The Madhyabindu District Hospital in East Nawalparasi is struggling to provide services without enough human resource and physical infrastructure.

The hospital is authorised and equipped to run 15 beds but since it receives around 400 patients on a daily basis it has expanded its bed capacity to 65. But the health institution cannot cater to a large number of patients due to the apathy of the authorities to upgrade the hospital and staff it adequately, says Dr Jitendra Kandel, the medical superintendent at the hospital.

“The hospital should manage at least 100 beds to provide quality services to each patient who visits it. The hospital development committee has been operating 65 beds for the past six years with its internal resources,” said Kandel. “The relevant authorities have yet to provide the budget necessary for the upgrade.”

The Gandaki provincial government had turned the Madhyabindu Smriti Community Hospital—established around 15 years ago with the initiative of the local residents—into the District Hospital in 2019, allowing it to run 15 beds.

The hospital has the posts of 31 health workers but only 13 are on duty at present.

The cash-strapped district hospital has appointed 63 health workers on a temporary contract basis. “The hospital development committee spends Rs1.8 million monthly to pay them,” said Kandel.

Though the community hospital turned into the district hospital years ago, the land it occupies is yet to come under its ownership. There are several dead trees on the hospital premises, which risk falling.

“The dried-up trees pose a threat and it would be advisable to remove them but the hospital has no jurisdiction for that,” said Kandel. “We wrote to the division forest office, municipality and provincial health ministry around two months ago. But our problem remains unaddressed.”

The local people built the hospital in the national forest land at Ward 16 of Kawasoti Municipality. The hospital management does not have the mandate to clear those dried-up trees as the land is part of the national forest area.

With permission from the provincial health ministry, the district hospital commenced dialysis service to kidney patients three months ago. The hospital currently has four dialysis machines and plans to purchase one more. However, the hospital does not have a building to provide the service from.

Kawasoti Municipality and Madhyabindu Municipality allocated Rs1.5 million and Rs300,000 respectively in the current fiscal year to construct buildings for the dialysis service. But the hospital management could not initiate the building construction over the issue of trees.

Mohan Kafle, chief of the Division Forest Office, admits that the hospital has been facing difficulties due to the trees around it. But the forest office does not have the authority to fell trees on national forest grounds. “It is the centre’s call,” he said. “We can’t decide on those matters. The Council of Ministers should take a decision to cut trees in national forests.”

People from six of the eight local units in East Nawalparasi visit the hospital for treatment, says Kandel.