Infrastructural needs for Nepal’s radiotherapy services
Year 2016 has been a significant year for cancer treatment in Nepal. Nepal Cancer Hospital and research center (NCHRC) in Lalitpur will soon start radiotherapy services with Varian Truebeam machine while Kathmandu Cancer Care and Research Center (KCCRC) in Bhaktapur has already started the services with Elekta Synergy machine recently. Both of these machines are modern medical linear accelerators from two different companies. Previously, only BP Koirala Cancer Hospital (BPKCH) in Bharatpur and Manipal Hospital in Pokhara had medical LINACS. NCHRC is also going to start High Dose Rate Brachytherapy with 24 Channel Gammamed ix plus machines to treat gynecological malignancies. With the addition of these two new external beam radiotherapy machines in Nepalese Health Care system and one HDR Brachytherapy machines, we are now capable of performing modern cancer treatment techniques like 3DCRT, IMRT, VMAT/Rapid Arc, Stereotatic Radiosurgery & Stereotatic Body Radiotherapy, Total Body Irradiation in the country.
Previously, cancer patients who had indication for such treatment techniques had to go abroad to receive treatments. That would put tremendous financial, psychological and practical difficulties for cancer patients and their families. Hence, the new medical facilities in the country are sure to relieve such pressures from patients and their families.
However, with the addition of new facilities in diagnostic radiology and radiation therapy, there is a rising challenges on the part of the service providers and government of Nepal to establish adequate radiation infrastructure for smooth functioning of such facilities in the country.
Firstly, since radiation therapy machine produces ionizing radiation to cure malignancies, proper handling of such equipment is important. There should be a quality assurance mechanism to ensure quality treatment with these machines. Proper treatment outcome of radiotherapy requires the joint effort of Radiation Oncologists, Medical Physicists, Radiation Technologist, Oncology Nurses and others involved. Nevertheless, Medical Physics, Radiation Technology and Oncology Nursing courses are not offered in the country. So there is a shortage of these professionals in the country. GoN should take actions to prepare such human resources in the country.
Secondly, radiation monitoring is an important aspect of radiation safety. But a lack of radiation law, radiation regulatory body and infrastructural arrangement pose challenges in adopting proper guidelines and dose audits. Therefore, it is important to draft radiation law, establish regulatory body and make infrastructural arrangement as soon as possible.
Thirdly, most radiotherapy machines and related equipments are specially designed highly advanced machine. Establishing radiotherapy facilities requires huge investment. The government of Nepal should facilitate in all possible ways to encourage health service entrepreneurs and hence increase access to specialized health services for cancer patients within the country. This will ultimately appease cancer patients and their near ones by minimizing their financial burden, psychological pressure. In addition, fund worth millions of rupees is retained in the country which would otherwise be spent aboard to get the radiotherapy services there.
The rise in the number of radiation facilities, particularly megavoltage radiotherapy facility, can provide most effective and smooth service to patients only if basic and additional infrastructures for quality radiotherapy services are put into place.
(Poudel is Medical Physicist at Nepal Cancer Hospital and Research Center, Harisiddhi, Lalitpur)
Effect of monetary policy on risk, stability and financial crises
The crisis of 2008–09 has reignited a new interest in understanding money and credit fluctuations in the macro economy, and the crucial roles they could play in the amplification, propagation, and generation of shocks both in normal times and, even more so, in times of financial distress. This may reopen a number of fundamental fault lines in modern macroeconomic thinking between theories that treat the financial system as irrelevant, or, at least, not central to the understanding of economic outcomes, and those that reserve a central role for financial intermediation.
Air pollution control measures for Kathmandu Valley
According to the World Air Quality Index website, Air quality index of Ratnapark, Kathmandu was 158 on April 22 which is unhealthy. This means children and people with respiratory diseases should avoid outdoor exertion at this pollution level. If this quantity increases to more than 300, air quality level is considered as hazardous which means everyone should avoid outdoor exertion.
The return trip
It took us over five hours, drenched in rain, walking through treacherous ratomato sluggishly. It should not have taken more than two hours in a normal day. It was the cruellest irony that no sooner did we reach Panchkhal and sat at the Pipal Chautari to rest, than the bus we had left behind, arrived with people in the bus bursting with laughter on seeing us.
Prospects for Nepali talents in the Diaspora
When Indu, a Nepali American teen studying in Virginia, asked Panta whether she could inspire Nepali youngsters into music industry and convince their parents to consider Nepali music as a path to professionalism, the female heartthrob of Nepali music could not fully convince her.
Traffic Police in Kathmandu
As busy and hassling as the traffic system in Kathmandu is, the Traffic Police here have to handle an equally strenuous job. Over 1,400 traffic officers in and around the Kathmandu Valley battle against the pestering traffic and air pollution each day.
Menstrual taboo outdated
I have seen my sisters and friends isolated and treated in discriminatory manner during their first menstruation cycle. They were not allowed to look at the sun, to touch water source, flower, fruits, any male family member, nor even hear their voice. The activist may claim the situation has changed and I do agree but still during every month my loved ones turns into untouchables beings.