Kathmandu metropolitan city (KMC) recently bulldozed five drug stores in front of Bir Hospital, Kathmandu, saying they were against the blueprint of the buildings approved by the local government.
Consequently, the authorised pharmacy inside the largest hospital in the country is now overcrowded.
On September 27, when Onlinekhabar visited the facility, the ground floor of the main building was crowded with people who wanted to buy medicines. But, they were not getting all the required medicines there. Due to this, the customers had to go to the pharmacies of the TU Teaching Hospital, Patan Hospital or other big hospitals.
The hospital administration, however, says efforts are underway to improve the capacity.
The gap
Bhupendra Bam of Dhading, who came to treat a relative’s chest problem at Bir Hospital, complained he did not get the medicine prescribed by the doctor at the pharmacy. “The doctor has prescribed seven medicines. However, only three were found here,” Bam complains, “There is no pharmacy outside. Now, you have to go to the pharmacy of another hospital to get the medicines.”
Previously, the relatives of the patients used to go outside the hospital’s pharmacy when the hospital’s authorised facility could not provide them with the items they demanded. On the other hand, the need to stand in a long queue and the rude behaviour of hospital staff pushed them out. At the pharmacies outside, they would get medicines quickly and easily.
Now, the customers’ pressure is high on the official Bir Hospital pharmacy, yet the hospital administration is not able to make the pharmacy service effective.
Doctor Shyam Mandal, the head of the hospital’s pharmacy, claims that around 70 per cent of the prescribed medicines are available. “Looking at the daily data, around 30 per cent of the patients have to be turned away due to the lack of medicines,” Mandal tells Onlinekhabar.
Relatives of the patients say that they have to go to other places mainly because of overcrowding in the pharmacy inside the hospital. Sita Paudel, who came from Jorpati for a check-up, returned from the hospital’s pharmacy without taking medicine. “Even after waiting in line for an hour, I could not get my turn. Moreover, all the medicines I need were not available,” Paudel tells Onlinekhabar, “I hence went to a pharmacy in Chabahil and get my medicines.”
When the journalist from Onlinekhabar sat in front of the Bir Hospital pharmacy for two hours, most of the customers left due to the overcrowded customers. According to the chief of pharmacy at the hospital, around 3,100 types of medicines are available in the hospital pharmacy.
On the one hand, the customers have to stand in line for a long time. However, since the hospital administration does not pay attention to crowd management and cleanliness, the customers are suffering from the stench of the toilets. “It’s been 20 minutes since I stood in the queue, but I am constantly bothered by the bad smell from the toilet,” says Ramprabesh Mahat, who came from Sarlahi.
The brand issue
Bir Hospital’s pharmacists say that most doctors, when prescribing medicines to patients, do not write the generic name of the chemical composition, but the brand name. And, this is a major reason why patients find many medicines unavailable there.
“Patients think they should get the exact brand as prescribed by the doctor although we have the same composition under different names,” a pharmacist says.
“When the hospital pharmacy purchases through the tender process, only one specific brand of any drug is purchased. There are hundreds of manufacturers who produce the same drug under different brand names, and it is making the customers confused,” the pharmacist says.
In the Bir Hospital pharmacy directory 2015, there is a clear provision to prescribe medicines by their generic name. However, doctors have not followed the rule.
An opportunity too
But, there is some good news too.
The income of the government-run Bir Hospital has improved after the demolition of other pharmacies. According to the pharmacy head Mandal, when there were drug stores outside the hospital, the daily income was around Rs 500,000, but now it has reached Rs 900,000.
The chief administrative officer of the hospital, Dr Bhupen Basnet, says, “The closure of outside drug stores has had some impact. However, we have made a plan to expand the pharmacy so that the patients can easily get all the medicines within the hospital premises.”
According to him, Bir Hospital is making a list of medicines required for emergencies and surgeries.
“We have given priority to medicines for emergency and surgical patients in the pharmacy of Bir Hospital,” says Dr Basnet, “OPD patients can go to other places to take medicine. However, the drugs needed in emergencies and operations are more sensitive.”
“After the then Health Minister Gagan Thapa took the administrative and legal initiatives to ensure that all government hospitals have their own pharmacies, Bir Hospital’s Pharmacy was established in 2016. But, as the hospital provides multi-specialist services, all types of medicine cannot be obtained,” Dr Basnet argues.
According to him, the hospital pharmacy is trying to increase the supply of nearly 5,000 types of medicines in the pharmacy.
Room for improvement
For the effective operation of the Bir Hospital pharmacy, the hospital has made the billing and distribution arrangements from four counters in the main building, as per the hospital pharmacy head Shyam Mandal.
In addition, pharmacy services have been started in the surgical building as well. To reduce the overcrowding of the hospital, yet another pharmacy is going to be started in front of the operation theatre of the surgical building within a short time.
“Both the pharmacy and the operation theatre on the ground floor of the surgical building will be combined and medicines are distributed to the patients in the surgical wards. From the pharmacy in the main building, the service will be provided targeting OPD”, Mandal says, ‘If necessary, we will increase the human resources, rooms and the number of the pharmacies.”
Currently, 23 people are providing 24-hour pharmacy service in the main building and 12-hour pharmacy service in the surgical building, according to the Bir Hospital administration.
Moreover, as some antibiotics in the hospital are much cheaper than outside pharmacies, patients are greatly relieved. Basnet claims, “We buy medicines through bidding. That’s why medicines here are not expensive in comparison to outside pharmacies.”
“Now, by increasing the operational level of pharmacy in the hospital, customers can get quick and easy service.”
This story was translated from the original Nepali version and edited for clarity and length.
