Over 95 percent private hospitals in the country are found to be operating out of rented residential buildings that have no proper patient safety measures. Nor are the facilities equipped to withstand disasters like earthquake and fire, and to handle patient flow caused by such disasters and disease outbreaks.

The Association of Private Health Institutions of Nepal (APHIN), an umbrella organisation of private hospital operators, had signed a memorandum with the Ministry of Health and Population in 2013. The organisation had committed to shifting the health facilities out of the rented buildings onto purpose-built structures.

Kumar Thapa, senior deputy chairman of PHIC, said his association will request an extension of the 2018-19 deadline for moving the hospitals to buildings with safer physical infrastructure. “We had asked for a 10-year deadline but the ministry awarded only six. We are now seeking an extension of the deadline,” Thapa told the Post.

He cited reasons such as the 2015 earthquake and India’s economic blockade that followed for the delay.

Curative Service Division (CSD) of the Department of Health Services, which monitored private hospitals in Kathmandu Valley and Chitwan, said the physical infrastructure of private hospitals does not support smooth operation of the facilities.

“Buildings that are currently being used by private hospitals were built many years ago and do not meet the basic criteria as they aren’t equipped with emergency entry and exit points, fire escapes, and waiting areas, among others,” Dr Manisha Rawal, the CSD director, told the Post.  The division monitored hospitals and nursing homes with 50 to 200 beds, which fall under the division’s jurisdiction.

Of the 83 private hospitals in the capacity range, 36 are operating in the Kathmandu Valley, 12 in Chitwan district, and others are spread across the provinces. According to Rawal, a few hospitals informed the inspection team that they have acquired land in order to build the hospitals. But over 70 percent hospitals are yet to shift to safer buildings.

The CSD also monitored hospital equipment, manpower, hospital waste management, power back-up, operation theatres and emergency wards. CSD Deputy Health Administrator Dr Arjun Sapkota said that a majority of private hospitals lack the required human resource.

“Most hospitals hire doctors on a part-time basis, and do not have the provision of assigning one nurse per bed in the intensive care unit. Most nursing staff are forced to work overtime in the absence of enough personnel,” said Sapkota.

Most hospitals are also found to be lacking in hazardous waste management system. The inspection team found that most hospitals do segregate hospital waste but the waste is then sent to private companies for management, where household waste is mixed up with the hospital waste. When hazardous waste produced from hospitals is left untreated, chances of infection spreading in communities are high.