Tilganga, Time and Tolerance
Krishna Kumar Yogi
Health services and sectors provided to patients are highly criticised in Nepal. Though the frequent blames upon health sectors may not appear fair and balanced, a numbers of criticisms critics curiously make indicate that there are genuine reasons behind their fault finding. Criticisms may not be for the purpose of their ‘own sake’, they do revail the reality as well. Health workers’ nasty and intolerable behaviour, divided mentality, orientationless treatment and the reactions of patients dissatisfactions on their service causes criticisms in reference to health institutions in Nepal. The recurring cases of corruptions, criticisms, superfaciality seem to be something retualized routine for health related institutions and its heads which characterize with their underlying problems.Everyone thinks that Tilganga is the excellent eye hospital in Nepal. I think, this statement has been no further reaveling the reality. I felt it when I visited this hospital as an eye patient two years ago as I had a terrible headache since a long. As I was returning from my college professing in the morning, I set off myself towards the hospital directly. When I reached in the permises of the hospital, there were many patients waiting for a turn to have their eyes checked up. It was exactly 10 am. There were some in the queues lining up themselves. Those who were in the lines were the old patients who had to register their names before 12 o’clock. I was one of them, who were in the queue waiting for the counter staff to come. It had been said that the time in between 10 to 10.30 am is a breakfast time. We, the patients were waiting tirelessly. There was no any option except that. They were all expecting the staff coming soon in the counter and giving them the file back which could initiate their check up. It had been already 10-15 minutes delay than the time prescribed for the breakfast. Nobody came to the counter.
After a few minutes, they came in the counter; we showed the cards given to us previously. There is a system of patients getting the cards if they once visited the hospital. It is supposed to show the cards before 12 noon and get his/her eyes check up. It was the second shift and perhaps the busiest hour, but there were no significant number of patients that day comparatively talking to any other days. In the counter, after looking at the file one of the staff said, ‘You should go in Room No. 1 and then Room No. 8.’ From the counter itself, the patients were distributed into different eye specialists in different rooms. The room that I went was split into two divisions, and there was the provision of examining patients both sides of Room No. 1. Our section had no doctor. I complained about the late coming of the doctor. Later on, I asked one of the staff about it, he replied in a suggestive manner‘You could go into the next section where there were the doctors examining the patients and have check up.’ Leaving others, two of us, went towards the next side. My eyes were examined and reffered to Room No. 10 where there was Dr. K. B. Khadka, who checked my eyes up. I was impressed by his simple and generous nature and realized true that the half of the illness of the patients can be cured by doctor’s friendly dealing. There was no delay in the process of examination upto this point of time.
After Dr. Khadka finshied examining, he asked me to go back to counter and repay the check up fees. I paid the fees and was suggested to go to Room No. 9 to have a more complicated examination. It was somehere outside of the main hospital building. There were many patients from all the way to Rautahat, Dolakha, Kavre, and I myself was from Surkhet hoping to have a smooth check up. But, it was something difficult, unsystematic and choatic with the ways the hospital staff were dealing with the patients. It seemed there were complete absence of rules; they believed as if they were the rule makers and breakers both. It was not at all systematic; whoever could have already contacted through phones could enter easily and have their examination. I questioned to myself: How could the concept of new Nepal be materalized in these circumtances? There were some patients going to and returning back after their check up. There was a big flow of patients. Those who were waiting for their turn were almost asleep, some were feeling dizzy, some were bored.
One and half an hour waiting in the clumsy corridor, I could not tolerate anymore - the unordinary behaviour of those nurses and and others who were the main cause of delay. Their behaviour could not be digestible it seemed as if they were just cutting jests with the children. They were just killing the time anyway maybe it was government owned hospital and might be guided by the false notion. It was one of the best ways how they could do nothing and pretend themselves busy giving a false impression like busy people. It was their natural tendency which can not be given up so easily that could be reflected through their activities. I went towards them and commented against their nasty behaviour. Then, only they started to check up the patients without any disturbance and delay motive. It shows that the staff of the hospital have been habituated with the fully individualitic and ill behaviour and not being at all responsible towards the patients. I opine that the hospital is a sacred place to serve those who seek help, hope for a whole treatment in a friendly manner. Instead of it, I realized Tilganga Eye Hospital is no more operated with the spirit of service which was felt so obviously. There were four desks where patients were found unnecessarily taking time in the examinaition of their eyes. I termed this room (Room No. 9) as ‘lazy women’s department’ as the women personnel were unintendingly performing their duty. Those who were waiting for their turn were dumbfounded; they even could not open their mouths against staff and doctors’ bitter behaviour and humanity-less treatment.
When I was waiting outside, one of the nurses came and asked who the patients was. I said it was me. She inquired about me and my status. After a long, tiring and boring hours of waiting, my turn came and my eyes were examined. I got the report, it was to be submitted to Dr. Khadka in Room No. 10, but he had already gone out. I thought he might have gone for lunch, as the lunch time was from 12.30 to 1.00. I also expressed my disagreement with the nurse that I earlier met saying who I could show my report to. I was very confused to whom I could show my report.
In the meantime, I saw a couple standing worried just infont of the gate.After a brief inquiry, I came to know that a woman patient with her husband of about 40-45 years coming there to have treatment of her weary eye. They had come from Nuwakot, it is according to her husband, 80-86 KM away from Kathmandu. Coming and going on the one hand, may make them tired. On the other hand, it was not practical to go and come back form Kathmandu to Nuwakot. Her case was quitre complicated as her right eye was much red and had with a sore. They were worried about her eye, but what could they do? Just nothing.
There was no one helping them or speaking for them so that the hospital adminsitaration will listen to them. So, I thought it was good for them to help because they were in a great obstacle in their life. No others were helping them, or intending to assist them, and then forgetting my own treatment, I advocated for them. Lastly, the staff asked them to get hospital the following day at 9 am. I knew that they were in the hospital in course of treatment for the last 3 days. They achieved nothing during those past days; just they had lost the money, efforts, and thought that they were just having futile days in Kathmandu. After a few minutes talk, I noticed that they had confirmed Dr. Suman but he was absent that day. Their waiting was like that of Waiting for Godot. Will they get good treatment with hospitable manner or not? This query will be rest in the womb of future days in Tilganga Eye Hospital, Kathmandu. They are not still sure and certain whether Godot (the day and the doctor) will come or not to serve them, and to treat them.
With this particular incident, my perspective towards Tilganga Eye Hospital was totally changed. I found the institution hollow nothing more. No path of progress it goes with rather it attaches itself with a principle of regression. The notions such as: expertism, the dedicated staff, the sense of service and hospitable manner of treatment and ease and comfort the patients need were turned to be false in the hospital premises. The reality was deconstructed or perfectly u-turned. Instead of getting excellent treatment, one can get intense troture as a patient that I realized as a vicitim. Wherever I have eye problem, I better find myself in an eye clinic where at least I find satisfaction. I realize that the pollutant has already entered inside the institution. I would like to suggest to the stockholders that the hospital adminsitration should move according to the test of time, the flavours of the patients having essential improvement. Most importantly, the hospital administration should comprehend the problems of patients as of their own where the sense of service truly becomes intensified and the name of the hospital remains inscribed with good memories in the heart of common people.
