Doctor exodus increasing, shortage of specialists

 Doctor exodus increasing, shortage of specialists

The state's investment is being wasted as skilled doctors, including those who studied on government scholarships, go abroad. The risk of quality decline and having to provide treatment by weak doctors in the future is increasing.

The number of doctors registered with the Nepal Medical Council is 38,499. Of these, 11,000 are specialists. Some of them are foreign doctors.

There is no exact figure for how many doctors registered with the Medical Council are currently in Nepal.

In a study conducted by the Nepal Medical Association in 2072 BS, about 36 percent of doctors were outside the country. At that time, only about 11,000 of the 17,000 doctors registered with the council were in the country.

Recently, doctors are being attracted abroad because they do not have guaranteed security at the workplace, are not paid according to their education and time investment, and do not see a career in Nepal. A clear indication of this is seen in the 'Good Standing Certificate' data provided by the Medical Council.

Doctors registered in Nepal must obtain a 'Good Standing Certificate' from the Nepal Medical Council to study or work abroad.

Not all people who have obtained a good standing certificate, which is required for registration with a foreign regulatory body, go abroad.

According to council officials, it is estimated that more than 70 percent of those who have obtained a ‘good standing certificate’ have gone abroad.

Out of 38,499 doctors registered with the Nepal Medical Council, 11,000 are specialists. However, in recent years, the trend of going abroad with a ‘good standing certificate’ has increased dramatically.

In 081/082 BS, the number of doctors who obtained a character certificate for study or work abroad was 2,681. In 2023, 2,318 people obtained a good standing certificate, while 2,692 doctors obtained registration.

Similarly, in 2022, 2,692 doctors registered, while 1,954 had good standing certificates.

In 2022, 1,954 people, in 2021, 1,327 and in 2020, 869 people obtained this certificate.

In 2021, 1,327 people obtained a certificate of good character. According to the Medical Council, 1,716 doctors were registered this year.

In 2020, 2,131 doctors were registered. In the same year, 759 people obtained a certificate of good standing.

Medical Council officials say that the number of people going abroad may be even higher as no one keeps integrated data on those going through processes such as study, fellowship, worker visa and dependent.

There is a continuous exodus of qualified manpower from the medical sector in Nepal. According to data from the Nepal Medical Council, the number of doctors going abroad is increasing every year.

In the last five years, 9,000 doctors have obtained a ‘certificate of good standing’ from the Medical Council. Among those who obtain such certificates, the highest number are doctors who are in the process of going abroad to the United States.

In the last five years, 2,466 people have obtained certificates to go to the US. Of which 276 in 2020, 273 in 2021, 496 in 2022, 843 in 2023 and 2,466 in 081/082 BS.

The number of doctors undergoing the process of going to the UK is also alarming.

In the last five years, 9,000 doctors have obtained 'Good Standing Certificates', with the largest number going to countries including the US, UK, Maldives, Australia, UAE.

In the last five years, 2,128 people have obtained certificates to go to the UK. According to the council, 162 people in 2020, 319 in 2021, 592 in 2022, 505 in 2023 and 550 in 2024 have obtained certificates to go to the UK.

Similarly, 216 people have obtained certificates to go to the Maldives in 2020, 403 in 2021, 453 in 2022, 395 in 2023 and 384 in 2024. The data also shows that the number of doctors going to Australia, UAE, Canada and Qatar is also increasing.

According to the Council's Registrar Dr. Satish Kumar Dev, the trend of doctors going abroad has increased significantly in recent years.

According to Dr. Dev, doctors who go abroad for study, training, fellowship or employment request a good standing certificate.

"Doctors have a high affinity for countries like the UK, America, Maldives, Australia and UAE," he said.

Most doctors going to the US want to participate in residency programs. The main purpose of doctors going to the Maldives and the UAE is employment. In Australia, the number of people who want to go for both study and employment is significant.

Dr. Dev warned that the exodus of doctors will lead to a shortage of skilled manpower in Nepal in the future. According to him, the minimum salary in the Maldives is 6-7 times that of Nepal, 8-10 times that of Qatar, and even more than that of the United States.

“It will be difficult to stop skilled doctors unless the state provides attractive opportunities and living standards,” he said.

Treatment is being escaped

The rapid exodus of doctors abroad in recent times has led to a shortage of doctors specializing in certain specialized and complex diseases.

For the past few years, there have been no admissions for doctors studying heart surgery, kidney and liver specialist studies in the DM and MCH (Super Specialist Research Degree) entrance exams.

According to experts, there have been zero or very few doctors studying super specialists in heart surgery and kidney and liver in the specialist field for the past few years.

Which, on the one hand, with the increase in diseases such as heart, kidney, liver and on the other hand, doctors are not interested in studying, such diseases will be prevalent in the country in the next few years It is clear that there will be a shortage of doctors in the field.

There are some reasons for the lack of interest in studying specialties such as heart, neurosurgery, kidney, liver, etc.

Complex and long studies, excessive hard work, low salary and allowances according to the effort and assignment, risky work, not being able to get a job in a private hospital after retiring from a government hospital or not being sure of a job even in a government hospital are the main reasons.

The outbreak of non-communicable diseases is increasing in recent days. According to doctors involved in the treatment, heart problems are becoming a factor in non-communicable diseases. Similarly, the burden of cancer, kidney, and tuberculosis is also increasing. Even now, the reason why such patients are forced to wait for a long time for surgery is the lack of enough specialist doctors.

Nepal Medical Association President Dr. Anil Karki says, “If the government does not create an environment for doctors to live within the country, there may be a situation where doctors from abroad will have to be brought in for treatment in 10 years.”

