The praises that Bhaktapur Municipality has earned by providing educational and health services for the town residents could be a model for identifying the effectiveness of the local government in a democracy.
Makar Shrestha : Centre for Investigative Journalism-Nepal
Bhaktapur is a small town to the east of Kathmandu, the federal Capital. But the power of this city is better measured not in its size but its achievement. The ongoing debate for nationalizing education and health services has already proved to be successful in Bhaktapur.
‘Anyone ill?’
“Is anyone ill at home?”
Nurse and volunteer enquiring health status of denizens at their homes in Bhaktapur Municipality
It may be strange for elsewhere if someone knocks on the door early morning to enquire about sickness. But Bhaktapur locals find it normal. This is what was seen at the house of Harikrishna Shilpakar at Jagati in Bhaktapur Municipality-8 on July 4, 2018.
Shilpakar, who was sipping tea in the upper storey of the house with the family, heard the doorbell. His youngest daughter, Rina, looked out the window. It was Staff Nurse Sarita Gosai, deployed by the municipality to serve people at their doorstep. Municipal health volunteer Ratnamaya Khayamali was with her, asking if anyone was sick.
After getting down to the doorstep, Rina informed Nurse Gosai about the age, occupation and education of father Harikrishna, mother Ramlaxmi, brothers Rakesh and Rajesh and sister Suprabha. According to the details, her parents can do simple reading and writing, she and her brothers have got master degrees while her sister is a graduate.
The landowner couple went down too. Nurse Sarita first checked Ramlaxmi’s blood pressure by seating her on the stairs. The 140-80 reading is slightly high. Advising her to cut on salt and fat, she examined Harikrishna and found his pressure normal.
As at Harikrishna’s, Bhaktapur Municipality Office sends nurses and health volunteers to the households in its 10 wards to enquire the townspeople about their health. Between 7 and 9am, teams check blood pressure of the city residents while they also care for patients of diabetes, females’ issues, children’ ailments, and asthma.
Nepal Majdur Kisan Party(NMKP) chairperson Narayan Bijuchhe for treatment in public health service center established by Bhaktapur municipality
The nurses and volunteers urge sick people who have not visited health facilities to go to the municipal Public Health Service Centres. They advise blood pressure and diabetes patients to take medicines regularly and to go to hospital if they are suffering much. They also inform the people about the health insurance programme introduced by the government in 42 districts including Bhaktapur.
Nurses and health volunteers collect details on the people’s health condition. They are also collecting data on the number of people suffering from a particular disease. As of June 14, health tests at 633 families found high blood pressure in 435 people, diabetes in 177 people, asthma in 80, orthopedic problems in 80, gastritis in 41 people, thyroid in 13, heart ailments in 31 and tuberculosis in 9 people.
The municipal records also have 3 cases of mental impairment, 7 of paralysis, 5 of kidney ailments, 4 of stone, 14 patients of cholesterol, 7 cancer and 1 person with disability. A team of nurses reaches the houses of these people regularly. Having been to all the houses in the ward once, they have the practice of revisiting them. This care of the municipality has cheered up locals.
Deployed in the 10 wards, nurses visit at least 20 houses a day. With data on the health, education and occupation of the city residents, nurses report to the three public health service centres of the municipality at 9:30am. They update their records there.
Before their arrival, the service centres are crowded with patients. At the centres that open at 7:30am, doctors, nurses and health volunteers await patients invited for treatment by visiting at their doorstep. The centres are located at Chyamasingh, Panchtalle Temple, Bhagawatisthan and Byasi. At the Chyamasingh centre, expert medical service is available for a fee of Rs 50. For follow-up treatment, a payment of Rs 30 suffices. Chyamasingh Centre chief Dr Ratna Sundar Lasiwa said care is available for ailments of children and women, and for orthopedics, dentistry, ENT and skin diseases.
