With an objective to operate a 600-bed hospital and provide medical education, physical infrastructures have been constructed in Geta of Kailali district at the cost of Rs6.68 billion. However, the newly built health infrastructures are already falling into disrepair before becoming fully operational. Despite the completion of 28 modern buildings in the fiscal year 2020-21, a lack of maintenance and operation has left the infrastructures neglected for four years.

Hemraj Pujara, former executive director of the Geta Medical College Infrastructure Development Committee, confirmed that significant funds were invested in the hospital’s infrastructure, yet 28 buildings remain locked since mid-2021. Engineer Pawan Rawal, who was involved in the project, stated that some buildings were even handed over to the hospital in early 2021 but have since deteriorated due to neglect. “Before these facilities can be used, millions will need to be spent on repairs and maintenance,” he added.

Despite the availability of infrastructure, medical education has yet to commence at Geta and even the 50-bed hospital approved by the Ministry of Health and Population is in disarray. Since mid-January 2024, the hospital has been without a director after Dr Ashok Shripaili resigned just three months into his tenure. The ministry has yet to appoint a replacement, leaving administrative and managerial tasks at a standstill.

According to Nainasingh Karki, information officer at the hospital, the ministry had approved 141 posts for the hospital along with temporary approval for a 50-bed hospital in mid-July 2023. Out of the 92 currently working employees, 62—including dental surgeons, orthopaedic specialists and general practitioners—are on short-term contracts. These contracts are renewed every six months, but with no director in place, contract extensions remain uncertain, and salaries have been withheld since January. Only eight permanent doctors are on staff.

“The hospital’s budget implementation remains stalled. Despite an allocation of over Rs420 million for the current fiscal year of 2024-25, hardly any funds have been utilised, and the risk of them being forfeited is high,” said Karki.

Geta Hospital currently lacks an emergency ward, significantly limiting its capacity to attract patients. “Without emergency services, outpatient consultations alone are not enough to serve the community’s healthcare needs,” said Siddharaj Bhatt, an officer at the hospital. “Furthermore, the pharmacy is running out of essential medicines and necessary procurement processes are stalled due to the absence of a hospital director,” he added.

At present, the hospital offers outpatient services, obstetric and orthopaedic surgeries, general surgical procedures, laboratory tests, echocardiograms, X-rays, ECGs, ultrasounds, mammography, and endoscopy. Daily patient numbers range between 50 and 80. Plans were in place to expand laboratory services, purchase a CT scan machine, and upgrade the hospital's infrastructure, but these initiatives have been delayed due to administrative paralysis.

Although the Ministry of Education has handed over six buildings, 22 others still under its jurisdiction, have been left unused and deteriorating. “Fully furnished and well-equipped doctor residences have been built, yet doctors are forced to rent private housing because the hospital does not own these buildings,” said Karki. “On the one hand, infrastructure is wasting away; on the other unnecessary expenses are being incurred for accommodations.”

The Ministry of Education transferred only the hospital building, mortuary, oxygen plant and a few other facilities, but the ownership of the remaining infrastructure remains disputed between the Health and Population Ministry and the Education Ministry. According to a former official of the Geta Medical College Infrastructure Development Committee, this conflict has directly contributed to the hospital’s current state of disarray.

The situation has worsened as the infrastructures and goods are left unused for a long time. Furniture, lecterns, desks, benches and whiteboards in the medical education buildings are now gathering dust, and mould and termites have begun to infest wood works. The air conditioning and ceiling fans may no longer function while unmaintained buildings have started developing cracks, their paint peeling away. Storms and rainfall have damaged windows and doors, and cobwebs fill the abandoned rooms. Overgrown weeds and bushes have further degraded the premises.

“If these facilities had been used on time, we wouldn't be facing such high maintenance costs,” said former engineer Pawan Rawal. “Now, a significant budget will be required just to repair and clean these structures before they can be utilised,” he added.

And it is uncertain regarding the operation of a medical college in Geta. For years, the government has debated whether to establish a medical college, an academy, or a university in Geta. A bill to establish Shahid Dasharath Chand Health Sciences University was introduced and passed by the National Assembly, but it is stalled in the House of Representatives.

During his visit in December 2023, Minister of Health and Population Pradeep Paudel hinted that establishing a university at Geta was not an immediate priority. Local people, including Loka Raj Pandey of the Geta Medical College Struggle Committee, argue that the government should immediately approve and run a 300-bed hospital at the site.

Gopal Hamal, mayor of Dhangadhi Sub-Metropolitan City, has also criticised the government for neglecting Geta. “The most pressing issue for Sudurpaschim Province is the establishment of a fully functional healthcare institution at Geta,” he said. “The government's repeated delays raise serious concerns about its commitment.”

With millions already invested and a fully constructed medical complex sitting idle, the fate of Geta Hospital remains uncertain. If immediate action is not taken, not only will the infrastructure continue to decay, but the region’s hopes for quality healthcare and medical education will remain unfulfilled.