The Nepal Health Account 2017 published by the Ministry of Health and Population states that due to the state’s lack of investment in specialized services, more than 200 billion people go abroad for health care annually, and about 17 percent of citizens have become poor due to receiving health services.

Experts say that due to the government’s weak human resource planning and management policy, doctors in various fields have not been produced and ordinary people are dying due to lack of timely specialist services.

Why are doctors leaving the country?

The reasons for doctors leaving Nepal are not uniform. Some have chosen to go abroad because they did not get secure employment opportunities at home, some because they did not get a favorable working environment, and some have had to endure exploitation by private hospitals.

Many who studied at private expense argue that Nepal’s earnings do not cover the investment in education. The common attraction of all of these is the relatively high income they earn abroad. Although the reasons are different, the rapid pace of foreign migration has increased the risk that it will be difficult to find specialist doctors in various fields in Nepal in the future.

The government has not added new posts, and it has been 8 years since the Public Service Commission advertised for filling existing posts. 100% of specialist posts in central hospitals are vacant. Examples of which are Dadeldhura and Gajendra Narayan Hospitals.

The last time 100 doctors were appointed to government hospitals was in 2074 BS. As the health system is stuck in the old post structure of 25 years ago, the path to entry for new doctors is almost closed. Therefore, the only option left for many is abroad.

A survey conducted by a government study team coordinated by the then chief specialist of the Ministry of Health and Population, Dr. Tanka Prasad Barakoti, has shown that a large proportion of doctors are willing to go abroad.

The exodus of doctors has reduced the number of people studying super-specialists in complex diseases such as heart, kidney, and liver to zero or very low. This has increased the risk of drought in the future.

Of the 43 students who passed MBBS in 2022 from Tribhuvan University Teaching Hospital Maharajgunj Medical Campus, 100 percent are planning to go abroad.

According to the report, 41 of them (about 95 percent) had already registered for the foreign exam. Five of the 41 have passed the exam and entered the matching process, while 31 are taking the exam. Most of them plan to take the US medical license exam.

Also read: Government is ruining the health service by stalling the recruitment proposal

According to Dr. Barakoti, lack of safety in the workplace, not getting a salary commensurate with the investment of education and time, and no future for a career in Nepal are the main reasons why doctors are attracted to abroad.

The report also points to low salary and benefits, lack of meaningful and respected work, lack of opportunities for study, research and professional development, increasing violence in health institutions, and lack of sophisticated infrastructure as the main factors behind the exodus of doctors.

The tendency to stay there while studying

To become a doctor in Nepal, one must study for five years and six months at the undergraduate level. Then, one must study for three years for the postgraduate level and three years for the DM/MCh level. Due to the work experience required to study beyond the undergraduate level, many doctors are already 40 years old by the time they complete their studies. More than half of a Nepali doctor's life is spent studying.

However, doctors who have studied for 12/15 years and spent crores of rupees do not have good job opportunities and the service and facilities are very poor, so their attraction is to go abroad.

The economic, political and social environment in the country is chaotic. This situation has arisen especially because of the despair among doctors.

Former Dean of the Institute of Medicine (IOM) of Tribhuvan University Dr. Jagadish Prasad Agrawal says that the exodus of skilled doctors abroad in Nepal will seriously affect the quality of health services in the coming days.

According to him, most of the highly qualified doctors who pass the licensing examination of the Nepal Medical Council are preparing to go abroad.

‘The most competent person goes. There is a tendency to stay there while studying,’ says Dr. Agrawal.

Low salary and benefits, lack of respectable jobs, lack of research, increasing insecurity in health institutions and lack of infrastructure are the main reasons for migration.

Even those who studied on government scholarships go abroad The state's investment in crores has been wasted.

He opined that the practice of providing medical education to students with weak educational background in the medical education system should be stopped.

'If the trend of going abroad continues like this, the standard of healthcare providers in Nepal will decline,' says Dr. Agrawal, 'tomorrow, a person who has failed the council exam 32 times may have to be treated.'

According to Dr. Shree Krishna Giri, former vice-chairman of the Medical Education Commission, there are few job opportunities in Nepal.

'There are no opportunities in Nepal. And it was natural to look for them outside. The facilities available to doctors in Nepal are few and living conditions are difficult,' says Dr. Giri.

He mentioned the possibility of doctors who have studied abroad getting jobs there as another reason.

'If they go to study in the US, there is a greater chance of getting jobs there. That is why there is a trend of doctors who go to study and stay here,' says Dr. Giri.

'In 10 years, there will be a situation where doctors will have to be brought in from abroad.'

Dr. Anil Karki warned that the rate of emigration of health workers and doctors in Nepal is increasing rapidly and said that immediate policy reforms are needed to stop this trend.

According to him, the state's lack of adequate investment in the health sector, lack of proper management of human resources, low salaries and benefits, legal complications and workplace insecurity have created deep despair among doctors.

"If this situation does not improve, Nepal may have to bring doctors from abroad for treatment in 10 years," says Dr. Karki.

According to him, the high wages, living standards and safe working environment abroad have further intensified the trend of going abroad.

He pointed out the scholarship contract system, the mandatory one-year experience rule before master's studies, the lack of increase in permanent positions, lack of increase in salaries and benefits and excessive workload as the main reasons for emigration.

He said that the government should increase social, economic, political and security guarantees and services and facilities that are sufficient to survive so that skilled manpower can return from abroad and be retained.

Urging the government to increase investment in the health sector, improve facilities, remove policy barriers, and ensure safety in the workplace, Dr. Karki says, "We should make it a habit to find solutions, not just complain about going abroad."

