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The decision to provide free health service was a hasty one, taken without assessing support services, manpower and infrastructure, especially in remote districts. The government provides essential medicines to health centres and posts and an additional grant of Rs 6,000- 42,000 to buy the rest. Organisations like INF, UMN, GTZ and UNICEF also provide support for medicine in the Karnali. However, health posts here have medicines only for fever and headaches.
There is no zonal hospital in the Karnali. The posts of the health-workers are vacant in all the five district hospitals. Three doctors have been appointed to the Jumla District Hospital, but only one is working. The hospital has provisions for six staff nurses but there are only four. Lab assistants and radiographers don't exist.
In Dolpa there are positions for public health officer, medical superintendent, doctors, staff nurses, family planning assistant, assistant statistician, dark room assistant and assistant administrator, but none of them are filled.
Among the 14 sub-health posts of the district, four do not have assistant health workers. Kalikot District Hospital does not have a health education specialist or even a lab technician. The situation is worse in villages-the primary health centre in Kopal village has neither a doctor nor a nurse, an assistant health worker is running the place. In Chilkhaya, even the assistant's position is vacant.
