The Lumbini provincial government has spent nearly half a billion rupees for the prevention and control of Covid-19 so far, but the rate of disease spread has not slowed down in the province, nor are the patients getting quality care.
According to the data of the Ministry of Social Development in the province, Rs 495.2 million has been spent to combat Covid-19 so far. Officials say a large chunk of this amount was spent on procurement of medical equipment and medicines for government hospitals and health facilities.

But despite making a big investment to improve and strengthen the medical care infrastructure in the province, patients are not getting admittance in government-run health facilities designated for Covid-19 care and treatment.

Forty-three-year-old Rishi Sharma, a local of Butwal Ward No 11, tested positive for Covid-19 two weeks ago. When he sought admission in government hospitals in Rupandehi following severe illness, every one of them turned him away saying they did not have enough beds.

“I was staying in home isolation but I had difficulty breathing after a couple of days. I needed medical assistance so I first sought admission at government hospitals but none of them had a bed for me,” he said. “I was then admitted to Universal Medical College in Bhairahawa, a private institution. I spent nine days at the hospital and spent Rs 20,000 per day.”

Lumbini Province has four Covid-19 special hospitals in Butwal, Bhairahawa, Dang and Banke districts to treat critical patients from 12 districts. There are also 13 hospitals, 12 district health offices and 12 Ayurvedic hospitals that have isolation facilities.

According to the data of the Ministry of Social Development, the provincial government has invested Rs 216.1 million for the management of four Covid-19 special hospitals and Rs 109.84 million on risk allowances for front line health workers.

But none of the government health institutions has been able to accommodate the rising number of Covid-19 patients. Currently, there are 195 beds in four Covid-19 special hospitals in Butwal, Bhairahawa, Dang and Banke. The active number of cases across the province reached 3,719 as of Friday.

Until Friday, 14,490 individuals have been tested positive for the coronavirus in the province. Of the total infected, only 1,085 people were able to get treatment at Covid-19 special hospitals. Among them, 66 succumbed to the disease during the course of treatment.

According to the records kept by the Provincial Health Directorate in Lumbini, 15 Covid-19 patients died for want of treatment because they were turned away by Covid-19 special hospitals, citing lack of beds.

Two months ago, a Cabinet meeting issued a directive to hospitalise only symptomatic patients while asymptomatic patients would be asked to isolate at home. Following the directive, free swab collection was also stopped in the province.

Dr Pushparaj Paudel, information officer at the Ministry of Social Development, believes the number of Covid-19 patients may be higher than what’s being reported daily.

“These days even those who are entering the province do not have to conduct mandatory PCR tests,” said Dr Binod Kumar Giri, the health director of the province. “PCR tests of asymptomatic patients have also been stopped. We are conducting free PCR tests only on critical patients.”

The provincial government has provided seven ventilators to three Covid-19 special hospitals (Bhairahawa, Dang and Banke) in the province. The Butwal-based Covid-19 special hospital has five ventilators. There are only 12 ventilators throughout the province.

A majority of Covid-19 patients have been asked to stay in home isolation but since there are no mechanisms to provide medical assistance to Covid-19 patients staying at home, most of them are unaware of changes in their medical condition.

There are 2,165 Covid-19 patients in home isolation who have not received any health services or medical care from the government.

“I did a PCR test in Lumbini Provincial Hospital after suffering from a high fever about three weeks ago. My report was positive. I stayed in home isolation for 14 days,” said Sushmita Pandey, a resident in Ward No. 6 of Siddharthanagar Municipality. “None of the authorities checked up on me so I had to monitor my health improvement myself.”

The provincial government says it will soon introduce plans to better the current medical infrastructure keeping in mind the chances of further spread of the virus during the festive season.

It, however, does not have plans to increase the scope of PCR tests, or monitor the health condition of patients in home isolation.

“The government is going to expand and increase health services in Covid-19 hospitals,” said Baijanath Chaudhary, spokesperson of the provincial government. “But there are no plans yet to extend the same services to those in home isolation.”

Sudarshan Baral, minister for Social Development in the province, said the ministry has released funds as per the demand of the health facilities so it is not the lack of money that has stunted the health sector in the province. “We have been providing the necessary funds to all Covid-19 specific and other hospitals to equip them to fight the pandemic,” said Baral.

But since there’s no proper mechanism to inspect and monitor the expenditures of the hospitals, the funds are not being utilised as needed, says Dr Krishna Kharel, a member at the Medical Council at the central level. “Even though hospitals have purchased medical equipment, the failure to manage skilled human resources in health facilities has rendered the investment null,” said Kharel. “The government is injecting funds in hospitals but there is no progress to show for all the money spent. The spending has not been result-oriented.”

Krishna Bahadur Paudel, an assistant accountant at the Ministry of the Social Development in the province, said out of 495.2 million, Rs 209.92 million was from the Covid-19 fund and the rest of the budget was provided by the provincial government.