How to mitigate the psychosocial impact of the current crisis?

 How to mitigate the psychosocial impact of the current crisis?

Nepal is currently in a period of political transition that has increased instability and uncertainty.

The deaths and injuries of adolescents and many others in the recent violent protests have raised deep concerns.

Immediate and long-term initiatives are needed, prioritizing mental health and psychosocial support.

Nepal is once again in a period of political transition. While change itself is an inevitable process, change accompanied by uncertainty creates more uncertainty than hope. At times, we are wondering whether Nepal is on the brink of instability.

The loss of lives of adolescents and young people in recent violent protests and movements, the injury of many people, is sending a message of sorts.

The massive damage to private and public property, from archaeological heritage to the prevailing sense of insecurity in the minds of ordinary citizens, have caused us deep pain. Not only the immediate damage, but also its long-term impact, its impact on mental health, is a matter of concern and discussion.

This crisis has affected all age groups in different ways. Children and adolescents have experienced fear, confusion, sleep problems, and difficulty concentrating in school. Youth and adults have experienced increased frustration, anger, anxiety about unemployment, and strained social relationships. The elderly are experiencing feelings of insecurity. People with disabilities and marginalized communities have their own unique concerns.

If these conditions are not addressed immediately, there is a risk of increased trauma, anxiety, depression, and suicidal tendencies. There is also a risk of social breakdown, deepening distrust, decreased productivity, and a decrease in human resource capacity.

Psychosocial support is urgently needed for children, adolescents, youth, women, the elderly, people with disabilities, and marginalized communities affected by violence, death, and insecurity. Many people are in a state of confusion right now. Most people seem to believe the information they receive on social media as official information. Many seem to be unable to distinguish between right and wrong.

This type of information seems to have made people very anxious due to the pressure of uncertainty about the future.

What to do in this situation?

Both immediate and long-term initiatives are needed to address such a situation. Primarily, psychological support, helpline services operated through telephone and social media, and community-based basic psychosocial support programs need to be started immediately.

Self-care and stress management skills should be provided to security personnel, health workers, media workers, and other service providers working in the field immediately. In the long term, mental health in schools, communities, and workplaces should be linked to education, protection, and health systems through policy management.

It is essential to develop a psychosocial support system with follow-up and conduct activities. Similarly, only by ensuring quality counseling services related to trauma and grief can victims have the basis to restore their lives to balance.

In this context, the first responsibility is to address the suffering of people who died, were injured, and were disabled in the movement. Immediate treatment, rehabilitation, compensation and ensuring justice should be the first step of the state. Trust in the people can be restored only by impartial investigation and accountability in cases of human rights violations.

Similarly, it is necessary to pay attention to the control of corruption and transparency in power raised by the protesters.

Special attention should be paid to returning people's lives to their previous state, restoring employment and creating new jobs. It is necessary to immediately facilitate and restart production and business that have been stalled due to various reasons. It is necessary to create an investment-friendly environment and create an encouraging environment.

Similarly, mental health and psychosocial well-being must be a national priority. The World Health Organization and the International Labor Organization have recommended linking mental health with development and employment. Therefore, Nepal needs to take the initiative in this regard in collaboration with development partners.

In the long term, it is essential to introduce psychosocial and mental health education in schools, communities and workplaces, a structure of community-based workers (CBTs) and psychologists, and policies and systems that link mental health to the primary health system.

Good governance and transparency are also indispensable. Rebuilding trust is not possible without participation in the decision-making process, accountability through e-governance, social justice and the implementation of concrete programs to end discrimination. Nepal stands at a crossroads of crisis and opportunity today.

Only if the state can put these five foundations into practice: justice and rehabilitation for the victims of the movement, eradication of corruption, job creation and economic expansion, ensuring mental health and social cohesion, and reconstruction with good governance and transparency, will Nepal's future not be just a story of struggle, but a common home for beautiful, peaceful, healthy and happy Nepalis.

What is Alpha School in America, where AI teaches instead of teachers!

 What is Alpha School in America, where AI teaches instead of teachers!

What comes to mind when you think of ‘school’? Surely, for many, classrooms from kindergarten to 12th grade, front-line teachers, and long lessons come to mind. This is how schools have been set up for centuries. But now, as AI is changing our lifestyle, the traditional way of learning and schooling has also started to take a new form.

Alpha School, located in Texas, USA, has become a global sensation due to its unique and modern way of teaching students. Instead of a teacher teaching 25-40 students at a time as per the traditional style, it is said that in this school, students are instructed individually by AI guides. It is said that the AI ​​system also analyzes their progress and provides immediate feedback, which helps them improve their weaknesses.

At Alpha School, students are said to have to study for only 2 hours a day. According to international media, after two hours of study, Alpha School students spend time on physical activity, problem-solving activities, leadership exercises, and life skills. These include activities ranging from long bike rides to creative projects and entrepreneurship training.

Another feature of Alpha School is its financial rewards system. Students are said to earn money for completing assignments, projects, or mastering skills, which they can spend on their own projects or interests, or even invest.

According to international media, Alpha School is not a school that appeared overnight or became famous. It has been operating on campuses in Texas, Florida, and California for more than a decade, and is now preparing to expand to New York City. It is said that a new Alpha campus is planned to open in Manhattan next September, with annual tuition fees ranging from $40,000 to $65,000, depending on the location.

This unique and technological teaching style demonstrated by Alpha School has shown the potential for education to take on a completely new form through innovation, not just limited to books and teachers.

