By Dr Sugam Gouli, Kathmandu
12 July 2017
Ten years ago, there were few medical colleges in Nepal and hence, fewer doctors. Telecommunication also wasn’t as efficient as today and we had limited sources of information – television and radio in the main. Only those in urban areas had access to Internet. Back then, being a doctor was great! It was an amazing feeling to learn how to treat people and save their life. Grateful patients and their family and friends would often shower praises on their doctors. Members of the public looked at medical professionals with dignity and respect.
Back in the days, very few dreamt of and became successful in being a doctor. But now with over a dozen medical colleges in Nepal, the number of doctors is on the rise. Add to it the pouring in of doctors from countries like India, Pakistan, China and Bangladesh. (Last time I checked the number of registered medical officers, MBBS graduates were around 20,000).
The number is not sufficient to meet the doctor to patient ratio but when we see the density of doctors in cities, it is quite high. The increasing production of doctors from private medical colleges has been a matter of controversy in recent years. There have been many news reports about lack of infrastructure in medical colleges such as lack of tutors and patients in order to practice the art of medicine. This raises a serious yet neglected question on “quality production” of doctors in Nepal. I know it because I am a graduate of a private medical college myself.
Recently, a sting operation was conducted to find doctors who did not have optimum certificate to study MBBS. It was quite successful with some quack doctors ending up in jail.
However, the operation was discontinued shortly after. It was looked upon as a movement to get rid of the bad apples of the medical industry. So far as the public is concerned, this operation resulted in a diminished faith in doctors. Running over-the-top headlines on these topics might have increased the sale of newspapers but the issue I want to point out here is the demonisation of the entire medical fraternity. It was a poor act that followed the sting operation.
Several incidents where doctors were accused of professional negligence causing death of patients have made headlines. Yes, death is indeed very much mournful and no family expects their sick relative to pass away while under treatment. But a pattern is emerging in how the doctors are blamed. When patients die, angry relatives destroy physical properties of the hospital and harass doctors and other staff. Media fuel these incidents further as they mention them as an act of negligence. In a few days, the issue gets settled after compensation to the patient party. Is this pattern becoming the norm in the hospital-patient relationship in Nepal? Where is the process of free investigation and lawful prosecution if someone is found guilty? Why does the media always have to report it as some sort of negligence? Defaming of medical professionals and institutions has become a habit, it appears. We see no effort being made to look into how the incident occurred in the first place or who is responsible for it. No one bothers to consider if the incident was inevitable. Everybody just jump to a conclusion.
Let me quote an incident that took place at a reputed hospital of Kathmandu, the Manmohan Hospital and what some media outlets had to say about the incident: “Few days ago Shiva Prasad Rimal, the permanent resident of Nuwakot, lost his one kidney because of monopoly of doctors of Manmohan Memorial Hospital”; “Hospitals selling kidney”; “Doctors secretly took out kidney”. These statements which appeared as headlines in many national and online media outlets clearly fuel the process of demonisation of doctors. In this particular instance, the hospital administration had clarified that operation was first intended to remove kidney stones but in due course the kidney was removed to prevent excess internal bleeding. Yes, there are chances of negligence and if so justice must be given to the patient but without proper investigation doctors have been tagged as “negligent”. So much uncalled-for accusation would adversely affect doctor-patient relationship and may not look into the real issues in clinical practice and medical education that need to be addressed first.
There needs to be proper intervention of the government as these incidents have been occurring fairly frequently. Devising proper rules and abiding by them in such incidents would stop this barbarism against the medical professionals. Law and order should be maintained first. No doctors should be victimised and also patients should be given justice but only after carrying out investigation into the allegations. A healthy patient-doctor relationship can then be fostered.
Also, the media should act responsibly in how news is presented. Journalists should be aware of the satellite effects that may arise out of any negative reportage.
Writer works as a medical officer in Nepal. He can be reached at firstname.lastname@example.org