The District Hospital Achham, the largest hospital in the district and built five decades ago, is now in a dilapidated condition. Health services have been severely affected due to old infrastructures of this major hospital in Achham, a hill district of Sudurpaschim Province.

According to Shiva Bogati, chairman of the district hospital management committee, rainwater leaks through the tin room into the operation theatre, emergency unit, and outpatient department (OPD) whenever it rains. “Among the district hospitals in the seven hill districts of Sudurpaschim, only Achham’s hospital lacks proper infrastructure. We have repeatedly urged the government to construct a new building or repair the existing one, but our pleas have fallen on deaf ears. Rainwater leaks into the operation theatre, and doctors lack adequate space to examine patients in the OPD. But our problem has been completely ignored by the authorities,” said Bogati.

Although it was originally a 15-bed hospital, it now operates 35 beds to accommodate the growing number of patients, despite its poor infrastructure.

“We had no choice but to add more beds to handle the patient flow, even though the facilities are in bad shape,” said Bogati, adding that the extra beds are in a sorry state.

The corrugated zinc sheets on the hospital roof installed several decades ago have not been changed yet. “When it rains, it’s hard to enter the gynecological ward, OPD, or the emergency unit. Even the infant ward is not in a good shape,” said Bogati, admitting that both patients and their attendants have been hugely affected due to the poor infrastrcutre.

The Department of Urban Development and Building Construction, under the Ministry of Urban Development, had decided to invite tenders for constructing a 50-bed hospital building in the fiscal year of 2021-22. But the tender bidding process stalled due to a lack of budget assurance.

“The Project Office of Urban Development and Building Construction in Doti had pledged to allocate Rs490 million budget for the construction of a hospital building. However, they later withheld the funds, citing a lack of budget assurance,” said Bogati. “I have heard that they are now planning to reduce the budget to Rs120 million. For the current fiscal year 2024-25, only Rs20 million has been allocated for the hospital building construction. Given the fund situation, the chances of constructing the hospital building are very slim,” said Bogati.

According to the Project Office of Urban Development and Building Construction in Doti, a project agreement worth Rs450 million was signed last year to construct a new building for the district hospital. But the project was cancelled last month due to the lack of budget assurance. A new project agreement may be initiated if the government approves a multi-year contract for the project,” said Ram Aashish Das, chief at the Project Office of Urban Development and Building Construction in Doti.

People's representatives have also expressed their dissatisfaction over the government’s neglect of the district hospital. "The hospital building is old and crumbling. When new and better hospital buildings have been constructed in other districts of the province, Achham has been ignored. I raised this issue time and again in the federal parliament (House of Representatives) but nothing has been done," Pushpa Bahadur Shah, who was elected to the federal parliament from Achham constituency 2 said.

Local residents complain that the hospital is gradually turning into a referral centre sometimes due to lack of human resources, equipment and sometimes due shortage of medicines.