Some of our habits, which can be improved to improve health

 Some of our habits, which can be improved to improve health

Eating late at night increases the risk of diabetes, so you should finish your meal by 8/9 pm and eat light meals.

Eating too fast can cause gastritis, so you should chew your food slowly and thoroughly.

Excessive salt intake increases high blood pressure, so it is recommended to not eat more than 6 grams of salt per day and eat less processed food.

A balanced and healthy lifestyle is essential to prevent and control any disease. Sometimes some habits cause disease. While some promote diseases. If we identify these habits and change them in time, positive improvements in health are possible.

There are some habits, which can be changed to avoid diseases.

1. Diabetes

Eating late at night can cause imbalanced blood sugar levels, which reduces the effect of insulin in the body. This makes it difficult to control sugar. It is better to finish eating by 8/9 pm. Dinner should be light. After eating, you should walk for a while.

2. Migraine

Skipping meals can increase migraine symptoms. Not getting enough nutrition on time can lower blood sugar levels and increase headaches. A regular and balanced diet helps in controlling migraines.

3. Heart disease

Physical inactivity is a major cause of the disease. Not exercising regularly can lead to obesity, high blood pressure, and cholesterol. You should do at least 30 minutes of light or moderate exercise daily. You can also walk.

4. Osteoporosis

Complete deprivation of sunlight weakens bones. Spend 15 minutes in the early morning sun and include calcium-rich foods in your diet.

5. Gastritis

Eating too quickly affects the protective layer of the stomach, which causes irritation and gas. You should chew your food slowly and thoroughly.

6. Acid reflux

If you sleep immediately after eating, stomach acid can flow back into the esophagus. You should stay active for at least 2 hours after eating. Eat light and less spicy food at night.

7. Stomach problems

Not drinking enough water can cause problems like constipation and acidity. You should drink at least 8-10 glasses of water throughout the day. So that the digestion process remains smooth and excretion is easy.

8. Liver disease

Excessive oil-spices and processed foods put an extra burden on the liver. Such foods should be avoided. Fresh fruits and vegetables should be prioritized in your daily diet.

9. Dementia

Mental inactivity and watching television for a long time negatively affect brain function. Therefore, you should learn something new every day and exercise your brain.

10. Insomnia

Excessive use of screens, especially before going to bed, affects sleep. You should stop using mobile and television at least 1 hour before going to bed. You should set a regular sleep time.

11. Anxiety

Spending time on social media can increase mental stress. Limit your use of social media. Include meditation, yoga, and relaxation techniques in your daily life.

12. High blood pressure

Excessive salt intake can increase blood pressure. Excess salt causes water retention in the body, which increases pressure on the heart. Therefore, you should avoid eating processed and fast foods that are high in salt and should not consume more than 6 grams of salt per day. You should also give up the habit of sprinkling salt on your food.

13. Anemia

Many people drink tea immediately after eating, but this hinders the absorption of iron in the body. Therefore, tea should be drunk at least 1 hour before or 1 hour after eating. Green vegetables, lentils, and iron-rich foods should be prioritized in the diet.

What are the procedures for postmortems and identification of those who died in the protests?

 What are the procedures for postmortems and identification of those who died in the protests?

Coordination between forensic science, police, and hospitals is necessary to identify and determine the cause of death of those who died during the protests.

An official letter of medico-legal examination from the police is required before the postmortem is conducted, which confirms the cause of death.

DNA analysis and other scientific methods are used to identify bodies that have been burned, but identifying completely burned bodies is challenging.

Violent incidents during protests cause great human loss. In such incidents, a complex and sensitive procedure is adopted to identify and determine the cause of death of those who die due to gunshots, fire, or other injuries.

Coordination between forensic science, as well as the police, and hospitals is very important to identify and determine the cause of death of the deceased. This process is sensitive from both a scientific and legal perspective.

Incident and initial procedures

People who die during the protests are often taken to the hospital immediately by eyewitnesses or friends. The name of the deceased is registered in the hospital and treatment is attempted. If the person is confirmed not to be alive, the body is sent for postmortem. Tribhuvan University Teaching Hospital, Kathmandu is a well-equipped centre for mortuary storage and postmortem. The body is preserved in a freezer facility. The teaching hospital has the necessary equipment for proper management of the body and postmortem, which makes the process systematic.

Identification process of the deceased

Initial identification

The identity cards, jewellery or other personal belongings of the deceased form the initial basis for identification. The name and address of the deceased can be ascertained from such items. If such items are not available, the relatives come to the hospital and identify the body.

Personal belongings are of great help in the identification process, but sometimes other scientific methods have to be used in cases where these items are destroyed.

Notification to relatives

Once the details of the deceased are registered in the hospital, the relatives are informed. The hospital maintains a list of the names of the deceased, which the relatives look at to identify the body. Once the identity is confirmed, the postmortem process proceeds.

Postmortem and medico-legal process

A medical-legal examination is required from the police before a postmortem can be conducted. In cases where police stations are affected, such a letter is issued by the Kathmandu Police Complex. A postmortem determines the cause of death, such as gunshot wounds, injuries or fire. This process is important for the relatives of the deceased and the community to uncover the truth.

The main causes of death during the protests currently include gunshot wounds, internal injuries, head injuries or fire. In cases of gunshot deaths, doctors analyze the nature of the bullet and the damage to the body.

Identification of people who died in a fire

The identification of bodies that died in a fire is complicated. For example, in the case of seven people who died in a fire in Bhatbhateni, identification is challenging. Methods such as presumptive identification and DNA analysis are used to identify burned bodies. If jewelry, clothes or other personal belongings are left, they can be used to identify them.

