The demolition of the Bir hospital pharmacy forces patients to rush elsewhere to buy life-saving drugs

File: Bir Hospital Pharmacy

The Kathmandu Metropolitan City (KMC) recently bulldozed five pharmacies in front of Bir Hospital, Kathmandu, claiming they were against the building plan approved by the local government.

As a result, the licensed pharmacy inside the country’s largest hospital is now overcrowded.

On September 27, when Onlinekhabar visited the facility, the ground floor of the main building was packed with people who wanted to buy medicine. But they did not receive all the necessary medicines there. For this reason, customers had to go to pharmacies in TU University Hospital, Patan Hospital or other major hospitals.

The hospital administration, however, says efforts are underway to improve capacity.

The hole

Bhupendra Bam from Dhading, who came to treat a relative’s chest problem at Bir Hospital, complained that he was not given the medicine prescribed by the doctor in the pharmacy. “The doctor prescribed seven drugs. However, only three were found here,” complained Bam, “There is no pharmacy outside. Now you have to go to another hospital pharmacy to get the drugs.

Previously, the relatives of the patients used to walk out of the hospital pharmacy when the approved hospital facility could not provide them with the items they requested. On the other hand, the need to queue and the rude behavior of the hospital staff drove them away. In pharmacies outside, they would get medicine quickly and easily.

Now, the pressure from customers is strong on the official pharmacy of Bir hospital, but the hospital administration is not able to make the pharmacy service efficient.

Dr. Shyam Mandal, head of the hospital’s pharmacy, says about 70% of prescribed drugs are available. “Looking at the daily data, about 30% of patients have to be turned away due to lack of medicine,” Mandal told Onlinekhabar.

Patients’ relatives say they have to move to other places mainly because of the overcrowding in the pharmacy inside the hospital. Sita Paudel, who came from Jorpati for a check-up, returned from the hospital pharmacy without taking any medication. “Even after queuing for an hour, I couldn’t get my turn. Also, not all the medicines I needed were available,” Paudel tells Onlinekhabar. “So I went to a pharmacy in Chabahil and got my medicine.

When the Onlinekhabar reporter sat outside the Bir hospital pharmacy for two hours, most customers left due to overcrowding. According to the head of the hospital pharmacy, about 3,100 types of drugs are available in the hospital pharmacy.

On the one hand, customers have to queue for a long time. However, since the hospital administration does not pay attention to crowd management and cleanliness, customers suffer from the stench of toilets. “I have been queuing for 20 minutes, but I am constantly bothered by the bad smell of the toilets,” says Ramprabesh Mahat, who comes from Sarlahi.

The brand issue

Bir hospital pharmacists say that most doctors, when prescribing drugs to patients, do not write the generic name of the chemical composition, but the brand name. And this is one of the main reasons why patients find many drugs unavailable there.

“Patients think they should get the exact brand prescribed by the doctor even though we have the same composition under different names,” says a pharmacist.

“When the hospital pharmacy buys by tender, only one specific brand of medicine is bought. There are hundreds of manufacturers producing the same medicine under different brands, and this confuses customers,” explains the pharmacist.

In the 2015 directory of Bir Hospital pharmacies, it is clearly planned to prescribe drugs by their generic name. However, the doctors did not follow the rule.

Also an opportunity

File: Bir Hospital in Kathmandu cannot cope with the number of patients.
File: Bir Hospital in Kathmandu cannot cope with the number of patients.

But there is also good news.

Bir public hospital revenue improved after other pharmacies were demolished. According to Chief Pharmacy Mandal, when there were pharmacies outside the hospital, the daily income was around Rs 500,000 but now it has reached Rs 900,000.

The administrative director of the hospital, Dr Bhupen Basnet, said: “The closure of outside pharmacies has had some impact. However, we have planned to expand the pharmacy so that patients can easily obtain all medicines within the hospital premises.

According to him, the Bir hospital draws up a list of medicines needed for emergencies and surgeries.

“We have prioritized drugs for emergency and surgical patients in the Bir hospital pharmacy,” says Dr. Basnet, “OPD patients can go to other places to take drugs. However, the drugs needed in emergencies and operations are more sensitive.

“After the then Minister of Health, Gagan Thapa, took administrative and legal initiatives to ensure that all public hospitals had their own pharmacies, Bir Hospital Pharmacy was established in 2016. But , as the hospital provides multi-specialist services, not all types of drugs can be obtained,” argues Dr. Basnet.

According to him, the hospital pharmacy is trying to increase the supply of almost 5,000 types of drugs in the pharmacy.

Room for improvement

File: Bir Hospital
File: Bir Hospital

For the smooth running of Bir hospital pharmacy, the hospital has made billing and dispensing arrangements from four counters in the main building, according to hospital pharmacy chief Shyam Mandal.

In addition, pharmacy services have also been set up in the surgical building. To reduce the congestion of the hospital, an umpteenth pharmacy will see the light of day in front of the operating room of the surgical building shortly.

“The pharmacy and the operating room on the ground floor of the surgical building will be combined and the drugs will be distributed to patients in the surgical departments. From the pharmacy in the main building, the service will be provided targeting OPDs,” Mandal says, “If necessary, we will increase human resources, rooms and the number of pharmacies.”

Currently, 23 staff provide 24-hour pharmacy service in the main building and 12-hour pharmacy service in the surgical building, according to the administration of Bir Hospital.

Also, since some antibiotics in the hospital are much cheaper than outside pharmacies, patients are greatly relieved. Basnet says, “We buy drugs through competitive bidding. That’s why the drugs here are not expensive compared to outside pharmacies.

“Now, by increasing the operational level of the pharmacy in the hospital, customers can get fast and easy service.”

This story has been translated from the original Nepali version and edited for clarity and length.

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