Patients queuing for checkup at public health service centre operated by Bhaktapur municipality
At the Chyamasingh centre, patients from Suryabinayak and Changunarayan municipalities also arrive for treatment. On an average, 300 people undergo medical examination and treatment at the centre daily. A regular visitor to the centre is Nepal Majdoor Kisan Party Chairman Narayan Man Bijukchhe. Bijukchhe arrived on foot at the centre at 9 o’clock on July 3. His turn for examination came after a wait of half-and-hour. He approached Room No 101 of the centre for physiotherapy of knee. He has been visiting the centre for a year to treat knee joint bone erosion. “Why go abroad, when consultancy services are available in town?” Bijukchhe wondered.
These health centres, catering to the health needs of Bhaktapur Municipality and its vicinities, have 9 consultant physicians and 14 medical officers. Nurses and other staff number 61 in total. “The public health service centre was established since the life expectancy of Bhaktapur residents is lower [than the national average] and that medical care is not commonly available,” said Mayor Sunil Prajapati.
Counseling in local language
Since most people in the Newar-majority Bhaktapur understand only the Newari language clearly, the municipality has arranged at the health centre for mostly doctors who know the language. Patients express their problems in Newari and suggest cure in the same language. Since the locals’ language is crucial for explaining the way of taking medicines, assistants do the job for doctors who do not use the Newari, according to centre chief Dr Lasiwa.
General public for eye checkup in public health service centre operated by Bhaktapur municipality
The centre charges comparatively cheaper fees for health services. X-Ray is available for Rs 300 and ECG for Rs 125. While the centre provided only OPD services previously, 24-hour emergency care unit was established on May 21, 2018 to address the need for rushing patients to other facilities in times of need.
More than 9,000 people have availed Ayurvedic treatment since the municipality launched Ayurvedic health care services on July 16, 2017. Since the new fiscal year that started two months ago, the municipality has been providing Rs 10,000 for each city resident requiring treatment for cancer, kidney transplant, heart surgery and paralysis.
The municipality provides Rs 100 in daily allowance for the health volunteers accompanying nurses in the door-to-door campaign of enquiring about locals’ health. Such health volunteers number 90. The municipality pays consultant physicians providing OPD services Rs 1,500 in daily allowance and up to Rs 15,000 monthly allowance for medical officers providing part-time services. “For effective health services, we have set aside Rs 35 million this year,” said Mayor Prajapati. “If we can’t pay attention to the health of city residents, who’ll avail of development works no matter what?”
The municipality has initiated the process for building a 25-bedded Khwapa Hospital. Permission has been obtained to run the hospital. Mayor Prajapati said Rs 250 million had been set aside for building the facility. “The same way as our affordable OPD services, we’re preparing to offer city residents inexpensive expert services,” said Prajapati.
The municipality operates child care centres at six places. The municipality has a policy of running a child care centre in every ward. The monthly fee for parents admitting their baby to the centre is Rs 1000. A caregiver has been appointed for 15 babies.
Seven educational institutions of own
The new constitution and laws have given the responsibility of managing schools to the local governments across the country. However, investment of the local level has not been made compulsory in schools. Most of the 752 local federal units are waiting for the respective provincial government to improve quality at schools under their area of jurisdiction. But Bhaktapur Municipality spends Rs400 million annually to run seven educational institutes that produce expert human resource.
Khwapa College established with an investment from Bhaktapur municipality
According to Mayor Prajapati, the municipality has invested in schools and colleges to “impart higher education for affordable fees, to make the society intellectual, to enable the new generation to face the challenges of the twenty-first century and to achieve the goal of education and prosperity by linking labour to productivity.” The municipality operates Khwapa Secondary School, Khwapa College, Khwapa Engineering College, Khwapa College of Engineering, Khwapa Polytechnic Institute, Sharada Secondary School and Sharada College. These institutes have a total of 5,600 students.
Nineteen years ago, the municipality started its investment in education by obtaining permission to run grades 11 and 12 at Khwapa School, where 2,300 students are currently studying. The school runs grades 11 and 12 in science, management and humanities streams. Three years later, the municipality established Khwapa Engineering College in affiliation with Purbanchal University where 1,447 students have graduated with bachelor and master degrees. At the bachelor level, the college teaches civil engineering, BE Computer, Electronics and Communication and Architecture; and earthquake engineering and urban design at the master level. At the college that started teaching computer engineering from this year, 1,103 students from 67 districts are currently studying.
