Deaths that could have been prevented

KATHMANDU, Nov 14: A man died due to lack of ventilator at Bir Hospital Monday evening.

Lambari Pandit, 35, had been taken to the emergency ward of Bir at six in the evening for treatment of head injury. CT (computed tomography) scan showed blood clots in his brain which had to be removed surgically. However, no surgery could be performed as the hospital lacked ventilator. He breathed his last even as his panicky family was exploring other options for treatment in the valley.

Similarly, United Communist Party of Nepal (Maoist) lawmaker Ram Kumari Yadav suffered severe burns after a fire in her kitchen on August 13 following a gas cylinder leakage and breathed her last in New Delhi, India a day after being taken there on an air ambulance.

Yadav and Pandit could well have been saved if the trauma center at Bir were in operation. But the center, which could have come to use by the end of 2008 and prevented many such deaths, has yet to come into operation, thanks to government lethargy.

Construction of the trauma center was completed by the Indian government at the cost of Rs 1.5 billion in August, 2008.

The Indian government has not installed medical equipments and the selection of doctors and other staff, who will be handling the equipment, has not been done. They would need to be trained for around three months in India before the center comes into operation.

“A service commission has been formed and the process to recruit staff is underway,” Vice-chancellor of the National Academy of Medical Sciences (NAMS) Dr Damodar Pokhrel said. Dr Pokhrel said NAMS would utilize the existing work force at Bir and also make fresh recruitment. “There will be a phase-wise recruitment of staffers that would continue for some time,” he added.

“If everything goes smoothly, we can bring the trauma center at Bir Hospital into operation in about 8-9 months.” - Dr Damodar Pokhrel
He revealed that the Indian government has started the tender process for furniture and equipment for the center in India. The Indian government is also concerned about the high maintenance cost of the center, whose operation cost is estimated at around Rs 3,000 per bed per day, and wants Nepal to formulate a long-term maintenance strategy for the center.

“Bir Hospital has been providing free treatment for accident victims till now. We have not decided whether to continue the practice or keep a private ward. We will discuss the issue with the government,” he said. “We want to at least provide free treatment for the day the patients are brought here,” he said.

Trauma -- road accidents, burns, falls, assaults and other sudden musculoskeletal injuries -- has internationally been claimed to be a leading cause of deaths under the age of 40. A trauma center provides complex, multi-disciplinary treatment, including neurosurgery and orthopedic surgery in order to give victims the best possible chance of survival and recovery.

Hundreds die of trauma in Nepal every year and most of such deaths could be prevented by the 200-bed modern trauma center. “We can prevent around 50% of accident deaths, if the patients arrive on time,” Dr Pokhrel claimed. But that doesn´t seem to be happening anytime soon. “If everything goes smoothly, we can start the center in about 8-9 months,” was the most Pokhrel could assure.

The 17,914 square-meter facility has five operation theaters, a library, a conference hall, separate rest and recreation rooms for doctors, nurses and paramedics and three cafeterias apart from 200 beds, and will require a staff of around 500 including doctors.

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