Tika Prasad Ghimire, a resident of Dhankuta Municipality-7, suffered a heart attack last week and was immediately rushed to the district hospital. But the hospital could not initiate his treatment and referred him to Biratnagar.

Kedar Dahal’s mother is an asthma patient. The resident of Dhankuta-7 says his mother needs immediate medical intervention whenever she suffers an asthma attack. Last week he rushed his ailing mother to the district hospital after she started having problems breathing.

“She was in pain and said she couldn’t breathe. I took her to the district hospital but the doctor on duty couldn’t treat her and referred her to Biratnagar,” said Dahal. “What is the point of a hospital if it cannot provide necessary services to patients.”

The district hospital in Dhankuta has become a shell of its former self for a lack of upgradation. One of the oldest medical institutes in Province 1, the then Tri Chandra Hospital was established in 1913 in Chowk Bazar, Dhankuta, the old regional headquarters of the Eastern Development Region.

This hospital catered to the patients of all 16 districts of the Eastern Development Region. Surya Bahadur Thapa, who was prime minister four times, kept this hospital on priority for the important role it played in providing medical services to a large population of the region. However, today the hospital is in complete disrepair and in need of major upgradation of physical infrastructure and medical facilities.

Last year, then chief minister of Province 1, Bhim Prasad Acharya, announced that the 15-bed district hospital would be upgraded to 100 beds and would further be expanded into a medical college in mid-October, 2021. However, his promises did not come to fruition.

Dr Manish Shah, acting chief of the hospital, says that patients come to the hospital seeking treatment but since the hospital does not have the needed manpower, resources and infrastructure, he refers all the patients to hospitals in Biratnagar.

“It is a shame that we cannot provide the necessary treatment. People come to us hoping to get treated but we sadly have to turn them away,” said Shah. “Ghimire, the heart patient who had come to the hospital last week, was in a bad condition. If he wasn’t taken to Biratnagar immediately, he would have suffered more.”

Dhankuta District Hospital is spread over 16 ropanis. It was estimated that at least 50 ropanis of space is needed to operate a 100-bed hospital. However, no work has been carried out in this regard.

According to the government standard, the minimum criteria to run a 100-bed hospital is to have eight specialist doctors and the necessary support staff. The hospital currently has only one medical officer employed on a contract basis. Dr Pradeep Khatiwada, the medical officer, works 24 hours a day as there are no other doctors. “I only conduct routine checkups here. General surgery and maternity facilities have also been stopped for a lack of manpower and other facilities,” said Khatiwada.

According to Khatiwada, an average of 1,300 patients visit the hospital annually.

Ventilators and ICU beds were installed in the district hospital two years ago during the Covid-19 pandemic but they were never used for a lack of skilled manpower and specialists such as anesthesiologists. The provincial government provided 10 ICU beds with four ventilators with the help of the federal government’s Public Security Fund. The equipment was installed at a cost of around Rs16.5 million.

“The posts of anesthesiologist and physician have not been announced. Since the district hospital does not have the right to advertise and fill the posts for specialist services, the posts have not been filled yet. The district hospital does not have specialist doctors so most services are unavailable here. Patients have to go to the BP Koirala Institute of Health Sciences in Dharan or a health centre in Biratnagar even in times of emergencies,” said Khatiwada.

Shah, the acting chief of the hospital, said that the provincial government was supposed to allocate Rs160 million to turn the hospital into a medical college but the hospital received only Rs40 million in the first phase.

“We returned the Rs40 million because the rest of the budget was never sent,” said Shah. “The hospital has not been able to prepare even the detailed project report (DPR) of the plausible expansion of the hospital since the land is yet to be allocated to the hospital.”

“The district hospital is in dire straits. Development and planning were decentralised on paper, but no access was given to resources. It seems impossible to expand the services or even upgrade the physical infrastructure,” said Bhojraj Bhandari, head of the health unit of Dhankuta Municipality.

“Referral patients from Terhathum, Sankhuwasabha and Bhojpur districts of the east come to Dhankuta, but due to the lack of health service facilities, patients who come in this way have to go to Dharan or Biratnagar for treatment,” he said.