The government decision to introduce a two-day weekend policy has left Swastik Kumal worried. On Thursday morning, Kumal reached out to the director of Tribhuvan University Teaching Hospital, Maharajgunj. His concern was about his father’s scheduled kidney transplantation.

“My father has been waiting for a kidney transplant for the last two years,” Kumal told the Post. “Transplantation date has already been postponed several times, and we are worried it could be pushed further, as the government has declared two days of public holiday per week.”

As per the Cabinet decision, which will come into force from May 15, government offices will remain closed on Saturdays and Sundays. Government hospitals, which have not been providing transplantation services on Saturdays will now close the services on Sundays as well.

Like Kumal, thousands of patients with serious ailments from across the country will have to bear the brunt of a five-day work schedule, doctors say.

“Unless there is a different provision for hospitals, all scheduled surgeries will be postponed or delayed at our hospital once the new rule comes into force,” said Dr Dinesh Kafle, executive director at the teaching hospital. “Ordinary patients have to wait one more day to show the reports and consult the doctor.”

Kumal’s father, Tara Bahadur, 44, has been undergoing dialysis twice a week, for which the family has to pay Rs6,000 (Rs3,000 per session).

“Earlier, the date for his kidney transplantation was postponed several times due to the Covid-19 pandemic,” said Kumal, a native of Binayi Tribeni Rural Municipality in Nawalpur district. “Now we are totally confused and still don’t know when the transplantation will be done.”

Doctors concede that thousands of patients across the country will suffer due to the two-day weekend rule.

According to the hospital administration, there are patients who have to wait for up to three years for some surgeries.

Doctors at the hospital perform surgery immediately only on those patients whose conditions are serious or on those needing emergency care.

Others whose health condition is not serious as per doctors’ assessment have to wait for months or years for their turn.

Kafle, director at the teaching hospital, says it will be unfair to those who have been waiting for years for their turn for surgeries if their schedule is postponed because of the two-day weekend rule.

Around 2,000 patients visit most of the big hospitals—Tribhuvan University Teaching Hospital, Bir Hospital and Patan Hospital, among others in the Capital. Patients from across the country come to the Capital for consultant care.

Doctors at the teaching hospital perform kidney transplantation surgeries once a week and the service is provided to only two patients. Given the backlog of cases, Sunday’s holiday will push other patients' dates automatically.

“The waiting list for transplantation is too long,” Dr Dibya Singh Shah, dean at the Institute of Medicine, Tribhuvan University, told the Post. “We could not perform any transplantation during the coronavirus pandemic. Patients have to wait for six months to a year for transplantation at our hospital.”

The government on Tuesday took the decision of introducing a two-day weekend policy with an aim to cut costs, especially the use of petroleum products. The import of fuel has been creating pressure on the country’s foreign exchange reserves which have dwindled to Rs1,171 billion by mid-March from the beginning of the fiscal year; the existing reserve is sufficient to sustain imports for 6.7 months against the target of seven months. Nepal’s fuel import bill has lately swollen to Rs1 billion daily, which is hurting foreign currency reserves badly. The Nepal Oil Corporation, the state-owned oil monopoly, has already declared that it is broke and the government has been pumping money to import fuel.

The government has also banned at least 10 types of items, which it considers luxury goods, including vehicles, mobile phones, television sets, playing cards and Lay’s potato chips to save foreign exchange.

The new weekend rule will come into effect from May 15, but effectively government offices and hospitals will have three off-days that week, since May 13 is election day and May 14 is Saturday. There are concerns that this could also increase case backlogs.

Nepal is among those countries with the most number of public holidays.

“Patients needing different types of cases will be affected,” said Kafle, the TUTH director. “Those with gallbladder problems have to wait for up to a year and a half for surgery at our hospital. If the government’s new decision is implemented, they will have to wait for even longer.”

Minister for Health and Population Birodh Khatiwada said he learned about the two-day holiday decision through the media.

“I was not present in the Cabinet meeting that took the decision,” Khatiwada told the Post. “This decision will certainly affect the poor patients who come to the Capital for treatment. This is a cause for concern.”

Khatiwada said that he will hold discussions with the parties concerned and stakeholders to find some ways to address the patients’ concerns.

An official at the teaching hospital said that in an institution where staffers often play truant, the government has offered two days’ leave on a platter.

“Of course doctors and employees will be happy, as they can go anywhere in the country for private practice. But this decision will hugely affect patients,” an official at the hospital told the Post, requesting anonymity. “Patients have to arrange more money to stay for more days in Kathmandu as they wait for their turn for surgery and other specialised treatment.”

The hospital administration said that the new decision will affect the hospital as well. The costly equipment including x-ray, CT-scan and MRI machines, procured by spending millions of rupees, do not come into operation on the off days. That means it will lessen the hospital’s income.

Patients have to wait for several days for a CT-Scan or ultrasound at state-run hospitals. Those who are in queue at state-run hospitals have to either wait for days even for minor services or pay exorbitant fees at the private labs.

Some hospitals said if the government has taken a decision, they will implement it.

Bir Hospital said doctors and other hospital staffers should not be deprived of the [holiday] benefit provided by the government.

Dr Bhupendra Basnet, director at Bir Hospital, said that the two-day weekend rule will certainly affect patients and that they will have to wait for more months if not a year for some surgeries, including the surgery of urology problems.

But he added that the hospital would implement the decision.

“How can you argue that doctors and hospital staff should not enjoy the benefits provided by the government?” he said. “We will implement the decision at our hospital.”