KATHMANDU: Nepal is likely to face a critical shortage of doctors due to medical brain-drain out of the country. The drain is fuelled by the government inability to attract doctors through salary and perks.

Disatisfied with the salary and perks, a physician in the capital's Bir Hospital is packing off to the Philippines.

"The remuneration provided by the government hospital has failed to attract me to stick in the job," said the residential doctor at the Bir Hospital, requesting anonymity. The doctor said that she was unable to survive in the insignificantly low salary. She works 12 hours a day in the hospital and pockets Rs 11,000 as monthly salary.

When asked, physicians in the government hospitals echo the same concern that they are leading a hand-to-mouth existence.

Two months ago, the government had hiked the salary of doctors by Rs 3,500, following a string of protests. But the physicians consider the amount too paltry to motivate them.

In addition to the low salary and perks, doctors cite wanton behaviour of the public including the recent incidences of attacks on hospitals and medical personnel as demotivating factor for doctors to stay in the country.

Senior physicians say the rush for greener pastures could have debilitating impact on the country's ability to fight diseases.

"If the exodus continous at the present level, in ten years the government hospitals will be emptied of doctors," warned Dr Kedar Narsingh KC, president of Nepal Medical Association (NMA).

The brain-drain figures unveiled by the NMC are staggering. If the latest statistics is anything to go by, out of the registered 9,000 doctors, only 4,000 are currently serving the nation. The remaining ones have either left the country or are in a process to emigrate.

Among those 4,000 doctors currently in the country, 75 per cent of them are serving in the private hospitals and clinics. The government hospitals are virtually dry with merely 900 doctors, many of them already heading for greener pastures.

According to NMA, the medical drain is fuelled largely by the state inability to tap qualified and trained human resource through salary and perks and that it lacks a clear-cut policies in health sector.

"The government has not reviewed its health policy since 1985 and the posting of medics is based on the old provision," he added.

KC blames the health policy of 1985 as inadequate to address the drain of medical personnel.

He also underlines the need for career development programmes in the country to tap the fleeing doctors.

KC further said that the medicos were not getting the respect they deserve and their moral has fallen low in recent times.

The doctor-patients ration in the countryside, outside the Kathmandu Valley is even more worrisome with a doctor having to serve at least 30,000 patients. In the urban areas, the doctor-patients ratio stands at 1:1000.

When contacted, Dr Laxmi Raj Pathak, spokesperson for the Ministry of Health and Population (MoHP), said the ministry was reviewing the health policy but said it was unlikely to raise the salary.

"It is impossible to increase the salary of doctors with the sole effort of MoHP only," said Pathak, adding that they were requesting the Ministry of Finance for the review of salary of doctors.

He, however, acknowledged that the health institutions were desperately lagging equipments, environment for doctors to work and other infrastructures, combinedly resulting in the present sad state of affairs.