Patients suffer as hospitals run out of critical care facilities

KATHMANDU, Nov 11: Lack of adequate critical care facilities at hospitals in the capital has hit the patients hard.

Lambari Pandit, 35, died due to lack of ventilator at the Bir Hospital Monday evening. CT (computed tomography) scan showed blood clots in Pandit´s head which had to be removed surgically.

However, he succumbed to death even as his panicky family was enquiring about availability of the facility in other hospitals.

“We need around 200 Intensive Care Units (ICU) in the valley alone. But there are just around 50 including those at the private hospitals,” said President of Nepal Medical Association (NMA) Dr Kedar Narsingh KC. “I receive at least two-three calls from my friends and acquaintances seeking information about availability of ICU facilities daily,” Dr KC added.

There are only five ICUs each in government hospitals like Bir, Tribhuvan University Teaching Hospital (TUTH), Patan and Kanti while private hospitals like Om, B&B, Norvic, Medicare and Kathmandu Medical College also do not have more than 10 such units. Life Care Hospital in Sundhara has the most ICUs at 12.

Ventilator and cardiac monitor, costing around Rs 1.5 million each, are basic equipment for an ICU but ICUs at some hospitals don´t have them. Private hospitals generally don´t have the necessary specialists to run their ICUs while the big government hospitals have few ICUs even though they have enough doctors to run more units.

Head of the Anaesthesia Department at Bir Dr Brahma Dev Jha claimed equipment enough to run 10 more ICUs remain unused at the hospital.

The ICUs with ventilator at government hospitals remain occupied all the time as a patient generally has to stay in ICU for around two weeks. A patient receiving treatment in ICU is charged anything from Rs 1,500 to 3,000 per day.

Chief of the emergency ward at Bir Dr DP Singh claimed that private hospitals refuse to admit critical patients and refer them to government hospitals. The fact that the relatives of patients who lose their lives have turned hostile in the recent past has also made private hospitals reluctant to admit critical patients. Bir and TUTH have to return at least a couple of patients in need of intensive care daily.

The patients have to pay exorbitant fees for ICU facilities at private hospitals. Shanta Chapagain, who was referred to Kathmandu from Dang following a motorcycle accident, had to be kept at Life Care Hospital after failing to find vacant units at any other hospitals. Her life was saved but her son Arun had to cough up around Rs 700,000 for the two weeks at the hospital.

“There aren´t enough ICUs at government hospitals. To keep a person at the ICU in a private hospital means paying around Rs 50,000 daily in name of medicines and other facilities,” NMA President Dr KC stated. “There is no monitoring and the government has also not paid attention to expanding critical care facilities at public hospitals,” Dr KC added.

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