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As you enter the main entrance of Civil Service Hospital and take a right turn, you are welcomed by rows upon rows of bikes parked by visitors. There is a guard managing the parking space, but it is beyond his control. He blows the whistle to remind visitors to park their vehicles at the designated parking lot. Not everyone heeds his instructions. As a result of haphazard parking, it is difficult to find a parking space at the hospital. On this particular day, I was lucky to find a slot after much hassle. I managed to squeeze my bike in among the sea of motorbikes. The story of the crowd doesn't end here, though. A long queue greets you at the entrance counter of the hospital. Walking inside, you feel like you are taking part in a fair. Located at a prime location in Min Bhawan, Kathmandu, the hospital draws hundreds of people seeking the services from the Kathmandu Valley and beyond every day. Also, the hospital, as its name suggests, is primarily meant for the treatment of civil servants, at discounted rates. On the first floor, a large group consisting of both patients and visitors is awaiting its turn. There are parents carrying babies, pregnant mothers, and elderly citizens. The seating area is packed and some of them are sitting on the floor. The 112-bed hospital has been serving more than 1,000 people daily. And the number of patients is rising. "The hospital lacks infrastructure to cater to a growing number of patients and visitors," says Prof Dr Bidhan Nidhi Paudel, executive director of the hospital. “Insufficient infrastructure and human resources are hindering our efforts to deliver quality health services." Dr Paudel says the hospital plans to extend the hospital and its services. The plan includes a 10-storey building with 1,000 beds. Once the government approves the budget, the construction work will begin. The hospital is hopeful of an early approval. "If we could shift the OPD to a new building, managing this kind of crowd will be no problem,” says Dr Paudel. For now, patients and visitors at the hospital will have to contend with the crowd, and service delays that come with it. Minimum two months waiting list for surgery The waiting list of patients needing surgery is serpentine, literally. “Some patients have been waiting for eight months. It takes a minimum of two months for surgery, depending upon your case,” says Dr Paudel. Though compiled data is unavailable, a large number of patients have been waiting for treatment from ENT, orthopedic and other surgery departments. The reason for the delay of surgical cases is the ongoing repair of four operation theaters. This could take another one-and-a-half months. "Once the operation theaters become operational, the number of patients on the waiting list will go down by half," says Dr Paudel. Right now, the hospital is performing emergency surgeries. Limited services Lack of infrastructure has made the hospital unable to provide multi-specialty services as well. Many patients are referred to other hospitals, as services related to spine, kidney and neuro, among others, are not available. The hospital has been offering MRI services with the 0.35T MRI machine, which cannot perform brain imaging. “If we had enough space and resources, we could have met the public’s demands to deliver multi-care services,” says Dr Paudel. Online registration, limited But there is a lot the hospital needs to improve on. It's not just the infrastructure it lacks. The hospital has an online registration system for patients.  It’s a welcome initiative meant to serve the public better, but the service is pretty much limited. “According to the rules of the hospital, patients can buy tickets from 12:00 pm to 11:59 pm. For today, the hospital has already distributed a limited number of online tickets,” reads the hospital’s pre-registration page when this reporter tried accessing it. This means one thing: The hospital has run out of tickets for today. Try your luck tomorrow between the designated hours. “Online booking are meant to save your money and time. But you can only book ten tickets in a day,” says Santosh Bastola, who has come all the way from Khotang to get his grandparents Renuka Devi Bastola (81) and Namo Narayan Bastola (83) checked. "How is this helpful?" Limited online booking service means people queuing up from early morning, crowding the hospital counter and the parking space outside. “I stood in the line for more than three hours to get the token,” laments Sunita Shah, a resident of Lokanthali. But her struggle is nothing compared to those people who have come to the hospital from outside Kathmandu Valley. Service seekers wish the hospital increased the number of online tokens, so they could make appointments easily. “There were different lines for the civil servants and the public earlier. But now they are in the same lines, making the lines longer,” says Bastola. Service seekers also want the hospital to give priority to the elderly and disabled while delivering services. Open drainages and a dog on the loose It would also do well for the hospital if it put some effort to keep its building and surrounding clean. Open drainages on the hospital premises pose a huge health risk. The hospital staff do not seem to care that they are breeding centers for germs, especially during the summer. The hospital corridors and other sections also need some serious cleaning job. Old beds, couches and discarded stuff litter the building. And don’t be surprised if you encounter a stray dog walking idly by in the corridors. Vacancies announced, protest began The hospital needs consultants and experts to deliver quality health services. Treatment services need to be expanded covering spine and kidney diseases. For this, the hospital has announced vacancies—to be filled internally and externally. Amid all this, a