Nepal | January 16, 2021

Corruption in healthcare: It’s killing Nepalis

Chandni Jaishwal
Share Now:

Corruption in the health budget has crippled Nepal’s health system. Given the scarce resources, the funds lost through it could otherwise buy lifesaving medicines and supplies, fund operations and hire more skilled health workers

“Corruption is a tradition. It might be wrong, but it is not illegal.” As a healthcare officer in Nepal, I often hear these words. Corruption is so rampant in Nepal’s health system that we accept it as a norm. Nepalis are deprived of quality healthcare services due to the unwritten rules of corruption. Healthcare corruption threatens accessibility, utilisation and quality of healthcare service and ultimately paralyses the healthcare system. Nepali women have lost their lives during childbirth owing to consequences of corruption.

Illustration: Ratna Sagar Shrestha/THT

The Nepali government allocates not much of its total budget for healthcare: less than 5 per cent. Because of financial embezzlement, healthcare is left with even less money. One report estimated that more than 5 per cent of the global health budget is lost to corruption even before it leaves the central government offices—from my personal experience the number is much higher for Nepal. According to the 2018 Corruption Perceptions Index, Nepal is among the world’s most corrupt countries (ranking 124 out of 175).

A well-run healthcare system requires not only sufficient funding but also effective spending. If wisely spent, resources could cover more people’s needs. According to the World Health Organisation, most countries could achieve significantly greater health system performance even at the current level of healthcare spending. Corruption in the health budget has crippled Nepal’s health system. The money lost to corruption degrades the quality of healthcare and reduces the availability and utilisation of services. In a country like Nepal where resources are already scarce, the funds lost through corruption could otherwise buy lifesaving medicines and supplies, fund operations and maintenance, and hire more skilled health workers.

Many Nepalis have lost their lives owing to corruption in the health sector. I have witnessed corruption in the purchase and distribution of medicines, which ultimately causes a shortage of drugs. Nepal’s high child mortality rate can also be partly attributed to the shortage of oral rehydration salts for children with diarrhoea, which owes to corruption, as well as to corruption in the immunisation programme. Shortage of medicine compels patients to pay for it.

Besides, broken medical equipment is often left unrepaired. Healthcare managers prefer to purchase expensive new equipment rather than repair the existing one as there is a huge kickback on the purchase. Patients are forced to visit a private health facility due to interruption of the services. This undermines Nepalis’ trust in healthcare services.

Corruption in the procurement of drugs is a big problem. Health officials usually expect illegal financial benefits while purchasing drugs. As a result, substandard drugs with a high financial beneficial package are procured rather than what is needed for the community. Use of such drugs won’t make patients feel better, therefore, they are compelled to overuse and misuse antibiotics. Irrational use of antibiotics helps to breed resistant bacteria that lead to antimicrobial drug resistance, an increasingly scary problem here. Procuring out-of-specification and substandard medicines at any price is too expensive. This adds to a widespread perception that government medicines are of low quality. Corruption in Nepal has deep, complex roots in the social, cultural, economic and political systems. Hence, there are no easy ways to win over it; rather it requires in-depth research and thorough analysis. Increasing salary and social security for government employees could help. Integrating awareness about anti-corruption laws and the detrimental effects of corruption in the school curriculum might produce honest and accountable citizens.

In October 2018, the government required civil servants to take an oath every day: ‘I will not indulge in corruption, I will prevent corruption and will honestly work for my country and people.’ But, I argue decision-makers urgently need to move beyond such ineffective anti-corruption measures. We need better regulation and monitoring, and effective penalties. Strong action against corrupt officials should take priority without political bias. Zero tolerance against corrupt practices by both healthcare providers and consumers, and policies to protect whistleblowers are equally important.

Tackling corruption in the health system is difficult, but not impossible. The responsibility to tackle corruption does not belong only to the Commission for the Investigation of Abuse of Authority. The Nepal Medical Association, National Human Rights Commission and trade unions should also play a proactive role in the enactment of such laws for transparency and accountability in healthcare.

Media engagement is equally important. Media should not be limited to the information provided by the anti-corruption bodies; rather it should do more investigative journalism to uncover deep-rooted corruption in the health system. Recently, Nepali media set a global example by covering the story of district health officials who pocketed cash allowances by creating a list of fake mothers.

Life is precious. Quality healthcare is a human right. Corruption in health care is neither normal nor acceptable; it is a crime.

Jaishwal is a Fulbright scholar and International Peace Scholar


A version of this article appears in print on January 29, 2020 of The Himalayan Times.


Follow The Himalayan Times on Twitter and Facebook

Recommended Stories:

More from The Himalayan Times:

First Arab Ama Dablam Expedition makes successful attempt on Thursday

KATHMANDU: A team from Seven Summit Treks ‘First Arab Ama Dablam Expedition’ comprising Qatari climber Fahad Badar, Sherief Elabd from Eygpt and Nadhira Al Harthy from Oman have attempted Mt Ama Dablam (6812 m) on January 14. The winter ascent to Ama dablam consisted of at least 14 climbers w Read More...

Biden unveils $1.9T plan to stem COVID-19 and steady economy

WILMINGTON, DELAWARE: President-elect Joe Biden unveiled a $1.9 trillion coronavirus plan Thursday to end “a crisis of deep human suffering” by speeding up vaccines and pumping out financial help to those struggling with the pandemic’s prolonged economic fallout. Called the “American Read More...

Mobile data users abandoning Ncell for NT

KATHMANDU, JANUARY 14 Mobile data users in the country are increasingly abandoning Ncell and subscribing state-owned Nepal Telecom. At least that is what the data compiled by Nepal Telecommunications Authority reveals. According to the Management Information System of NTA, 60 per cent of the t Read More...

Rival NCP factions hold standing committee meetings

KATHMANDU, JANUARY 14 Nepal Communist Party (NCP) led by Pushpa Kamal Dahal and Madhav Kumar Nepal held its Standing Committee meeting and discussed ways to effectively carry out its protest programme against dissolution of the House of Representatives. NCP (Dahal-Nepal) Spokesperson Naryan Ka Read More...

Security personnel of Khotang District Police Office destroy cannabis planted illegally by the locals in Durchim VDC of Khotang district on Monday, December 21, 2015. Photo: RSS

Cops intensify drive to destroy cannabis, opium plants

KATHMANDU, JANUARY 14 Nepal Police destroyed cannabis and opium plants cultivated in a large swathe of land across the country in the fiscal year 2019-20, according to an annual report recently released by the Ministry of Home Affairs. According to the report, cannabis plants being cultivated Read More...

WHO supports member countries to end COVID-19 pandemic

KATHMANDU, JANUARY 14 Member countries in the World Health Organisation South-East Asia Region are gearing up for massive vaccination campaigns in a bid to end the COVID-19 pandemic. The WHO South-East Asia Region has 11 member countries — Bangladesh, Bhutan, Democratic People’s Republic o Read More...

Bhattarai calls for decisive agitation

DAMAULI, JANUARY 14 Janata Samaj Party-Nepal Federal Council Chairperson Baburam Bhattarai has stressed the need of a decisive struggle to protect democracy and the constitution. Accusing Prime Minister KP Sharma Oli of putting the constitution and democracy at risk by dissolving the Parliamen Read More...

Locals protest East-West Railway survey

BARA, JANUARY 14 The locals have protested a survey of the East-West Railway in Bara. The locals were up in arms after a survey was done affecting the main settlement in the bazaar area of Nijgadh Municipality. According to the survey team Incharge Suraj Poudel, the locals impeded the d Read More...