31 Vaishakh, Siraha — The CT scan machine installed at the Ramkumar Sarada Umaprasad Murarka Provincial Hospital in Lahan has not been put into operation due to a shortage of personnel. Although it was hurriedly inaugurated on 21 Vaishakh, the service has not started because there is no qualified radiologist or technician to run the machine. As a result, despite crores being spent on procurement and installation, local patients are forced to pay for expensive private CT scans outside the area.

Problem in brief

  • Although the machine has been installed and inaugurated, it remains non-operational because of a lack of human resources; according to local records and hospital administration, this situation has become a health risk and an economic burden for patients and the community.

Facts — What, When, How

  • Documents from the Supply Management Center and public statements indicate that the provincial government purchased two CT scan machines in fiscal year 2081/82 at a cost of roughly 12 crore rupees.[1]

  • The hospital administration and the Supply Center have said one of those machines was installed at Lahan Hospital and the other placed at the Madhesh Medical Science Academy in Janakpur.[1]

  • According to the hospital, operating the CT requires at least one radiologist, one radiology technician and one support staff member; these positions have not yet been filled.

  • Local staff and sources have criticized the then-medical superintendent, Dr. Ranjit Jha, for inaugurating the machine before completing personnel arrangements prior to his transfer. Ramnarayan Mehta, chairman of the hospital management and operations committee, said it is regrettable that the machine exists but cannot provide services.

Timeline (summary)

  • Financial decision/budget allocation: Fiscal year 2081/82.[1]

  • Procurement and installation: Machine brought in and installed after procurement procedures.

  • Inauguration: 21 Vaishakh (inaugural program held).

  • Current status: Even weeks after the inauguration the machine has not been put into service; service is pending due to lack of staff.

Why is there no staff? — Causes explored

  • Need for administrative coordination: A major reason appears to be unclear coordination between current and former hospital leadership over transfers, adjustments and staffing requirements. Staff allege the previous administration prioritized installation and inauguration but did not complete necessary human resource and commissioning plans.

  • Shortage of radiologists across the province: Hospital chief Dr. Varsha Prakash said there is a shortage of skilled radiologists in Madhesh Province and the ministry has been repeatedly requested to send specialists; with few experts in the province there is no certainty of an immediate posting. This kind of human resource challenge puts equipment on 'standby' and leaves patients without services.[2]

  • Gaps in procedures/agreements: Questions remain about how clearly the procurement contract and provisions for commissioning and training by the equipment supplier were defined between the hospital and the Supply Center—whether the supplier trained local technicians before operation and whether a commissioning report was prepared remain to be determined.[1]

Human stories — Patients and local impact

  • Economic burden: A local patient's family said that after a minor accident, because the regional hospital did not have CT services, they had to pay out of pocket to get a CT scan at a private clinic in Biratnagar. The family said: “We had to gather money early in the morning and go out; if we hadn't had 10–15 thousand saved, we couldn't have gotten the scan.”

  • Inequitable access: Villagers around Lahan had expected easy and affordable services; the machine’s unavailability forces people to travel far, increasing travel costs and delaying treatment, which raises health risks.

  • Hospital staff account: Nurses and technical staff say they feel extra daily stress—having equipment but not being able to use it has doubled problems of patient turnaround and morale.

Questions for the accountable

  • Decisions by the former superintendent: There needs to be an answer as to why Dr. Ranjit Jha did not complete staffing plans before the inauguration; there are demands that government managers and the hospital release documents related to that decision.

  • Supply Management Center and provincial ministry: Was there a clause in the procurement ensuring that the administration would secure staff? Was there a provision requiring the supplier to train local technicians? Such documents should be made public and a response provided.[1]

Expert comment and possible solutions

  • Tele-radiology: As a short-term measure, tele-radiology can provide remote reporting—images from the hospital can be sent to specialists at central locations who can produce reports; this could offer immediate relief to local patients.

  • Temporary/contract specialists: Medical and policy experts have suggested the province could deploy contracted radiologists from the private sector or central level for a limited period.

  • Training and capacity building: A policy should mandate timely training of technicians and local doctors alongside equipment procurement; experts recommend including training clauses in supplier agreements (warranty/commissioning).

  • Service sharing and rental models: By slightly increasing costs, the hospital could share machines with neighboring districts through mobile/share networks or run temporary services via public–private partnerships.

Conclusion and what is needed
The CT machine installed at Lahan Provincial Hospital is visibly present but unused—this shows that bringing expensive equipment alone is not enough; people, training and operational plans must be in place as well. The hospital and the provincial health ministry must immediately publicly take the following steps: (1) release the commissioning, supplier training and operation plans for the equipment, (2) start short-term tele-radiology and contract specialist arrangements, and (3) implement a long-term human resource policy to ensure reliable radiologists and technicians. Officials must be publicly accountable, with the health and expenses of local patients kept a priority.

What we will do — Journalistic next steps

  • We have requested documents and official responses from the hospital administration, current and former management, and the provincial health ministry, and will publish further details as soon as replies are received. Readers and local residents urging the hospital and ministry for public accountability is itself a first step toward a long-term solution.

Sources

  • [1] Tender Archive — HLL Lifecare Limited (example of procurement/installation tenders and archival notices related to CT scanner procurement): https://www.lifecarehll.com/tender/archive

  • [2] Tender Khabar — CT scanner procurement listings and related tender information (context on procurement processes for CT machines in the region): https://www.tenderkhabar.com/categoryresult/CAT%20contrast%20agent%20injector