DR. MAN BAHADUR KC Heart Mender

Nepal has drastically improved its health system including care and treatment for cardiac health. Although cardiac arrest is still a leading cause of death in Nepal, the mortality rate has gone down and there are institutions, technologies and medical experts to save people from cardiac arrests. Dr. Man Bahadur KC, son of a farmer, a resident of the remote village of Baglung district, has seen all this change through the lens of a patient, practicing doctor and manager

April 18, 2022, 7:45 a.m. Published in Magazine Issue: VOL. 15, No. 17, April.22, 2022 (Baishakh 09. 2079) Publisher and Editor: Keshab Prasad Poudel Online Register Number: DOI 584/074-75

Born in a remote part of Baglung district in western Nepal, Dr. Man Bahadur KC, who now offers service at Nishan Clinic, a renowned cardiologist of Nepal, always preferred to work in shadow. Although he has spent enormous time bringing the change in cardiologist’s treatment and care system in Nepal making it affordable and accessible to poor and middle-class families, Dr. KC, who is one of the first cardiologists appointed to work in Sahid Gangalal National Health Center (SGNHC) in early days of establishment, is still unknown to many.

After resigning from Gangalal, Dr. KC has reduced his work pressure and burden. Spending his leisure time with two young daughters Shiwami KC (22), Omisa KC (19) and wife Sarala Bohara, Dr. KC, who served as a personal physician of politicians like Girija Prasad Koirala and Sushil Koirala, feels proud to be a part of specialized medical profession saving the life of common people.

Living in his quiet residence in Bansbari, Dr. KC, who learned ethos like a sacrifice, dedication and commitment to serving mankind from his family, finds enormous inner satisfaction in serving the needy. Spending almost 22 years in a national effort to make heart treatment affordable to the poor and middle class, Dr. KC resigned from the SGNHC two years ago.

Along with him, the dedication and commitment of half a dozen of cardiologists including Dr. Damodar Pokharel, Dr. Bhagwan Koirala, Dr. Yadav Dev Bhatta, and Dr. Dibakar Sharma, Dr. Jyotindra Nath Sharma and Dr. Ramesh Koirala, has brought a strong hospital specialized to treat heart.

Although it was during the period of Dr. Bhagwan Koirala the Hospital had built its credibility and fame, Dr. KC worked quietly in a team to achieve this success.

Dr. KC, who also served as the director of the hospital for four years, was among a few early doctors contributing to enhancing the capacity of Nepal as a country having an institution with all cardiac medical and surgical facilities but he always remained in low profile. From scratch, Nepal has made a big jump in the treatment of cardiac-related complications within the country.

Dr. KC’s Life

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Born in 2023 BS in Salyan Village of Baglung district of Dhaulagiri Zone, a remote southern part of Baglung bordering Gulmi district, Dr. KC studied up to primary 7 grades in his own village and completed 8, 9 and 10 from Udaya Madhayamik Vidhyalaya, Shantipur, and Gulmi. This is one of the oldest schools in the district.

Groomed by an extended family in his childhood, Dr. KC learned from his grandfather many useful habits. The main one was the discipline of early sleep and early wake-up. “My grandfather was known in our village as a person who shut down his door at 5 PM and woke up at 3 AM. He told me a very interesting story about his wake-up. He went to bed at 5 as usual. He woke up just two hours after sleeping. However, he thought he woke up in the morning and started preparing to go to the field. Knowing all family members laughed at his grandfather.”

“What I still practice is waking up in the early morning and going to bed early. My wife and my daughters start laughing when I start sleeping at 9 and wake up at 5,” said Dr. KC.

Passing SLC in 2040 from the school, topping Gulmi district by securing the first division, he was admitted to ISC in Trichandra College in 2041.

