The health of a nation is often judged by the quality and reach of its health service. Some industrialised countries like the United States ail within because medical treatment is too expensive, and out of reach of many. On the other hand, there are low-income countries like Sri Lanka and Cuba which have universal, free and quality health care.
Every four years at election time in the United States, health care reform becomes a make-or-break agenda item, as it will in the run-up to November. Americaâs medical-industrial complex, which includes private insurance companies, do not like reform because it will reduce health costs and eat into their profits.
It is not surprising, therefore, that health care has become such a political hot potato in Nepal as well. The medical mafia and its political patrons in government and the legislature have investments in private hospitals and the lucrative medical education sector, and they are against any attempt to regulate private health care. As in every other arena of Nepalâs publicÂ life, the fox is guarding the chicken coop.
The rot is so deep that the Minister of Health and the State Minister of Health and Population (both from Tarai districts with abysmal statistics for physical wellbeing of citizens) have been blatantly demanding kickbacksÂ from the poor. With the clock ticking on their time in office, last week they openly asked for kickbacks of up to 50 per cent in return for approval of annual government grants that 23 community hospitals across rural Nepal are entitled to.
Corruption has corroded every facet of government, but it is when it afflicts health care that kleptocracy kills. Stealing money from hospitals is akin to murder. Outraged by all this, Nepalâs Gandhian physician,Â Govinda KC, has been on a lifelong crusade to make health care affordable and accessible to Nepalâs 30 million people. On Tuesday, he is on the tenth day of his eighth hunger strike, with a list of long-standing demands that have either been ignored or only partially fulfilled after previous satyagrahas.
Needless to say, the medical mafia and its political comrades-in-crime have been trying their best to discredit him, obstruct his fast at the Tribhuvan University Teaching Hospital, and even gone as far as to try to deprive the frail KC of medical attention. It is ironical that top political leaders who have visited the Federal Alliance âhungerâ strikers at Tundikhel do not have the intestinal fortitude to call on KC, even to show concern for a doctor who is risking his life for the people.
Unfortunately, KCâs fast this time coincides with a power struggle that threatens to bring down the coalition of Prime Minister K P Oli of the UML. And since UML politicians and cronies have the biggest investments in the private medical industry, Oli has an excuse not to do anything, because he is ostensibly a lame duck. Even without KCâs hunger strike, the ongoing regime change drama has serious consequences for the budget, the constitution and the inclusion of Madhesi and Janajati concerns, as well as for Nepalâs geopolitical equilibrium. Our only hope was in the legislature, but parliamentarians are behaving like flailing tentacles of the political cartel sucking the blood of Nepalis.
It is clear that the deathly silence of the politicians is not just due to their businessÂ interest in the medical sector, but because of the fear of reprisals from Lokman Singh Karki, the dreaded head of the Commission for the Investigation of Abuse of Authority (CIAA), which has itself become the biggest abuser of authority in the land. Even during his fifth fast two years ago, KC had demanded that Karki and Commissioner Rajnarayan Pathak be removed for obstructing reforms in the medical sector because of their vested interests.
The CIAA is still at it: it has overstepped its mandate in order to protect the family-business ties of its commissioners in the medicalÂ sector, it has brazenly interfered with Kathmandu University School of Medicine, and it has tried to influence the licensing of new medical colleges, forcing out functionaries of the Institute of Medicine who stood in the way.
Nepal is run by a syndicate of tainted politicians who are in cahoots with cartels in health, education, transportation, food supply, tourismÂ âÂ you name it. They are not here to serve the people but to steal from them. The tragedy is that they have infiltrated Parliament through nominees in the proportional representation quota, to make laws that perpetuate their profiteering.
The Health Bill passed last week doesnât include any of Govinda KCâs demands for healthcare reform. Enough said.
Truth be told, Bidushi Dhungel