The Government’s Priority Responding To The People’s Needs

By Yug Bahadur

AS CAN be expected, the law and order situation of the nation is the concern of any government. It is no different for the present Nepali Congress government led by Prime Minister Girija Prasad Koirala.

Priority

In fact Prime Minister Koirala, as soon as he took office about a fortnight back, had committed himself to make the tackling of the deteriorating law and order situation his first priority.

Coincidentally, an instant challenge was thrown to the government barely a few days after it had been formed. The biggest opposition party in the Parliament, the CPN (UML) organised a nationwide bandh (closure) not even a week after the present government came to power. However, it must be clarified that the UML had scheduled the bandh about a month back and it did not deliberately want to create trouble because a new government was there.

However, it is also a fact that the main opposition party did not bother to withdraw the crippling strike, just because a new government had been formed. “It is the government of the same party, so we did not feel the compulsion to give it more time,” a UML leader had explained.

Organising another bandh, the CPN (Maoists) did not bother to make even such explanations.

However, apart from cracking into action to face the challenges of such bandhs held last week and earlier, it is encouraging the government has also initiated a move, which could be directly felt by the people. This is indeed a pragmatic step, which had not been thought about by decision makers in the previous government.

The new arrangement made by the government that is being mentioned here, is the announcement where it made an appeal asking the people to directly contact the police or the Chief District Officer, whenever forced donations are asked from them.

The authorities have done well by adopting this policy, where they have sought the cooperation of the people in controlling unlawful activities. There have been reports of how people have been forced to part with hefty “donations”, but under threat of violence.

A statement of the Home Ministry has given direct telephone lines here in Kathmandu, where aggrieved persons can call directly 24 hours a day. In the districts, people have been told to call the CDO.

Quite naturally, this security dragnet will be effective only in the major city areas and district headquarters where there are facilities to easily communicate with the authorities and where the government has adequate security personnel. In the remote areas, other methods will have to be taken up to guarantee the safety of the people.

Yet for now, credit must be given to the present government for at once getting into action and initiating some measures to make the government responsive to the people’s needs. This is in accordance with the promises made by Prime Minister Koirala.

Right now, after the dismal performances of the various governments that have come to power in the past couple of years, it has become imperative for a stable government to give a sense of security to the people. The general populace must be made aware that the government has not forgotten to look after their wellbeing.

The present security angle, though very vital, is just one of the issues which has to be tackled at once. Apart from a deteriorating law and order situation, the people have also been hit hard by a slow moving economy and massive corruption.

When one contemplates the situation of the country now, it can be presumed that a vicious cycle of underdevelopment, corruption and now violence is gripping it. One doesn’t have to be an expert to again guess that bad governance and corruption have contributed in worsening the situation.

Therefore, apart from providing a sense of security to the people and targeting to tackle the deteriorating law and order situation, equal attention must also be given to combating corruption and making efficient the bureaucratic machinery.

The first steps that could be taken, could be in initiating investigations regarding the activities of individuals, who have been accused of being involved in corruption. Such accusations need not come through formal channels only.

For example, the media has played a significant role in exposing many corruption related activities taking place in government institutions and also the corrupt persons involved. But rare is the case when the government has initiated any investigation based on such charges made in the media. This has blunted the power of the media, as corrupt people feel they don’t have to fear anything even if their names come up in newspapers.

But if the authorities are to start serious investigations on incidents that have been reported by the media, then many people could be deterred even just by this fear.

Similarly, if real good governance is to be provided then a proper evaluation of those in power must be made. Like the cooperation sought by the security agencies in deterring donation seekers, complaint boxes could be kept in ministries and various other government institutions as well. And then, what the people have written in the messages in the complaint boxes, must be seriously followed up by the concerned authorities.

Exercise

Such simple exercises to know the feeling of the public could go a long way in providing good governance in the country. But of course, the follow up measures must be serious and thorough. Thus, even some simple initiatives from the government could go a long way in winning the confidence and more importantly the cooperation of the people in tackling the various challenges that face the nation at present.