DNA Analysis

When a body is not completely burned and some tissue remains, DNA is extracted and analyzed. This process is carried out at the Central Forensic Science Laboratory of the Nepal Police. DNA analysis can confirm the identity of the deceased, but this process is time-consuming and resource-intensive.

DNA Analysis Process

DNA Extraction

DNA is extracted from white blood cells, because red blood cells do not have a nucleus. DNA can be extracted from bones or teeth in burned bodies, if they are not destroyed.

Polymerase Chain Reaction (PCR-M)

If the amount of DNA is low, the amount of DNA is increased by the PCR-M process. This makes it easier to analyze the DNA sequence adenine, guanine, thymine, cytosine.

Profile Matching

The DNA profile of the deceased is compared with the DNA of his father or mother. A 50 percent match between the father or mother's DNA confirms the identity.

Challenges in completely burnt bodies

If the body is completely burnt and the tissues are destroyed, DNA analysis is not possible. In such a case, identification becomes impossible. Also, if the relatives of the deceased do not contact them in time, the process becomes more complicated. The possibility of identifying completely burnt bodies is limited, but we must make the most of the resources and technology available.

This process is not only to identify the deceased and determine the cause of death, but it is also a means of ensuring truth and justice in society. Such sensitive processes provide comfort to the victim’s family and provide truthful information to society.

Back Pain: An Accounts Officer in the Circle of Wrong Treatment

 Back Pain: An Accounts Officer in the Circle of Wrong Treatment

Accounts Officer Tilak Shrestha started treatment for back pain at the Physiotherapy Unit of Bir Hospital in 2082 Jestha.

Tilak spent more than two hundred thousand rupees on various clinics and treatments for 6 months, but it did not get better.

Physiotherapy at Bir Hospital reduced Tilak's pain by teaching him evidence-based treatment and exercises, and he returned to work.

Tilak Shrestha (name changed) by profession, an accounts officer by profession, arrived at the Physiotherapy Unit of Bir Hospital in 2082 Jestha.

His problem was back pain.

He came here after wandering around many places for treatment but the problem was not resolved.

He recounted the list of frustrations he faced during treatment.

This experience is not unique to him, many people with back pain experience the same. Many people fall into the trap of wrong treatment by following unnecessary suggestions from various people.

Suffering from pain

Tilak had been suffering from back pain for 6 months. The pain was worse when he woke up in the morning. It was worse when he sat or stood for a long time. At first, he ignored it, considering it normal. The pain gradually spread to his legs and made it difficult to walk. He even changed his office chair twice, wondering if it was because he was uncomfortable sitting while working.

Unable to concentrate on work, unable to sit in the office for a long time, and daily life became difficult, he started looking for treatment.

Initial efforts

Initially, he went to an Ayurvedic treatment center in Basundhara as suggested by his uncle. There, he was told that his back hurt due to heavy lifting and sitting in the wrong posture. Tilak did not do heavy lifting. He concluded that his back hurt because he sat in the same position for a long time in the office.

He was given acupuncture services, hot water baths, and massage once a week. He was also told to take some medicines. Although these treatments reduced some of the pain, the problem did not completely resolve. He was charged Rs. 2200 each time for these treatments. The cost of the medicine was separate.

After the fourth massage during the treatment, he started having problems with tingling in his legs and increasing pain.

And at the clinic

When the problem did not work, he went to a clinic near his house to consult a doctor. On the doctor's advice, he got blood tests and X-rays done. These tests did not show any major problems. He was informed that there was a normal bone loss.

It was suggested that further tests be done for further investigation. Accordingly, tests were done for CBC, ESR, vitamin D, calcium, uric acid levels, etc. Additional blood tests were also done for other parameters.

After finding that all the parameters were normal, an MRI was asked to find out the cause of the back pain.

In the same clinic, ‘needle therapy’, ‘traction’, ‘tension’ were given as physiotherapy. However, Tilak did not feel any improvement. Instead, he felt more pain. He was advised to rest for some time and stay at home, not go to the office and not do daily household chores.

Second clinic and expensive expenses

Then he was advised to go to a clinic in Tripureshwor. After examining his problem, it was suggested that he should burst the lump in the back. For this, methods such as ‘needling’, ‘manual’, ‘chiropractic’ massage gun were used.

He underwent the treatment as prescribed there for 15 days at a rate of 1000 per day. But the pain did not reduce much.

More expenses at the third clinic

Then he went to another clinic near the Civil Hospital in Baneshwor. There he spent 500 per day and took hot steam for 9-10 days. He also took massage therapy for the same number of days. He spent 600 per day on that. Here, he spent about 10 thousand.

Although these simple massages and steam treatments provided immediate relief from the pain, they did not provide a long-term solution.

Towards natural treatment

Finally, Tilak went to a center in Baneshwor to seek natural treatment. Where he underwent treatment for 10 days continuously. There, treatments like ‘acupuncture’, ‘cupping’ were given. There, he was given 10 minutes of physiotherapy daily. In which the therapist would stretch his hands and teach him some exercises to do on his own.

These treatments also could not completely cure Tilak’s back pain.

Consultation with a doctor at the National Trauma Center

After many types of treatment did not help, he went to the National Trauma Center to consult an orthopedic doctor. There, the doctor said that the condition was very complicated and that an MRI should be done.

The doctor suggested taking medicine and doing physiotherapy for some time. If that did not help, he was told to get injections.

Tilak informed the doctor that he had not gotten better despite undergoing physiotherapy at various places. After hearing all that, the doctor suggested injections and surgery if necessary, and ordered an MRI.

