospital with above mentioned facility. There are 2 medical officer, who run the OPD, see 15 bed ward, do USG, interpreat X-rays. There are few cases of Below knee amputation done over there.

Bahira ko hospital can be a role for learners, it the place where most of the people develop their clinical skill.

[Love Nepal]

The issue of working/learning in small hospitals in rural areas are two fold.Its a great place to learn if u have someone senior by ur side and if u have at least minimum means of investigation.or else its a painful experience.
About investigations,its really stupid to say,i wont work in a small hospital because there is no ECG.Hell if there is ecg also,how do u manage AMI without CCU,cardiac monitor,thrombolytics etc,lets not go there folks.The main diseases we see in the villages are infectious diseases and the diagnostic modalties and treatment options are directed for infectious diseases and thats what we look forward to manage.
If you dont have ECG and u think someone has AMI,give aspirn,nitroglycerine(if you have) and refer.But i can assure you,u wont see it much often.You would be busy treating diarrhoea and typhoid most of the times.And you dont need much sophisticated investigations to diagnose them.

[pathakom]

i agree with JNUS and LOVE NEPAL. but fact is that many young doctors r not goin or not willing to go to periphery.........whatever the reason being either due to deficiency of medicine n\or equipments or problem with the further study or due to lack of motivation.
guys lets try 2 find out some points.....what has 2 be done to the minimum so that doctors will go to periphery........the students chapter of PSRN( physicians for social responsibilities nepal) is organizing a program on this issue mainly targetting young doctors and the resolution, hopefully representing voice the medical society will be submitted to the relevent authority. i hope u will help me to find out answers.............

[pathakom]

whatever the reason there are definitely some problems that is preventing many doctors to go to periphery. so guys lets sort out some points....... WHAT HAS 2 B DONE 2 THE MINIMUN SO THAT DOCTORS WILL GO 2 PERIPHERY.....bcoz students chapter of PSRN(physicians for social responsibilities nepal) is organiging a program targetting mainly young doctors so that we can submit its resolution to the relevent authority as a voice of medical society.

[autowreckers]

The truth is no one wants to venture and risk his life.

We study so much spend so much of time and money have sleepless nights and come out fresh as a budding doctors full of theorotical knowledge very much eager to learn. How can you expect someone like this to work in the land of far far away with lack of health facility. Everything cannot be done on clinical basis. I still remember those days when I used to send blood test which always used to come back normal, ridiculous. And what about help from other skillful people like nurses, OT staff, health workers. Prescribing amox for any fever, amytriptiline for any repeat visit, cough suppressant for any cough etc is not the solution.Just see how many among your friends aim for USMLE and other exams and seek for a better and brighter life to seek for more opportunity and ofcourse money.

Doctors arent paid well to be honest. Working as a volunteer is really cruel. Doctors are not machines. They need rest as well. the more fresh they are better the outcome. Negligence on the side of doctors also crops up because of this lack of sleep, exhaustion. tiredness, lack of food. How can you possible expect him to work at this state. and obviously they are bound to make mistake.

I think Nepal Medical Council should rise up now. I dont think they do anything except than taking this stupid nmle exam. They should make doctors work in a proper way and protect patients. Treat patient like humans and not bunch of animals. Do you think NMC is doing you anything for your registration fee that you are paying?

Young doctors esp interns should never be allowed to practice on their own without proper supervision. Internship is a year for learning not providing service remember that. Though you might call yourself a doctor, ask youself are you really a doctor who is able to fulfill all patient's demand?

I think the attitude to work in city and to go abroad shall never change. who would like to risk there life in the midst of strangers. Would you? ask yourself. And its not easy like you think.

Brain drain will continue.