Bir Hospital
Encyclopedia
Bir Hospital is the oldest and one of the busiest hospitals in Nepal
Nepal
Nepal , officially the Federal Democratic Republic of Nepal, is a landlocked sovereign state located in South Asia. It is located in the Himalayas and bordered to the north by the People's Republic of China, and to the south, east, and west by the Republic of India...

. It was established in July 1889 by Bir Shamsher Jang Bahadur Rana
Bir Shamsher Jang Bahadur Rana
Maharaja Sir Bir Shamsher Jang Bahadur Rana, GCSI, , was the 17th Prime Minister of Nepal. He was born to the Chief of the Army Dhir Shamsher Rana . He and his brothers plotted the assassination of their doddering uncle, the Prime Minister Renaudip Singh Bahadur...

. It is located at the center of Kathmandu city. The hospital is run by the National Academy of Medical Sciences, a government
Government of Nepal
The Government of Nepal, or Nepal Government, is the executive body and the Central government of Nepal. Prior to the abolition of Monarchy in Nepal, was officially known as His Majesty's Government....

 agency since 2003.

The hospital provides medical and surgical treatments to people from all across the country. Many patients from the rural areas come to this hospital to get free treatment. It current has a capacity of 535 beds. Some of the county's top doctors work in this hospital.

Every year it produces trained post graduates in different subjects of clinical medicine e.g. general surgery, internal medicine, orthopaedic surgery, pathology etc. It has become an Internship centre for students who had passed MBBS from China and Russia and other parts of the world. Hundreds of nurses of different levels get nursing training in this hospital.

Nephrology

Nephrology
Nephrology
Nephrology is a branch of internal medicine and pediatrics dealing with the study of the function and diseases of the kidney.-Scope of the specialty:...

 service in Nepal started at Bir Hospital. Though over 40 kidney biopsies are done every year, due to lack of well trained manpower in the field of renal histopathology
Histopathology
Histopathology refers to the microscopic examination of tissue in order to study the manifestations of disease...

, glomerular diseases cannot be easily diagnosed with accuracy. Again, IgA nephropathy also remains undiagnosed. Hence, training a renal histopathologist and a histopathology
Histopathology
Histopathology refers to the microscopic examination of tissue in order to study the manifestations of disease...

 technician is found to be the most important task for the hospital in order to provide accurate service to the patients.

Disaster Response

The hospital has one of the best disaster response team in the country. Vast majority of disaster and mass casualty victims are treated either free or with minimal charges. Disaster situations faced mostly are from natural causes or road traffic accidents. The hospital's disaster management plan was used first in 1988 following a stampede incident in the national stadium in Kathmandu.

Surgery

The surgery department is the oldest department of the country. It has different units as General surgery, Gastro and hepatobiliary surgery unit, Burn and Plastic surgery Unit, Urosurgery, Cardiothoracic, Neurosurgery.
The general surgery department performs about 3,000 elective and emergency operations each year, and similar number of minor general surgical cases. The department of surgery is the place from where the most of the top surgeons practicing in the country and abroad have been trained. The department needs further Trained manpower and equipments with refurbishment of ward and increase in the number of beds as well as operation days. This is the place where the countries most underprivileged get their treatment almost for free.The Department of surgery calls out for help in further training , in establishing Mch program in different super specialties and donation of equipments.

Burn and Plastic surgery Unit

Burn and Plastic surgery unit has 16 beds, including 3 burn ICU beds. Every year more than 100 severely burned patients used to be admitted in this unit. It is providing both life savings and corrective surgery for burn patients. The unit is currently run by two general surgeons. The WHO Nepal has sponsored a surgeon (Dr Peeyush Dahal) to have fellowship training in plastic and reconstructive surgery. This unit is also conducting the research in burn care management.

Every year national and international medical students are getting opportunities to grab the evidence based burn management in a holistic approach. It is always ready to share the ideas, knowledge, experiences and the technology for the better care of burn victims.
In 2001, the Burn Unit at Royal Perth Hospital (RPH) in Western Australia (WA) and the Bir Burn Unit (BBU) at Bir Hospital agreed to share information for staff educational programmes on burn care. An exchange was planned and two nurses got the opportunity to have the training but the linkage program is no more now.

The Burn and Plastic Unit lies helpless with only sisters taking care of the burn patients. The Nations only burn unit lies helpless without a consultant after Dr. KD Joshi left the hospital, there is no surgery taking place for burn patients for years now. The hospital management just lies watching. The doctor funded by WHO Dr. Peeyush Dahal is posted to Jhapa and is doing general surgery the government, the Ministry of Health and the Bir hospital management is just watching what is happening when the Burn unit established by efforts of many lies in ruins says Dr. Romeo Kansakar,Assistant Professor in the Department of Surgery, Bir Hospital,NAMS

Dental department

Dental department started its new unit of orthodontics and dentofacial orthopedics since 2009 with the cost about one forth than that of other clinics and hospitals. Degrees in prosthodontics and periodontics have also been offered since 2009.

Funding and challenges

The yearly budget of NRs 27 Crore (About US$ 4.1 million), two third of which is funded by the government. government
The hospital has been facing financial difficulties for many years now. The lack of adequate funding, non-functional equipments, and inability of the administration to get those running pose significant challenges to the hospital's functioning. Moreover, inappropriate politicisation of the administration seem to be the major contributor to the sorry state of affairs at the hospital.

Despite the rising costs at other hospitals, it has not hiked its fees. To help in the financing of the hospital expenses, it runs a medical school, which conducts post-graduate medical, surgical and other specialists training and also runs bachelor's level in nursing..
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