Journey To MBBS

In 1988, Dr. KC, under a government scholarship, was selected to study MBBS in the People’s Republic of China. Following the completion of year-long language training in Beijing, he left for Wuhan City for MBBS in 1989. Since there were uninterrupted classes, the annual and the final examination was also predictable. In 1994, he completed his MBBS. “At that time the name of my University Was Hubei University which is now called Wuhan University School of Medicine. This is one of the oldest Universities in the world. As a topper of the university in my batch, the university offered me a special scholarship to complete a master's in cardiology. The university is well known in the world for the study of the heart. It was a leading university for research, study and treatment in the world. I specialized in Cardiac arrhythmia. When I returned to Nepal, I was the first to have specialized in the subject. There are two types of treatment prevailing in the heart: curative and palliative. Most of the rhythm-related cardiac problems are curative. I have started the treatment for it. Had not I specialized in this sector, I would not have been in Nepal for another 30 to 40 years. Once I started treatment for heart rhythm, I encouraged newcomers to specialize in this area. This subject is difficult and complicated compared to other cardiac-related studies. Similarly, the treatment procedure is also a bit complex. Many people do not prefer to specialize in the area because it is difficult to study, complex in treatment and attracts less money.

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Rural Spirit

“I am inspired very much by my rural spirit and rural values. I socialized in a family and community that always take pride in helping and supporting needy people. My grandfather was a well-known person in the village for early bed and early bird. He said to go to sleep at 5 and wake up at early 4.

They taught us to give more to the needy and support the poor and vulnerable. Even after decades, my lifestyle is still a continuity of my childhood years. We were taught to sleep earlier and wake up in the early morning. I sleep at 9 and always wake up at 4. I have started to reduce my workload. I quit my job in Gangalal to reduce the pressure and burden of work. Similarly, I have started not to visit the clinic on Saturdays and check fewer daily patients. But, I cannot say no to those who came to my clinic in an emergency situation.

Money And Service

There is always a limit to money. I always prefer service, not money. Although all clinics have already increased the price of checking patients, I have yet to increase the fees. In my Nishan Clinic, we always discuss money and service. There is no doubt that money is important but it is not everything. For doctors and other medical practitioners, the quality of service matters much.

Government Scholarship

During my student days, there used to be a practice to provide government scholarships to the top students. The scholarships were based on merit. Had not to merit followed, it would not have been possible for me to be nominated to pursue medical education in China. I secured the top 3 positions in the ISC examination from Tri-Chandra College. I was selected for the scholarship due to my score and division. Had I completed my education at present, I would not be a doctor. There is no guarantee that top can get the scholarship. Although I was active in student politics and was arrested many times during the student demonstrations, my student politics had nothing to do with my merit-based scholarship. The Panchayat regime had many bad things but its merit-based selection criteria for the scholarship were exemplary. I did reject two scholarships but I got one of my choices. I don’t think that kind of merit-based selection is possible now.

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Journey To Gangalal

I returned in 1997 after completing my master’s degree. I joined TU Teaching Hospital and worked there till 1998. Although Gangalal was established in 1995 in the paper, there were no doctors and other staff. During that period, Nepal had few senior doctors who specialized in the heart. Dominated by senior doctors who were either in government jobs or retired, I was the first young doctor with cardiac specialization. I joined the Gangalal in 1998 and served there for around 21 years. I was appointed as director of the hospital in 2068 Baisakh and my tenure was completed at the end of Shrawan of 2072. I left the hospital in 2075, Ashadh.

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Old Mindset

When I returned to Nepal, the medical field was dominated by Russian returnees. However, the medical doctors who had studied in other countries always expressed doubt about the quality of Russian Education. They do have similar kinds of doubt to Chinese Universities as well. Knowing this mindset of Kathmandu, I did a lot of study in China to make me more competitive. I don’t know much about Russian universities but Chinese Universities offer world-class medical education. The only difference was that I studied Chinese. My hard work and university education paid off when I started to work in Nepal. I am happy to say that the strength of Gangalal is the doctors who returned from China. The current director Dr. Chandramani Adhiakri also completed a master's from a Chinese University. There are more than dozens of doctors who graduated from Chinese University working in Gangalal as strength.

