Last year, Salyan District Hospital purchased medical equipment and tools worth Rs 20 million to be used in the treatment of coronavirus patients. But the equipment and tools meant for the Intensive Care Unit of the hospital remain unused in the absence of skilled manpower.

Salyan, a hill district of Karnali Province, has been hit by the third wave of the Covid-19 pandemic, with the district reporting 185 active cases as of Sunday. But the unavailability of Intensive Care Unit services has hampered the treatment of Covid-19 patients, health workers say.

The 40-bed district hospital does not have an ICU and ventilator facility, which has forced doctors at the hospital to refer critically ill patients to health facilities outside the district.

"We have to refer critically ill patients and Covid-19 patients with severe symptoms to health institutions outside the district, as ventilator and ICU facilities are not available at the district hospital,” said Dr Asim Prajapati, a medical officer at the hospital.

“The treatment of Covid-19 patients in the district will be possible only when we have skilled manpower to use the equipment and tools in the ICU,” he said. According to him, the hospital is in a sorry state with even the X-ray machine for dental treatment lying defunct and the ambulance grounded for want of repair.

"The medical equipment and tools that arrived months ago are yet to be installed and brought into operation due to a lack of skilled human resource and infrastructures," said Dasharath Shrestha, chief at the District Health Office. According to him, the Karnali Provincial government had allocated Rs 25.8 million budget to purchase the necessary medical equipment and tools for the operation of ventilator and ICU facilities at the district hospital.

"The medical equipment and tools were purchased to run six ventilators and 14 ICU beds," Shrestha said.

The provincial government had allocated the budget when the second wave of Covid-19 was wreaking havoc in Salyan last year.

"But the medical equipment for the ICU remained unused last year. This year too, we may not be able to use them if the concerned authorities do not deploy trained human resources immediately," said Shrestha.

Two medical officers and two staff nurses at the hospital received a month-long training to operate the ventilator and ICU facilities last year. But the health workers were transferred before the service came into operation.

According to the District Health Office, most of the Covid-19 patients in Salyan are currently in home isolation since none of the health institutions or the local units are operating isolation facilities in the district.

Sharada Municipality built a 25-bed isolation facility at the district hospital last year at the cost of Rs 20 million. But the isolation facility is not in operation this year due to a lack of required human resources.

Despite the surge in Covid-19 cases nationwide, the district hospital of Salyan is not prepared to handle the third possible wave of the deadly virus. The hospital does not even have a medical oxygen plant as of now.

"We have not been able to install an oxygen plant due to budget crunch. We have been using oxygen concentrators as an alternative," said Prajapati.

The district hospital in Salyan currently has a specialist doctor, five medical officers, two dentists, 12 staff nurses and seven paramedics.