Senior cardiologist and lifestyle guide, Dr. Bharat Rawat, is currently associated with Medanta Hospital, Indore, India, as Associate Director – Cardiology. He completed MBBS in 1991 and MD General Medicine in 1994 from MGM Medical College, Indore, and DM Cardiology in 1997 from Banaras Hindu University, Varanasi, India. In 1998, Dr. Rawat along with his wife came to Kathmandu, Nepal for three months but ended up staying here for 17 years till 2015 during which he worked as the Executive Director and Chief of Cardiology at Norvic International Hospital.
Dibesh Dangol of B360º interviewed Dr. Rawat during his visit to Nepal to know his views regarding challenges faced by foreign medical practitioners in Nepal, development happening in the sector of Cardiology in the South Asian region – especially India and Nepal, and tips on owning a healthy heart.
What brings you to Nepal this time?
I came to Nepal to meet old friends and colleagues with whom I have worked with during my stay in Nepal. So whenever we, me and my wife, think about going for a vacation, we always consider coming to Nepal and meeting our patients, their families, friends and colleagues. I came here for 48 hours during which I have already given 5-6 talks.
From your experience, what are the challenges foreign medical practitioners have been facing in Nepal?
The policies of any country, and not just Nepal, are decided by the government of the country, and all foreign medical practitioners should respect the rules and regulations of the country. There will obviously be regulations due to which foreign medical practitioners will have some restrictions regarding their practice in any country, and Nepal is one of them.
From my point of view, I think proper licensing, asking reasons regarding why the doctor wants to practice in Nepal, licence valid for just a year, renewal of licence, etc., are valid challenges. These are all related to legal issues, but again all foreign medical practitioners should respect the policies of the host country.
Do you think Nepal Medical Council’s policy regarding foreign medical practitioners should be revised?
NMC along with Ministry of Health are capable to assess if Nepal does require foreign doctors and in which faculty and for how long. According to that, they should make policies.
What could be the major reasons for doctors to migrate overseas for work, or for those who stay, why do they prefer to work in urban areas only?
The doctors want to migrate overseas obviously for more opportunities like better job, lifestyle and earnings because there are limited opportunities in Nepal. Also, further trainings of doctors is an issue here in Nepal which is why they tend to go out for trainings initially but then due to the opportunities in foreign countries, they find it difficult to come back.
As for working in urban areas only, this isn’t the case just for doctors. Everybody, whether they are engineers, bankers or people involved in any other professions, would like to work and stay in urban areas because of the infrastructures available. Like anybody else, doctors also think about comfort and facilities for ease of their family members and children.
So, what type of facility the government or country can provide them in rural areas, would possibly decide whether they want to work in rural areas or urban areas, and the same is with the doctors migrating overseas for work.
What kinds of development are happening in Cardiology in the South Asian region, especially India and Nepal?
In the last 20 years, there has been profound development. In Nepal, 20 years ago, almost everybody needed to go to India, Thailand or Singapore for their bypass surgery or origo angioplastica, but now those treatments are available here in Nepal. So, a big development has taken place.
There is only one thing unavailable in Nepal which is heart transplant. In India also, there are very few hospitals for heart transplants which is a big challenge and not an easy medical procedure. But except for that, I think we are doing pretty fine.
As for additional development needed, firstly, there should be development in the remote areas regarding basic facilities like thrombolysis for heart attack patients, availability of ECGs and trainings. Secondly development should be in terms of prevention and awareness. So, these are two important things.
What kind of policies should NMC make for public-private partnership in medical sector here in Nepal?
In many countries including India and Nepal, there are policies where government hospitals also look into the opportunities where they can invite private sectors to help them. There are such hospitals in Indore and other parts of India where if a particular faculty doctors aren’t available or are less in number, they take help of the private hospitals or doctors to work briefly for them. Similar can be done here in Nepal and a public-private partnership can be formed in the medical sector.
Top five tips to keep the heart healthy.
1. Wake up early in the morning and be physically active. Anybody who doesn’t get up early in the morning is in for serious problems.
2. Losing temper easily and getting upset for minor mistakes should be avoided. For small reasons, people shouldn’t spoil their mood and criticize people. Rather smile and be happy.
3. People should watch what they are eating. Eat small amounts at a time, eat homemade food, avoid sugars and sugary food as much possible. Consuming unhygienic or hydrogenated fat products like dalda ghee and refined carbohydrate products like wheat flour should also be avoided.
4. People should avoid any type of addictions whether it is addiction to tobacco, alcohol, mobile phones, social media sites, late-night parties, etc. Such addictions aren’t good.
5. Everybody should know to check their blood pressure and blood sugar at least once or twice a year. Doing several tests isn’t necessary and just checking of these two things will be sufficient indication.