{"id":8854,"date":"2025-10-29T16:19:44","date_gmt":"2025-10-29T10:34:44","guid":{"rendered":"https:\/\/medicosnext.com\/?p=8854"},"modified":"2025-10-29T16:21:37","modified_gmt":"2025-10-29T10:36:37","slug":"hospital-readiness-amidst-gen-z-protests","status":"publish","type":"post","link":"https:\/\/medicosnext.com\/?p=8854","title":{"rendered":"Hospital Readiness Amidst Gen-Z Protests."},"content":{"rendered":"
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\"\"<\/figure>\n<\/div>\n\n\n

Prof. Dr. Pradeep Vaidya<\/strong><\/p>\n\n\n\n

Hepato-Biliary-Pancreatic Surgeon & Emergency Preparedness Leader<\/strong><\/p>\n\n\n\n

Prof. Vaidya is a surgeon and a leading figure in emergency and disaster preparedness<\/strong> in Nepal. As the President of the National Society for Emergency and Disaster Risk Management<\/strong>, he has been instrumental in strengthening Nepal\u2019s health system resilience and hospital disaster readiness.<\/p>\n\n\n\n

He is one of the key developers and regional instructors of the Hospital Preparedness for Emergencies (HOPE) course<\/strong>, a globally recognized program that equips healthcare professionals with the knowledge and skills to manage hospital operations during disasters and public health emergencies. Through his extensive training and advocacy, Prof. Vaidya has helped build a culture of preparedness across healthcare institutions in Nepal and beyond.<\/p>\n\n\n\n

As a Hepato-Biliary-Pancreatic Surgeon<\/strong> at Norvic International Hospital<\/strong>, he combines his surgical expertise with his passion for health system strengthening and disaster risk reduction. Prof. Vaidya\u2019s work bridges clinical excellence with strategic leadership<\/strong>, making him a vital contributor to Nepal\u2019s advancement in emergency health management.<\/p>\n\n\n\n

\n\n\n\n

Nepal Gen Z Protests \u2013 Health Sector Response (September 2025)<\/strong><\/h2>\n\n\n\n

In September 2025, widespread protests led by Gen Z<\/strong> erupted in Nepal after the government banned approximately 26 social media platforms<\/strong>. Protesters also voiced concerns over rampant corruption across all sectors of life. The unrest resulted in clashes, numerous injuries, and several fatalities<\/strong>. Hospitals across the country played a crucial role in managing the surge of victims, including both injured protesters and deceased individuals. Below is an overview of the health sector\u2019s preparedness, response, and lessons learned<\/strong>.<\/p>\n\n\n\n

\n\n\n\n

Hospital Preparedness for Such Events<\/strong><\/h3>\n\n\n\n

The Nepalese government has long been preparing hospitals for disaster events through training programs and structured planning:<\/p>\n\n\n\n

