On March 20, a man who had recently returned from India was admitted to Rapti Health and Science Academy on suspicion of Covid-19. Health workers at the hospital were alarmed as they had never been involved in the treatment of Covid-19 patients before. Soon, the number of suspected Covid-19 cases at the hospital rose to five.

Prakriti DC, a nurse employed at the medical ward in the hospital, was deployed to care for these patients. DC knew she had to wear PPE to secure herself and asked the hospital administration to provide the suit. But Dr Basanta Lamichhane, dean at the hospital, told her that PPEs were not necessary at the moment.

“I hadn’t asked for a PPE while looking after other patients, but taking care of suspicious cases required me to use PPE to protect myself from contracting the disease and spreading it further,” DC said. “The dean said PPE shall be used only when there's a crisis situation and that at the moment we should make do with aprons and masks.”

A few days later, DC sent out a Facebook story stating that for health workers like her, looking after patients suspected of Covid-19 without PPE is akin to soldiers going to war without any weapon. “This is how things are in our Academy,” she wrote.

Soon, the hospital administration fired her, taking issue with her social media post. She was relieved of her job on April 13. “I was fired just because I complained about the lack of PPE,” DC told the Post. “I raised the issue for the security of health workers who are on the frontline in the battle against Covid-19. But the hospital administration discouraged everyone who speaks for our security.”

Dr Amrita Shrestha, who works at the hospital’s emergency ward, was also fired because she also posted about the lack of protective equipment on Facebook. “When the administration didn’t take heed of my concern, I resorted using a public platform, and I was fired for doing that,” Shrestha said.

Even today, many health workers in Dang who are involved in the treatment of Covid-19 patients or suspects are without protective equipment and are at risk of catching the virus. “Health workers should have been encouraged at a time like this, but instead we are being thrown under the bus,” Shrestha said. “This is discouraging for all health workers.” 

WHO has recommended not to use PPEs until they’re necessary to minimise the risk of shortage, and hospital administrations are misinterpreting this recommendation to deny the protective equipment to even the physicians and nurses, health workers say. 

Meanwhile, Vice Chancellor of Rapti Health and Science Academy Dr Sangeeta Bhandari said PPEs are provided to health workers whenever necessary. “Even the senior doctors among us are using only masks while doing our rounds to check on patients,” she said. “PPEs should not be misused and we have provided the equipment to those who absolutely need it.” 

Bhandari said posting on social media about PPE shortage at the hospital was unacceptable. “It is not becoming of health workers to demand PPEs even when it’s necessary, and taking to social media to publicise it,” she said. “The Academy has five PPEs at the ready and they can be used when necessary. But it’s not a good practice to take to social media to post about PPEs.”

She, however, denied that DC and Shrestha were fired for their social media posts.

They were relieved of their duty after their contracts were over, she claimed.

In another incident, the Dang District Court held an online hearing in a timber smuggling case after the defendants could not undergo medical tests as the staff at District Health Office refused to test them citing lack of medical equipment including PPEs.

“The court had demanded coronavirus test reports of the defendants to proceed with the hearing. But we could not get the defendants tested at the District Health Office,” Deepak Gyawali, chief of Sunpur Forest Sub-division Office, said.

Sunita Poudel, chief of the health office, said the facility did not have PPE to test suspected Covid-19 patients.

“We require WHO-certified PPEs to test and treat the patients. We haven’t had any cases so far. But once the cases start to emerge, we may not be ready to do our jobs without proper protective gear,” Poudel said. 

Dhundiraj Poudel, a senior physician, said that every health worker dealing with a COvid-19 patient or a suspected patient should be provided with a reliable PPE.

“Many health workers around the world have been infected with the viral disease due to a lack of proper security measures, and that can happen here too,” Poudel said. “If the health workers themselves get infected, then that would be a very dangerous situation, so everyone should be committed to providing security to health workers.”