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Monday, March 4, 2013

TUTH: Peeking into the doom ahead

What does Dr. Koirala's resignation mean? Well, it means many things to many people. But most are utterly disappointed. An overview of evolving scenario at TUTH: 

It was not business as usual in TUTH today. As the yesterday's rumors about resignation of Dr. Bhagawan Koirala evolved into truth, nearly everyone was somehow relating the resignation to the future of the institution and most importantly, himself/herself.

Beside all the welcome changes brought to the institution, Koirala's deeds had promised something for most people associated with the institution. The fact that the hospital had started making profits after years of consistent loss-making notwithstanding, the over-all financial health of the institution was improving enabling it to pay the employees' salaries in time. Students and the junior faculties have their future intimately associated with that of the institution and they were more disappointed than the others. There was even signature campaign among faculties to demand for reinstatement of Dr. Koirala to the post, supposed to be sent to TU and PM office.

While the premature departure of Dr. Koirala from the administrative position of the hospital spells trouble for the institution, the bigger danger lurks ahead: this is likely to be interpreted as the failure of meritocracy in the institution promoted by current Dean Dr. Prakash Sayami. As things stand, the possibility of Dr. Koirala's successor being any different from his corruption-friendly predecessors is nearly nil.

Dr. Koirala has cited noncooperation by people ranging from PM Bhattarai to senior professors in the institution as the reason behind his resignation. In fact, his kind of road-map to revamp the institution is impossible without cooperation of those people. The problem is, his road-map, while rejuvenating the institution, is unlikely to promote the interest of the people ranging from the doctors providing surrogate service to the hospital to the TU officials and the PM himself.

The irony now is, the new appointee in the post of Executive director will come with solid knowledge that the difficulties for the institution pointed by Dr. Koirala are very much in place and with the implication that he is ready for the highly likely scenario of the institution being driven further into the morass by 1) condoning/promoting/indulging in corruption 2) witnessing the utter inefficacy in the service delivery by the institution 3) letting people to resume the plethora of unethical practices like smuggling the patient to the private hospitals and 4) letting the institution to relapse into loss-making that threatens to collapse the institution itself.



Besides some tangible changes brought to the institution, Koirala's tenure at TUTH has proved that it is indeed possible to run the institution fairly and ethically and holding higher posts does not necessarily mean you have to embezzle more money. If they had not sold their ethics and professional conscience to the small time criminals named politicians, both the predecessor and the potential successor of Dr. Koirala would have introspected and contrasted themselves with him.

At the least, the potential successor has to answer these questions: Does TUTH need a reform as advocated by many over the years? Was the modus operandi of Dr. Koirala likely to achieve those changes, and if not why? Does he have any alternative vision to that end? An honest answer to these questions would, however, start with the way the practical problems related to the administration are sorted out; for example, how he will address the problem of making crores of payments for purchases supposedly made during the tenure of Dr. K P Singh (just before Dr. Koirala).

In reality, however, little doubts linger. Among the professors, one most trusted by related politician will be chosen for the job and he will rush to make those payments as the automatic connection between the payments and the kickbacks (to both the official as well as the politician) will resume from the earlier era. In best case scenario for the nexus, Dr. Sayami will also quit sooner rather than later and the synchronous drainage of the institution from various levels will be facilitated. While paying lip service to the reform agenda, the officials will keep working as the loyal cadre of the politicians regardless of whether the institution nears the collapse.

Predicting doom to an institution one loves is a painful thing. Probably I should stop here. 

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