Three years ago, the local units in Achham, a remote hill district in Sudurpaschim Province, laid foundations for hospitals as part of the federal government’s ambitious plan to build one hospital each in all local units across the country. However, the federal project has not progressed in most local units in Achham.

Out of the 10 local units in the district, eight had laid the foundations for hospitals on the same day. Mellekh Rural Municipality is the only local unit in the district that completed the hospital and brought it into operation. But in seven other local units, the hospitals are nowhere near completion.

The government in the annual budget for the fiscal year 2019-20 had announced plans to construct one hospital each in all 753 local units of the country.

“We have just initiated hospital construction work from this fiscal year. We could start the work earlier mainly due to a delay by the government in providing the promised budget,” said Dhan Bahadur Thapa, the chief administrative officer of Chaurpati Rural Municipality. Despite Thapa’s claim, construction work has not gathered pace on the ground.

Chaurpati Rural Municipality through a competitive bidding has selected a contractor and signed a project agreement to build a 15-bed hospital.

“But the land set aside for the hospital is not enough for a 15-bed hospital. So we are working to arrange land from the adjoining plots,” said Thapa. According to him, the federal government has allocated Rs180 million for the hospital this year.

There already are two hospitals in the district—the district hospital in Mangalsen Municipality, and the Bayalpata Hospital in Sanphebagar Municipality

The Bayalpata Hospital decided to use the fund meant for a new hospital to upgrade itself. Some local units have just completed the tender process while others are still working on the foundations for the hospitals.

Turmakhand Rural Municipality, which lies to the southeast of the district headquarters at a road distance of around 60km, recently invited bids and signed a project agreement with a construction company to build a 10-bed hospital. “The rural municipality initiated hospital construction work by completing the tender bidding process. The workers started digging pits to erect pillars for the structure a few days ago,” said Ekendra Bayak, the chief of the rural municipality’s health unit. He, meamwhile, admitted that progress on the work has been sluggish. “The construction work was started at our own initiative. The federal government does not even inquire with us about the project,” he added.

The situation at Bannigadhi Rural Municipality is no different. The local unit started the construction work only recently. “We recently selected a contractor and currently we are working on the foundation. We are working our best to speed up the construction work,” said Basanta Rawat, chief of the rural municipality’s health unit.

The district health office, which is supposed to coordinate with all health institutions in the district, is also unaware of the progress on the hospital projects. “We didn’t know how the hospital projects were progressing, so we recently asked local units to submit progress reports. We learnt that the Ramaroshan Rural Municipality has not started the construction work yet, and in most local units, the construction works are in the initial stage,” said Jhanak Dhungana, chief of the district health office.

According to Dhungana, lack of coordination among the authorities concerned, delay in allocating the budget and land-related disputes are the leading causes for the delay in construction in most local units of the district.