State minister for health and population Dr Toshima Karki promises big reforms. Here are her limitations.

A new face in Nepali politics, Dr Toshima Karki, it appears, does not have enough information regarding duties and functions of minister of state.

NL Today

  • Read Time 3 min.

Kathmandu: Nepal’s Prime Minister Pushpa Kamal Dahal expanded his Cabinet on Tuesday, inducting some completely new faces. Dr Toshima Karki was among one who was entrusted with the responsibility of state minister for health and population. 

Soon after her appointment, she went viral on social media platforms for taking part in a ribbon-cutting ceremony with the minister. In what looks like a clumsy scene, in  a recent video circulated on social media, Karki is seen cutting a ribbon that was stretched separately in the lower column–the upper one being set for the health minister. Many criticized her for limiting her role to ‘ribbon cutter.’ She is no different than what she used to call “traditional leaders” of the country, people reacted on social media. 

This particular act, however, does not tell the whole story. A section of society is already excited by her appointment while some argue that it is too early to predict her performance. After assuming office, she promised that the situation of people losing lives without treatment due to lack of money will be ended and she will make efforts toward that direction.

Promises are good. But it is a bitter reality of Nepali politics that promises are what politicians have been making to the people without keeping any of them. 

In order to stand out, she must move ahead with concrete action plans on issues and pro-people policy recommendations. It is not an easy task though. Here are some key challenges that she should not overlook during her tenure as the state minister for health.

Question on the duties and responsibilities: The position of state minister is largely perceived as a role to manage political ambition of some politicians. In reality, the state ministers have little to do. Regulation related to work division of the Nepal government does not specify the clear role for the state minister. Besides, the politicians who have worked before as the state minister say that being a state minister has no other job than just being a name. 

Environment of trust with the minister: Dr Karki is a state minister. Her performance will largely depend on the trust environment between the minister and herself. It is, given the usual standard of Nepali politics, not an easy task as the Minister for Health and Population Padam Giri is from a different political party. 

Bureaucracy: Another key factor for her success is whether she can take the bureaucracy into confidence or not. Needless to say, Nepal’s health system is hierarchical. It comprises some of the finest health professionals including medical doctors. And it is said that seniority makes a difference in the system. Given that she is comparatively a junior, it is not sure how well, or whether, the seniors at the ministry will follow her instructions. Taking the bureaucracy into confidence and convincing her seniors in the ministry is a challenging job for her.

Conflict of interest: Rastriya Swatantra Party has been criticized for conflict of interest. Dr Toshima Karki does not seem to have had visible business interests so far. But it is always challenging in Nepal to stay away from the influence, and also pressure, of interest groups. How she will identify the interest and manage the pressure is another crucial factor that determines her success in the days to come. 

Limited exposure to the government functioning: Another area of lapses on her part can be her limited exposure to the functioning of Nepal’s government system. Recently, eminent economist Dr Swarnim Waglé had expressed his opinion on how the system tricks people in power. The interest groups can either influence her or rig the system to keep her outside. She needs to be cautious of the fact.

Gap between ambition and ground reality: Delivery is easier said than done. Efficient delivery is possible only when the existing gaps and problems are identified and addressed accordingly apart from political will. Getting factual information about ground realities, identifying gaps and challenges and addressing them in a systematic way is definitely a challenging job. 

Above all, as stated earlier, she is just a state minister. As a medical doctor involved in Dr. Govinda KC’s medical education reforms and other campaigns, it is obvious that people have a lot of trust in her. Now is the time to prove that she is a good leader who can build an environment of trust. It is time to prove that she is a leader who can put the agenda logically. Now is the time to prove that she can expose wrongdoings, if any. Now is the time to prove that she can introduce relevant policy and push for the timely endorsement. Only her good performance will make her stand out from the crowd of ‘corrupt’ politicians.