Burn victims seeking care at Bir Hospital and their family members often ask doctors why they are being charged for treatment, even though the health minister had declared that impoverished patients would get care free of cost.

Doctors attending to the patients always give the same answer: they will stop charging when the government starts reimbursing the hospital for free care of burn victims.

“We provide free surgery to burn victims from the hospital’s charity,” said Dr Peeyush Dahal, chief of the Burns and Plastic Surgery Unit at Bir Hospital. “We also heard of the new government scheme to provide free treatment to impoverished burn victims, but we haven’t received anything.”

Bir Hospital is among the eight hospitals in the country to which the Ministry of Health and Population committed, in October last year, to reimburse the treatment cost of poor burn victims.

Kirtipur Hospital in Bagmati province, BP Koirala Institute of Health Sciences in Koshi province, Narayani Hospital in Madhesh province, and Pokhara Institute of Health Sciences in Gandaki province are among the hospitals.

Likewise, the government had also pledged to reimburse treatment costs at Bheri Hospital in Lumbini province, Surkhet Provincial Hospital in Karnali province and Seti Provincial Hospital in Sudurpaschim province.

However, except for Kirtipur Hospital, most hospitals never got the fund, which means impoverished patients have been forced to pay medical bills by taking out loans or selling property.

Kirtipur Hospital, which was given Rs15 million to provide free care, said it had already spent Rs27 million on the treatment of impoverished burn victims until April 15.

“Health Minister Pradip Paudel has assured us that the additional amount will be reimbursed,” said Dr Kiran Nakarmi, director at Kirtipur Hospital. “We have also been using the hospital’s charity fund and collecting donations from national and international donors, to provide free care to poor patients.”

There were over 40 burn patients receiving care at Kirtipur Hospital on Monday, while seven were admitted at Bir Hospital.

Minister Paudel had declared that poor burn victims and their families need not worry about high medical expenses, as the government would cover all treatment costs for those who cannot afford them. As the decision was taken by a Cabinet meeting, Paudel made a big fuss and portrayed it as a major achievement.

Nepal is among the countries with the highest incidence of burn injuries. It is the second most common injury in rural Nepal, accounting for five percent of disabilities, according to the World Health Organisation.

The health ministry estimates that each year, 55,000 people throughout the country have burn injuries.

One study shows that over 40,000 people suffer from burns [minor or severe] every year in Nepal. Among them, about 1,500 to 2,000 succumb to their injuries.

The Kirtipur Hospital alone provides treatment to around 800 victims each year.

The government has neither upgraded nor expanded treatment facilities, nor has it run awareness programmes to deal with the immediate aftermath of burn incidents.

Most hospitals treating burn victims provide only minor treatment. Experts say minor care does not ensure patient safety, and a multidisciplinary team of experts is needed to provide specialised care to victims.

For that, highly trained medical professionals with years of training, advanced equipment and advanced facilities are needed, which in turn calls for a big investment, and it might not be possible to put together such a large sum.

Doctors say awareness can substantially increase the chances of survival of burn patients.