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Technological advances and growing digitization have forever changed many industries, the trend only accelerating in the post-pandemic world. Of all these, healthcare, arguably, has benefited the most. The sector has changed in unique ways to improve the level of service it provides. Due to substantial advancements in technology and methods required to serve the increased demand for access to healthcare, expanding digitalization with protected health information is the way forward. 

The rapid evolution of technologies like artificial intelligence, extended reality, and bioprinting have led to some ground-breaking innovations in healthcare. This article discusses various trends in healthcare technology and its future in Nepal. 

Artificial intelligence (AI) has generated a lot of buzz as a practical technology across several sectors, particularly in healthcare. AI is a potent tool for effectively processing available data to improve efficiency in decision-making. For instance, AI is helping detect pneumonia through an analysis of CT scans. Natural Language Processing is an AI domain being used in Chatbots, which has the potential to improve telehealth efficiency. 

We thus see that data is the most significant element in the success of Artificial Intelligence in healthcare. An AI model performs better with higher quality and a broader range of information. 

Another trend has been the incorporation of extended reality in healthcare settings. The sector offers a lot of promise for extended reality, a broad phrase that encompasses Augmented Reality (AR), Virtual Reality (VR), and Mixed Reality (MR). Extended reality assists in the planning of surgeries, patient care, and the explanation of difficult medical procedures to patients and their loved ones. Along with providing heads-up information to the surgeons, it is also helpful for training purposes. 

AR has been used to develop various assistive devices as well. For instance, AccuVein, a US-based startup, has developed an AR-based device to assist nurses in finding the vein in patients, which has traditionally been an arduous task, especially in children and the elderly, with data suggesting a 40 percent of IVs (intravenous injections) miss the vein on the first stick. 

A prominent innovation that has been a boon for healthcare is integration of technology in wearables. Patients carrying devices to access their healthcare information and receive treatment have been standard for a long time. Diabetes patients wear glucose monitors. Instead of a gadget that sits on a table and needs to be linked, implanted devices like pacemakers and defibrillators offer a life-saving, close connection with patients. 

Wearables like smartwatches are becoming an integral part of our day-to-day life. They can regularly monitor an individual’s health parameters like heart rate and blood oxygen saturation without an additional device. Smartwatches can also be equipped with other micro-sensors in the future to avoid life-threatening conditions.

Bio-printing is another field disrupting healthcare with artificial organ development. Bio 3D printers are similar to traditional 3D printers. Here the digital model of the organ to be printed is first designed on a computer. Then it is sliced and exported to a 3D printer, which creates the 3D object layer. These printers use bioinks as the material; great attention is needed to retain the desired resolution and structure. Different organs have been developed using bioprinting and are under clinical testing. 

In Nepal, it is crucial to keep an eye on the current trends influencing healthcare technology as we move forward. Modern hospitals and care facilities rely heavily on legacy infrastructure and software. But time has now come to think about how those systems might be integrated with newer technologies or eventually replaced by more dependable ones. 

A technology incubation center to develop and test these technologies is of utmost importance—we need to be abreast of the rest of the world in this digital technological revolution, enhancing the quality and efficiency of our present healthcare system. Most notably, along with technological incubation, the healthcare sector should, with greater use of new technologies, prioritize improvements in performance, productivity, efficiency, and security without compromising dependability and accessibility.

Close to 15 years ago, my wife, Radhika, fancied buying a treadmill for home. I went along; it sounded better and more convenient than going to a gym—a handful then. We bought one.                                      

We began our workout regimen, walking and jogging without further ado. In our eagerness, we sometimes got carried away and pushed ourselves to the limit—only to end up with sore muscles and aching legs. After a layoff of a day or two, we resumed with a vengeance. Radhika lost tidy weight, too. 

With each passing year, the earlier enthusiasm waned, followed by frequent time-outs. But we did not quit and kept wearing thin our trainers on the treadmill belt. As age caught up, we settled on walking alone.  

Then, some eight years later, my wife developed lower back pain. Her work-out on the treadmill came to a grinding halt. The doctor prescribed some pills, recommended some stretches, and suggested cutting down on her weight as her BMI (body mass index) was high.  

Then, to my great surprise, she quit using the treadmill. She said a friend told her it was ‘terrible’ for the lower back and the knees. She further said she heard the same story from someone else and suchlike. That baffled me. 

I was sure she was misled. I tried to convince her the other way round, bringing up some study I’d done—but she stood her ground, and the matter was dropped.  

Our treadmill took a longish respite as I’d developed a passion for cycling and spent more time on it. Then, one day, Radhika raised the issue of disposing of the machine. Begrudgingly, I gave a yes to it; I’d my cycling to cheer me up. There were no buyers.  

