National 3 (Spotlight Weekly)

Increasing Consciousness

The natives of Dhading articulately express their concerns - complaints, suggestions and demands - about health issues in public forum

By THAKUR AMGAI

Health issues are not in the priority list for most Nepalese. Even at the dawn of 21st century, particularly the rural folks of the country are least concerned about the issues of health until they are bed-ridden and unable to continue their day-to-day chores. Worse, the negligence is increasing at a time when they have to fight against the psychological trauma ensued by the conflict.

Amid such situation, natives of Dhading district, however, have woken up to their health concerns. They have been raising voices about their problems and questioning and suggesting the concerned authorities about issues ranging from corruption in health institutions to hazards created because of the incompetent health manpower through public hearing programs.

The voices were raised in Public hearing programs organized by the District Health Office (DHO) and supported by Health Sector Support Program- a project funded by German Technical Assistance (GTZ), in eight randomly chosen health institutions throughout the district. The hearings started from October 12 and have made its way through the rural parts to the district hospital in three months. The final hearing was organized at the District hospital on Monday (December 20).

At the hearing on Monday participants demanded a probe on the illegal abortion conducted by an unauthorized hospital and the complication it caused to the patient and put their points about lack of manpower in rural areas, incompetence of the available manpower, shortage of medicines in the rural parts, unqualified and unregistered selling similar drugs at varying prices and hostility of the hospital staff, among others. Dr. Sinendra Raj Uprety, medical superintendent of the hospital answered to the queries and tried to clear their doubts. He also vowed for the improvement in the entire health sector by plugging the pitfalls and probing and punishing the guilty health workers.

A Woman in a health camp : Gradual ncrease in conciousness

Thanks to the hearings organized throughout the district, apart from raising awareness about health among the public, the public have also got a forum to express their agonies and problems. At a time when there is a political vacuum from the center to the local bodies, these kinds of public forums are extremely important. No one involved directly or indirectly with the hearings deny that the forum has given a positive impression to the public and is a beginning towards the improvement of the health sector. Nanda Prasad Rijal, the president of the Hospital Support Committee, has been actively involved in the social sector since a long time. “Everyone is happy that the hospital organized such hearing,” he said.

The facilitating team of the public hearing has prepared a report summarizing the hearings of the seven health institutions and submitted it to the DHO for action.

The hearings have also unraveled the immediate problems faced by the public in health sectors. Sitaram Adhikari was closely involved in each of the hearings. He is the local representative of the Informal Sector Service Center (INSEC) and a local correspondent of a daily paper in Kathmandu and he worked as the moderator for the hearings. Here is what he has to say, “The problems faced by the public is of varying nature. The public raised voices about issues ranging from financial irregularities in health institutions to non-performance and incompetence of the health workers. What most people concurred in was the lack of manpower and shortage of medicines. The people, however, were happy that they got a forum to speak out their agonies.”

Commenting about the suggestions given by the report, Geeta Bhattarai, the district coordinator of the HSSP told SPOTLIGHT, “Most of the suggestions that came from the hearings are beyond the control of the DHO. However, we will do everything possible from our side to address the problems raised by the public.”

"Moreover," she explained. "The program has given public an opportunity to express their voices. This is important as there is no local government - which would otherwise raise voices on behalf of the public - functioning at present."

The program has not only raised awareness about health among the public, it has also cautioned the health workers of their unquestioned misconduct, corruption and incompetence. The increased consciousness to the health is also shown by the stiff increase in the number of people visiting the health facilities. Last year 1,50,000 people made use of the government health facilities as compared to less than 1,00,000 the previous year. This is more than 40 percent of the total population of 3,50,000 in the district.

The district is privileged with perpetual service of two medical officers, unlike most of the remote districts, where doctors are rarely available. The district has 52 health institutions including two primary health care center, one district hospital, 16 health posts and 33 sub-health posts. All 50 VDCs of the district have at least one health institutions with more in two VDCs. There is a quota for 255 technical staff of which 22 are presently vacant. Although, the situation is better than most of the remote districts, the manpower is still insufficient to cater to the need of the population and the problem of health workers remaining absent from their workplaces for a long time still haunts the district. The post of one doctor at the district hospital and one each at Salyantar Primary Health Care Center and Gajuri Health Care center has remained vacant since a long time. The transportation difficulty is one of the major problems in the northern region.

Despite the physical closeness of the district from the Capital, the district is still far behind the time socially, educationally and economically thanks to the difficult mountainous topography.

Women of the district have been making extensive use of the facility of abortion available at the district hospital. Particularly, married women having unwanted pregnancy have benefited from the facility.

Dr. Uprety informed that altogether 37 women had come for abortion in the district hospital and all the cases were successful without any complications. The district hospital is the only place authorized for abortion and the doctor duo working at the hospital are the only authorized person to conduct it. The hospital conducts abortion at the rate of Rs. 1,200.