Acción no violenta para reformar la educación médica en Nepal - las huelgas de hambre del Dr. Govinda KC / Non-Violent Action to Reform Medical Education in Nepal - The Fasts-unto-death of Dr Govinda KC
Resumen
En la actualidad, se necesitan urgentemente reformas al sistema de educación médica vigente en Nepal, por sus carencias críticas. La integridad del sistema de educación médica de Nepal se ha visto amenazada por inversionistas, incluidos algunos miembros del parlamento, líderes políticos y empresarios influyentes que abordan la apertura de nuevas escuelas privadas de medicina como una manera fácil de hacerse de ganancias de forma rápida y sin esfuerzo, aunque no exista una autoridad central efectiva que las regule. La presión en relación al establecimiento de nuevas escuelas de medicina aumenta incluso cuando la educación resultante pueda ser deficiente y los graduados, cargados de deudas, no puedan encontrar oportunidades de capacitación de postgrado ni estén dispuestos a aceptar puestos fuera del Valle de Katmandú. Una fuerza importante que impulsa los esfuerzos por reformar, sistematizar y mejorar la educación médica en Nepal ha sido la serie de diez huelgas de hambre, que han implicado la muerte de un médico, el cirujano ortopédico principal, el Dr. Govinda KC. Para poner sus esfuerzos en un contexto histórico, revisamos la historia de la educación médica en Nepal desde 1978, cuando se creó la primera escuela para la formación de médicos de Nepal, el Instituto de Medicina. Buscamos aclarar si la tendencia actual hacia la educación médica con fines de lucro es compatible con la norma legal en Nepal, o si el país corre el riesgo de convertirse en un estado fallido por ignorar la necesidad de adaptar la producción de médicos a las necesidades sanitarias nacionales. Abstract At present, reforms of the critically flawed system of medical education in Nepal are urgently needed. The integrity of Nepal’s medical education system is threatened by investors, including members of Nepal's parliament, political leaders, and influential businessmen who treat the creation of new for-profit medical schools as an easy way to generate profits quickly and effortlessly, while no effective, impartial central authority exists to regulate the situation. The pressure to approve new medical schools increases even when the resulting education may be substandard and debt-burdened graduates neither able to find post-graduate training opportunities nor willing to accept positions outside of the Kathmandu Valley. A major force driving efforts to reform, systematize, and improve medical education in Nepal is the series of ten non-violent fasts-unto-death campaigns of one dedicated physician, senior orthopedic surgeon Dr. Govinda KC. To put his efforts into historical context, we review medical education in Nepal from 1978, when Nepal's first medical school, the Institute of Medicine, was created. We seek to clarify whether the current trend toward for-profit medical education is compatible with the rule of law in Nepal, or whether Nepal risks becoming a failed state as it ignores the need to align the production of physicians with that of national health needs.Citas
Ayurveda Campus Homepage. http://www.iom.edu.np/examsection/ayurveda.html
Dickinson, John. 1984. Twelve New Doctors for Nepal; British Medical Journal 12/22/1984, Vol. 289 Issue 6460, p1715
Dishanirdesh with Dr. Govinda Kc - 26.07.2012. https://www.youtube.com/watch?v=KfL61OEDZGc
Dixit, Hemang. 1999. The Quest for Health. Kathmandu: Educational Enterprises.
Dixit, Hemang. 2009. Development of medical education in Nepal. Kathmandu University Medical Journal 7.1.25, 8-10.
Gautam, Manish. 2014. Dr Sashi Sharma is the new IoM dean. Dr Govinda KC threatens hunger strike ‘to save IoM." http://kathmandupost.ekantipur.com/news/2014-01-10/dr-sashi-sharma-is-the-new-iom-dean.html
Gautam, Manish. 2015. Govt, Dr KC Reach 11-pt deal. http://kathmandupost.ekantipur.com/news/2015-09-05/drkc-signs-an-11-point-agreement-with-the-government.html
Karki, Arjun. 2016. "Private medical schools amassing profits at cost of quality." Kathmandu Post 4 January 2016. http://kathmandupost.ekantipur.com/printedition/news/2016-01-04/private-medical-schools-amassing-profits-at-cost-of-quality.html
Kathmandu Post Report. 2016a. 25 January 2016. Public campaign launched against government move. http://kathmandupost.ekantipur.com/printedition/news/2016-01-25/public-campaign-launched-against-government-move.html
Kathmandu Post Report. 2016b. 13 May 2016. Health edu final act draft handed to PM. http://kathmandupost.ekantipur.com/printedition/news/2016-05-13/health-edu-final-act-draft-handed-to-pm.html
National Population and Housing Census 2011. Government of Nepal National Planning Commission Secretariat Central Bureau of Statistics Kathmandu, Nepal. Published by Central Bureau of Statistics Ramshah Path, Thapathali Kathmandu, Nepal. 2014. http://cbs.gov.np/image/data/Population/Urban%20Volume/UrbanVolume_Part01.pdf
Prasai, B.R. 1983. The Undergraduate Medical Education in Nepal: Its concepts and problems. Kathmandu: Mrs. Subhadra Prasai, 3.
Repubica on-line. 2016a. 25 January 2016. http://www.myrepublica.com/feature-article/tag/dr%20govinda%20kc.html?start=4#sthash.ndKNBjRj.dpuf
Republica on-line. 2016b. 5 December 2016. Dr KC ends fast-unto-death on 22nd day. December 5, 2016 01:00 AM. http://www.myrepublica.com/news/10455 .
World Health Organization 2010. http://www.who.int/healthinfo/systems/WHO_MBHSS_2010_full_web.pdf
Zimmerman, Mark, Rabina Shakya, Bharat M Pokhrel, Nir Eyal, Basista P Rijal, Ratindra N Shrestha, Arun Sayami. 2012. Medical students’ characteristics as predictors of career practice location: retrospective cohort study tracking graduates of Nepal’s first medical college. BMJ 2012;345:e4826