    \n
  • Staff Training:<\/strong>\u00a0Most hospital staff, particularly in\u00a0Hub Hospitals<\/strong>\u00a0and their\u00a0satellite hospitals<\/strong>, have been trained in the\u00a0Hospital Preparedness for Emergencies (HOPE) course<\/strong>. This accredited disaster management course is recognized in Nepal and conducted in\u00a014 regional countries<\/strong>.<\/li>\n\n\n\n
  • Hub-and-Satellite Network:<\/strong>\u00a0To enhance coordination during disasters, the\u00a0Ministry of Health and Population (MOHP)<\/strong>\u00a0designates\u00a0Government and Private hospitals<\/strong>\u00a0in a hub-and-satellite system.\n
      \n
    • Kathmandu Valley Hub Hospitals:<\/strong>\u00a0Bir Hospital, Tribhuvan University Teaching Hospital, Patan Hospital, Shri Birendra Army Hospital, and Civil Service Hospital.<\/li>\n\n\n\n
    • Outside the Valley:<\/strong>\u00a0Various provincial hub hospitals and their affiliated satellite hospitals.<\/li>\n<\/ul>\n<\/li>\n\n\n\n
    • Hospital Disaster Preparedness and Response (HDPR):<\/strong>\u00a0Both hub and satellite hospitals have undergone\u00a0HDPR<\/strong>and\u00a0HOPE<\/strong>\u00a0training.\n
        \n
      • HOPE Program Overview:<\/strong>\n
          \n
        • Piloted in Nepal in\u00a02004<\/strong>\u00a0and conducted regularly since.<\/li>\n\n\n\n
        • Over\u00a050 courses<\/strong>\u00a0conducted; approximately\u00a014 courses<\/strong>\u00a0for hub and satellite hospital staff across provinces.<\/li>\n\n\n\n
        • 2000+ HOPE graduates<\/strong>\u00a0and nearly\u00a0100 instructors<\/strong>\u00a0trained, who also deliver the course in\u00a014 regional countries<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n\n\n\n
        • Disaster Plans and Coordination:<\/strong>\n
            \n
          • Each hospital develops its own disaster plan.<\/li>\n\n\n\n
          • Regular coordination meetings between hub and satellite hospitals are conducted by the\u00a0Health Emergency and Disaster Management Unit (HEDMU)<\/strong>\u00a0via the\u00a0Health Emergency Operation Center (HEOC)<\/strong>.<\/li>\n\n\n\n
          • Tabletop exercises and drills<\/strong>\u00a0have been conducted in most hospitals to simulate disaster scenarios.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n

            Challenges:<\/strong> Despite training, disaster events are infrequent, and hospital management may not prioritize disaster preparedness. Frequent staff transfers or promotions can result in outdated or difficult-to-implement disaster plans during actual emergencies.<\/p>\n\n\n\n

            \n\n\n\n

            Key Statistics and Scope of the Incident<\/strong><\/h3>\n\n\n\n
              \n
            • Deaths:<\/strong>\u00a074 fatalities reported across various hospitals nationwide.<\/li>\n\n\n\n
            • Injuries:<\/strong>\u00a0Over\u00a02,000 people injured<\/strong>, many requiring hospitalization; some discharged after treatment.<\/li>\n\n\n\n
            • Hospital Involvement:<\/strong>\u00a0Injured patients were treated in\u00a028\u201352 hospitals<\/strong>\u00a0across the country.<\/li>\n\n\n\n
            • Major Hospitals Handling Cases in Kathmandu:<\/strong>\u00a0Civil Service Hospital, National Trauma Centre, Everest Hospital, Kathmandu Medical College, Tribhuvan University Teaching Hospital, and others.<\/li>\n<\/ul>\n\n\n\n
              \n\n\n\n

              Hospital Response and Operational Measures<\/strong><\/h3>\n\n\n\n

              Emergency Mode Activation:<\/strong><\/p>\n\n\n\n

                \n
              • Hospitals activated\u00a0disaster-response protocols<\/strong>.<\/li>\n\n\n\n
              • Hospital Incident Command System<\/strong>\u00a0was activated in several hospitals.<\/li>\n\n\n\n
              • At the\u00a0Trauma Centre<\/strong>, doctors, nurses, and paramedics were fully mobilized.<\/li>\n\n\n\n
              • Non-emergency surgeries were halted<\/strong>\u00a0to prioritize critical patients.<\/li>\n<\/ul>\n\n\n\n
                \n\n\n
                \n
                \"\"<\/figure>\n<\/div>\n\n\n
                \n\n\n\n

                Resource Realignment<\/strong><\/h3>\n\n\n\n

                Surge Capacity Management:<\/strong><\/p>\n\n\n\n

                  \n
                1. Re-allocation of Space:<\/strong>\u00a0Extra spaces were used, such as placing injured patients on mattresses on floors, when patient influx exceeded hospital capacity.<\/li>\n\n\n\n
                2. Shifting Staff:<\/strong>\u00a0Doctors and medical personnel were called in from nearby hospitals to help manage the increased patient load at affected hospitals.<\/li>\n<\/ol>\n\n\n\n

