Krishna Kumar Gurung, a 38-year-old from ward 9 of Machhapuchchhre Rural Municipality in Kaski, laments that the only primary health centre in his ward is in a state of disrepair, making it difficult for the locals to access health services.

The three-room structure that Lwangghalel Health Centre in Saintighatta operates out of is on the verge of collapse. The walls and the roof of the health post built in 1988 have caved in and are buttressed by wooden poles.

“It is dangerous to even enter the health centre. The roof might fall on your head anytime,” said Gurung. “The structure is more than three decades old but it has seen no repair or maintenance since it was built.”

According to Gurung, patients have stopped visiting the centre and instead go to Pokhara for treatment even for minor illnesses. “Smooth operation of the health centre would ease our lives. We wouldn’t have to go to Pokhara seeking treatment for ailments that could be treated in the village itself. This health centre is located along the Machhapuchchhre Model Trek trail, and if it were well-maintained it would help not only the locals but also tourists who trek this route.”

Sushil Neupane, head of the Lwangghalel Health Centre, says the number of service seekers has trickled down in the past few years at the health centre. “Four to five years ago, we had at least 20 patients including tourists per day visiting the health centre. Today the number is less than 12. People are afraid of entering the centre lest the roof falls on their heads,” he said.

There are currently five employees at the health centre—a health assistant, a senior Auxiliary Nurse Midwife (ANM), an ANM, a senior auxiliary health worker and an office assistant.

"Although there is a need for a birthing centre in the village, we haven’t been able to expand our services to maternal health,” said Neupane. “The structure is close to falling apart. During inclement weather instead of staying indoors, we take out all the medical equipment and run out to avoid getting crushed indoors.”

According to Dilliraj Dahal, head of the health unit of Machhapuchchhre Rural Municipality, plans to start a birthing centre at the Lwangghalel Health Centre were afoot and the necessary equipment were also procured, but the poor condition of the structure was unsuitable for operating a birthing centre. “We have stored the equipment at the Lumre ward office of Machhapuchhre Rural Municipality ward 8,” he said.

The poor condition of the health centre has affected all services, says Dahal. “The villagers need a fully-equipped health and birthing centre. But the physical infrastructure of the health centre is a hindrance. Even the employees have started expressing dissatisfaction and retaining them is getting difficult,” he said. “The closure of the centre will deal a hard blow to the locals so they are making do with whatever resources they have.”

Rajendra Chettri, ward chairman of Machhapuchchhre Rural Municipality ward 9, says they have been doing everything possible to keep the health centre running within a limited budget and resources. “In the current fiscal, the municipal office spent Rs1 million on a six ropani plot of land to build a new building for the health centre. A detailed project report (DPR) has been prepared for the construction of a new building for the centre and has been submitted to the federal and Gandaki Provincial governments. The construction of the new building in such a remote area is only possible with the help and coordination from the higher authorities,” Chhetri told the Post.

According to Chettri, the estimated budget for the project is Rs24 million. “We are hoping the government will address our issue in the next budget session,” he said.