17-23 January 2014 #690

Making a complete mess

Trishna Rana
While Krishna Adhikari’s frail parents have been on hunger strike in Bir Hospital since 24 October demanding justice for their son who was killed by the Maoists during war, doctor Govinda KC of TU-affiliated Institute of Medicine began his fast-unto-death at Teaching Hospital last Saturday protesting the political interference in the appointment of deans. In a country where even two months after elections, we are nowhere close to forming a new government, the only way for citizens to make their voices heard, it seems, is to sacrifice their own lives.

The rot within Nepal’s medical fraternity is not new and we have become inured to political leaders using students and teachers in state-run schools, universities, and hospitals as pawns. In 2012, KC was on a similar hunger strike to object the appointment of a politically-backed candidate as dean of IoM. During the same time, teachers and students of Patan Academy of Health Sciences were on a war path against their new vice-chancellor, a Madhesi minister’s sister.

Till the new millennium, the country had only one medical college. Today there are 19 schools, half in Kathmandu, which churn out around 1,500 doctors every year. Like most other South Asian countries, the medical school industry in Nepal is worth billions. A five year course costs Rs 20 million in average and owners spend anywhere between Rs 8-10 billion building campuses and have to wait almost two decades just to break even and turn a profit.

It’s no surprise then that they openly indulge in shady backroom dealings with administrators so they get medical affiliation certificates much earlier without fulfilling even the basic requirements or get permits to admit more students than what the existing infrastructure and staff can handle. And this is where the politico-business nexus operates: bumping party loyalists into top administrative positions in hopes of pocketing any windfall.

The former dean of IoM, Prakash Sayami, who was appointed in August 2012 after a similar furor over TU posts, resigned in December because he could no longer handle the pressure from all sides to provide affiliation certificates to five medical colleges. Once Sayami had been sidelined, it cleared the way for Sashi Sharma. What makes Sharma’s rise to IoM’s top boss, particularly disheartening, is that he is currently under the investigation of the CIAA for alleged corruption and misuse of power during his time as vice-chairman of the Nepal Medical Council.

There are only two doctors for every 10,000 population in Nepal; the country needs more medical schools, not less. But producing thousands of badly trained doctors with little to no exposure is not the solution either. Quantity, quality, and equity should be made non-negotiable. But for this the power structures of the medical industry needs a thorough shake up. While acts of individual dissent like that of Dr KC help focus national attention on the impending decay, there has been little effort from within the universities and colleges to set things straight.

There is no doubt that the nebulous criteria for selecting administrators lies at the heart of the problem. Having a committee of tenured faculty, administrative and student representatives and making potential candidates undergo rigorous assessments would be the most practical solution. But our student, teacher, and even parent unions are seeped so deeply in partisan politics that expecting radical change at the moment is futile until politics on the top sorts itself out.

Read also:

Just want justice

Bad prescription

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