A day before Prime Minister KP Sharma Oli was admitted to the Tribhuvan University Teaching Hospital on Monday for a second kidney transplant, he issued a video message assuring the nation that he had put in place measures to ensure smooth functioning of all necessary governance-related activities in his absence.

But there is still a lack of clarity on who is the executive head of the country while Oli remains in the hospital for his surgery and post-operative recovery. The transplant is scheduled for Wednesday and doctors have said that Oli will require at least a week in hospital and two weeks to take up minor tasks.

Sunday’s Cabinet meeting, the last before Oli was admitted to the hospital, did not decide who would be the officiating prime minister in Oli’s absence. According to Oli’s advisors, the constitution does not mention the delegation of authority while the executive head remains within the country.

“Just go through the constitution. We go by what the constitution says,” said Surya Thapa, the prime minister’s press advisor, a statement that was echoed by Bishnu Rimal, Oli’s chief advisor.

As Oli has not left the country, he cannot nominate an officiating prime minister, said Rimal.

But, according to constitutional experts, the constitution does not say that the prime minister should nominate an officiating executive head when they leave the country either, but the established practice has been designating a trusted minister to run the country in their stead.

It was a mistake on the part of the prime minister to not designate an officiating head when he is in hospital, said Bhimarjun Acharya, a constitutional scholar and advocate.

“Who will take decisions if the prime minister has to stay in hospital for a few weeks?” said Acharya. “The constitution is a prescriptive document; it does not include descriptions for every scenario.”

For the week that Oli is in hospital recovering, he will not be able to hold Cabinet meetings, stymying a number of crucial decisions that need immediate attention, like the government’s response to the Covid-19 outbreak.

Since a transplant is not a simple operation, complications could arise, further lengthening his stay in the hospital. Doctors have also said that Oli will need a minimum of a month to recover fully, during which time he will not be able to take up major tasks.

Constitutional experts believe that Oli and President Bidya Devi Bhandari, who is the guardian of the constitution, should read the statute in its spirit.

“Such issues need not be written in the constitution. The prime minister or the president could have taken a step to avoid a possible constitutional hurdle,” said Balaram KC, a former Supreme Court justice. “Our constitution has not outlined a situation where the prime minister is unconscious. What if the government needs to take an emergency decision or declare an emergency?”

In the absence of the executive head of the country, the President does not have the power to make a decision in case of an emergency.

“It’s not that we have anything negative against Oli but anything can happen when the executive head is unconscious,” said KC. “It is natural for a man to become ill, but the nation cannot.”

In the immediate aftermath of the operation, a heavily medicated Oli will not be in the right frame of mind to take sensitive decisions. The appointment of an officiating prime minister for the duration that he is incapacitated could have eased governance, said experts.

“It’s the political right of all citizens to be governed by a physically and mentally healthy prime minister,” KC said.

According to Acharya, the constitutional scholar, it is the opposition that should’ve raised this issue, long before Oli left for the surgical procedure.

While Radheshyam Adhikary, a member of the National Assembly from the primary opposition Nepali Congress, agreed that Oli should have assigned someone to look after governance, he wasn’t certain when or where the issue would be raised.

“The prime minister should have assigned someone his duties and informed the public,” said Adhikary. “We will raise the issue on Wednesday.”

Some ruling party leaders, too, believe that Oli should have decided on an officiating prime minister before heading into surgery, as there could be a leadership gap at a crucial time.

“Even if there is no such practice, the prime minister should set a precedent for the future,” said Ram Narayan Bidari, a member of the National Assembly from the Nepal Communist Party (NCP).

Bidari said that he had heard that Deputy Prime Minister Ishwar Pokhrel would take over while Oli was in hospital, but that there was no official decision. In the past, Pokhrel had assumed the role of officiating prime minister whenever Oli left the country for medical treatment or official visits.

However, Dipendra Shrestha, personal assistant to Pokhrel, reiterated that the prime minister cannot give an officiating role to anyone when he is within the country.

“Ishwar Pokhrel will not take charge as the officiating prime minister but as the senior-most member of the Cabinet,” Shrestha told the Post.

According to doctors attending the prime minister, his surgery will begin from 9 am Wednesday.

A team of doctors led by Dr Prem Raj Gyawali, a consultant urologist and kidney transplant surgeon at the TU Teaching Hospital, will perform the surgery, according to hospital sources. Dr Ananta Kumar from India, a senior transplant surgeon at Indraprastha Apollo Hospital in New Delhi, has also been called in to assist the Nepali team of doctors. Oli’s first kidney transplant was performed by a team of doctors led by Kumar at the Indraprastha Apollo Hospital in 2007. Yet another doctor from India, an expert in internal medicine, is also in Kathmandu.