Dr Prajjwal Pyakurel
COVID-19 is the defining global crisis of the current century and greatest challenge to the mankindsince world war two. Since its emergence in the Huanan Seafood market in Wuhan, China on December 31, 2019 the virus has spread globally killing 2,34,408 people (1st MAY 2020 ,10:16 GMT). The disease created panic among global world and boundless advancement which it witnessed since last 30-40 years came like a shattered glass.
I rate myself as a Community Physician and Public Health experts and work in one of the best medical colleges in Nepal with adequate infrastructure, manpower and resources to handle COVID-19. I also believe that I am enthusiastic and passionate enough to contribute to the country in times of need.But the hanging question always come in my mind, is there a difference between working for COVID-19 response from within and outside the valley. Different experts rate this argument in different ways, but I want to argue this statement in terms of for and against. Expertise and knowledge knews no bounds. If you have knowledge and skills, commitment,and dedication to work yourdeed could be recognized anywhere across the country. Our collective human wisdom has long been built through the exchange of ideas, from our first navigational knowledge of the seas to our ongoing exploration of the heavens. So, one should always think from that broader perspective. However, the against argument is that one could not instantaneously come in glarealthough he/shepossesses all the above-mentioned affirmation.The pertinent intellect is that the bell always rings in the door and not in the window. These all arrays of argument pulled the country into three tier health system with federal, provincial, and local government. But the questions again arise in the adaptability of decentralization of these three tiers of health system and its facilitation of COVID-19 response in righteous path.
Kathmandu valley has always been recognized as the most developed place in Nepal. Historically it is known as Nepal Valley or Nepa Valley and the natives of Kathmandu still called it as Nepal. It is the place where all the federal level government health system including Ministry of Health and Population of Government of Nepal is located and where the COVID-19 response begun. Although the provincial government and local government has greater autonomy compared to before Nepal went to federal structure the ball is still in the patio of federal government and the reverberation does not comes in the provinces until it is programmed at the federal level. This means that those who are working in Kathmandu valley gets first pass. However, those who are equally competent and efficient and working outside the Kathmandu valley are disdained. The provincial government and local government at different province are still heedless of the same level of expertise at their own provinces and are cold-shouldered. From the point of view of experts at the provincial level more needs to be executed to be spotted at central level and reverberated back to provincial level. The government at various level should recognize the right competency and expertise in their provinces and channelized accordingly for effective response for COVID-19. The COVID-19 response is not the one army exposition. It needs a great deal of team effort with equal support at local, provincial, and federal government with strong communication and coordinating mechanisms with appropriate policy changes.
- Dr Pyakurel is an Executive Member of Nepalese Society of Community Medicine (NESCOM)