                  Management of Critical Injuries<\/strong><\/h3>\n\n\n\n

                  Proper Triage:<\/strong><\/p>\n\n\n\n

                    \n
                  • Many patients presented with\u00a0bullet wounds<\/strong>, including injuries to the head, chest, and abdomen.<\/li>\n\n\n\n
                  • Hospitals performed numerous\u00a0emergency surgeries<\/strong>, often using\u00a0multiple operating theatres simultaneously<\/strong>.<\/li>\n<\/ul>\n\n\n\n

                    Referral System:<\/strong><\/p>\n\n\n\n

                      \n
                    1. Patients requiring specialized surgery were referred to appropriate hospitals.<\/li>\n\n\n\n
                    2. Some patients, seeing crowds at onsite hospitals,\u00a0self-referred<\/strong>\u00a0to other hospitals for quicker care.<\/li>\n<\/ol>\n\n\n\n

                      Pre-Hospital Care:<\/strong><\/p>\n\n\n\n

                        \n
                      • Ambulance services effectively referred critical cases to appropriate hospitals, ensuring better management despite risks to staff and vehicles in some locations.<\/li>\n<\/ul>\n\n\n\n
                        \n\n\n\n

                        Forensic \/ Post-Mortem Work<\/strong><\/h3>\n\n\n\n
                          \n
                        • Tribhuvan University Teaching Hospital\u2019s forensic unit<\/strong>\u00a0conducted autopsies on deceased victims, identifying some while others remained unidentifiable.<\/li>\n<\/ul>\n\n\n\n
                          \n\n\n\n

                          Coordination and Alert Systems<\/strong><\/h3>\n\n\n\n
                            \n
                          • The\u00a0Health Ministry<\/strong>\u00a0ordered all hospitals to remain on high alert, mobilized ambulance services, and coordinated patient transfers.<\/li>\n<\/ul>\n\n\n\n
                            \n\n\n\n

                            Psychological \/ Emotional Impact Among Health Workers<\/strong><\/h3>\n\n\n\n
                              \n
                            • Doctors and nurses were emotionally affected\u2014some broke down, while others worked\u00a0extended hours without rest<\/strong>.<\/li>\n\n\n\n
                            • Debriefing:<\/strong>\u00a0HEDMU recommended cold debriefing within\u00a0two weeks<\/strong>\u00a0of the event to identify gaps and improve future disaster plans.<\/li>\n<\/ul>\n\n\n\n
                              \n\n\n\n

                              Free Treatment Policy<\/strong><\/h3>\n\n\n\n
                                \n
                              • The\u00a0Health Ministry issued circulars<\/strong>\u00a0directing all federal hospitals to provide\u00a0free treatment<\/strong>\u00a0for those injured in the protests.<\/li>\n\n\n\n
                              • All hospitals, including private institutions, were required to treat victims\u00a0free of cost<\/strong>\u00a0and later claim reimbursement after submitting accurate documentation.<\/li>\n\n\n\n
                              • Although most private hospitals complied, there were some reports of\u00a0charging patients for medicines<\/strong>\u00a0while waiving hospital service fees.<\/li>\n<\/ul>\n\n\n\n
                                \n\n\n\n

                                What Worked<\/strong><\/h3>\n\n\n\n
                                  \n
                                • Free treatment order<\/strong>\u00a0removed financial barriers, allowing victims to seek care promptly.<\/li>\n\n\n\n
                                • Mobilization of multiple hospitals<\/strong>\u00a0prevented any single facility from being overloaded.<\/li>\n\n\n\n
                                • Activation of disaster response protocols<\/strong>, even if imperfect, demonstrated good preparedness.<\/li>\n\n\n\n
                                • Forensic capacity<\/strong>\u00a0helped identify deceased individuals, providing closure to families.<\/li>\n\n\n\n
                                • High alerting and patient transfer protocols<\/strong>\u00a0allowed triage and stabilization of critically injured patients in major hospitals.<\/li>\n<\/ul>\n\n\n\n
                                  \n\n\n\n