I never gave up using my trusted old machine; it worked wonders during the monsoon as my cycling rides got cut down. Radhika never took kindly to the treadmill, however. Her knee problem and back pain stayed on. Her outdoor walks became erratic, and she put on weight.  

I thought it was high time that I convinced her to make a comeback. I buried myself in the Internet to learn more, especially the downsides of it—if any. 

The benefits of walking, whether the traditional way outdoors or on a mechanical treadmill, are a mile long. Following my research, I found some disadvantages of walking on a treadmill. Hang on! Those drawbacks came in the way only if done improperly, though. Here are some tips I gleaned from my research:  

1. Maybe you are overdoing it—always stick to moderation. Start at a slow, easy speed to gradually work your way up to a moderate pace without the support of the handrails. 

2. Proper trainers are a must; use closed-toe athletic shoes for comfort, grip, and better cushioning for those with back or knee problems—no high-impact exercises like running to avoid jarring and pounding.  

3. Treadmill walking, by and large, is better than walking on the asphalted surface like roads as the belt offers extra cushioning.

4. Are you maintaining a natural gait on the machine as you walk outside, including arm movement? A sine qua non. Keep the machine's incline flat while recovering from back pain. Go for a trusted brand with the minimum belt rebound. 

5. Poor walking posture can lead to lower back pain. Leaning on the treadmill bars or walking with your body hunched forward causes lower back muscles to work harder.

6. Avoid taking long strides; walk on the center of the belt, strike the belt first with your heel, roll through the step from heel to toe and push off with the toes. Look straight ahead.  

As a bonus, the treadmill offers an unparalleled cardio advantage over walking outdoors; it allows retro/reverse or backward walking, enabling your heart to pump faster than moving forwards and a metabolism boost. 

Reverse walking burns 30-40 percent more calories than walking forward and works as a therapy for knee problems and lower back pain; it improves gait and mobility in the lower extremities. And science backs this theory. 

There is an old saying in Nepali: Kasai le, Kag le Kaan lagyo bhanyo bhane, Kag ko pachhi daudane hoina, afno Kaan chamne (If somebody tells you the crow has snatched your ear away, you don't run after the crow but feel your ear. No?)  

That said, it still remains touch-and-go. Convincing Radhika would be like moving mountains. 

Disclaimer: Those with lower back pain or knee problems need to consult a health care provider before starting walking/reverse walking on a treadmill. 

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Every now and then, our political leaders, civil servants, policymakers and planners fly to near and far-off shores with different agendas.

Chances are that if our political leaders are not smearing each other, they are on foreign trips. For one thing, our leaders are always in dire need of medical treatment of all sorts.

Is it the result of having to fight too long and hard for democracy, human rights, secularism, federalism and what not?

Does it not mean that time has come for the old guard to retire instead of burning themselves out? Anyways, what significant gains has their supposed hard work over the decades brought to the country? Are we doing better in facets of national life like the rule of law, national security, good governance, living standards, corruption control and financial health?

Is there more to it than meets the eye when it comes to these engagements?

Who would know? Medical professionals? Political pundits? Astrologers, perhaps?

The VIPs and VVIPs of this country will always get numerous opportunities to go abroad for state-funded medical treatment.

But what about the members of the general public? At private medical facilities, services cost a small fortune. This means the people in general have to rely on a public health system not in the pink of health. Even treatment at public health facilities does not come cheap. An ‘ancient’ joke telling how those lacking money end up exiting Bir Hospital through a labyrinth without getting treatment is but a mild satire on our public health system.

Families going broke in the course of treatment of ailing member/s has become a regular affair.

Appeals for funds for medical treatment of kith and kin along the clogged arteries of our metropolises, through mass and social media have started sounding like a cry in the wilderness.

Even after a series of epoch-making changes over the decades, a reliable public health system for treating hearts, limbs, brains, stiff backs and a myriad other aching/ailing parts is lacking. Isn't it a pity?

Back to the foreign trips of our leaders and others in positions of power.

Medical treatment is but a ruse, members of the public feel, and they start speculating about the hidden agendas of impromptu visits, guessing whether this country will lose more pounds of flesh after such a trip.

This is because important agendas are almost always under wraps in our high-level bilateral, multilateral and international engagements. Details of secretive engagements and the prices attached with them coming to light decades later come as a rude shock for successive generations.

At our bilateral engagements in particular, notetakers are always missing. Occasional pictures of our leaders engaged in important discussions taking notes on loose sheets of paper show that the Nepali state needs to act far more professionally, not like a college student attending a lecture that he is least interested in.

