Specialist shortage forces Salyan district hospital to halt surgeries

Surgical services at the Salyan district hospital have ground to a halt since Saturday, a consequence of two temporary specialist doctors completing their assignments. The hospital now lacks the trained personnel to perform any surgeries.

Dr. Rahish Koju, an MDGP specialist, and medical officer Dr. Suman Yadav, deployed by the Nick Simons Institute (NSI), finished their two-month tenure in mid-July. Their departure has left a critical void, forcing the hospital to suspend all surgical procedures. For a decade, the NSI had been instrumental in supporting the hospital's Safe Motherhood Programme, enabling vital C-sections for high-risk pregnancies. Under the recently departed doctors, the hospital had expanded its surgical capabilities to include procedures for appendicitis, hernias, hydroceles, and orthopedic injuries.

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Taking an ambulance to the district hospital would have cost us only Rs1,000. We ended up spending Rs8,000 to reach Tulsipur. We only found out halfway that surgeries had stopped at the district hospital.

The suspension has created significant hardship for patients. Those needing urgent care, especially pregnant women, must now travel to hospitals in Dang, Surkhet, or Nepalgunj. This extended journey not only increases travel time but also significantly raises treatment costs. Purnima Budha shared her distress after her daughter-in-law, needing an emergency operation, was referred to the district hospital only to find surgeries suspended mid-journey. The family incurred an Rs8,000 cost to reach a hospital in Tulsipur, a stark contrast to the Rs1,000 they would have paid locally.

Pimlal Nepali faces a similar dilemma, struggling to afford the increased travel and treatment costs for his 10-year-old son's hydrocele surgery. He had hoped for a local procedure costing around Rs3,000-Rs4,000 but now must seek care much farther away. Dr. Arjun Budha Magar, chief of the Salyan Health Service Office, confirmed the NSI program's end and the departure of the two doctors. Despite requests to provincial and federal governments for replacements, there is little hope for their imminent arrival. Since the suspension, three patients have already been referred elsewhere, and the hospital typically performs 10 to 12 C-sections monthly.

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I had delayed the treatment because I couldn't afford it. I was hoping to get the operation done at the district hospital for around Rs3,000 to Rs4,000. Now I have to find enough money to take him much farther away.