22-28 July 2016 #818

Kleptocracy kills

The lethal politics of an ailing nation.

The health of a nation is often judged by the quality and reach of its health service. Healthcare in Nepal has become a political hot potato because, as with every arena of public life, the fox is guarding the chicken coop. Health is such a lucrative business that businessmen and their political patrons in government and the legislature have investments in private hospitals and the profitable medical education sector. Naturally, they are against any attempt to regulate private healthcare.

The rot is so ingrained that the Minister of Health and the State Minister of Health and Population —  who are both from Tarai districts with abysmal statistics for the physical wellbeing of citizens — have been blatantly demanding kickbacks from the poor. With the clock ticking on their time in office, last week they openly asked for kickbacks of up to 50 per cent in return for approval of annual government grants that 23 community hospitals across rural Nepal are entitled to (see page 13).

Corruption has corroded every facet of governance, but it is when it afflicts healthcare that kleptocracy kills. Stealing money from hospitals is akin to murder. Outraged by all this, Nepal’s Gandhian physician, Govinda KC, has been on a lifelong crusade to make healthcare affordable and accessible to Nepal’s 30 million people. On Friday he is on the thirteenth day of his eighth hunger strike, with a list of longstanding demands that have either been ignored or only partially fulfilled after previous satyagrahas.

Needless to say, the medical mafia and its political comrades-in-crime have been trying their best to discredit him and obstruct his fast at the Tribhuvan University Teaching Hospital, and have even gone as far as to try to deprive the frail KC of medical attention. It is ironical that top political leaders who have visited the Federal Alliance ‘hunger’ strikers at Tundikhel do not have the intestinal fortitude to call on KC, to show concern for a doctor who is risking his life for the people. 

Unfortunately, this time KC’s fast coincides with a power struggle that threatens to bring down the coalition of Prime Minister KP Oli of the UML. And since UML politicians and cronies have the biggest investments in the private medical industry, Oli has an excuse not to do anything, because he is ostensibly a lame duck. Even without KC’s hunger strike, the ongoing regime change drama has serious consequences for the budget, the constitution and the inclusion of Madhesi and Janajati concerns, as well as for Nepal’s geopolitical equilibrium. Our only hope was in the legislature, but parliamentarians are behaving like flailing tentacles of the political cartel sucking the blood of Nepalis.

It is clear that the deathly silence of the politicians is due not just to their business interests in the medical sector, but also the fear of reprisals from Lokman Singh Karki, the dreaded head of the Commission for the Investigation of Abuse of Authority (CIAA), which has itself become the biggest abuser of authority in the land. Even during his fifth fast two years ago, KC had demanded that Karki and another Commissioner be removed for obstructing reforms in the medical sector because of their vested interests.

The CIAA is still at it: it has overstepped its mandate in order to protect the family-business ties of its commissioners in the medical sector, it brazenly interfered with the Kathmandu University School of Medicine, and it has tried to influence the licensing of new medical colleges, forcing out functionaries of the Institute of Medicine who stood in the way.

Nepal is run by a syndicate of tainted politicians who are in cahoots with cartels in health, education, transportation, food supply, tourism — you name it. They are not here to serve the people but to steal from them. The tragedy is that they have infiltrated Parliament through nominees in the proportional representation quota, perpetuating their profiteering by passing laws that benefit them. 

The Health Bill passed last week does not even begin to address the demands of Govinda KC and other advocates of a rights-based approach to health care over the past years. Members of the Social Justice and Human Rights Committee of parliament finally visited KC in hospital on Tuesday, but UML members were conspicuous by their absence. 

Read also:

Free-for-all healthcare, Duncan Maru and Roshan Bista

In rural Nepal, health is about more than the body, RAMAYATA LIMBU

Turth be told, Bidhusi Dhungel

Why some doctors stay and others go away, Nepali Times