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Bir Hospital (बीर अस्पताल) is the oldest and one of the busiest hospitals in Nepal. It was established in July 1889 by Bir Shamsher Jang Bahadur Rana. It is located at the center of Kathmandu city. The hospital is run by the National Academy of Medical Sciences, a 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 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, glomerular diseases cannot be easily diagnosed with accuracy. Again, IgA nephropathy also remains undiagnosed. Hence, training a renal histopathologist and a histopathology technician is found to be the most important task for the hospital in order to provide accurate service to the patients.
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.
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 increase in trained manpower and equipment, as well as refurbishment of the wards 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 equipment.
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 saving 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 program has since gone extinct.
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 opened a new Orthodontics and dentofacial orthopedics unit in 2009 with the cost about one fourth that at other clinics and hospitals. MDS degrees in Prosthodontics and Periodontology & oral implantology 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 equipment, 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.