On Sunday, Bir Hospital, the oldest medical facility in the country, celebrated its 130th anniversary.

Inside the hospital, Raj Kumar Bishwokarma was struggling to find a bed in the Intensive Care Unit for his critically sick father. Doctors told him he should find another hospital and that they weren’t responsible if anything happened to him.

“I have checked with the Tribhuvan University Teaching Hospital but they said they do not have beds available,” Bishwokarma told the Post. “We cannot afford an ICU bed at private hospitals.”

Like Bishwokarma, dozens of severely ill patients who come to Bir Hospital are forced to return without treatment or seek exorbitant private care because there simply isn’t enough room for patients at the oldest and one of the largest government-run hospitals. Once renowned for its quality care at affordable rates, the hospital also offers free treatment for poor patients who travelled to Kathmandu from some of the most remote parts of the country. But with its failing management and crumbling infrastructure, not all poor patients can get treatment here.

Every year, the government provides over Rs 2 billion to the hospital, which has over 1,200 staffers, including doctors and nurses. Last year, 422,801 patients from across the country received services from the hospital.

The hospital, which once used to operate 460 beds, was damaged during the 2015 earthquake and since then, it has 378 beds available. The entire building, where the hospital used to run a 27-bed intensive care unit, suffered heavy damage during the quake, forcing it shut.

“It is very difficult to find a bed in the intensive care unit at our hospital,” said Dr Swyam Prakash Pandit, former director at the hospital. “Patients have to be either completely healed or die for the ICU section to have any beds available.”

Earlier in May, a building with a 100-bed capacity was reconstructed with help from the Japan International Cooperation Agency. But the hospital administration has been operating only 24 beds, citing lack of manpower.

“We have not been able to run the building in its full capacity,” Dr Kedar Prasad Ceintury, the hospital’s director, said at a programme held to mark the hospital’s anniversary. “A lot of patients could get treatment in our hospital if we can run the new building in its full capacity.”

The hospital administration had requested an additional 411 staff with the Ministry of Health and Population months ago, but doctors say they haven’t received a response.

The hospital has also been plagued with irregularities. Several pieces of equipment that have been purchased for millions of rupees, like the intraoperative CT-Scan machines and tomotherapy machines, have been sitting idle, collecting dust.

Doctors admit that patients who visit Bir Hospital have also been forced to seek treatment from private clinics because of the administration’s failure to repair its dysfunctional CT-scan, angiogram and mammogram machines, along with other equipment.

“The management has to take the blame for all of the hospital’s problems,” said Pandit. “This hospital does not lack the resources and infrastructures—it lacks efficient management.”