Dr Bhagawan Koirala is a household name in Nepal. For those who have got a new lease of life through his medical treatment, he is akin to God, as his name stands for. Best known for leading the team of Nepalis surgeons that successfully conducted open-heart surgery in Nepal for the first time, the sexagenarian surgeon during his three-decade long career has conducted over 14,000 heart surgeries. His recently launched book Hridaya (Heart) has become a best-seller. He is a member of a specialized medical committee formed recently by the Ministry of Health and Population to provide healthcare services to VVIPs and VIPs within the country. Here are the excerpts of the interview by RSS Feature Chief Krishna Adhikari.
The number of heart patients is increasing in Nepal lately. What are the main reasons for this?
Indeed, the number of heart patients is increasing in Nepal. Unhealthy lifestyle and unbalanced diet are the leading causes. Although cases of communicable disease such as tuberculosis, malaria and diarrhoea were decreasing in the country, number of incommunicable ailments such as heart disease is on the rise. With the increase in average life expectancy of Nepalis, the prevalence of incommunicable diseases also grew. The heart related complications detected among the youth in the recent times are largely due to unhealthy lifestyle and unbalanced diet.
What kind of attention one has to pay to prevent heart disease?
Some of the causes of heart disease such as age, gender and genetics are not under our control. However, most of the risk reduction is in our hand. Heart disease can be prevented by avoiding cigarette and alcohol, lifestyle change, exercising regularly and reducing obesity among others. Air pollution is also known to increase risk of heart diseases and other ailments. Lack of timely diagnosis and treatment and utter negligence to the treatment that could be done on time among others aggravate the problems later. If people exercise spiritual practice and increase the habit of doing yoga and meditation regularly, it will automatically generate positive energy which thereafter helps to prevent any complicated health problems including heart diseases.
How can heart disease treatment services be made accessible to common Nepalis?
Since getting healthcare services is fundamental right for any citizens, it is necessary to ensure everyone’s access to healthcare services. Some healthcare services need to be decentralized to take it to local level while others could be brought to the centre or major urban areas. Health services that could detect heart disease at an early stage could be decentralized from district hospital to the local level health centers. Likewise, the specialized service could be expended to major cities. At present, all sorts of heart disease treatment services are available at the Shahid Gangalal National Heart Centre and the Manmohan Cardiothoracic Vascular and Transplant Centre in Kathmandu. The service initiated in the Bir Hospital in the 1980s and interrupted in between has been resumed. Quality heart disease treatment services are being rendered in Chitwan, Pokhara, Butwal, Nepalgunj, Birgunj, Dharan, Biratnagar and Jhapa districts.
What is the quality of Nepal’s heart disease treatment service compared to other countries in the world?
The treatment services for heart diseases in Nepal cannot be considered weak or substandard in comparison to other countries of the world. There is certainly a lack in technology compared to rich countries but the Nepali surgeons are no less competent than those of them there. There is availability of treatment services including surgery needed by the general people in Nepal. The Shahid Gangalal National Heart Centre has been transformed into an important hospital of the country. Likewise, the Manmohan Cardiothoracic Vascular and Transplant Centre is also equally effective.
The Kathmandu Institute of Child Health (KIOCH) is being established in your initiative. What prompted you to establish such a hospital?
Children’s health should be viewed holistically, not just as a treatment of heart. We reached this conclusion after a wide-breath of experiences in health sector. I felt the need for super-specialty hospitality for the treatment of children in Nepal after seeing the pain suffered by many children in lack of money and access to proper treatment facilities on time. To address that dearth of dedicated and decentralized healthcare service centers for children, I made a plan to construct a Hospital so that no children should lose their life in lack of money or lack of technology or lack of access to medical treatment. A dedicated hospital like Kanti Children’s Hospital ought to decentralize its services but owing to various reasons, it has not been able to do so. Hence, we are establishing a specialized children hospital (KIOCH) in Kathmandu with seven satellite centers in all seven provinces in support of the government of Nepal. Here, those who cannot pay the fee are provided treatment free of cost. The first provincial branch of the Hospital is already operative in Jhapa district.
Out of every 100 children born in Nepal, 3 to 4 do not see their fifth birthday. Those children lost their life because they were bereft of basic health services and specialized treatment on time. Lack of specialized hospitals for children in Nepal was a cause of concern for me. The desire to establish a children’s hospital arose in me to fulfill the lack of specialized hospital for children and no child should die prematurely due to lack of money, services and access to treatment.
The government has recently formed a specialized medical committee including you to provide healthcare services to the VVIPs and VIPs within the country. What’s your take on this?
While the government is improving the quality of healthcare facilities and rendering quality healthcare services, the committee was formed acknowledging the scenario that a large amount of money was being spent abroad for the treatment of VVIPs and VIPs annually and they do not seem to have confidence over the healthcare providers and services within the country. The formation of a committee certainly has sent a positive message to the public. But it is also necessary to spread the message that this kind of healthcare services is not only provided to the VVIPs and VIPs, the public also get such services.
Treatment could be provided from all major hospitals across the country by preparing procedure for forming a group of specialized doctors, for management of treatment according to specialized medicinal methods and process. We doctors are excited and happy because when we provide medical treatment to the VVIPs and VIPs at home, it helps save state coffer and build up and increase public’s confidence in doctors.
What motivated you to write the book Hridaya?
Upon the completion of my study, I got the opportunity to work in various health institutions in various capacities. In the book, I have illustrated about the how much of suffering or ordeal one has to endure to establish healthcare centers providing complex and risky healthcare services. I have put forth analytical views on the ways to solve the problems prevailing the health sector and medical education sector. The book is a recollection of countless memories of stress, struggle, restlessness as well as funny anecdotes and success stories in my career spanning over 30 years. The book aims to give a message that anyone could solve any problems and attain success if one is committed to one’s cause.