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Friday, March 29, 2013

Struggle for fairness and justice in Medicine: Lessons for the future

 Reflecting on the lessons to be learned from the imperfect way in which we dealt with the admission fiasco in some KU colleges:

With today's developments, the struggle towards forcing the Kathmandu University colleges to take admission in PG seats on basis of merit has reached a critical point.

To start with, little comes out of blame game and I will desist from blaming one person or the other for our failure to meet expectations of most of us at the end of this phase in the long struggle.

I have already written about the difference that has been made over the year with the change of guard at the helm of KU with entry of Dr. Makaju's team. The gains are appreciable in themselves and all friends who were involved in pressurizing the authorities all over these years deserve credit for that along with the new team at KU. To be frank, for many people including myself, KU was a lost case till recently, for all sorts of illicit activities it was involved in over the years gave that impression.

Moreover, the struggles for fairness and justice are same everywhere; not only in KU. For a whole generation of upcoming medical graduates, this struggle bears immense importance. Hence this is not a one-point and one-time struggle.

Here I will summarize what exactly we could achieve so far in case of KU admissions and what is left to achieve.

In majority of the colleges, there was no problem with the admission. 

Coming to the issue of colleges with problems, by yesterday, there was a cemetery-like silence in DSON and other forums so far as the voice of majority of aggrieved students in the current admission fiasco was concerned. Most of them were not even in touch with their colleagues who had put a brave face by approaching KU authorities. The medical colleges in question had somehow convinced that the bond was indeed a must if they were to be admitted in the courses. By today, a handful of students were left who came under enormous pressure from the college authorities. Compounded by the concern of their guardians, they could no longer bear the pressure and agreed to the terms of those colleges to get admission. While it is yet to be verified, some of the students are likely to have abandoned the idea of getting admission with bonds in favor of quitting the seats altogether.

 While it would have been exceedingly fruitful to force the medical colleges to respect the law of the land at this opportunity, the failure has also provided ample opportunities to learn for us. To list a few:

1) Unity is one thing that eludes us. Most of us are so focused on our careers that we are missing the dark clouds that threaten the future of whole generation. If we want to secure our and only our futures, the costs involved are enormous for the whole community of medicos.

2) 95% of medicos will likely never own a hospital of our own and will have to work in hospitals run by either government or the businessmen. While some of the people with business in health sector are honest people with soundly ethical business practice, others lack this. The latter are involved badly in the informal economy of the country (that is rapidly swelling) and enjoy political patronage and keep a sizable workforce of vandals and bouncers. Unfortunately, given the ramshackle state of Nepal, these are the people whose empires are fast expanding in health sector. And these are the people commonly known as 'medical mafia'. As someone symbolically said: 'if you do not check the practice of these people on time, tomorrow you will have to seek permission from them to see a patient'. In all likelihood, these empires will flourish well into the future and if we go on compromising or surrendering to them, the future is really, really bad for everyone.

3) My parallel observation here: Medical field is not alone in being plagued by mafioso and there are worse sufferers in the society. We often forget that, regardless of our degrees or profession, we are part of the society and its ills affect us. Take for example, the poor teachers who are paid a mere Rs 8000 monthly in a private school that takes Rs 16000 monthly from a single student. It is indeed in the whole world that there is a worrisome tendency of concentration of wealth in the hands of few at top who monopolize every resource and wealth. The difference in our society is that here there is practically no discrimination between wealth earned by fair and unfair means and financial crimes take place without fear of any legal retribution. This makes our position further precarious.

4) Not everyone is farsighted enough to see these perils of remote future. Also, our communicative skills appear to have been poor. Organization level is pathetic as such. We have to organize and integrate ourselves much more concretely if more is to be achieved.

In the meanwhile, I urge all friends who have got admission in the colleges with illegal bonds to maintain a common position that the bonds are illegal as such and a legal remedy for them have to be sought. If they take initiative, I think it is still possible to seek help of CIAA or National Vigilance Center.

At another level, the struggle to hold the colleges accountable to law of the land should continue. That is not a matter of a year, a decade and a generation but that of generations to come. By resisting the tendency of the few people to monopolize private health sector by writing the law themselves, we are serving the cause of society and the country beside the medical fraternity.

I remind again: the silence of dozens of people who have entered in illegal bonds with private medical colleges is a huge obstacle to the struggle. Please come forward and clarify your position. If you think this struggle harms your prospects, feel free to communicate your arguments (we are, after all, slim and law-abiding people who cannot even use harsh words). If you realize your mistakes, make it clear publicly so that if you have problems related to the bond after completion of the course, there will be people out to help you. While understanding the difficulty at your position, it is impossible to move forward without proper communication. It is, after all, the question related to the future of thousands of students after you, and generations to come.

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