At a time when the world is embracing communications technology in all aspects, and 63.31 percent of Nepal’s population is connected to the internet, the health departments across the three tiers of government have not been using a technology that was saving lives more than a decade ago. Telemedicine—the use of telecommunications technology to diagnose and treat patients remotely—was used to connect rural district hospitals with experts in government hospitals in Kathmandu as far back as 2004. Now, it lies dormant, meaning less access to expert healthcare for the people who cannot afford it. Even as the adoption of federalism promised to bring government services closer to every doorstep, it's obvious that the system has failed in healthcare delivery.

For many in rural Nepal, it is not only the monetary costs but also the restrictive geographical barriers that make access to quality healthcare a major problem. People sometimes have to travel hours on foot to reach the nearest health post. Due to the lack of manpower and budget, such health posts are not resourced with doctors or the necessary diagnostic tools. Moreover, when patients are referred by the posts to district hospitals, they sometimes travel for two-and-a-half days to find that the district hospitals are barely better. Another major issue is the centralisation of quality diagnostics and experts in the Kathmandu Valley, where doctors earn better from more patients, due to the higher population density and higher average wages.

Due to these issues, the adoption of telemedicine was considered an instant advantage since the pilot stage in July 2004. Initially, the programme was developed as a connection between three hospitals, including AMDA Hospital in Damak, to experts in three hospitals in Kathmandu, namely Kathmandu Medical College, Teaching Hospital and Shahid Gangalal Hospital. The pilot programme worked so well that by the early 2010s, healthcare providers and doctors from around 30 district hospitals—some in the remotest districts of the country—were consulting experts at Patan Hospital’s round-the-clock telemedicine desk to save patients’ lives. In this context, it is quite disappointing that the concerned authorities have not been able to keep telemedicine services afloat.

People from remote areas simply cannot afford to travel all the way to Kathmandu for treatment every time—especially during times of emergency. Barring the introduction of expert doctors from every field in every district hospital, telemedicine simply has no replacement at the moment, let alone a more cost-effective one. The Department of Health Services, under the purview of the federal Health Ministry, cites lack of financial resources for abandoning this project. The federal government must understand the importance of healthcare as an essential sector that affects the very lives of every Nepali directly. It should tender an appropriate budget to help implement telemedicine throughout the country. Moreover, the provincial and local governments can bear the cost of managing the programme post-implementation, since it benefits their constituents directly. The transfer of provincial health budgets to other programmes unrelated to health, as Province 2 was found to have done, cannot continue.

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