Even after spending nearly three decades in Nepal’s medical practice and earning a name and fame almost unparalleled among his contemporaries, Nepal’s renowned cardiothoracic surgeon, Dr. Bhagawan Koirala restless these days. He says he’s embarking on a new journey in his career and he’s not sure how it will continue.
He intends to open a multidisciplinary children’s hospital in Kathmandu with seven satellite centers, one in each of the seven provinces. That dream was seeded three decades ago while studying pediatric heart disease in the United States.
A concern for children
The question that Dr. Bhagawan Koirala’s most common question these days is why he works for the children’s hospitals. But dr Koirala says he’s dreamed of working in child health since 1993, and in his life more than half of heart surgeries have been performed on children.
As part of his professional training, Dr. Koirala the opportunity to perform pediatric heart surgeries in the United States. He later completed a one-year fellowship at one of the top three children’s heart hospitals in the world in Toronto. Since then he has been interested in the field of children’s health.
In developed countries it was recognized that there should be separate hospitals for juveniles and children. However, at the government level, there is only one Kanti Children’s Hospital that treats children, although they currently cover 40 percent of the population. There are also departments in two or three private hospitals and some medical colleges.
When children get sick, there is a lack of specialized health facilities where all diseases can be treated under one roof. Although Kanti Hospital is run by the government, specialized pediatric services are not effective there.
Less than five years after birth, 30 children die due to lack of treatment. But dr Bhagawan Koirala knows that most children can be saved if they are treated properly.
Around 600 pediatricians are currently employed across the country, but most of them are concentrated in Kathmandu and other urban areas. Children in remote areas are treated by family doctors for complex illnesses or die without treatment.
dr Koirala therefore has a dream to reduce child mortality in Nepal. No one should die for lack of treatment or money. Against this background, satellite centers are planned in all seven provinces, including a central hospital in Kathmandu.
After working as a cardiac surgeon for more than three decades, he once again took a big risk in the medical field by transforming the children’s healthcare sector. This plan scares him. However, he did not accept defeat at all. He is determined and says: “Within 10 years I will be managing children’s hospitals in all federal states.”
dr Bhagawan Koirala ran the Gangalal National Heart Center for about eight years. After that, he brought Tribhuvan University Teaching Hospital (TUTH) and Manmohan Cardiothoracic Vascular and Transplant Center to a higher level. He is also considered to be competent in leading executives.
“I still work for the government. And I will work for the state hospitals until I retire,” says Dr. Koirala, “I will champion children’s health as long as I have strength and wisdom in my life after retirement.”
dr Koirala has been working day and night to improve government health services. During that time, it wasn’t that he hadn’t received large sums of money from private hospitals. However, he found his complacency in government service.
He had no obligation to improve pediatrics in the country. However, in the program the state showed no willingness to centralize pediatric services. Therefore, Dr. Bhagawan Koirala took the lead by founding the Kathmandu Institute of Child Health (KIOCH) with some helpful minds. He plans to operate the hospital service in the public service model through a non-profit organization.
Surgery in province 1 after three months
In the first phase, the KIOCH team is constructing a building for the central hospital in Kathmandu on a government property in the Budhanilakantha-7 municipality. Meanwhile, the service will begin within three months at the building being premiered as a satellite center by the Nepal Red Cross Society in Damak Township, Jhapa, Province 1.
In Province 1, the association gave the building away for free for 30 years. Work is underway to install the equipment and train the staff. Once the two hospitals in Kathmandu and Jhapa are established as role models, Dr. Bhagawan Koirala Children’s Hospitals spread to other provinces.
The team is aiming for the central hospital to have 200 beds, while a satellite hospital will have 50 to 100 beds each. All hospitals have ICU, NICU and PICU.
Services are provided free of charge for patients who cannot pay, but those who can pay must pay. dr Bhagawan Koirala says, “We will solve most of the children’s problems at the grassroots level. Complex cases are referred to Kathmandu.”
Without completing the two hospitals in Kathmandu and Province 1, says Dr. Koirala: “The organization promises that nobody should return empty-handed from our hospitals.” Koirala says children’s hospitals are also expanding to include government health insurance and concessionary programs under other free health services.
Meanwhile, the organization aims to carry out non-communicable disease prevention programs along with therapeutic services. It will reduce rates of infant mortality and morbidity, Koirala believes.
He says his team has an agreement with various national and international organizations to run prevention programs.
Post with a selfless spirit
dr Bhagawan Koirala has described his plan as a contribution-based project rather than an investment. Many people and organizations have joined his plan as partners and supporters. He says if the children’s hospitals in Kathmandu and Jhapa can be run in a good model, it won’t be difficult to get support for the next hospitals.
dr Koirala has estimated that running children’s hospitals in all seven provinces will cost about 5 billion rupees ($40 million). Although the structure is ready to operate the hospital in province 1, the full budget for the multi-disciplinary children’s hospital in Kathmandu under construction has not been secured.
Now supporting hands are added. “I have vowed to work for the hospital as long as my body is able and only leave after the project is successful. Support is growing and I’m confident it will be successful,” he says.
dr Bhagawan Koirala, the current chairman of the Nepal Medical Council, works 18 hours a day these days. He says he spends most of his time at the Manmohan Cardiothoracic Vascular and Transplant Center, giving time to medical advice as needed.
“The rest of the time I’m busy working for the children’s hospital. It’s a pity to manage time everywhere. But it’s better to be busy than free,” he says with a smile.
This story has been translated from the original Nepali version and edited for clarity and length.