Tuesday, November 13, 2012

Protests at Patan Hospital

We have heard of the King Midas from Greek mythology. The one endowed with the Midas touch. Everything he touched turned into gold. Whatever the long-term implications were, the power was a reward Midas had asked for. In an instant, he could turn anything into coveted gold. 
 
What if you had the same power, but this time you were able to turn things into disarray? More like Tony Soprano from the television show Sopranos: I'm like King Midas in reverse, here. Everything I touch turns to shit.
 
Unfortunately, our current political system exhibits Tony Soprano characteristics in abundance. Here is an example:
 
Patan Hospital has a lot of desirable things. In this hospital, if you go to the emergency room sick, you are guaranteed a treatment whether you can afford it or not. Unlike other hospitals in Kathmandu, you are not asked to go buy everything before you can get treatment. It is the same in the wards too for the most essential stuff. You are billed at the end. If you cannot pay, social services department generally helps. In this way, they have been able to care for many sick patients who would otherwise have difficulty elsewhere.
 
They have been able to do this by faithfully abiding to the core principles they agreed upon at the outset: to take care of the patients regardless of their ability to pay. This conviction forms the spirit of the institution and people ascribing to it work together to achieve the goal.
 
The hospital as it stands now is a legacy of Christian missionaries' charity work.  It started as a clinic in 1950s gradually evolving into the current ~400 bed hospital. It is surmisable how much of hard work and sacrifices must have gone into establishing a non-profit organization serving poors. Expanding on its role in training health care personnels, Patan Academy of Health Sciences (PAHS) was established in 2008. While managed earlier by United Missions to Nepal (UMN), currently, Patan Hospital is administered by a board and PAHS is an autonomous public institution whose vice-chancellor is appointed by the Prime Minister of Nepal.
 
I joined PAHS just about the time the tenure of founding vice-chancellor was ending. There were small squirmishes between the administration and the hospital unions regarding salaries and benefits. It did not bother me much. I found a core group of people who were selflessly dedicated to the institution. It was wonderful working with them, bound by common aspiration to serve and better the institution. "Espirit de Corps," one of my colleagues used to say when we were discussing some changes that would be difficult. It was during this excitement that I left the country for nearly one and a half month. A new vice-chancellor had  just been appointed at that time. Folks were not excited about her but I did not hear any outright opposition. 
 
When I returned, I was shocked by what I saw. Almost everyone was against the new vice-chancellor. They wanted her to go away at any cost. And for that, they had ample reasons. 

Allegations were flabbergasting. Bypassing the executive committee, she single-handedly appointed a friend from outside institution as the Rector and informed only after the appointment while there were much more qualified persons within who understood the missions and goals of the institution better. She was disparaging to the people who have worked numerous years designing a novel curriculum and selection process for MBBS students geared towards producing doctors for rural community. Ignoring the established tradition of group work and raising a suspicion about her motives, she decided to centralize all procurement decisions to herself. She went to the senate with a proposition to centralize all the power to her without consulting with the executive committee (which was rejected by the senate). She lies, speaks disrespecfully to the officials, teachers and students of the institution. 

The hospital is in protests now. So far, clinical services have not been interrupted much. Vice-chancellor is not allowed within the premises: protestors stay at the gate from 8am to 4pm. Her office has been padlocked several times. We see riot police in our hospital premises, clad with riot gear. Some of our students have received baton charged already when trying to padlock vice-chancellor's office. Protests are bound to grow. I see interruption of non-emergency services coming. From what I understand, vice-chancellor has got to go.
 
Why did this happen? When my colleagues went to the Prime Minister, they were convincingly told how he had caved in to the complexities of maintaining a coalition during this political transition. He assured them he knows Patan Hospital is a different institution. That's why he even held signing the name recommended by the selection committee for 2 whole weeks. But he did not hear anything from Patan Hospital so he went ahead and signed. They were tremendously impressed by how attentively he listened and empathized with them. Had Patan Hospital lobbied for someone, would this situation have been averted?
 
The inside story of the appointment, which I tend to believe is this: The vice-chancellor is politician Sarat Singh Bhandari's relation. It was by political lobbying through him that she got the post. It is for sure, she was not given the position because of her credentials. And it is increasingly clear she has no skills to hold a leadership position.
 
I go to hospital searching the excitement I left with. Everything is at standstill. When the clinic is closed from 10-11am, I join the protests with my colleagues, hospital staff and students. Many of them are animated and excited. I have no doubt they are excited for the cause. But I can't avoid thinking, how much the fact that they don't have to work during that time is responsible. A look at similar other public institutions where protests like this are commonplace offers no solace.
 
We have been given a Tony Soprano. I still subscribe to goodness in people and believe that this blatantly unqualified vice-chancellor will be removed sooner or later. My worry is how much damage the whole exercise would have inflicted upon the institution by then; and will it be able to pick up from the place where it left?

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