At the Pain Care Center

Tilak was scared when they said injections and surgery would be necessary. When he consulted his friends and relatives, some gave examples of people who had undergone surgery and recovered, while others advised against surgery. This confusion left him in a dilemma.

After being diagnosed, he again started looking for non-surgical treatment. In the same vein, he reached the Pain Care Center. There, he was prescribed medicine for 20 days. After undergoing various therapies and treatments, he took the service for a few days at the rate of 700 rupees per day.

6 months of suffering and unnecessary expenses

Tilak went to various places for about 6 months for treatment of his back pain. During this, he had to endure physical pain, mental stress, work interruptions, and expenses of more than two hundred thousand rupees. He could not give time to his family. And his lifestyle was greatly affected.

He took 18 days off from work repeatedly during this time. Even after all this treatment, problems such as difficulty doing household chores, sitting in the office for long periods of time, and pain increasing when riding a scooter in potholes persisted.

What is his real problem?

The problem of back pain and the experience of suffering for treatment are common problems for many back pain patients in Nepal. In most cases, back pain is common and complications are rare. But if there is a health problem, it seems that the problem becomes more complicated when various people give various suggestions and the patient follows them.

The use of non-physiotherapy in the name of physiotherapy or the failure to use evidence-based physiotherapy treatment methods are also causing unnecessary suffering to the patient.

Time and money are being spent for free on treatments that do not yield results. There is a tendency to confuse patients by promoting new and unproven methods.

A misconception and practice that when there is a pain problem, an ‘MRI should be done’ at the first appointment has increased in Nepal. On the one hand, there is the problem of healthcare workers who insist on getting an MRI, and in some cases, patients themselves are dissatisfied with the healthcare workers not suggesting an MRI. There are also patients who think that the doctor did not ask for an MRI, perhaps ignoring my problem.

In fact, most back pain is not unnecessary to get an MRI. When an MRI is performed for normal pain, it may show normal ‘disk bulging’ or ‘degenerative changes’, which are also seen in many healthy people with age. When patients are told about these things seen on an MRI, patients are unnecessarily scared. They consider it a big problem and worry.

Similarly, the practice of injecting ‘steroids’ to relieve pain is also increasing in Nepal. Although steroids relieve pain immediately, their long-term effects and repeated use can have negative effects on the body.

What is even more worrying is the increasing trend of recommending surgery for simple back pain. While only 1-2 percent of back pain sufferers have a complex problem that requires surgery.

This is why patients are going through unnecessary suffering, expense, and mental stress. We need to understand that back pain is not a serious illness, it is a normal reaction of the body and can be managed with proper understanding.

The most important thing for back pain is reassurance, patience, and accurate information. About 95 percent of back pain is of a normal nature. It resolves on its own within 6 weeks to 3 months or is completely cured with good self-management.

Evidence-based ‘conservative’ treatment should be the first priority for the first 3 to 6 months. It is necessary to receive individualized physiotherapy services from a certified physiotherapist.

Exercises and hands-on therapies such as mobilization, manipulation, and stretching are provided according to the person’s condition, pain level, and functional capacity. The main goal of physiotherapy is to prepare the patient for self-management by teaching them about their body and pain. The physiotherapist assesses the patient’s functional capacity and suggests ways to increase their functional capacity.

This includes the following:

1. Self-management and patient education

The patient should be explained why back pain occurs, what its normal course is, and that in most cases it can resolve on its own. It is important to develop the idea that ‘back pain is not always serious’. Giving the patient accurate information about their pain reduces unnecessary fear and anxiety.

Fear and anxiety can cause and worsen pain. The patient should be reassured that back pain is normal and is not a long-term problem. Instead of bed rest, they should be encouraged to be active in their usual activities.

2. Pain management and exercise

Exercises that strengthen the back and abdominal muscles, increase flexibility, and improve posture (such as cobra pose, cat-camel stretch, pull exercises) should be taught according to the patient's condition.

Activities such as walking, cycling, and swimming increase blood circulation and help reduce pain. Hot or cold packs can be used to relieve short-term pain.

If the pain is unbearable, painkillers or muscle relaxants can be used on the advice of a doctor. However, relying on such medications for long-term pain relief can have negative effects.

3. Physical exertion and continuation of daily activities

You should be encouraged to continue your normal daily activities despite the pain. Prolonged inactivity can worsen the pain. Teach the correct way to sit, stand, and walk. Correct technique should be adopted when working on a computer or lifting heavy objects. Do not stay in any one posture or position for more than 30 minutes. Take ‘microbreaks’ every 20-30 minutes, such as getting up, walking, or stretching.

4. Psychological support

This is a treatment method provided by a physiotherapist in general and a clinical psychologist in complex cases when the patient shows yellow signs. For example: The role of mental health is important in chronic pain. It helps to change negative thoughts and behaviors towards pain. Meditation and mindfulness practices teach you to reduce the feeling of pain and accept it.

In what cases is complex treatment necessary?

If back pain lasts for 6 months If the pain persists for more than a month, does not improve with treatment, or if other serious symptoms occur along with the pain, other types of treatment are necessary.

For example, if there are problems such as weakness in the legs, problems with urine or stool control, persistent fever, or pain at night, additional tests such as MRI are necessary.

In this case, steroid injections or surgery should be considered. These treatment methods should be recommended only after a thorough evaluation by a specialist doctor.

The change in Tilak

What Tilak suffered in the name of treatment, he became a victim of malpractice. Which tortures the patient financially, physically, and mentally and reduces the importance of physiotherapy.

