Health is a birthright of the Nepali people. The government has grand designs for building major and minor hospitals all over the country and encouraging the training of human resources for health (HRH). But is there something amiss? The buildings have not been built; much of the equipment is in storage, some still unpacked and others non-functional - broken down! The much hyped insurance scheme is not working because of various setbacks! One suspects that all this intentional to benefit someone in the shadows.
Following the end of World War II many Jewish citizens of the then USSR wanted to immigrate to Israel. The authorities of USSR demanded payments for the education and training of these citizens wanting to go and leave their then Motherland as new citizens. Years later, when a large number of Indians left India for foreign shores then PM Indira Gandhi was upset. Seeing such numbers of intellectual work force leaving India for foreign shores, and as the home country had spent much on their training she felt it was very unjust. She suggested that the benefitting countries should compensate developing countries such as India for the manpower going there. I am not aware if this was done.
I remember a WHO nursing section head at Geneva remarking to me that the Philippino nurses were welcome in the US because of their command of the English language. There was at that time a current saying, ‘The cheapest medical school of the USA is in the Philippines!’ In this context I also remember a Saudi Arabian doctor remarking to me about forty years ago that it was far more economical for Saudi Arabia to hire doctors and other technicians from foreign lands than to train them within the country. This policy however was changed later as this individual became the first Dean of the medical school set up in the country!
The Institute of Medicine (IoM) has just celebrated the 50th Anniversary of its establishment. When the MBBS course was started there, many of its distracters stated that the products of this institution’s Community Oriented Course would be substandard and graduates would not be welcome elsewhere. During the course of fifty years IoM has gone from strength to strength and currently runs 57 courses in various disciplines. Large numbers of doctors, dental surgeons, pharmacists, nurses and other technical personnel produced by IoM and its affiliated campuses are scattered across the country and serving the nation. The students who study on government scholarships or grants have to serve the country for specific periods of time before they can depart for good from Nepal, to work in foreign lands. Nepali nurses too have been going to different lands to serve. Understandably, those who have studied at their own expenses, prepare at the earliest for USMLE, PLAB and various other tests to go abroad. Such individuals consider that it is their right as they have financed themselves from primary school to university level with their own resources.
Initially, Britain gave Nepal funds for building the Tri-Chandra Hospital in appreciation for services rendered by the military. Whether money is paid for recruitment of Gurkhas, I do not know. However Gurkha soldiers are still asking for similar service terms for Nepali citizens serving in the British Army. The recruitment of Gurkhas has had some changes over the years but still more needs to be done. Those serving in the British or Indian Army get a pension at the end of their services plus also health facilities for themselves and their families.
The British Government has recently signed an agreement for enable Nepali nurses to go and work in the U.K. Other categories of HRH may also be able to do so in later years. Taking it however on a broader perspective one can state that the developed countries, to which our doctors, dental surgeons, nurses and technicians head to, should pay to Nepal a certain designated sum for each individual going to these foreign shores. If this is not done the vast amount of aid given to Nepal, now on the verge of becoming a ‘Developing country’, has no meaning.
We in Nepal, once termed a ‘Least Developed Country’ have been helped by foreign support. But giving by one hand and taking away by another our trained manpower is not correct and so some method of compensation should be worked out to correct this anomaly. Taking away trained technical workforce, albeit at financial benefit to them though a likely outcome also demands that some form of compensation be done by the country benefitting. Justice demands that such medical hypocrisy be corrected!
America has aided Nepal by giving refugee status to about a lakh of Bhutanese citizens of Nepali origin who were languishing for almost ten years and allowing them to start a new life in the US. After the earthquake of 2015 a number went on temporary visas and gained some support. Finally there are also a number of Nepalis who have struck lucky in the DVA program and have gone there. To really help Nepal, I suggest therefore that for every doctor, dental surgeon, nurse or other technical persons who take up American or other country citizenship, the concerned country should pay a certain levy to us in Nepal. After all, these countries are going to benefit from the services of people who were formerly Nepalis. This certainly is a more rational form of compensation to a developing country such as Nepal for our citizens who they have been attracted to their land!
As stated in our Parliament, it is nice to know that the Education Ministry is seriously considering the application of the proposed Khopna Medical College with proposed ceiling of 15 lakhs for its medical course. We could be producing human resources for health (HRH), not only for ourselves but for the world. However the world should also compensate us for our expenditure on producing HRH so that we can continue to serve humanity as a whole.
The author is a retired medical doctor and writes fiction under the pen name of Mani Dixit also. Website: www.hdixit.org.np. Twitter: @manidixithd