                                  Improvements Required<\/strong><\/h3>\n\n\n\n

                                  Ambulance & Pre-Hospital Care:<\/strong><\/p>\n\n\n\n

                                    \n
                                  • Strengthen\u00a0ambulance networks<\/strong>\u00a0with improved dispatch systems for faster response and better pre-hospital triage.<\/li>\n\n\n\n
                                  • Implement an\u00a0Integrated Emergency Medical System (IEMS)<\/strong>\u00a0led by HEDMU to refer critical patients directly from the injury site to appropriate hospitals for early, specialized care.<\/li>\n\n\n\n
                                  • Although\u00a0Nepal Ambulance Service<\/strong>\u00a0in Kathmandu provides free services within the valley, broader coverage and integration are necessary.<\/li>\n\n\n\n
                                  • Further Improvements Required<\/strong>
                                    1. Ambulance Services & Pre-Hospital Care<\/strong>
                                    All ambulances should be\u00a0fully equipped with EMT personnel and necessary medical equipment<\/strong>.
                                    Ambulance services during disasters should be\u00a0free, well-manned, and fully equipped<\/strong>.
                                    Upgrade most ambulances to\u00a0B-level<\/strong>, with EMTs and basic medical equipment.
                                    Ensure ambulances are\u00a0strictly used to transport injured patients<\/strong>\u00a0to maintain public trust.
                                    Educate the public on the importance of ambulances in saving lives to prevent damage and threats to staff.
                                    Train\u00a0paramedics and community members<\/strong>\u00a0in\u00a0First Aid and Basic Life Support (BLS)<\/strong>\u00a0to enhance pre-hospital care.

                                    2. Surge Capacity & Infrastructure<\/strong>
                                    Many hospitals\u00a0lack sufficient space<\/strong>\u00a0to handle a sudden patient influx; overflow onto floors was common.
                                    Pre-planned\u00a0surge capacity management<\/strong>\u00a0should be incorporated into hospital disaster plans.
                                    Operating theatres<\/strong>\u00a0may become bottlenecks; adding more theatres or establishing\u00a0shared regional surgical centers<\/strong>\u00a0could help during mass emergencies.

                                    3. Equipment & Supplies<\/strong>
                                    Ensure\u00a0adequate trauma kits, surgical tools, wound care materials, and imaging (X-ray\/CT)<\/strong>, particularly for bullet or internal injuries.
                                    Maintain\u00a0stockpiles of consumables<\/strong>: drugs, dressings, anesthesia, and blood products.
                                    Hub hospitals often have\u00a0equipment containers that are not replenished<\/strong>; hospitals should restock promptly with\u00a0government support<\/strong>\u00a0through funding and policy enforcement.

                                    4. Human Resources<\/strong>
                                    Train and maintain a sufficient number of\u00a0trauma surgeons, emergency physicians, anesthetists, and nurses<\/strong>\u00a0to handle mass casualties.
                                    Develop\u00a0postgraduate courses<\/strong>\u00a0in relevant emergency and trauma disciplines.
                                    Utilize the\u00a0Hub and Satellite system<\/strong>\u00a0to temporarily borrow staff during disasters.
                                    Train more staff in\u00a0disaster medicine, triage, and mass casualty management<\/strong>.
                                    Community training in\u00a0First Aid and BLS<\/strong>\u00a0is essential.