DOTS Strategy & TB Control In Nepal

By Balaram Chaulagain

IN a bid to control the country’s rampant situation of TB, His Majesty’s Government of Nepal adopted DOTS strategy in 1996. It was first developed in the United States for those stubborn patients who would not comply with the prescribed medicines. Currently, some 125 countries use DOTS to combat TB. It is a community and home based TB treatment method which is some time called as supervised treatment, too.

TB is highly contagious and cosmopolitan air borne disease caused by infection with micro-bacterium TB. Increasing poverty, neglect of TB programmes and spread of HIV/AIDS are major contributing factors for high prevalence rate of TB. As per WHO protection one third of the total world population suffers from this disease and some 5,000 die of the disease every day. Cough lasting more than three weeks, evening rise of temperature, loss of body weight, loss of appetite, blood in sputum, chest pain or more than a month and past history of TB are main cardinal signs of pulmonary TB. From public health point of view pulmonary TB is believed to be a most dangerous hence priority should be accorded for its proper control.

TB is more prevalent in developing countries like Nepal. Besides about 40 per cent of those suffering from the illness are in South Asia alone. Nepal’s situation is also equally bad with almost 45 per cent of people being affected by TB and around 1,00,000 people actually having active TB infection. Moreover the sad fact pertaining to TB in Nepal is the annual death of around 15 thousand innocent Nepalese. These are just rough estimation, the figure may go high.

In Nepalese context, there is no dearth of resources to control the alarming situation of TB. In the same way, it is well known fact that TB is 100 per cent curable and a vaccine preventable disease but we need total commitment and a sound health policy. It is woeful to note that our national health policy, more particularly National Tuberculosis Programme (NTP) is completely frail. Notwithstanding substantial amount of resource from the public coffers and other donor agencies like the WHO, JICA, Norwegian Heart and Lung Association, International Union Against TB and Lung Diseases, BNMT, LHL, as well as other line agencies to incessantly fund the fight to curb this menace in the country, the efforts seem to be quite inadequate. The high goal set by NTC and the subsequent announcement of 89 per cent unprecedented success rate of DOTS implementation in Nepal seem to have puzzled the health arena across the globe.

No doubt, DOTS is an effective breakthrough in the field of TB reduction and is a kind of magic wand to eliminate TB and Multiple Drug Resistance (MDR) cases. But the principle of DOTS should be strictly followed. Here, in the case of Nepal, no one is unfamiliar with the agony on the part of doctors’ reluctance to stay in district hospital or other peripheral health facilities. As such, how can we achieve the laudable goal of DOTS in absence of reliable medical staff, especially in rural-based hospitals where they are most needed? TB treatment in district hospital or in village level health post is an integral part of an integrated health services to be rendered by all government-run health institutions scattered all over the country. The delinquency on the part of the doctors and other trained health personnel has create a great havoc in health care delivery system of Nepal. Let alone other sophisticate health services, the people residing across the length and breadth of country are facing the hardship due to the absence of doctors. Lack of properly functioning TB Programme, trained staff indifferent and wrong attitude towards primary health care providers working across the country’s health facilities are among the hurdles faced by the national NTP. So long as there lacks a well functioning national tuberculosis programme high sounding slogans and ambitious announcement would not be enough.

All health workers, social mobilisers and political leaders working at micro-level should be brought into the mainstream of NTP. In the Nepalese context, doctors themselves are found to be responsible for the jeopardised situation of TB in Nepal. Even the doctors who are currently on the payroll of NTC seem to be not showing the required minimum interest to check up the TB-suspected patients thronging to the health centres from all over the country. Let alone the matter of day to day medication by doctors, TB diagnosis in some health centres seem to be performed by paramedics like Health Assistants (HA), Auxiliary Health Workers (AHW) and other Nursing Staff. Instead of this the doctors who are posted by NTC are either always found to be engaged in private practices or roaming abroad. Besides, most of their time seem to be wasted in conducting meetings, seminars, symposiums and such others. On the other hand, the poor patients are found to be examined and prescribed by not so much qualified HA and AHWs.

