Darchula. Gokuleshwor Hospital under Shailyashikhar Municipality has been facing difficulties in its operation. The hospital is facing difficulties due to lack of budget and manpower. The post of Medical Superintendent level 9 has been vacant since its establishment in the hospital, which is located in the main hub of Baitadi and Darchula. Two medical officers are on contract.
‘Even though there is a post of medical officer, it is not possible to stay here full-time,’ said Shivadatta Joshi, the municipality’s health coordinator. ‘Few people are interested in staying here due to the lack of service facilities.’ Apart from the prescribed salary, the local government has had to provide additional budget to retain doctors. Only Dr. Manoj Bahadur Pal and Uttam Singh Dhami are working in the hospital.
The municipality alone cannot provide good service facilities. Joshi says that service facilities are necessary to retain doctors. The hospital does not have adequate physical infrastructure. Services have to be provided from a building constructed when it was a primary health center in the fiscal year 2055/56.
The three-bed primary health center has been upgraded to 15 beds. The entire building is now operational, says Health Coordinator Joshi.
The Gokuleshwor Hospital also receives more service recipients due to its proximity to the road. There is a problem in running the hospital with only the resources of the municipality. He complains that he has not received any support from the provincial government for the operation of the hospital.
Health Coordinator Joshi says that despite inter-municipal coordination meetings with the local levels of neighboring districts Baitadi and Darchula, support has not been forthcoming for the operation of the hospital. The hospital’s condition is deteriorating day by day due to lack of budget and equipment support from elsewhere.
Patients from Lekam Rural Municipality, Shailyashikhar Municipality, Marma Rural Municipality, Naugad Rural Municipality and Apihimal Rural Municipality in Darchula come to this hospital for check-ups. Similarly, service recipients from Dilashaini Municipality, Dogadakedar Rural Municipality, Purchaudi Municipality in neighboring Baitadi district and Bungal Municipality in Bajhang have reached the hospital.
It takes three hours to reach the district hospital from Shailyashikhar, which is connected to the Mahakali Highway. Dr. Pal, a doctor at Gokuleshwor, says that the hospital here is becoming the first choice for patients as it is easy to refer patients who cannot recover in Gokuleshwor to Dadeldhura Hospital or Dhangadhi.
The equipment at the hospital is deteriorating and no one is interested in repairing it, which has caused problems in the service delivery of the hospital.
Municipal Mayor Vijay Singh Dhami said that discussions are underway to bring this hospital under the control of the provincial government. ‘Initially, we will discuss with the neighboring local level,’ he said. ‘If they are ready to share services, we will run them under local control, but if there is no cooperation, Shailyashikhar Municipality alone cannot run the hospital.’
Problems in service delivery due to breakdown of ultrasound machine
The hospital’s ultrasound machine has broken down, causing problems in patient examinations. The hospital has stated that the ultrasound machine has been broken for three months. City Health Coordinator Joshi informed that there was a problem in examining patients coming to the hospital as the machine could not be repaired.
‘The hospital initially had three ultrasound machines,’ Joshi said. ‘Two machines broke down earlier, and one has been causing problems since Chaitra.’ Hundreds of patients come to the hospital daily. This hospital is a center for service recipients not only in Darchula but also in Baitadi.
The number of pregnant women who need video X-rays at the hospital is 15-20 daily. Apart from that, there are hundreds of general patients. According to Doctor Pal, the lack of video X-rays for patients coming to the hospital is a problem.
The ultrasound machine that was sent for repair by the Ministry of Social Development of Sudurpaschim Province a month ago has not yet been repaired. According to him, the damaged machine was also ineffective. There is no information whether the machine has been repaired or not.
Health workers have not received salaries for seven months
Health workers here have not received salaries and other services for seven months. Since salaries are not even received on time, health workers are struggling to work. Although federal employees receive their salaries on time, health workers are facing problems due to the local level and the additional services provided by the local level.
15 employees, from office assistants, sweepers to AHEBs, who were hired on contract by the municipality, have not received their salaries for seven months. ‘Initially, three months’ salaries have been withdrawn,’ says the health worker. ‘Apart from that, we have not even been able to eat our salaries yet.’
The additional salaries of two doctors working at the hospital have not been paid by the municipality. Due to the lack of service facilities, health workers are also facing problems in working. Health Coordinator Joshi admits that there is a problem in managing services and facilities, including salaries, as no one except the local government is supporting them. No one has helped in purchasing infrastructure, manpower and machines.
He said that operating through local resources and revenue is very challenging. He said that he is taking the initiative in managing services and facilities including salaries to health workers on time.
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