Grabs from such meetings show the other side dictating our representatives. The whole idea of this photo-up, it appears, is to show who is the boss/the gangster in this rough neighbourhood that is at the center of a massive global transformation.

During such engagements, our side does not get that much air-time. Even if it does, its concerns do not get due attention. This again brings to notice the unjust and unequal nature of our adjectives-filled relationship.

On the other side of the table, notetakers are always there to keep record of agendas discussed and  understandings reached, thereby boosting institutional memory of the other party and giving them an upper hand in future negotiations.

Our functionaries hardly bother to inform the people about their upcoming impromptu visits, what takes them to those, who take the entire subcontinent as their own backyard (read: fiefdom), the decisions taken after such exchanges and their possible impact on generations to come. These people never feel the need to apprise the sovereign Parliament of their engagements and what national interest they served.

This lack of transparency during such crucial engagements makes a mockery of ideals like democracy, sovereign equality of nations, human rights and a rules-based international order.

‘Powers that be’ are choosing to remain silent on the agendas discussed and understandings reached may be a stark pointer that they, once again, furthered the interests of a clique by selling the country down the river.

Our functionaries lacking the spine to stand for Nepal has been a chronic problem spanning decades. In this context, facilitating and funding medical treatment of our leaders is like treating the symptoms instead of getting at the root cause of the disease. Therefore, national energies should be channelized to strengthen the spine of our subservient political leadership so as to enable it to stand upright and safeguard national interest.

In my family, we have a ritual of drinking the evening cup of tea together, especially during weekends. One on such occasion last week, my parents called my brother and me to fetch our tea cups from the kitchen. I went and got mine. Soon after, I heard my brother shouting in another room at my sister (who doesn’t like or drink tea and was busy watching her favorite TV show). “Can’t you listen at once? Are you so selfish not to see that I’m busy and can’t help get my cup of tea? Will your feet hurt in doing me a small favor?”

My brother’s actions got on my nerves, and I sternly said, “Don’t you even know how to talk to someone properly?” His focus immediately shifted to me, “Why are you scolding me? Did you even need to speak in this matter?” We got into an argument, followed by complete silence for a couple of hours. 

What affected me the most about this incident and led me to react was that I could see the reflection of my younger self in my brother. Reactive. Oblivious of the impact of one’s actions on other people. As a teenager, I grew into the idea that people wouldn't listen to me until I raised my voice to make the other person submit in fear. 

On the flip side, I sometimes completely shut myself down, so the other person felt guilty for their actions. I most certainly believed that other people were responsible for my feelings. So, I assigned blame every time I felt a plethora of unpleasant emotions, and I found others to be praiseworthy when they made me ‘happy’ or anything related. These patterns are what I saw my brother replicating. 

“All problems are interpersonal relationship problems”—is the most powerful phrase I’ve ever read (‘The Courage to be Disliked’ by Ichiro Kishimi and Fumitake Koga). As I look back at the incident with my brother and all previous times I was dealing with another human (or, let’s say, I was incapable of doing so), this idea has been more than true. It’s not because I was dealing with people who were necessarily different or worse than me. It’s because I lacked the social awareness to handle another human who had similar feelings, needs, objectives, and challenges as I did. 

Had I still hung onto my past patterns of blaming others for my feelings and not considering other people’s feelings and needs, it would have perhaps taken me a very long time to make amends. Thankfully, it wasn’t the case this time. 

I was initially making assumptions about my brother (he only cares about himself), taking his actions personally (he needs an excuse to disrespect me), and not communicating what was important (how his actions impacted my sister and me). After buying my time and space, I realized that these unhelpful habits were not helping me. I then shifted the focus to what was going on for him. 

Recalling my brother’s past patterns, I realized that he usually got scolded for leaving his food and beverages unattended when he got immersed in some task. So, to connect with his feelings, I realized that while he seemed to lash out in anger at my sister and me, beneath that anger was a fear that if he didn’t get his tea before it turned cold, he would get scolded again. 

Once I understood he felt fearful, I could also connect with his deeper needs, which was ‘protection’. He also needed ‘problem-solving’ and ‘empathy’. He couldn’t get his tea from the kitchen, so he wanted help from someone desperately. Later, I even had a conversation with my brother. He verified my guesses about how he felt at that moment and what he needed. 

A natural subset to developing emotional intelligence is that we not only start becoming aware of our feelings and needs but of other people’s feelings and needs as well—it is what we call ‘social awareness.’ A question might arise. Is it possible to fully understand the spectrum of other people’s emotional states? I’ve learned from experience that we won't know until we try. 

The author is Linchpin at My Emotions Matter, an education initiative that helps individuals and teams learn the mindset and skills of Emotional Intelligence. Learn more at myemotionsmatter.com