Institutionalization of Gangalal

When I joined Gangalal Hospital in 1998, cardiac services were available in a few hospitals. There was limited service in TUTH and Bir Hospital. In the private sector, only Norvic has limited treatment facilities. There were limited numbers of doctors so as the service, technology. Everything was limited. Those who had financial capacity went to India. For the poor, there were no options. When I joined Gangalal, everything was empty and we started the hospital from the scratch. I had started ward, OPD from zero. Slowly and steadily, other doctors were added. We were young and enthusiastic about the skills acquired from foreign countries. We had a strong feeling to do something in the country. Because of our enthusiasm, I used to spend most of my time in the hospital. Out of my 22 years of service, I entered the hospital at 6:45 and worked there till 8 PM. My views may be unbelievable to the people now. What I am saying is the reality of our life. I had never turned to the clock whether it was day or night. I provided the service round the clock. Out of 22 years in my career, I did not take 20 days of leave due to my individual work. I might have taken leave for official work, seminars and other things. To bring Gangalal into the present shape and fame, not only me, dozens of doctors, medical staff and other employees also have equally sacrificed their time and offered their devotion. In extreme, I did not attend Nwaran (the cultural rituals performed 11 days after a baby's birth like a baptism of a new baby). During the Nwaran of my elder daughter, we were the only two in the hospital to run OPD and other services. Although there were a few more doctors in the Nwaran of my second daughter, I did not find another one to replace my work. Had I attended the Nwaran, the patients would have suffered. As a doctor, I chose my professional ethics to provide treatment to the patient. Such kind of our devotion brought Gangalal into the present shape. For the young people, my statement is like Dantyakatha (stories) or unbelievable story. We are all young doctors who devoted our time to the hospital. In the early days when we joined the profession, we were nowhere and we were unknown to society and people. Even some senior doctors suspected our quality of service. Given the time, such suspicions were natural. However, we proved what we were doing was absolutely right through our qualifications, devotion and hard work. We also proved that we provide quality service. The current status of Gangalal also tells this. Although it was started in 1998, the hospital was capable to provide full-fledged heart service in Nepal since 2008. Gangalal has now all the treatment facilities available in the world. Similarly, the hospital has been providing world-standard cardiac treatment at home.

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Family And Profession

I have never forced my children to do this or not to do that. However, my elder daughter Shiwami K.C., 22, has decided to follow me and she is now studying MBBS at Kist Medical College. She is now a third-year student. Although second daughter Omisha KC, 18, is undecided, she is also preparing for the MBBS entrance examination. One needs to spend 12-15 years to complete up to specialized courses in medicine. She sometimes asks me when one can enjoy life if he or she spends such a long period in studies. My answer to the daughter is don’t study it if you think so. However, many surrounding factors including a study by her own sister are luring her into medical education. She is now preparing half-heartedly because of me and her elder sister; she is showing interest in the medical profession. This is a very difficult profession as one has to give up family and personal life. However, there is also a matter of satisfaction when you save the life of people and provide medical treatment for needy people. I actually discouraged my elder daughter saying that medical study is time-consuming and hard to make a career for girls. I also give a successful example of Dr. Sudha Sharma's how to make a career in medicine. My elder daughter decided to join medicine and she is pursuing MBBS in her third year.

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Family time

For a successful career, family support is important. I am fortunate to marry Sarala Bohara who has supported me all the time to pursue my medical career. She understands my profession and service. She completely took control of household matters allowing me to pursue my medical career. My spouse has played an important role to make me successful. As I have mentioned to you, the profession of medical doctors requires more devotion to the needy patient. Of course, I have also family and I have a responsibility toward them. However, I give priority on the basis of needs. For instance, I prefer to go to the hospital if the patient desperately requires my presence and my support can save his life. When I have to choose my time for a family’s pleasure trip or saving the life of a patient, I will prefer the hospital. Despite some complaints from my daughters and wife, I am fortunate enough to say that my wife and daughters understand my professional obligation. My two daughters also understand my professional responsibility. Given my busy schedule at work, they certainly have grievances about not finding enough time to spare and play with me. However, they are so supportive and cooperative that they have never interfered with my professional work. Without the support of my wife and two daughters, it is not possible for me to devote my time to the profession.

Pioneering Work

Dr. KC has made pioneering work in cardiac interventional electrophysiology. For his contribution in the work, he was decorated with the Young Scientist Award by NAST in 2006.

