A few days ago, Dirgha Urau, a 65-year-old woman from ward 2 of Katahari Rural Municipality in Mornag, visited the Shailaja Acharya Cardiac Centre located at ward 14 of Biratnagar Metropolitan City for the treatment of extreme chest pain. During her medical examination at the cardiac centre, it was found that her blood pressure had climbed to 180/120.

The doctor advised that Urau should be administered medicine through injection to lower her blood pressure and start further treatment immediately. However, due to the unavailability of the particular intravenous medicine and emergency treatment facilities, she was referred to Koshi Provincial Hospital, said Dr Surbesh Kumar Jha, head of the Shailaja Acharya Cardiac Centre.

“Urau was in immediate need of a holter monitor on her chest, but due to the absence of the equipment and the intravenous medicine, we referred her to Koshi Hospital,” said Jha. Holter monitor is a wearable device that records the heart's rhythm and is used to spot irregular heartbeats.

Shyam Mahato, a 70-year-old man from Siraha, suffered a heart attack on Tuesday, and his family brought him to the Shailaja Acharya Cardiac Centre for treatment. Mahato’s family brought him directly to the centre after hearing the news that the Koshi Provincial government had established the hospital.

According to doctors at the centre, Mahato needed immediate angiography and further treatment, but at that time only Outpatient Department (OPD) services were available, so his relatives also took him to the Koshi Hospital for treatment.

On January 22, 2024, the Koshi Provincial government inaugurated the centre without any preparation, promising to provide free treatment to heart patients in the province.

During the inauguration, the then Chief Minister Kedar Karki said that the centre would provide free treatment to all heart patients including critical cases, and had also mentioned that he had reallocated some of the budget originally allocated for building a temple to construct the Shailaja Acharya Cardiac Centre so that people can get free treatment.

On the occasion of the completion of 100 days of his government, Karki had inaugurated the centre without ensuring necessary human resources and equipment by replacing the signboard of the Infectious Disease Treatment Centre, which was under the provincial government, renaming it Shailaja Acharya Cardiac Centre. The provincial government invested around Rs 50 million in the heart centre.

The centre, which the then chief minister Karki described as a gift to heart patients, is in a pathetic condition due to a shortage of manpower, equipment, and proper planning. Most of the patients visiting the centre are sent to other hospitals due to the absence of resources.

“There is a severe shortage of equipment at the hospital, and those that are available have not been used due to a lack of skilled manpower. The hospital was supposed to run with the funding of the provincial government, but after the hospital was inaugurated, officials from none of the agencies of the provincial government or the relevant authorities have visited the Shailaja Acharya Cardiac Centre,” said Jha.

The centre, which was supposed to help all heart patients of the province for free, is only providing normal OPD services, and in emergencies, a patient's family has to take the patient to other health institutions.

“We have made repeated requests to the government and the secretary of the province to provide equipment and skilled manpower, but they have not replied yet. I also feel bad turning back needy patients requiring immediate treatment,” Jha added.

On an average 40 heart patients visit the centre on a daily basis. According to Dr Jha, the patients are referred to other health institutions following minor check-ups here at the centre.

The centre currently has a doctor, seven staff nurses and a radiographer. Four months ago, the Koshi provincial government had announced to increase the perks and benefits of those working at the centre by 150 percent, but they have yet to receive the promised raises.

Among the daily visitors, around five to eight patients visiting the centre need hospitalisation. But the centre refers such cases to health institutions in Biratnagar owing to resource crunch.

The centre has a treadmill test machine but it is sitting idle as there are no tools and equipment to operate it. The government of India had provided an ambulance to the centre, but it is not in operation due to shortage of fuel. “The centre does not have authority to spend even a single rupee. The provincial government does not provide fuel expenses. So the ambulance has been grounded,” said Dr Jha.

The provincial government allocated Rs 55 million to the centre in the current fiscal year of 2023-24. But a knowledgeable source says the centre needs at least Rs1 billion to provide all the health services promised by the then provincial government. “The then chief minister Karki launched the centre without proper management of the required human resources and equipment. The present government is in serious trouble whether to operate the centre or not,” said a highly placed source at the provincial health ministry.