                                    5. Coordination and System Preparedness<\/strong>
                                    Establish\u00a0clear, practiced protocols<\/strong>\u00a0for mass casualty incidents, covering triage, transfer, command structure, and resource sharing between hospitals.
                                    Activate the\u00a0Incident Command System<\/strong>\u00a0within HEDMU to ensure centralized coordination.<\/li>\n<\/ul>\n\n\n\n

                                    <\/p>\n\n\n\n

                                    6. Coordination and System Preparedness (Continued)<\/strong><\/h3>\n\n\n\n
                                      \n
                                    • HEDMU should coordinate through\u00a0HEOC<\/strong>\u00a0and\u00a0Provincial Emergency Operation Centers (PHEOC)<\/strong>\u00a0during disasters to manage\u00a0human resources, logistics, and IEMS<\/strong>.<\/li>\n\n\n\n
                                    • Hospitals should be\u00a0monitored by HEDMU<\/strong>\u00a0to ensure treatment standards are maintained even under difficult conditions.<\/li>\n<\/ul>\n\n\n\n
                                      \n\n\n\n

                                      7. Forensic and Identification Capacity<\/strong><\/h3>\n\n\n\n
                                        \n
                                      • Enhance the ability to\u00a0quickly perform autopsies, identify bodies, and assist families<\/strong>.<\/li>\n\n\n\n
                                      • Strengthen\u00a0DNA testing facilities<\/strong>\u00a0for unidentifiable cases.<\/li>\n\n\n\n
                                      • Establish\u00a0clear protocols<\/strong>\u00a0for handling bodies and preserving evidence.<\/li>\n<\/ul>\n\n\n\n
                                        \n\n\n\n

                                        8. Free Treatment and Financial Protection<\/strong><\/h3>\n\n\n\n
                                          \n
                                        • Ensure the directive for\u00a0free treatment<\/strong>\u00a0is implemented uniformly across public and private hospitals.<\/li>\n\n\n\n
                                        • Implement systems to\u00a0reimburse hospitals<\/strong>\u00a0so that providing free or low-cost care does not strain finances.<\/li>\n<\/ul>\n\n\n\n
                                          \n\n\n\n

                                          9. Communication and Information Management<\/strong><\/h3>\n\n\n\n
                                            \n
                                          • Improve\u00a0public communication<\/strong>: inform the public which hospitals are available, referral paths, and resources.<\/li>\n\n\n\n
                                          • Maintain\u00a0internal hospital communication<\/strong>: OR availability, on-call staff, and emergency procedures.<\/li>\n\n\n\n
                                          • Inform the public about\u00a0ambulance services, blood requirements<\/strong>, and updates on hospital status.<\/li>\n<\/ul>\n\n\n\n
                                            \n\n\n\n

                                            10. Security & Safety in Hospitals<\/strong><\/h3>\n\n\n\n
                                              \n
                                            • Hospitals can become chaotic during unrest;\u00a0crowd control<\/strong>\u00a0is essential to protect patients, staff, and ambulatory pathways.<\/li>\n\n\n\n
                                            • Establish\u00a0protocols to secure entrances<\/strong>, manage visitor flow, and designate areas for patients and visitors.<\/li>\n\n\n\n
                                            • Create awareness among the public and law enforcement that hospital premises are for\u00a0medical management only<\/strong>.<\/li>\n<\/ul>\n\n\n\n
                                              \n\n\n\n

                                              11. Post-Trauma Psychological Support<\/strong><\/h3>\n\n\n\n
                                                \n
                                              • Provide\u00a0short-term and long-term psychological support<\/strong>\u00a0for healthcare workers.<\/li>\n\n\n\n
                                              • Designate hospitals to offer\u00a0free post-trauma consultations<\/strong>\u00a0for a month or longer if required.<\/li>\n<\/ul>\n\n\n\n
                                                \n\n\n\n

                                                12. Debriefing<\/strong><\/h3>\n\n\n\n
                                                  \n
                                                • HEDMU and MOHP should conduct\u00a0debriefing sessions<\/strong>\u00a0with all major stakeholders to evaluate what worked and what needs improvement.<\/li>\n\n\n\n
                                                • Accountability and lessons learned will\u00a0strengthen future disaster response<\/strong>.<\/li>\n<\/ul>\n\n\n\n
                                                  \n\n\n\n

