Laxmi Thing of Manahari in Makawanpur chose to take her pregnant sister-in-law for delivery to Bharatpur Hospital in Chitwan despite the Hetauda Hospital being closer. Bharatpur Hospital is around 46 kilometres from Manahari while the Hetauda Hospital is only about 10km.

Her sister Phool Maya Tamang gave birth to a baby boy, her second child, at Bharatpur Hospital last week. One of the major deciding factors for Thing choosing to take her sister-in-law to the hospital in Chitwan was the quality of service it provides, says Thing.

“We came to Bharatpur Hospital as the local health workers back in our village advised us to go to a well-facilitated hospital because they had concerns about the fetus’ weight,” said Thing. “My sister-in-law had come to the same hospital for her first delivery and we were impressed by the quality of care and medical services.”

Thing, however, says that while the hospital has consistently provided quality medical care, the increase in the number of patients over the years has strained the hospital’s resources leading to a neglect of matters like sanitation and hygiene on the hospital premises.

Padam Bahadur Darai of ward 11 of Madhyabindu Municipality in East Nawalparasi stayed nearly a month at Bharatpur Hospital in June for the treatment of his younger brother who had sustained a serious leg injury. Impressed by the reasonable cost and quality care at the hospital, Darai returned to the hospital last week for his wife’s health check-up.

“There are some hospitals closer to our house, but we chose to come to Bharatpur Hospital which is around 50 km away,” said Darai. “This hospital has always remained our first choice for treatment of all types of ailments.”

In the last few years, Bharatpur Hospital has been the preferred choice for patients from Chitwan, Makawanpur, East Nawalparasi, West Nawalparasi, Gorkha, Dhading, Tanahun, and Lamjung, among other districts due to its reputation for quality healthcare. As the patients’ continue to place their trust in the hospital’s services, it is facing significant challenges in meeting the rising demand in lack of essential upgrades

“On September 21, a total of 2,609 people visited the Outpatient Department of the hospital while 231 others visited the emergency unit. The flow of patients has increased significantly over the years,” said Narayan Prasad Rijal, medical recorder at the hospital.

Every morning, one can see a serpentine queue of patients and their attendants in front of the ticket counter, OPD rooms, laboratory and pharmacy. The hospital is having a difficult time managing the patients’ flow and catering to the patients with quality health care, says Rijal.

The hospital records show a total of 307,121 patients visited Bharatpur Hospital for OPD services in the last fiscal year, 2022-23. “Among the OPD visitors, 31,137 people were admitted to the hospital for further treatment and 9,133 underwent surgeries,” said Rijal.

Bharatpur Hospital has a long history dating back to the time when people from various districts began migrating to Chitwan, an inner Tarai district. Around 67 years ago, the Raptidune Development Project set up this health centre and appointed Dr Hiranya Dev Pradhan as its first doctor. Some 60 years ago, a concrete building was constructed with the assistance of the US government. The hospital was officially inaugurated by King Mahendra Shah and was known as Mahendra Aadarsha Chikitsalaya until the People’s Movement-II in 2006.

Initially, it was a 25-bed hospital. And in 2010, Bharatpur Hospital received permission to run 300 beds. The hospital has had 600 beds since 2010 as the hospital development committee decided to run 300 additional beds through internal resources of the hospital.

Bharatpur Hospital has been the region's major health institution for safe delivery. A total of 11,869 women received delivery services in the hospital in the last fiscal year alone, according to the data from the hospital.

“The bed occupancy rate was 81 percent last year,” said Dr Krishna Prasad Paudel, the medical superintendent at the hospital. Paudel estimates the occupancy rate will cross 90 percent this year. “The flow of patients has been increasing every year and we have a tough time providing tailored health services to each patient for a lack of human resources among other things,” he said. He, however, believes that despite the shortcomings, the hospital has been providing quality health services to those who have put their trust in the hospital.

In 2019, the federal government decided to upgrade Bharatpur Hospital allowing the hospital to operate 500 beds, which means it opened posts for equivalent human resources. “But the government provides only 175 posts and eight of them remain vacant. The hospital needs more than 1,000 posts of health workers to operate 500 beds,” said medical superintendent Paudel. According to him, around 400 health workers and employees receive perks and salaries through various funds of the federal government while the hospital development committee has appointed a total of 665 doctors, health workers and employees on condition of providing salaries from its internal resources.

The shortage of anesthesiologists in the hospital has hugely affected surgery services, says Paudel. “The hospital has around 40 surgeons but we have only six anesthesiologists. There should be at least 10 anesthesiologists to provide better and faster services,” said the medical superintendent. “We have been operating seven operation theatres. We plan to increase it to 15 keeping in view of the increasing flow of patients. But our plan can only materialise if we add anesthesiologists and surgeons,” he added. According to him, the patients have to wait as long as nine months for laparoscopic surgery to remove gallstones.

The hospital does not have a cardiac catheterisation laboratory for the treatment of heart ailments and an MRI machine.

A large number of patients, according to the hospital management, visit Bharatpur Hospital mainly due to the health insurance facility. Bharatpur Hospital is one of the designated health institutions to provide health services to people who have health insurance policies.

According to Gopal Paudel, the information officer at the hospital, a total of 2,609 people, the highest-ever recorded, visited the Outpatient Department on September 21 this year. “Among them, 2,143 patients were the health insurance policyholders,” he said.

The doctors at the hospital urge the government authorities to better manage other health institutions and effectively implement the health insurance programme to address the excessive patient load. “The insurance policyholders generally prefer to visit big hospitals even for minor ailments. So primary health checks should be done in other health institutions and only those patients in genuine need should be sent to larger health institutions,” said the medical superintendent Dr Krishna Prasad Paudel.

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