As advised by the physiotherapy unit of Bir Hospital, Tilak started taking regular physiotherapy sessions. He was given correct information about back pain. He was taught exercises to do daily. He improved his sitting style. He started walking regularly.

He realized that back pain is not always serious and staying active is the best treatment for it. Within a few weeks, his pain significantly decreased and he was able to return to his work fully. He was spared unnecessary expense and suffering.

6 Health Benefits of Giving Up Fried Foods

 6 Health Benefits of Giving Up Fried Foods

Trans fats and high calories in fried foods increase the risk of obesity, heart disease, and diabetes.

Giving up fried foods helps you lose unnecessary weight and improves heart health.

Giving up fried foods improves your digestive system and makes your skin healthy and glowing.

Recently, people are increasingly reluctant to compromise on their taste. It is difficult to resist when you see stalls of various delicious fried foods in the market. When you want to eat something spicy, spicy, or hot at home, fried foods like samosas, pakodas, chips, and French fries are the ones of choice.

These fried foods have become an integral part of our daily lives. However, scientific studies have provided a lot of evidence about their negative health effects. For example, fried foods contain trans fats, saturated fats, and high calories, which increase problems like obesity, heart disease, and diabetes.

If we completely eliminate these foods from our diet, positive changes occur in the body, which improves mental and physical health and also keeps the skin healthy.

1. Unnecessary weight loss

Fried foods are high in fat, which accumulates unnecessary calories in the body and increases weight. These foods are full of high calories and trans fats, which increase the risk of obesity. If fried foods are regularly avoided, calorie intake decreases. The body starts using the stored fat as energy. This also reduces other problems related to obesity, such as joint pain and fatigue.

2. Reduced risk of heart disease

Fried foods are rich in trans fats and saturated fats, which increase bad cholesterol in the body and reduce good cholesterol. This increases the risk of high blood pressure, obesity and heart disease. If fried foods are completely eliminated, heart health improves, which reduces the risk of heart attack, stroke and heart failure.

3. Relieves oxidative stress

Fried/fried foods accumulate unhealthy fats and oxidative compounds in the body, which damage cells and increase stress. This increases the risk of diseases such as diabetes, cancer and arthritis. Fried foods cause obesity, heart disease, type 2 diabetes and intestinal problems. When these foods are avoided, the body's damaged cell repair process is better.

4. Improves the digestive system

Fried foods are difficult to digest, which leads to acidity, constipation, gas and intestinal problems. According to the Cleveland Clinic, these foods increase reflux and bloating. Fried foods cause discomfort to those with irritable bowel syndrome or acid reflux. When these foods are avoided, the digestive system functions better, nutrients are absorbed better and the balance of intestinal bacteria is improved. This leads to overall health benefits, such as improving mood when you give up fast food.

5. Healthy and glowing skin

Many fried foods increase acne, rashes and oily skin problems. They also show signs of premature aging. When you give up fried foods, the natural glow of the skin returns and the effects of aging appear later. This also increases confidence.

6. Reduces the risk of diabetes and improves lipid profile

Fried foods are high in unsaturated and trans fats, which negatively affect blood lipid levels and increase the risk of diabetes. Fried foods increase the risk of heart disease, stroke and premature death. When their intake is reduced, the lipid profile improves, blood sugar levels are controlled and the risk of diabetes decreases. Regular consumption of fried foods increases the risk of chronic diseases, but when you give up, the risk of heart disease and diabetes decreases.

Journey from the history of maternity hospitals to modern services

 Journey from the history of maternity hospitals to modern services

Paropakar Maternity and Gynecology Hospital BS. 2016 is the only gynecological hospital in Nepal.

The hospital delivers 22,000 to 24,000 women annually.

Paropakar Maternity and Gynecology Hospital is the only gynecological hospital in Nepal. This hospital is known as the maternity hospital. Established as an important institution in the health sector of Nepal, Paropakar Maternity and Gynecology Hospital is making an invaluable contribution to the health and safety of women and mothers.

This hospital has played a historic role in Nepal's health service, focusing especially on obstetrics, gynecology and newborn health.

Establishment and early history

Paropakar Maternity and Gynecology Hospital was established in BS. 2016. This hospital was established in the name of Indrarajya Lakshmi Devi Shah, the wife of the then King Mahendra Shah. At the time of its establishment, the hospital was provided with the help of Paropakar Sanstha by Singh Shamsher.

Indrarajya Lakshmi Devi Shah died due to infertility. This is why history mentions that a hospital was established in her name with the aim of preventing others from dying from such problems.

Paropakar Maternity and Gynecological Hospital is a proud health institution of Nepal, which has provided maternity and gynecological services to lakhs of women in a period of 66 years.

Expansion and Development

The hospital has made remarkable progress in a period of 66 years. Initially started with 40 beds, this hospital is currently operating with a capacity of 515 beds, and a proposal to expand to 700 beds has been submitted to the government. Every year, 22,000 to 24,000 women deliver here.

Along with maternity services, the hospital has been providing various gynecological services, which include treatment of uterine prolapse, uterine tumors, cancer, hemorrhage, ovarian tumors and fertility problems.

Specialized Services

The hospital has expanded specialized services over time. Paropakar Maternity Home is the first government hospital in Nepal to start IVF service for infertility treatment. This service is being systematically run at the IVF center in Kupandol.

There are plans to make this center a center of excellence, and so far, 5 provincial doctors and nurses have been trained.

This service has been started through a tripartite agreement with the Government of Nepal, the Department of Health Services, and UNFPA for the treatment of urinary incontinence. This service is provided free of charge, especially for women affected by complicated deliveries and surgeries. There are plans to send two doctors to Pakistan for training for this service.

