When his four-month-old grandson died earlier this month due to an overdose of polio vaccine administered at Khar in Jorayal, Tek Bahadur Malla went from pillar to post looking for a doctor who could conduct a post mortem.

The family reached the District Hospital in Silgadhi, Doti, in the hope of finding a doctor who could provide them with the service they required, but they returned disappointed.

Malla recalls carrying his dead grandson from Jorayal, 220km from the district headquarters, to the District Hospital in Doti in search of an appropriate doctor.

“There were no doctors to perform a postmortem in Doti District Hospital, so I took the body to the Sub-regional Hospital in Dadeldhura. But that hospital too didn’t have doctors who could conduct the procedure. I finally reached Seti Provincial Hospital and got it done there. The ordeal was unspeakable,” he said.

Like Malla, many locals living in the Sudurpaschim Province hills have been facing the same difficulty for the last two weeks due to the shortage of skilled doctors in district hospitals.

The shortage of doctors is a result of the Employee Adjustment Programme wherein the Ministry of Health had allowed doctors to choose their duty stations. Consequently, most of the doctors opted to stay away from the hill districts in Sudurpaschim.

Though the District Hospital in Doti has four positions for government doctors—two each for medical specialists and medical officers, there are no postmortem specialists.

Ramesh Malasi, chief at the District Health Office in Doti, said that they had been unable to conduct complicated postmortem cases due to a lack of doctors.

“We have only two medical officers here. They cannot work on complicated postmortem cases as they don’t have the skills or the training to conduct such procedures,” said Malasi.

According to him, Dr Bhusan Mishra, the only doctor capable of performing the procedure, was transferred to Kathmandu two weeks ago.

Superintendent of Police Dilip Singh Deuba in Doti said that they had been sending bodies to Dhangadhi for the last two weeks as the Sub-regional Hospital in Dadeldhura too lacked skilled doctors.

“Because of this, we are not able to investigate crime incidents on time as it takes a long time to prepare a postmortem report,” Deuba said.

This problem is currently playing out in hospitals across Dadeldhura, Achham, Baitadi and Bajura districts. Most of the district hospitals are without medical specialists.

Sudurpaschim Health Directorate, the government organisation responsible for filling the posts of medical practitioners in district hospitals, is unaware of this problem.

Dr Gunaraj Awasthi, chief at the directorate, said they were unable to maintain a database of health workers commissioned to various hospitals.

“We find ourselves caught up in power tussles among the three levels of government,” he said. “There’s no one-door reporting policy. All three levels of governments have been transferring employees without proper plans and policies in place. This is why the directorate does not have the exact number of health workers in the province.”

The directorate last year had trained nine doctors from various districts in Sudurpaschim to enable them to conduct postmortem services.

“But I don’t know how many have been transferred and where they are currently based. I have directed the subordinate offices to collect details of health workers to resolve this problem,” said Awasthi, adding that the directorate was planning to train 25 doctors for postmortem services by mid-February 2020.