Established 20 years ago in affiliation with Tribhuvan University, bachelor level courses of civil, electrical and computer engineering are taught at Khwapa College where 623 students from 64 districts are currently studying. In the past 10 years, 678 students have completed their education from here. “To begin with, the municipality built the infrastructure for all the seven institutes,” said Prajapati. “While the municipality provided for the expenses initially, the college is running with its own income. It has also been able to build additional infrastructure. The municipality does not have to fund it anymore.”
Students participating in laboratory experiments of Khwapa college operated by Bhaktapur municipality
All the seven institutions earn the annual cumulative operational cost of Rs 410 million. Prajapati said that the municipality does not have to invest in education anymore. “Since investment in infrastructure continues, earning from the colleges has not been returned to the municipality,” he said. “If the colleges earn well, the income may now be invested in town development.”
Khwapa College offers courses in several disciplines up to the master’s level under management and humanities streams. According to Principal Rupak Joshi, 1,300 students are currently studying at the college. All the seven colleges offering quality education for affordable fees are not affected by strikes and shutdowns. According to Principal Joshi, teaching-learning activities continue at the college even on most public holidays due to qualified and responsible teachers and able staff, well-resourced library and well-facilitated laboratory.
Established at a rented building, Khwapa College and Khwapa Engineering College are now housed in own buildings erected on the land provided by the municipality. The municipality is preparing to offer courses on painting, astrology and astronomy at the two colleges.
At the Khwapa Polytechnic Institute, 280 students are studying the CTEVT courses on nursing and civil engineering. While other colleges are being criticized for charging hefty fees for the courses, Khwapa offers three-year civil engineering course for Rs 240,000. Nursing courses are also available for the fees set by the Council for Technical Education and Vocational Training.
Besides, Sharada Secondary School and Sharada College are also been managed by Bhaktapur Municipality. When the school management was impressed by the municipality’s initiatives in education, the two private institutions were taken over by the local government.
Students participating in laboratory experiments of Khwapa college operated by Bhaktapur municipality
Not only Bhaktapur locals study in the institutions run by the municipality. According to records at the municipal executive office, students from all the districts of the country except Manang are studying in the schools and colleges run by the municipality. The municipality has adopted a policy of providing special training in Nepali, English, Science and Math subjects with an aim to make students able and competitive with the changing times.
On the back of its successful management of the seven educational institutions, the municipality has initiated a campaign to improve the 35 community schools under its jurisdiction. It has started training teachers of schools in the municipality. The municipality has put forth a plan to utilize the Rs 240,744,000 provided by the central government as grant including for the teachers’ salary. The municipality plans to add Rs 10 million to the amount for improving the quality of community schools.
‘Khwapa’ or Bhaktapur
These seven educational institutions being run by Bhaktapur Mucipality were not born overnight. There’s a two-decade long story behind this success story. During the 1997 local body vote, Prem Suwal won the elections for his manifesto of making education and health accessible to everyone.
Winning the election was not only the taste of success for Suwal but also a litmus test for his responsibility. Translating the promises made in the manifesto into action was a challenging task for him. For instance, students had to travel to Kathmandu or Lalitpur for college despite commuting hurdles.
Students participating in laboratory experiments of Khwapa college operated by Bhaktapur municipality
The municipal board led by Suwal decided on July 16, 1999, two years after his election, to get affiliation with the erstwhile Higher Secondary Education Board to teach grades 11 and 12 immediately. At that time, it was beyond imagination that a local body could operate colleges. Government officials had no different belief.
Even as the council officials advised the municipal delegation to get affiliation in an individual’s name, the municipality refused it. The municipality got the go-ahead after it submitted an application along with the evidence of college building constructed also with labour contribution by the locals.
