Health & Ethics

THAT health is a fundamental right of the people is well-recognised. But resource crunch comes in the way of providing health services to all people. A nation must have a health service delivery system that is accessible and affordable to the poor. The limited resources that we have must be utilised in the most optional manner. How to do that is a question whose answer lies often in well-conducted health research. Health scientists, public health experts and Nepal's health research body, the National Health Research Council (NHRC), must direct their research skills into finding out the most cost-effective system of health care delivery. That research is needed is indisputable. But health research is not always a simple cut-and-dried research like some socio-economic studies are. Health research works have to be guided, more than anything else, by a stringent set of ethics. Nepal as yet does not have a national health research ethics. The NHRC has been slow to recognise that the country needed to have such guidelines. It seems it has woken up now. Currently, it is drawing up a National Ethical Guidelines for Health Research. In order to discuss the draft of the guidelines, it started a four-day consultative meeting Monday which was inaugurated by Prime Minister Girija Prasad Koirala who cautioned that health research should be guided by certain ethical principles and that research should do no harm to the people it aims to ultimately benefit. In the past, there have been controversies kicked off by health research that were seen not to have been designed with that "no harm" policy. Recently, a research conducted by a foreign organisation with a local partner in Lalitpur district had to be ultimately stopped as there were serious questions directed at the way the research was being conducted. Such things should not happen. It is against this backdrop that a set of national guidelines that guide would-be health researchers how to conduct research with ethics at the heart of it was overdue. As a speaker at the start of the consultative meeting said, an ethically sound research with human beings include adequate disclosure of information prior to voluntary consent, a favourable benefit-risk ratio and a fair distribution of burden and benefits of research. These parameters, it is hoped, would be adhered to in the future health research in Nepal, according to the forthcoming guidelines, so that health research is "healthy".

Patience Pays

GOING by what Bhutan's development partners, in a roundtable meet held in the Bhutanese capital, Thimpu, last week had said to the Dragon Kingdom concerning the Bhutanese refugees of Nepali-origins in refugee camps in eastern Nepal, it seems that Nepal's patient yet consistent stand for a speedy and honourable repatriation of these unfortunate people is finally paying off. It may be recalled that the Nepalese government, in all its meets so far with the Thimpu regime's representatives detailed to hold talks on the Bhutanese refugee problem, has been strongly advocating for a safe, quick and honourable repatriation of the about 100,000 Bhutanese refugees whom Nepal had given shelter for over ten years on a purely humanitarian basis. As per the news report carried by this daily, Bhutan's development partners, including some UN agencies, not only discussed with the Bhutanese government about the return of the Bhutanese refugees from the camps in eastern Nepal, but also voiced their strong concern and anguish over the discriminatory measures being resorted to by the Thimpu regime when it comes to dealing with the Lhotsampas, as Bhutanese of Nepali origins are called in that country. During the meet, if some representatives of Bhutan's development partners objected to the manner in which Lhotsampas in Bhutan are being retrenched from government services simply because they happened to be relatives of the Ngolops (those living as refugees in Nepal), then others raised the issue of Lhotsampas being denied citizenship ID cards and easy access to education and other facilities. Additionally, if some development partners called for the speedy constitution of refugee verification team--which, coincidentally is what the Nepalese government has been advocating ever since Kathmandu-Thimpu talks over the refugees problem started--then others, while terming Bhutan as a multi-ethnic society, warned of the dire consequences that could befall on the Dragon Kingdom if Thimpu continues to relentless pursue with its policy of exclusion of its minority communities in its development endeavours.

The fact that this was the very first time that the representatives of the Dragon Kingdom's development partners, in a high-level meet in Thimpu itself, spoke on the Bhutanese refugee issue, is definitely not lost to the Bhutanese government. Nor, for that matter, the consequences it may have to face and bear with if it, as usual, lapses again into its stonewalling tactics as and when Nepal-Bhutan talks for a speedy and honourable repatriation of the Bhutanese refugees from Nepal resume.