group of employees have launched a protest demanding resignation of the hospital’s executive director and scrapping of the vacancy announcement. “The employees and doctors are hindering the process for fulfilling vacancies because they know it is a cut-throat competition and they don't want to sit in the exams fearing that they will fail. The vacancy has been announced after a decade and it will be fulfilled through examination and interview. Deserving candidates should come forward to improve the services. ,” added Dr Paudel. Crunch of medics in Nepal: WHO The World Health Organization has said that there is a shortage of medical practitioners in Nepal. In a recently released WHO health workforce support and safeguards list 2023, the UN health body has identified 55 countries as vulnerable for availability of health workers required to achieve the UN Sustainable Development Goal target for universal health coverage (UHC) by 2030. The UN health body has enlisted Nepal in the list along with Bangladesh and Timor-Leste from the Southeast Asia region. No less than 55 countries are struggling with serious health worker shortages as they continue to seek better paid opportunities in wealthier nations that have stepped up efforts to recruit them amid the COVID-19 pandemic, it has said. “Health workers are the backbone of every health system, and yet 55 countries with some of the world’s most fragile health systems do not have enough and many are losing their health workers to international migration,” said Dr Tedros Adhanom Ghebreyesus, WHO director-general. The countries included in the WHO health workforce support and safeguards list 2023 have a UHC service coverage index below 55 and health workforce density below the global median: 49 medical doctors, nursing and midwifery personnel per 10,000 people. These countries require priority support for health workforce development and health system strengthening, along with additional safeguards that limit active international recruitment. The WHO does not prohibit international recruitment, but recommends that government-to-government health worker migration agreements be informed by health labor market analysis and the adoption of measures to ensure adequate supply of health workers in the source countries; engage Ministries of Health in the negotiation and implementation of agreements; and specify the health system benefits of the arrangement to both source and destination countries. The health body noted that the negative health, economic and social impact of COVID-19, coupled with the increasing demand for health and care workers in high-income countries, might be increasing vulnerabilities within countries already suffering from low health workforce densities. According to Nepal Medical Council, there are 10,080 specialized doctors, 27,805 MBBS and 4,413 BDS registered doctors in the country. According to Nepal Nursing Council, there are 73,889 nurses registered in the country. The medical practitioners have been migrating to developed countries seeking better pay and facilities.

The University of Nepal Infrastructure Development Board, established by the Government of Nepal, is working toward establishing the University of Nepal (UoN) in Gaidakot and nearby municipalities. A government bill to this effect is under discussion in the Committee on Legislative Affairs at the National Assembly, the upper house of the parliament. The aim is to pass a model legislation that will establish a world-class university in Nepal that will stand out from more than a dozen other universities that the government has established over the past 65 years. This is the first time that a new university is being established in Nepal through almost five years of efforts using a consultative and collaborative approach involving a diverse array of stakeholders, including existing academics, non-resident Nepali experts abroad, international professors, Nepali educationists, and the wider civil community. The aim is to ensure that the UoN is developed in a way that reflects the unique needs and priorities of the higher education sector in Nepal in the context of a globalized world. The model being followed is that of a public university, which does not necessarily have to be a governmental institution in terms of its structure and approach. The Board is also prioritizing the development of the UoN as a world-class institution that adheres to the highest standards of quality, research, and innovation. To achieve this goal, they are adopting a liberal arts and sciences approach, emphasizing the development of international faculty, research infrastructure, and innovative teaching methods, among other measures. Furthermore, the establishment of the UoN must comply with a regulatory framework that promotes quality and accountability. The proposed legislation being discussed in the parliament aims to establish clear standards and guidelines for the functioning of the new institution. Nevertheless, this is a challenging task. Many countries around the world have made significant progress in the education sector, but Nepal's universities have struggled to compete. Lack of focus and professionalism is evident across the board. Insufficient public funding is a common issue in Nepal's education sector, which limits resources for research, quality faculty, and infrastructure upgrades. There is also a shortage of qualified and experienced faculty members. Furthermore, these universities have been using outdated curriculum not aligned with industry trends or the needs of the job market. Political instability and unrest in Nepal are some of the reasons why universities are not performing as desired. This instability has negatively impacted funding, enrollment rates, and the overall academic environment. Additionally, poor governance has led to corruption, mismanagement, and nepotism within