The first educational institution opened by the municipality was Khwapa Secondary School. The Newari name for Bhaktapur is Khwapa. While opening the college, the municipality had launched a campaign called ‘One House, One Graduate’ with the goal of having at least one member with a bachelor degree from every family. The municipal executive claims that the goal is about to be achieved.
Two years after the establishment of Khwapa College, the municipality needed a campus to teach higher secondary graduates. The Khwapa College and the Khwapa Engineering College were opened to serve the purpose. The two colleges were affiliated to Tribhuvan University and Purbanchal University, respectively. By the time the first batch graduated in bachelor of engineering, the college had got permission to run master’s in engineering.
These two colleges put an end to the compulsion of Bhaktapur students to go elsewhere for higher education. At the same time, they were also the places of study for students coming from almost all the districts of the country. These two colleges affiliated to two different universities are located at the same place and managed by a single administration. Engineering College Principal Sujan Mak said there have been no problems so far in managing the two colleges this way.
Students participating in laboratory experiments of Khwapa college operated by Bhaktapur municipality
Bhaktapur residents are indebted to Engineer Rajan Suwal, who contributed to the opening of the two engineering colleges and Khwapa Polytechnic Institute. At one time he was the principal of all the colleges except Sharada College. Under his leadership, Khwapa Engineering College, for the first time in the country, started architecture engineering at the master’s level. Rajan is among a few experts who argued that the engineering sector is also responsible for the colossal physical and human casualties caused by the April 25, 2015 earthquake.
After the Local Government Operation Act-2074 came into force, the municipality has prepared the local curriculum for grades 1 to 6. Mayor Prajapati said the courses incorporating subjects such as the history, geography, arts and culture, heritage and sports would help the new generation learn about Bhaktapur. The municipality plans to implement the local curriculum up to the eighth grade.
Besides, in order to improve the quality of community schools, the municipality has adopted the Montessori learning method. Before that, teachers at the community schools of the city were trained in the approach. The municipality will monitor the impact for six months of the training on instruction.
The municipality has set aside Rs 15.5 million to issue loans upto Rs 500,000 for poor and hardworking students by keeping their academic certificates as the mortgage. Mayor Prajapati said the lending procedure was being drafted.
Bhaktapur Municipality is preparing to open a university now. The government had registered the Khwapa University Bill in Parliament. Since deliberation on the bill did not take place on time, the bill became ineffective with the dissolution of parliament. The proposed university will undertake study, teaching and research on arts and culture, science, law, agriculture, economics, and technology and vocational courses besides medical education. The municipality has set aside Rs 1 million to form the taskforce that will make preparations for the university.
Good but unilateral: Opposition
Bhaktapur Municipality has no worry, like other local governments, for financial resources. More than Rs 250 million is generated annually from foreign tourists who come to visit Bhaktapur. It has no remote geography. The municipality can spend as much as it wants in priority areas.
Khwapa Engineering College established with an investment from Bhaktapur municipality
Other local bodies were run for years by bureaucrats. But Bhaktapur Municipality was always under the watch of former people’s representatives. “Until new elections, the former people’s representatives had the order to work as the incumbents,” said Prajapati. “The priority areas set by the party got continuation. Therefore, we excelled in education and health.” Bhaktapur Municipality has people’s representatives elected only from the Nepal Majdoor Kisan Party. There are no opponents of what the party does.
Opposition parties accuse the NMKP leading the municipality of not acknowledging the existence of other parties. Nepal Communist Party (NCP) Bhaktapur town coordinator Balmukunda Suwal says, “Development is good but the NMKP must not act as if it was funded by the party’s own income.”Balmukunda says there was no collaboration with other parties in the past, nor is it there now. “All is a monopoly.”
Former town committee secretary and Nepali Congress Provincial Assembly candidate Anil Bhuju agrees with Balmukunda’s views. “We’ve no objections that there has been progress in education and health,” says Bhuju. “But why does a party have the monopoly over works undertaken with the town residents’ taxes. It must learn to honor others’ views and existence.”
