The death of a four-year-old in Myagdi district hospital represents a classic evidence of irresponsibility at both institutional and individual level. Nisha K C of Pulchaur VDC died eleven hours after being admitted to the hospital awaiting specialised medical care, which the hospital could not provide for want of a doctor. Cases like Nisha’s often feature in the news but not all of them hog headlines. Thousands of others including children die due to no first aid, emergency care and access to regular medicines and other services. In some instances, the doctor’s callousness and indifference lead to premature death. Though health services are overstretched, Nisha’s death raises serious questions regarding management of hospitals by the Ministry of Health. The whole practice of sending medics for training by putting the lives of patients in jeopardy at the hospitals will have to be reviewed. The staff’s statement that Nisha would have survived with a little bit of doctor’s care makes the issue of granting “study leave” all the more pungent.

Nisha died because their doctors left the functional duties at the district referral hospital that is visited each day by over 30 patients from different basic health units in the region to a health assistant. There is no dispute over the fact that training is a must. But when it has to be had at the risk of endangering the patient’s life as in Nisha’s case, there is no reason why it cannot be postponed. What is the use of reinforcing a doctor’s academic credentials when children as young as four have to wait in referral hospitals for eleven hours before breathing last? It amounts to dereliction of duty, no matter what the pretext. Taking leave knowing well that one’s departure would cripple the facility is as cruel as it is inhuman. It also throws the Hippocratic oath and medical ethics down the chute. In fact, it is tantamount to exploitation and injustice. If a medic’s departure imperils the lives of 30 people each day, no training is worth the bargain and the Ministry must have the commonsense to make arrangements to forestall such nightmarish scenario. Meanwhile, Dr Ram Bahadur KC and Dr Lal Bahadur Malla, appointed to replace their predecessors, must be held accountable and made to explain what prevented them from joining the Myagdi hospital on time.