On August 27, the Birgunj-based Narayani Hospital announced vacancies for 47 doctors and health workers on a contract basis. However, on September 1, the Ministry of Health and Population instructed the hospital to suspend the recruitment process until further notice.

The hospital had announced a recruitment process as per the Guidelines for Management of Health Workers in Contract Services-2019 and the Hospital Pharmacy Directives-2015. The notice invited applications for five medical officers of the eighth level, 25 staff nurses, four pharmacy assistants, and two auxiliary nurse midwives.

On June 28, the hospital called for applications for 33 staffers on a contract basis. Around 200 people had applied, but the recruitment process was also suspended at the ministry’s verbal instruction. On June 24, recruiting two staff nurses had reached the final stage with assistance from the United Nations Children’s Fund. The selection had been made, and only the contract signing remained. This process was also cancelled following a “verbal order” from the ministry.

The hospital dismissed 47 daily wage workers in mid-June after Anamul Haque was appointed the officiating medical superintendent. He sacked health workers, including 11 eighth-level medical officers, one seventh-level medical officer, 12 staff nurses, three health assistants, five radiographers, four auxiliary health workers, and seven office helpers, citing a financial burden.

The sacking of wage workers and repeated suspensions of the contract recruitment process have disrupted hospital services. Due to the manpower shortage, patients are forced to seek treatment at private hospitals, which a majority of patients cannot afford.

According to Dheeraj Gupta, chairman of the hospital development committee, the recruitment was halted due to the absence of coordination with the ministry.

“Previously, the deadline for filling applications was a week,” said Gupta. “However, the hospital administration didn’t coordinate with the ministry this time, although a ministry representative should be on the committee that makes contract appointments.”

Officiating medical superintendent Haque said the recruitment process would be restarted in coordination with the ministry. “The ministry has not provided any reasons for suspending the process,” he said. “We will restart it.”

The hospital’s coronary care unit (CCU) has been closed for three and a half months. The CCU, which previously had eight beds, is out of operation due to staff shortages. The 48-bed medical now operates only 31 beds. Due to the lack of staff, the paediatric ICU has had its beds reduced by five, and the Surgical Ward now operates with ten fewer beds than before.

The kidney dialysis unit, which previously had 12 staff members, now has six. According to the administration branch, the ministry has instructed establishing a cancer treatment centre by September 10. “However, no personnel or machinery was provided provided,” an administrative officer said. “Can services be started merely with instructions?”

Gastroenterologist Dr Arun Gyawali and nephrologist Dr Niraj Dhakal, both of ninth level having joined the hospital on August 7, have other assignments. According to the hospital administration, they had gone on leave shortly after joining the hospital. On August 14, the health ministry assigned Dr Gyawali to the chief minister’s office in Lumbini Province and Dr Dhakal to Bir Hospital, Kathmandu.

Records with the administration show that 30 doctors and health workers, including Dr Gyawali and Dr Dhakal, are officially positioned at Narayani Hospital but are working at other hospitals across the country.

“As many as 17 doctors, ten staff nurses, two nursing officers, and one public health inspector are working elsewhere,” an administrative officer said. “These staff members work at various hospitals, leaving Narayani Hospital without adequate service.”

The hospital has a sanctioned staff strength of 321, with only 234 currently working. Although the hospital has an approved bed strength of 500, it operates only 286 beds. Despite being declared a federal hospital on February 15, 2019, there has been no improvement in staffing, services, or equipment.

According to the hospital administration, specialised services such as cardiology, nephrology, and neurology have been announced but have yet to be launched.