We visited a couple of Health posts on our trek as we had friends working in them. These remote clinics use volunteer doctors (Western and Nepali) to deliver health care to trekkers for a very reasonable fee. In return they provide free healthcare for porters and locals. It is a model that has worked well for a couple of decades and is supported by the charity International Porter Protection Group and the HRA. All parties benefit in that trekkers are educated about altitude risk and have access to a high standard of care. Porters get good care and the volunteers acquire excellent experience.
Sadly this is all now under threat from corruption, insurance fraud, vested interest and big money. Private hospitals and lodge owners are receiving kick-backs from helicopter companies for providing helicopter evacuation for the most dubious of reasons. We witnessed, in our lodge, a Russian trek leader organising a helicopter evacuation for a client with a cough. The client had received no local treatment despite being just 200m from a health post. The trek leader was not interested in medical advice he just instructed the client to be taken to the ERA hospital in Kathmandu so that the appropriate insurance claim could be validated retrospectively.
These ‘10%’ scams have been going on for a long time and at least some insurance companies have caught up with the abuse. But that doesn’t mean that things are getting better. Indeed, a new and more damaging bit of insurance fraud appears to be afoot.
Private hospitals in Kathmandu have started opening up private clinics in selected lodges, They staff them with the most junior doctors they can find so these are not serious attempts to provide health care for either trekkers or locals. Instead, the business model appears to be based on summoning a helicopter evacuation as often as possible. The appropriate ‘10%’s’ are paid and this time the insurance claim is validated by the doctors’s signature before the aircraft leaves Kathmandu.
This isn’t a victimless crime for the lodge owners are now directing their guests to the private clinics because they too want their ‘10%’. The charitable health posts are seeing their paying clients evaporate and thus are struggling to provide the free care that is so valuable for locals.
At some stage very soon the Health Posts will be put out of business and at some point the insurance companies will wake up to the mutation of this fraud and it will become prohibitively expensive to insure a trek in this region. All very sad.
It wouldn’t be right to close this post without mentioning an excellent interaction with the health post at Gokyo. One of our group members had an infected haematoma which required incision, drainage and antibiotics. This, together with some acute mountain sickness, meant that he was on the verge of descending. The doctors at Gokyo did all that was required and the next day he successfully traversed the Renjo La - undoubtedly the high point of our trek in every sense.
It would be a tragedy if these wonderful services to trekkers and locals disappear because of private clinics, greed and corruption.