Reality

Despite the fact that Nepal has bagged different kinds of medals and letters of appreciations from different international agencies for successful implementation of DOTS in the country, in practical the reality is different. As things stand, Nepal still has to so a long way to attain the laudable DOTS goal as envisaged by WHO and other line agencies. For this, the prime duty of the NTC should be focussed to prod its doctors for TB-case detection. They should be urged to attend out-patients departments run by NTC. To strengthen the sorry situation of NTP, a strong commitment from the health authorities and medical staff as well as full public participation of the people and patients is most imperative.

Political Appointments

By Bijay Aryal

THE economic committee of the cabinet has recommended scrapping all the political appointments made to public corporations and not filling those posts with new political appointments. And many of those posts are to be filled by government bureaucrats. It is reported that those coming into the reserve pool after the reduction of the number of ministries are to be appointed to top-level posts in corporations. Also reported is that such appointments will be made on the recommendation of an evaluation committee yet to be created within the cabinet.

Will this new policy contribute to the objective of achieving an efficient administration? Will the performance of the fully or half-owned government enterprises improve visibly? The newly recommended government policy means in effect that the practice of bringing in people from outside the corporations (or even from government civil service) has been a stumbling block to corporations. This also implies a belief that this sorry situation can be corrected by bringing in bureaucrats from the government’s civil service.

There is a separate service for hiring employees for corporations. If each service has its own procedure of recruitment and each corporation is government owned, the employees too should belong to the government. But there are two types of employee: one is selected to man the government’s departments and ministries and the other is employed for the corporation concerned. As a result, those in the government civil service are appointed to the corporations’ top positions while those in the corporations have no chance of similar appointment to government departments and ministries.

Not only that. Second class government employees known as under-secretaries are appointed to be boss to and decide the fate of even first class corporation employees. And this has long served to bring down the morale of corporation employees. In government civil service there are not many rungs of the hierarchical ladder to ascend: first you are selected for section officers, your next promotion makes you undersecretary, then you become joint secretary, and then secretary. There is a provision at present of additional secretary. In corporations, you cannot normally get appointed to a post higher than a sixth-level officer and, when you get promotion, you move up to the seventh level, both belonging in the third class officer category equivalent to section officer. But in second class category too, you have got to be promoted first to the eighth level and then to the ninth level, the corporations’ second class being similar to undersecretary in the government’s civil service. In the first class, you have tenth level officer post, eleventh level officer post, and twelfth level meant for general manager who is not recognised as a special class officer as a secretary is.

Even second class undersecretaries are sent to occupy top positions in corporations, such as member of the corporations’ boards, their general managers. First class joint secretaries often occupy the posts of executive chairmen or chairmen in many corporations. If the corporations are government owned and their employees too are the government’s, why are not they trusted to run the corporations? Or why are not the employees of corporations sent to occupy the posts of tax officers, director general of customs department, and so on? If they belong in different categories of service, then the appointment of government bureaucrats to corporations’ top posts is also political because they had not been employed in the service of corporations concerned.

For the employees of corporations, government bureaucrats too are outsiders, with different selection procedure, with different service rules, with different promotion systems, with different perks, with different career goals, applying to them. Moreover, the employees of corporations have total career stakes in their own corporations, and therefore their career would collapse with the collapse of corporations. But government bureaucrats appointed to corporations are like tourists whose expenses are paid by the corporations concerned and these tourists lord it over the corporation employees during their stay there. But the visitors remain unaffected even if the corporation went to the dogs.

There is little sense in replacing one set of political appointments with another set of political or semi-political appointments from the government civil service.