Federal government injecting budget into district hospitals in haste without proper studyThe hospitals identified by the federal government as corona-specific hospitals are in no shape to be upgraded immediately for the treatment of coronavirus patients, say district hospital authorities.
The federal government has decided to upgrade Arghakhanchi and Kapilvastu district hospitals as Covid-specific hospitals. However, both the designated hospitals suffer from poor infrastructure, limited human resources, and a shortage of medical equipment.
On Monday, the Ministry of Health and Population decided to provide Rs 20 million each to Arghakhanchi and Kapilvastu district hospitals to upgrade the institutions with four ventilators and 10 ICU beds each.
The district hospital building in Arghakhanchi, which was established 33 years ago, still has a zinc-sheet roof. On a daily basis, the hospital receives 200 patients but has the capacity to admit only 15 patients to the inpatient care department.
“The federal government has decided to provide Rs 20 million to upgrade the hospital. But we don’t know what to do and how to prepare to handle Covid-19 patients,” Dr Kapil Gautam, acting medical superintendent of the hospital, told the Post. “We can’t start taking in more patients in this poorly built hospital which is understaffed at the moment. Adding ICUs and ventilators is not going to prepare us to treat Covid-19 patients.”
According to him, there are six medical officers and four nurses working at the hospital.
According to Gautam, the provincial government had planned to upgrade the hospital to a 50-bed health institution two years ago but the plan is yet to come to fruition.
“On Tuesday, Minister for Social Development Sudarshan Baral said he will decide on the hospital’s upgradation into a 50-bed hospital within a week,” he said.
The 15-bed district hospital in Kapilvastu currently employs only six medical officers.
“Among them, five have been appointed on a contract basis. The federal government’s decision to inject Rs 20 million into the hospital does not change anything. We are not prepared to handle Covid-19 patients immediately as envisioned by the federal government,” said Dr Kishor Banjade, acting medical superintendent of the hospital. “It is not possible to immediately purchase medical equipment and install them and also manage human resources to fill the vacant posts.”
According to him, there are currently 25 vacant positions for medical officers in the hospital.
Dr Binod Kumar Giri, provincial health director, said the federal government has been making decisions on distributing budget to district-based hospitals without coordinating with the provincial governments.
“The federal government made the decision without a proper understanding of the ground realities,” he said. “There are no consultants, physicians, anaesthetists and other health workers to operate ventilators in the district hospitals.”
According to him, the federal government did not consult with the provincial government before making the decision to provide a budget to Arghakhanchi and Kapilvastu district hospitals and a PCR machine to Palpa Hospital.
The data of the Provincial Health Directorate shows that there are 19 government hospitals in Province 5. A total of 70 consultants, 156 medical officers and 149 staff nurses are working in these hospitals. But there are only four anaesthetists—medical professionals who are needed in ICUs.
“ICU and ventilators cannot be operated without anaesthetists. We had given out a notice asking for anaesthetists but haven’t received any applications,” Giri said.
“The government can use private hospitals as corona treatment centres rather than distributing budget to the district hospitals haphazardly,” said Devraj Pokharel, a social campaigner in Rupandehi. “Government hospitals with poor infrastructure and a lack of human resources cannot be upgraded immediately. It takes time to manage medical equipment and skilled workers. But Covid-19 patients need treatment immediately.”
The provincial government in the current fiscal year has allocated Rs 1 billion budget for Covid-19 prevention and treatment. Dr Pushparaj Paudel, information officer at the Ministry of Social Development, said, “Out of 12 districts in the province, four hospitals in three districts have been developed as Covid-specific hospitals. But those hospitals are also reeling under a shortage of essential medical equipment and skilled human resources. There are only 33 ICUs, 33 monitors and 17 ventilators across these hospitals.”
Minister for Social Development in Province 5 Sudarshan Baral said the need for Covid-19 specific hospitals is immediate in the province given the spread of the virus.
“Covid-19 has started to affect senior citizens and the number of symptomatic patients has risen of late,” he said. “There are no ICUs and ventilator beds available in the province and there is a shortage of skilled health workers.”
Kapilvastu is ranked the first in Province 5 in terms of total cases of Covid-19. Until Friday, 1,110 people tested positive for coronavirus in the district; four deaths have been reported so far. Meanwhile, in Arghakhanchi, one person had died and 379 individuals had tested positive for coronavirus as of Friday.