Keeping Nepal’s doctors in Nepal

Every year, Nepal celebrates another graduating class of young doctors and nurses. Families gather with pride. Parents celebrate years of sacrifice. Universities produce another generation of highly trained healthcare professionals ready to serve their communities. Yet, for many of these graduates, another journey soon begins. Not to a district hospital. Not to a rural health centre. But to an international airport. Within months or years, many leave Nepal to build careers abroad in Australia, Japan, the United Kingdom, the United States or Gulf countries. Nepal loses some of the very people it has invested years in educating. Among many reasons, an important one is sole dependency on relatively low salaries from their medical practices. Whenever we discuss this problem, we usually ask one question. How do we stop doctors and nurses from leaving? Let’s ask a different question. How do we make staying in Nepal a better choice? No healthcare system can become stronger while continuously losing its most valuable resource. Buildings can be constructed. Equipment can be purchased. Technology can be installed. But experienced healthcare professionals cannot be replaced overnight. Healthcare ultimately depends upon people.

One uncomfortable reality deserves honest discussion. Many doctors and nurses in Nepal are not undertrained. They are underutilised, and many are underpaid. The years required to become a physician or a specialist are long and demanding. Nurses likewise carry enormous responsibility for patient care. Yet many healthcare professionals struggle to earn incomes that reflect their expertise and contribution. Some take on multiple jobs to support their families. Others conclude that the only practical path to financial security is to leave the country. This is not simply a workforce issue. It is a healthcare issue. Every doctor or nurse who leaves takes knowledge, experience and capacity with them.