Miscellaneous
Going it alone
Dr Govinda KC circles back to his pet issue. He always does. He is seated in his out-patient department cubicleManish Gautam
Mostly a mild-mannered speaker, when KC starts talking about how medical universities are being run in Nepal—how they are being granted affiliations to run classes and how the selection process for who gets to run the medical colleges are being made—he gets riled up. He speaks in rapid sentences, his voice gets louder and the furrows on his forehead start to deepen.
He knows just talking about the problem will not bring about change. So just as he has done in the past, he will soon be staging a hunger strike again, in a little over a week, if the government does not heed his demands. He will be back on his lone crusade to bring about change in the medical fraternity.
Dr KC’s transformation from a practicing doctor into a doctor-activist began around four years ago. In March of 2010, the country witnessed a protest at TUTH, Maharajgunj, regarding irregularities in the conducting of its entrance exams. On March 13 and 14, the Institute of Medicine (IoM) at TUTH had conducted an entrance exam for post-graduate applicants, the questions for which had already been leaked. Along with students and doctors, Dr KC took to the streets demanding that the institute look into the matter; TUTH was consequently closed for 19 days. Following a directive given by the apex court to the government and the hospital to investigate the issue, a committee—spearheaded by former secretary Jay Ram Giri—submitted a report two months later, which explored these irregularities and also recommended punishments to be meted out. However, till date, no one has been booked.
It is because the government has never kept its word on such issues that Dr KC decided to switch tactics: from staging rallies to going it alone. Hungry. On May 14, 2012, KC staged his first hunger strike, demanding an end to the longstanding practice of political appointments being made at universities. It is a demand that he stuck to in the three hunger strikes he subsequently staged. On July 6 of the same year, he resorted to staging a strike again, which ended when Dr Prakash Sayami, a veteran surgeon, was appointed as the dean of the IoM, in a move that was seen by many as finally putting an end to TU’s making political appointment at the IoM.
But Dr Sayami was forced to resign a year into his tenure because he was unable to withstand the pressure brought to bear by lobbyists seeking affiliations for various medical colleges. Dr KC countered in 2014 with two hunger strikes. He ended his 14-day strike on January 24 after a four-member government taskforce, headed by the then Secretary at Prime Minister’s Office Krishna Hari Baskota, assured him that his demands would be addressed at the earliest. The government team said that they would conduct a feasibility study on providing autonomy to the IoM, stop handing out affiliations to new medical colleges and set up a mechanism to appoint a new dean on the basis of seniority and work experience, as demanded by Dr KC. But because the government kept dragging its feet, Dr KC once again resorted to staging a hunger strike on February 8, which ended in seven days.
But even this protest was not enough to nudge the government into action. The teams formed by the government did complete the study, but the government still hasn’t implemented the proposals of the study, which, among other demands, called for the building of a new university to hand out affiliations to new medical colleges.
That is why, Dr KC says, he is readying to strike again. It takes much conviction to
keep taking on a government that will not keep its word. What is it that drives KC?
“It all boils down to ethics,” says KC. “The medical fraternity must be represented by the best that the field produces. Appointing people on the basis of political connections, rather than performance and seniority, is unethical. So is handing out affiliations to institutions that do not have the wherewithal to produce doctors of an acceptable quality”.
The people he is taking on, however, will not back down either. They have no reason to. Medical colleges, once they garner the coveted affiliation, make for great businesses. On average, they charge around Rs 4.5 million per student for an MBBS degree, and in as little as four or five years a new medical college can recoup its investment.
For the owners of new medical colleges, greasing the palms of the officials in government, even if they have to fork out crores in the process, is seen as an investment well made. KC is appalled by this culture of corruption. He is also of the opinion that IoM, with the capacity it now has, cannot oversee the running of the medical education sector. That is why he has been calling for the creation of a new, professionally run umbrella body that will give affiliations to medical colleges that meets its standard. But his opponents think otherwise, and thus the standoff, which eventually leads to the hunger strikes.
But then there is the issue of the patients’ suffering whenever KC’s strike starts. Every time Dr KC goes on a hunger strike, TUTH first gets closed down and the other hospitals around the country follow suit. Such closures affect over 2,000 patients who come to TUTH to avail of its services. Furthermore, the closure of hospitals is illegal as defined by law.
So are all these closures worth the fight?
“His demands are genuine,” says a senior doctor at TUTH, who requests anonymity because he doesn’t want to be dragged into the controversy. “But how many times a year should we shut down the hospitals? This year alone, we have shut down two times. And now again if we close the gates, we should be prepared for public outrage.”
But Dr KC will not be cowed down by such rebuttals. “One, I have never asked my friends to shut down the hospitals and I actually don’t like it when that happens,” says Dr KC. “And two, the onus lies on the government to keep their promises. When they don’t, of course, this is the only recourse left to those in the medical establishment who would like to root out our culture of corruption.”