The tiny pharmacy at Dadeldhura Health Office has run out of oral rehydration salts. For months, there’s been a shortage of saline water at the district hospital in Darchula. Other health facilities, including several remote outposts in the country’s Province-7, have been reeling under a shortage of basic medicines that the government distributes free of cost.

But these medicines and general healthcare supplies aren’t out of supply—they have been sitting in a packed medical store godown in Dhangadhi, the provincial capital, for the last four months because no one knows who pays for transporting the medicines.

Officials at the medical store told the Post that they are unable to supply medicines to health posts across the province’s nine districts because they haven’t received funds for transporting medicines to the regional outposts following the restructuring of health offices in the federal set-up.

“The medicines have been sitting in storage because we didn’t have the money to move them out,” said Laxmi Kumar Shrestha, the storekeeper. Shrestha said they need at least Rs1 million to transport medicines in one lot to all the nine districts.

The federal government provides 70 types of medicines free of cost through district hospitals, 58 through primary health centres, and 35 through local heath posts.

An official in the neighbouring district of Dadeldhura, some 60km from Dhangadhi, said only a limited stock of emergency medicines remains at the district medical store. The official, Dil Bahadur Shahi of the Dadeldhura Health Office, said even his district hasn’t received the money to transport medicines to local health posts.

“We have no idea when we can deliver the medicines,” Shahi said. Another official at a health post in Bajura, which has seen severe cases of malnutrition in recent years, said the district has not received basic medicines “for a long time.”

Provincial government officials acknowledge there is a problem, but blame the issue on mismanagement of the health industry. “The Dhangadhi godown has run out of space to store any more medicines,” said Gunaraj Awasthi, a director at the Ministry of Social Development. “So, it is a tragedy that these medicines can’t reach people in the districts who really need them.”

Other officials said the budget allocated for the management of medicines at the district level has been stuck because of the Ministry of Social Development. “We admit there’s been a delay in processing the budget but we have urged the regional medical store not to halt transportation of emergency medicines,” said Hemraj Khadka, a spokesperson for the Ministry of Social Development in Dhangadhi.

Awasthi, the senior official at the ministry, said the health sector has been left in disarray after the government decided to disband the district health offices.

According to the federal structure, there will be only one health directorate in a province. Under the directorate, a single “A” class health office will remain in Dadeldhura while “B” class health offices will be based in Kailali, Achham, and Baitadi districts which will also oversee matters in the neighbouring districts.