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Nepal Curbs on NGOs Leave Medicare Gash Wide Open - NGOs - Global policy Forum Nepal Curbs on NGOs Leave Medicare Gash Wide Open
By Keshab Poudel
Oneworld
December 17, 2003Nepal's decision to place curbs on international nongovernmental organizations (NGOs), including the Nobel Prize-winning Medecins Sans Frontieres (MSF), will badly hit medical services in the rural hinterland, where insurgency is hemorrhaging healthcare. The clampdown on international NGOs arises out of the government's belief that the Maoists are receiving support from foreigners. Such paranoia has forced the Ministry of Home to issue a directive to the chief district officers to strictly regulate NGOs working in and outside district headquarters across the country. The body blow was dealt by the Social Welfare Council (SWC), an apex body that regulates the functions of local and international NGOs. In a recent move, the government imposed restrictions on the France-based MSF, popularly known as Doctors Without Borders, working in the Rukum district hospital, 400 miles west of the capital Kathmandu. It has extended health services to a number of villages in the district, regarded as one of the most violence-prone. MSF started delivering health services here in 2002, after signing an agreement with the Ministry of Health.
The first hurdle was placed in its path when the chief district officer of Rukum prevented MSF officials from visiting village health posts without the SWC's permission. The operational straitjacket means MSF cannot venture into too many villages. "We planned to work in 43 Village Development Committees in Rukum. But for now, if we could cover just four health posts, it would be quite enough," says MSF country director Robert Parker. Significantly, MSF works mainly in war-prone countries and has a presence in over 80 countries across the world. It is the only organization providing emergency health services with the capability to evacuate patients out of remote villages -- an acute need in Nepal. "If they had come through proper government channels, the Health Ministry's permission alone would have been enough. But they have come to Nepal on their own, therefore, they must register with the SWC," says Ministry of Health secretary Benu Bahadur Karki. Then there are visa controls. Nepal is providing only one extendable visa to foreign NGOs. "We will issue a long-term visa to foreigners once they fulfill the legal requirements, including clearance from the SWC and the Ministry of Health," says the director general of the Department of Immigration, Subarna Shrestha. But MSF has not been issued even that. Three MSF team members in Rukum and the other three in Kathmandu are working under tourist visas. Such visas have to be renewed periodically, which means the officials must leave the country every 150 days.
The SWC defends its move, saying it has the right to decide which NGO can function in Nepal. "Almost all renowned international NGOs have registered with us," claims SWC member secretary Prabha Basnet. But Parker draws the line there. "We have no problem registering but we want to be recognized as an emergency medical organization, not a development international NGO. Our wish to serve the poor and needy should not be restricted," he points out. The move against MSF may impact scores of other NGOs from Western countries who are providing health services in hotbeds of Maoist insurgency in Nepal's mid-western and far-western districts. Thanks to the enhanced security threat, more than 30 districts in the insurgency-torn country remain without doctors. In many of them, Maoist rebels have even torn down health posts. Existing hospitals are functioning without doctors and trained medical staff. According to the Social Welfare Council Act, every NGO has to be registered at the SWC before it can start projects.
As the process of approval of projects by the SWC is long drawn, the move has already affected the programs of many international NGOs. If the SWC does not change tack, many others face similar restrictions. Several NGOs complain about the SWC's high-handedness. "In the name of regulation, it is trying to control the activities of NGOs," maintains the president of the Federation of NGOs of Nepal, Gauri Pradhan. Pradhan says regulation is not needed as there are laws and by-laws to act against NGOs. "Whatever they say in public, the Nepalese government wants to discourage foreign charities and other organizations willing to serve the poor in Nepal. Despite fulfilling all kinds of legal procedures, we have been facing many difficulties in acquiring long term visas for our volunteers," alleges the country representative of an international NGO. Over the years, international NGOs have stepped in where the state has made its exit. CARE-Nepal, Save the Children USA, Save the Children UK, United Mission to Nepal, International Nepal Fellowship, the Britain Nepal Medical Trust, Marie Stopes International and The Asia Foundation operate in Nepal, offering various health services. In a country of over 23 million people, of whom less than 10 percent have direct access to modern healthcare, their departure would be catastrophic.
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