Despite the spread of new hospitals in towns across Nepal, doctors are still reluctant to serve in remote areas. The newly established Patan Academy of Health Sciences (PAHS) aims to change all that by training doctors who are committed to working in the districts.
The retention of doctors, especially in government hospitals in rural areas, has always been a problem in Nepal, and PAHS aims to change that by making a paradigm shift in medical school philosophy, a part of its curriculum.
"We have a clear mission to extend health care to people outside the Valley," says Arjun Karki, founder and vice chancellor of PAHS, "we select students by assessing their academic ability and humanistic qualities."
In this year's batch of pioneer students, for instance, 60 per cent of those enrolled are from underprivileged families. Their scholarships require them to work for two to four years in rural areas. If they don't, they won't get to graduate. The remaining 40 per cent are not obliged to go, but Karki hopes they will.
The students will be posted to remote area hospitals every six months for two weeks each so they get over their fear of the unknown, and get to see how they can make a difference right from the start of their training.
"We want to produce health care personnel with a social responsibility and a keen desire to work in remote areas," says Karki, "we want to help strengthen the national health system, but not create a parallel structure to the Ministry of the Health."
This year, PAHS selected 60 of the finest medical students from over 2,000 applicants, focusing on a holistic model that emphasised personal qualities that could potentially change attitudes in health care workers. The idea was to ensure that more compassionate and empathetic physicians will enter the public health system.
The students will face their first real test when they're posted as interns in rural hospitals as part of the course. "The hidden objective is to expose them to the disparity of opportunity and health care in this country," says Karki.
Nepal's private and government medical schools produce 1,500 doctors each year, but half of them migrate overseas and the ones that stay in Nepal choose to work in urban areas.
The six-year PAHS program will try to change this and more importantly combat the two-decade difference in life expectancy between people living in Kathmandu and those in remote districts like Mugu.
PAHS will also work on improving public health through awareness about communicable diseases in remote areas through their doctor placements. Karki adds: "Until people are prosperous and have the means to find a way out of the poverty cycle, people will be vulnerable to diseases.''
Telemedicine is about to take off in a big way with Patan Hospital and its affiliated Patan Academy of Health Sciences implementing a program to help in the diagnosis and care of patients in remote areas via the Internet. PAHS hopes that its interns and graduates will also be able to refer patients to Patan when they are placed in remote parts of the country. Patan already has five doctors assisting district hospitals with feedback on patients.
Telemedicine is already working through a prototype in 20 villages in Myagdi, Kaski and Parbat districts conducted by Nepal Wireless Network Project, a brainchild of Mahabir Pun. The project has also been extended to Makwanpur, Palpa and Dolakha. Doctors at the Model Hospital in Kathmandu regularly consult patients and health workers at the Gaurishankhar Hospital in Dolakha via webcam.
The Indian government announced this week that it would help Nepal with a Rs 30 million telemedicine project that will allow Nepali doctors to refer cases via the Internet to medical facilities in India.