Nepal’s quest for health
Professor Hemang Dixit is an inspiration for all doctor-writers. There have been a number of doctor-writers in the literature. Sir Arthur Conan Doyle, Somerset Maugham and Anton Chekhov are a few which come to mind. The third edition of Dr. Dixitâ€™s path breaking book on â€˜Nepalâ€™s quest for healthâ€™ gives a comprehensive view of the health scene in Nepal.
The book is divided into six chapters. The book starts with a list of operational definitions. â€˜Medicine in the beginningâ€™ talks about Ayurveda and faith healing in Nepal. The introduction of allopathic medicine by the Christian missionaries is well covered. Health care development under the Ranas is exhaustively covered.
The second chapter concentrates on â€˜Diseases and control attemptsâ€™. Various infectious diseases are well described. Being a member of the Mountain Medicine Society of Nepal (MMSN), I was gratified to find a reference to altitude sickness. Primary healthcare is vital to improve the health status of a community or country, and professor Dixit has rightly emphasized primary care. The section on Essential drugs gives a basic overview of this vital topic. The revamping of primary care has been mentioned.
The third chapter on â€˜Child and maternal health, family planningâ€™ gives exhaustive statistics on the health status of Nepalâ€™s women and children. The high population growth rate should be a matter of concern. The various health schemes for women and children are described. I obtained an idea of various childrenâ€™s organizations and non-governmental organizations (NGOs) working on child health and nutrition in Nepal,.
â€˜HRH, Academics and Researchâ€™ talks about the various health institutions in Nepal. Nepal, in common with the other South Asian countries, has more doctors than nurses. This may hamper cost-effective healthcare delivery. The breakdown of manpower at various levels of healthcare is interesting. The establishment of private medical colleges in Nepal is a recent phenomenon. Health research in Nepal has also been mentioned. The various research topics mentioned will be helpful in directing health researchers in Nepal.
The fifth chapter describes the â€˜Development of health servicesâ€™. The various five year plans are well covered. The various hospitals in Nepal are given an exhaustive description. PHCs, ayurvedic hospitals and homeopathic dispensaries are described. Community hospitals and health insurance schemes may be a cost effective means of healthcare delivery. The various NGOs and INGOs which are active in the health sector have been described. We have to work out a method to ensure effective, accessible and affordable healthcare to the population.
The last chapter describes â€˜Plans, policies and their implicationsâ€™. The annexes deal with health legislation, acts and rules, and various councils.
The book is an invaluable source of information about Nepal. There are a few suggestions for improvement. The index can be made more comprehensive. Colour can be incorporated in the charts and diagrams, but this may increase the cost of the book. Photographs and pictures can be added to the book. â€˜Migration of medical manpower to the developed countriesâ€™, â€˜The Nepalese pharmaceutical industryâ€™, â€˜Improving access to health and medicinesâ€™ and â€˜Clinical research in Nepalâ€™, may be topics which can be covered. A summary at the end of each chapter will be very useful. The comprehensive references at the end of each chapter are useful. I would be very much interested in this distinguished academicianâ€™s prescription for improving health in Nepal.
The cover has been beautifully designed by Dr. Angel Magar, a very talented young doctor. The size of the book makes it very handy and portable. The print and paper quality is good, and at Nepalese Rs. 250 (around US$ 4), the book is affordable. The book should be necessary reading for all doctors, health personnel, medical, nursing and pharmacy students and health administrators. A powerful
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