universities. The lack of research opportunities and funding for research have also contributed to their poor performance. While there are many dedicated and passionate faculty members, Nepali universities have been slow in implementing improvements to the academic environment due to these realities. These common trends are the result of some of the most overlooked issues in higher education in Nepal. With the exception of Kathmandu University, none of the universities in Nepal are functionally autonomous, and instead have political appointees serving as vice-chancellors. Many of these appointees lack renowned academic leadership skills, a visionary outlook, or competitiveness. They also lack fundraising capabilities, which is essential for the growth and development of universities. Furthermore, there is little room for international recruitment, as rectors, registrars, and deans are appointed within the system. The management created by these political appointees is often acceptable to the political elites of the country, primarily the ruling party or coalition, but falls short of meeting the requirements of a thriving academic institution and an aspiring body of modern students. The system that has been created is built on trade unionism and political connections, lacking legal, political, and functional autonomy. Diversity and inclusion in faculty and students have been neglected in institutional management in Nepal. Competitive appointment systems have not been implemented. These universities have remained isolated within the national system, existing mainly due to limited government funding. Reforming these institutional arrangements is a daunting task, as vested interests have developed around them over decades. Establishing a new model university that addresses these challenges is imperative for the country's progress. The main objective of an education system should be to meet the requirements and aspirations of the wider community and contribute to the growth of the country as a whole. If an education system does not prioritize the well-being and progress of the broader national community, it is not fulfilling its purpose effectively and should not be given priority for investment or support. This emphasizes the significance of considering the broader social context and impact of education while formulating policies and allocating resources, rather than only concentrating on narrow measures of academic success or individual achievement. Despite being a developing country, Nepal is located in a geographically advantageous position to excel in higher education internationally. The country has the potential to become a hub for industries that focus on creating, disseminating, and applying knowledge. By creating a favorable environment for education, research and development, software development, media and publishing, consulting, and other knowledge-intensive services, Nepal can foster and make the most of intellectual capital, which includes the knowledge, skills, and expertise of workers, as well as technology and innovation. This industry is often associated with high-skill, high-wage jobs, and is regarded as a crucial driver of economic growth and development. In order to achieve this, it is crucial to establish a liberal environment and links with other high-yielding international academic centers. The political leaders of Nepal must recognize that in the knowledge industry, knowledge is a critical resource that can be utilized to create new products, services, and processes, and improve existing ones. Companies and organizations in this sector invest heavily in research and development, and work continuously to enhance their knowledge and skills. The education industry is a crucial part of the global economy and is likely to grow in importance as technological advancements and globalization continue to reshape the world of work. However, systemic challenges and limited resources can make it difficult for Nepali universities to realize their full potential. The development of a successful model university can be a crucial step toward reforming the higher education sector in Nepal. By learning from the experiences of this university, the government can formulate clear and effective policies and processes for reforming the existing universities. Moreover, the government can use the model as a platform to collaborate with international institutions and experts, and bring in best practices from around the world. Overall, the development of a successful model university can be a catalyst for broader reforms in the higher education sector in Nepal, and can help to ensure that universities are better equipped to serve the needs and interests of the wider national community. The author is associated with Kathmandu University in Dhulikhel

My human hands Don't have the mystic touch To rewind time nor freeze it. But, I can, however, Turn the arms of your watch a bit. Twisting the nods ever-so slightly, Making us strangers with time. Warped and wayward We would lose touch with reality, For eternity you'd be mine. Abhigya Shrestha, Grade: 10 Rato Bangala School

Every story is similar But never the same. Sometimes, it might feel like a war But life is just as through an aim.   Aim makes many stops At major points of one’s life fight, Even when your smile drops A good moment is never out of sight.   People say happiness doesn’t last forever But so doesn’t misery, That’s the thing, they don’t understand ever The thought of it is kind a scary.   It’s scary because they easily forget The value the worth of being alive  It’s scary because all they know is hate Their minds, full of thoughts, buzzing like a bee’s hive.   Though every life ever born It’s beautiful, that’s why to strive Life isn’t paper to be torn So,even in great sorrow you’ll enjoy it if you thrive.   Asma Miya Grade: 7  Meridian International School