KATHMANDU: Hundreds of thousands of patients across Nepal were left without medical care on Tuesday after doctors nationwide suspended outpatient services to protest against a rising number of assaults and verbal abuse targeting healthcare workers.
Emergency services continued to operate, but all other outpatient departments (OPDs) were shut at government, private and community hospitals.
The nationwide protest was triggered by an incident on Saturday at Narayani Hospital in Birgunj, where Dr Pramod Ram was assaulted after a 45-year-old heart patient died in the hospital's emergency ward. Relatives of the deceased allegedly stormed the hospital, vandalised property and attacked doctors and other health workers.
Dr Ram was later transferred to the National Trauma Centre in Kathmandu, where doctors said he is now out of danger.
The Nepal Medical Association (NMA), the umbrella body representing medical and dental practitioners, criticised the authorities for failing to swiftly arrest those responsible or take legal action four days after the attack.
The association called for a nationwide boycott of all non-emergency services, while doctors and health officials at Narayani Hospital submitted mass resignations, demanding tougher legal action against the attackers and stronger security measures at hospitals.
"Halting medical care is not our choice," said Dr Sanjeeb Tiwari, the NMA's senior vice-president.
"Physical assaults and verbal abuse against our fellow doctors have become frequent. We feel insecure as people threaten to attack us wherever they find us, while the authorities fail to provide adequate protection."
The NMA said it receives reports of two to three incidents each week involving physical assault, verbal abuse, death threats or the defamation of doctors through YouTube and other social media platforms.
More than 90 cases of physical assault and abuse have been formally reported to the association over the past 10 months, although many incidents are believed to go unreported because doctors either do not lodge complaints or resolve matters locally.
Recent cases include the alleged verbal abuse and threats directed at Dr Kamlesh Prasad Yadav, acting medical superintendent of Lamkichuha Provincial Hospital in Kailali, by Lamkichuha Mayor Sushila Shahi.
In Udayapur, Katari Hospital medical superintendent Dr Gaurav Shah was reportedly threatened over a post-mortem report prepared by the hospital.
At Bheri Hospital in Nepalgunj, a group allegedly entered the hospital, verbally abused doctors and health workers, recorded videos and issued death threats.
Another doctor at the Karnali Academy of Health Sciences was reportedly abused by a group of youths while having lunch, with footage later uploaded to social media.
The suspension of outpatient services disrupted treatment for thousands of patients. Many who had travelled from distant districts for specialist consultations were forced either to return home untreated or extend their stay in Kathmandu and other cities.
Bel Bahadur Shrestha, 59, from Sindhupalchok, waited outside the National Trauma Centre hoping to see the doctor treating his infected fractured leg.
His son, Kumar, said the specialist only held outpatient clinics on Tuesdays and Fridays.
"We could not meet the doctor today and now have to return on Friday. Local health workers warned that my father could develop gangrene if treatment is delayed," he said.
Another patient, 23-year-old Usha Yadav from Siraha, who recently underwent surgery to repair a ruptured Achilles tendon, was unable to receive her scheduled wound dressing.
"I am worried the wound could become infected if it is not treated today," she said.
Bir Hospital alone treats about 4,000 outpatients daily, while Tribhuvan University Teaching Hospital sees more than 4,000 patients each day. Patan Hospital treats around 3,000 outpatients daily.
Officials from the Ministry of Health and Food Safety said more than 300,000 patients seek treatment every day at hospitals, health posts and primary healthcare centres across Nepal.
Meanwhile, services at Narayani Hospital remained suspended for a third consecutive day, with doctors maintaining their collective resignation in protest over the attack.
Rights groups condemned the violence against healthcare workers but also urged doctors to avoid disrupting medical services.
The Consumer Rights Protection Forum described attacks on hospitals and doctors as serious criminal offences and called for strict legal action against those responsible.
However, the forum's general secretary, Bishnu Timilsina, said suspending healthcare services also harmed the public.
"Doctors also commit another offence by halting services and depriving thousands of patients of healthcare. They should adopt other forms of protest," he said.
The National Human Rights Commission also expressed concern over the nationwide disruption to healthcare services.
Following an on-site investigation, the commission said attacks on doctors and medical facilities undermined the rule of law but stressed that suspending essential healthcare services also infringed upon citizens' constitutional right to health under Article 35 of Nepal's Constitution.
On Tuesday evening, the Nepal Medical Association announced that the nationwide protest would continue on Wednesday. - Kathmandu Post/ANN
