Diagnosing Nepal

Nepali Times issue #182 6-12 February 2004.

20 years ago this week, Nepali Times carried a guest column by visiting medical doctor Stephen Bezruchka who had been coming to Nepal annually for the previous decades to improve surgical care in remote hospitals.

Bezruchka pointed out that private ‘disease palaces’ were booming in Kathmandu even as doctors remain under-employed. Not much has changed 20 years later, as our page 1 story shows.

Excerpts of the article published on issue #182 6-12 February 2004:

As a medical doctor and a student of population health, I am amazed at how many under-employed doctors there are in Kathmandu, as well as how many brand-new under-utilised disease palaces there are that together tempt the well to become sick. Medical schools and various colleges of so-called health sciences abound to produce even more resources to treat the wealthy well.

There are few practitioners in Nepal who minister to the sick, but there are surgeons who cut, physicians who diagnose, endoscopists who look around, urologists who probe and neurosurgeons who suck out brain jelly. The construction boom in hospitals, nursing homes and research centres ensures that medical harm will become a leading cause of death in Nepal, as is the case in developed countries.

…So what kinds of solutions might be considered? To begin with, the massive concentration of wealth is not conducive to justice. Then perhaps an emergency needs to be declared to provide basic needs as enunciated by King Birendra decades ago. The focus of such programs have to be in Mugu, Bajura and Kalikot, the three least-healthy districts. The average length of life in Kathmandu is 30 years more than in remote Mugu.

Nepal can take cues from Kerala state in India or Sri Lanka and pursue social-welfare led development. Both countries have a health status close to America's.

For archived material of Nepali Times of the past 20 years, site search: nepalitimes.com

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