I am very proud to say that my younger colleague Dr. Roshan Raut is emerging as a world-class doctor in cardiac rhythmic treatment. He also asked me the same question about the role of my wife. I have to accept my personal weakness not giving enough time to my family. Nowadays, I have started to spend my time with my family.

Remembering Parents

As I left the village following SLC, my encounter with my mother and father was rare. I visited my village for just a few days since completing school. For decades, I did not have physical contact with my parents because I was in China. After I started my medical career, my parents came to stay at my home. As I mentioned, I did spend a little time with them. We still are in an extended family. Out of four brothers, one brother died and we are three now. I am the elder one. My middle and last brother are now living in Butwal. In the last days of their life, my mother and father lived with me. My father died in front of me in 2073. After the death of my father, my mother also started to live with me. However, she insisted to go back to the village and she died while in the village in 2075.

Son of A Farmer

I prefer to say that I am the son of a farmer in a remote part of Nepal. To compete in the sector which is mostly dominated by offspring of the urban elite is out of imagination for me. I studied hard and secured good marks enough to select for the government scholarship to pursue medical education in China. I am fortunate to be a batch of students who got a government scholarship to pursue medicine. I carried a spirit and commitment from my village to do something for the nation and society. What I have fulfilled was my aspiration from village days to contribute something to the nation and society. I am still doing it. Frankly speaking, I always believed Gangalal was more important than my own personal property and personal life. With that spirit, I contributed all my young life to Gangalal. I feel proud of this mission. We contributed to establishing Gangalal and Gangalal supported us to get the present fame and status.

Reform in Gangalal

I took several reforms during my tenure as a director in the hospital including the improvement of the physical infrastructure, incentives for human resources and technology for the treatment. I also worked for the financial benefit of the employees of Gangalal and the improvement of the quality of medical services. I took the issues to provide incentives to anesthetists, surgeons and other supporting staff. For them, the government salary is the only way out. Given the pathetic financial situation, I pursued the proposal for the need for incentives for those staff. For the surgeon, it is always a hard job. He or she has to reach the hospital early in the morning on a day of surgery and needs to stay at the hospital till late. If surgeries develop complications, the surgeon needs to spend overnight in the hospital. As soon as I was appointed a director, I took the issue of incentives in the Ministry of Health. After analysis of our points, the ministry agreed to provide incentives to the surgeon. I introduced the performance audit-based incentives to the surgeon and other support staff with a hard lobby. Despite working in government hospitals, the surgeons are getting a good amount of incentives. Thanks to these incentives, the hospital is able to keep the surgeon to sustain the surgery in Gangalal. I also introduced incentives to the nursing staff. Although the average salary of nursing staff is lower all over Nepal, the nurses working in Gangalal draw the highest salary. In terms of degree holders, Gangalal is at the forefront to have nurses with a higher degree. I have also worked to provide incentives to administrative staff as well.

Although I have changed my schedule after resigning from the hospital, my choice is patient even now. I know my family may complain about my decision. I choose the profession knowing that one has to sacrifice personal life before the profession.

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Serving Politicians

From his student days, Dr. KC has been active in politics as an active member of the Nepal Students Union, a sister organization of the Nepali Congress. Affiliated with Nepali Congress, Dr. KC has a long leaning with Nepali Congress and Nepali Congress leaders.

He served as a personal physician of Nepali Congress leaders Girija Prasad Koirala and Sushil Koirala. His patients include the vice president of the Nepali Congress Purna Bahadur Khadka.

Dr. KC is a familiar name among the congress leaders who visit him and recommend his name for the treatment. He was the last doctor who visited Girija Prasad Koirala before his death. Similarly, Sushil Koirala visited him in hospital a week before his death.

He knows ins and outs of most Congress politicians and they also treat him as near and dear. It may sound strange. However, Dr. KC was appointed as director of the Gangalal Hospital during the tenure of Maoist leader Krishna Bahadur Mahara as Minister of Health and Population. The basis of his appointment as a managing director is merit and seniority.

At a time when there is a rush among medical doctors to secure public positions using personal influence, what Dr. KC believes is hard work, devotion, merit and qualification.

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