An interview with Dr. Dinesh Nath Gongal
ashutosh_tiwari
What follows is from the latest issue of Kathmandu-based
Independent newsweekly.
When I last spoke with Dr. Gongal in Kathmandu in August 1997,
he was very concerned about the politically/personally
useless infighting that went on in his profession in Nepal, thus
tearing medical fraternities apart.
We can all learn from his his life's stories and ideas.
Enjoy.
oohi
ashu
**********************************
"The poor must not be ignored"
Dr. Dinesh Nath Gongal, MS, FRCS, FACS, a senior consultant
surgeon has devoted 44 years of his life to the medical service
in Nepal. He worked in the Bir Hospital as a medical graduate in
1956 and as a surgeon from 1961 until 1997. In between he spent
two and half years in Koshi Zonal Hospital as the chief. He ran
the department of surgery in Bir Hospital as the head of the
department and was also the chairman of Bir Hospital Development
Board for 3 years. He is currently working as a local convenor
for the FRCS exams of The Royal College of Surgeons of
Edinburgh. His biggest achievement was the establishment of
surgery in Nepal and in particularly neurosurgery. He has also
contributed a lot in training the much required surgical
manpower in the country .He was recently awarded for his
achievements by the prestigious award, the Jyotirmaya Subikhyat
Trisatthipatta by His Majesty King Birendra. He was also awarded
the College Medal by the Royal College of Surgeons of Edinburgh
for his contribution to the College and surgery in general. He
talked about his experiences recently with Sushma Amatya of The
Independent. The excerpts:
Q: What gives you greatest pleasure in your profession?
A: To see my patient get well after surgery especially when all
odds are stacked against him. I am sure this is true for other
doctors too.
Q: What is your opinion on the medical practice in our country?
A: Medical practice has undergone tremendous development and we
are trying to keep pace with it. Sub-specialities are
developing. We have highly qualified young colleagues. The
facilities and quality of service have improved. The only sad
note is that there seems to be increasing commercialisation of
the profession.
Q: Kathmandu has more doctors than it really needs while other
parts of Nepal suffer from a paucity of doctors. What do you
have to say about this sorry state of affairs?
A: Not only Kathmandu but other cities like Pokhara, Birgunj,
Biratnagar too have more doctors than needed. The situation is
going to remain as such until other areas of our country prosper
and job opportunities become available. Certainly, Kathmandu is
super saturated with doctors.
Q: With many students aspiring to become doctors, don’t you
foresee a shortage of other medical hands?
A: Yes, there are many students wanting to become doctors. At
the same time, there are increasing numbers of medical related
subjects e.g. nursing and paramedics. I agree that they play an
important role in the management of health service. But with the
rising number of paramedical institutions, there is a danger of
compromise in quality.
Q: What is your opinion on accountability of doctors?
A: This is one profession where accountability has always played
an important role since ages gone by. Moral accountability is
important for building of trust between the doctor and the
patient. However, there seems to be a decline in accountability
of late in medical practice, perhaps due to commercialisation.
I do agree that patients must start asking questions and they
must also try and educate themselves regarding the body and the
diseases that they are suffering from. I believe that the issue
of accountability must also be considered by doctor community
and bodies like NMC. They should probe into unethical or
unscientific practices and negligence should not be tolerated.
Q: How was your experience in Bir Hospital like?
A: Working in Bir Hospital was an excellent experience. It was a
great challenge, working with limited facilities and having to
provide high quality care and training. I thoroughly enjoyed it.
I must have spent 60-70% of my waking hours during that time in
the hospital and I would not have had it any differently. The
highlight of my career was when I could establish the
neurosurgery ward.
Q: What was the saddest period that you recall?
A: When I lost my first heart operation patient (mitral
valvotomy) on a young girl, Goma. That tragic incident was
followed by a similar but successful operation on Ganesh Bahadur
after 2 weeks.
Q: Getting a medical education is an expensive affair that only
the well to do can acquire. How can it be made mass friendly?
A: No doubt that medical education is expensive in Nepal. It is
even more expensive abroad and even in India except in
government run institutes. Health and education have become
purchasable commodities and this is a sad fact. No matter how
poor the parents are, they would always want to give their
children the best education and forego many things themselves in
the process. This is another reason that is probably promoting
corruption. This undeniable fact needs to be taken seriously by
the people who govern the country. Reasonable budget needs to be
allocated to health and education. The private medical colleges
were meant of NRIs who can afford their rates. However, we can
always look at the colleges positively for the services they
provide to the local people, hopefully at reasonable rates.
Q: FRCS exams are being held here. Could we not have facilities
whereby our medical students could complete their higher studies
in Nepal?
A: We are holding full FRCS exams here and also hold the Diploma
ceremony. Advanced degrees are important and I am convinced that
we should have our own Royal College in affiliation with
international colleges so that we can train our manpower
locally .
Q: How have the years of work and all the experiences changed
you as a person?
A: I have learned to accept challenges in my profession and in
life. I think I have also become more patient and tolerant.
Q: How do you occupy yourself these days?
A: I am working in the HM Hospital. When I have time, I go to my
ancestral farm in the Terai. I am kept busy during the winters
by organising Fellowship exams.
Q: What advice would you give to young doctors?
A: My message especially to young doctors is to treat their
patients with respect and patience. Patients should be treated
like gods, no matter who they are, how poor or rich they may be.
Doctors should develop good rapport with the patients and build
confidence of the patients.
Q: How can an important issue like health be given its due
respect and the related problems solved in our country?
A: To make life more comfortable for all of us, it is important
to break away from the set norms and stop making health and
education a purchasable commodity. I agree that development of
private sector in health has helped to take the patient load but
this is only available for those who can afford it . The
government cannot forget the unfortunate poors who not only have
the burden of poverty but also have to bear the misery of
suffering from diseases. Government hospitals must be better
funded. The poor must not be ignored.
Q: You earned a reputation of being very curt and impatient.
What do you have to say about that now? Of course’, that in no
way detracted from your reputation as a very diligent and
competent doctor.
A: Yes, many times, I have been very rude to people due to lack
of patience, a quality that I realise is so important now; and
all the more reason I advice the young doctors to develop this
important quality. In the process of practicing selflessly I
often overlooked this important humane quality.
THE END
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ashu...@post.harvard.edu
What follows is from the latest issue of Kathmandu-based Independent
newsweekly. For details: check: http://www.nepalnews.com
When I last spoke with Dr. Gongal in Kathmandu in August 1997, he was
very concerned about the politically/personally motivated infighting
that went on (and one assumes still goes on) in his profession in Nepal,
Such infighting will throw out logic and evidence, and use only
emotions, thus intentionally or unintentionally
pitting friends against one another, and with minor resoluble
disputes breaking out like World War II ko battles, and
thus ultimately tearing (medical) fraternities apart.
Enjoy.
oohi
ashu
THE END
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