                                                  13. Practice and Drills<\/strong><\/h3>\n\n\n\n
                                                    \n
                                                  • Conduct\u00a0regular drills<\/strong>\u00a0with realistic scenarios, including civil unrest, violence, epidemiological disasters, and multiple casualties.<\/li>\n\n\n\n
                                                  • Drills should include\u00a0various hospitals, hub and satellite networks, communities, ministries, public and armed forces<\/strong>, potentially culminating in valley-wide exercises.<\/li>\n<\/ul>\n\n\n\n
                                                    \n\n\n\n

                                                    14. Legal, Ethical, and Human Rights Considerations<\/strong><\/h3>\n\n\n\n
                                                      \n
                                                    • Maintain proper\u00a0record-keeping<\/strong>\u00a0to document injuries, treatment, and referrals.<\/li>\n\n\n\n
                                                    • Monitor treatment standards for detainees and injured protesters.<\/li>\n\n\n\n
                                                    • Document\u00a0wound types (live\/rubber bullets)<\/strong>\u00a0for human rights investigations.<\/li>\n\n\n\n
                                                    • Ensure treatment records are available for\u00a0government reimbursement<\/strong>\u00a0purposes.<\/li>\n<\/ul>\n\n\n\n
                                                      \n\n\n\n

                                                      Conclusion<\/strong><\/h3>\n\n\n\n

                                                      The Gen Z protests in Nepal<\/strong> placed hospitals under acute strain. Despite this, many hospitals adapted quickly, mobilized resources, provided free care, and activated disaster response systems.<\/p>\n\n\n\n

                                                      However, the crisis revealed gaps in infrastructure, planning, supply chains, staffing, pre-hospital care, and coordination<\/strong>. Strengthening these areas will prepare Nepal\u2019s health system for protests, civil unrest, natural disasters, mass accidents, and epidemiological crises<\/strong>.<\/p>\n\n\n\n

                                                      Regular practice of disaster risk management systems<\/strong>, including the Incident Command System (ICS)<\/strong>, is essential to ensure readiness for future emergencies in a country with challenging infrastructure, geography, and resource limitations.<\/p>\n","protected":false},"excerpt":{"rendered":"

                                                      Prof. Dr. Pradeep Vaidya Hepato-Biliary-Pancreatic Surgeon & Emergency Preparedness Leader Prof. Vaidya is a surgeon and a leading figure in emergency and disaster preparedness in Nepal. As the President of the National Society for Emergency and Disaster Risk Management, he has been instrumental in strengthening Nepal\u2019s health system resilience and hospital disaster readiness. He is one of the …<\/p>\n","protected":false},"author":110,"featured_media":8837,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"","jetpack_seo_html_title":"","jetpack_seo_noindex":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[146,2577,39,107,42],"tags":[],"class_list":["post-8854","post","type-post","status-publish","format-standard","has-post-thumbnail","","category-cover-story","category-event","category-feature","category-flash-news","category-in-the-news"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/medicosnext.com\/wp-content\/uploads\/2025\/10\/Screenshot-2025-10-19-at-3.26.14-PM.png?fit=1090%2C1540&ssl=1","jetpack_likes_enabled":true,"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/medicosnext.com\/index.php?rest_route=\/wp\/v2\/posts\/8854","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicosnext.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicosnext.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicosnext.com\/index.php?rest_route=\/wp\/v2\/users\/110"}],"replies":[{"embeddable":true,"href":"https:\/\/medicosnext.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=8854"}],"version-history":[{"count":1,"href":"https:\/\/medicosnext.com\/index.php?rest_route=\/wp\/v2\/posts\/8854\/revisions"}],"predecessor-version":[{"id":8857,"href":"https:\/\/medicosnext.com\/index.php?rest_route=\/wp\/v2\/posts\/8854\/revisions\/8857"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medicosnext.com\/index.php?rest_route=\/wp\/v2\/media\/8837"}],"wp:attachment":[{"href":"https:\/\/medicosnext.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=8854"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicosnext.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=8854"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicosnext.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=8854"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}