The maternity home has also started newborn screening. The ‘New Born Screening’ service was started last year to identify hereditary disabilities. Seven hereditary diseases including thyroid, phenylketonuria, and thalassemia can be identified.

Out of 2000 newborns, 20 have been diagnosed and treated. Which will help reduce the mortality rate of newborns.

Fetal and maternal echocardiography facilities are also available. From which 6,100 patients are availing the service in a year. This service has been run in collaboration with experts from Gangalal Hospital and Bir Hospital for the heart examination of pregnant women and newborns. This service has eliminated the obligation of patients to pay expensive fees in private hospitals. It has helped in timely identification and treatment of heart-related problems, especially in complex pregnancies.

The hospital also has a mental health OPD facility, through which 1,800 patients have already benefited. The mental health OPD service has been started for the treatment of postpartum mental health problems.

What did Dr. Shree Prasad Adhikari do after becoming the director?

The current director, Dr. Shree Prasad Adhikari, has made significant improvements in the hospital in the last two years. Since he took over, four new counters have been added, two OPDs, one billing, and one pharmacy. The online ticketing system has been made systematic and advanced, which has eliminated the obligation of patients to stand in line. Services have been expanded in Kupandol since Asad 15, 2081. IVF services, infertility treatment, safe abortion and a nursing college have been brought into operation.

Since the infertility treatment service began, 9,100 people have come for infertility treatment. Out of these, 300 have already taken IUI and 43 have taken IVF services, says Dr. Adhikari.

The hospital has brought a simulation lab into operation. According to the hospital director, Dr. Adhikari, it was established with the aim of producing skilled manpower for the treatment and care of mothers and newborns. He said that treatment practices will be conducted without affecting any patient.

Fistula surgery has also been started. This service is being run for the first time in a government hospital, which provides free treatment to women affected by complicated childbirth.

Former director Dr. Sheela Verma's statement

Former director Dr. Sheela Verma says that the maternity hospital feels like a family home to her. “I have always been impressed by the dedication and support of the staff and employees here,” she says. “I am proud to work here.”

Dr. Barma says that during her tenure, she implemented the Mater Suraksha program, which spread throughout Nepal. The program served many women, but there were also challenges due to lack of resources. The dedication of the team here and the excellent service the hospital provides She says that the desire to dance has brought this organization to this point.

She said that the Maternal Safety Program has contributed significantly to reducing maternal mortality in rural areas of Nepal. This is mentioned in the report of the Ministry of Health.

Challenges of the hospital

Although the hospital has made a lot of progress over time, some challenges remain. The hospital buildings are old, and there is a problem of water leakage during the rainy season. Director Dr. Adhikari says that a new building and cabins are needed.

The hospital is currently run by the committee's staff and contract employees. If the proposal for 700 beds is approved, staff and services can be added. The budget is also decreasing every year, which she complains is hindering the expansion of services. Patients are inconvenienced by the lack of parking and space.

A symbol of service and dedication

The maternity hospital, born from the tragic incident of the royal family, has today become a trusted friend of service recipients from all levels of Nepal. This hospital has been providing special services not only to women from low and middle income groups, but also to the upper middle class. The hospital currently provides OPD services to over 100,000 patients annually, which is significant compared to other government hospitals in Nepal.

What are the health risks of repeatedly frying samosas and jerry in oil?

 What are the health risks of repeatedly frying samosas and jerry in oil?

Experts say, ‘Reusing oil increases the risk of heart attack, cancer and other diseases.’

Repeated heating of oil has a negative impact on health as it causes chemical changes and increases the amount of trans-fat.

It is recommended to store oil properly and use new oil.

Often, samosas, pakodas, jerry, etc. are cooked in the same oil repeatedly in chowks and markets. Some people even use the remaining oil after cooking food once in their own homes and kitchens. What happens when oil is used repeatedly in this way?

Experts say, ‘Reusing oil increases the risk of heart attack, cancer and other diseases.’

Not only at home but also in restaurants and roadside stalls, food is prepared by reheating oil. This has a negative impact on health. This can be responsible for many diseases, says senior nutritionist Bhupal Baniya.

Health effects of reusing oil

1. Chemical changes and increase in trans-fat

Repeated heating of cooking oil changes its chemical and nutritional properties. According to a study published in the Journal of Food Science and Technology (2021), repeated heating of oil increases the amount of ‘total polar compounds’, which is harmful to health.

These compounds damage the structure of the oil and increase the level of trans-fat. Bania says that trans-fat increases the risk of heart disease by increasing the amount of bad cholesterol.

According to a study published in the Journal of Nutrition 2020, reheated oil produces free radicals, which damage cells. Free radicals cause oxidative stress, which increases the risk of chronic diseases such as cancer and diabetes.

2. Cancer risk

Harvard T.H. A study by the Chan School of Public Health (2022) noted that reheated oil produces toxic substances such as aldehydes.

These substances can damage DNA, which encourages the growth of cancer cells. In particular, the oil used in fried foods is repeatedly heated, which increases the amount of these toxins, Bania said.

According to a study published in the International Journal of Cancer (2019), polycyclic aromatic hydrocarbons found in reheated oil increase the risk of cancer in the lungs, skin and other organs. This risk is especially high in fried foods in hotels and restaurants, where the oil is heated for a long time.

3. Inflammation

Reheated oil promotes inflammation. According to a study published in the American Journal of Clinical Nutrition (2021), the production of free radicals and other harmful compounds in reheated oil damages blood cells. Chronic inflammation can lead to diseases like heart disease, joint pain, atherosclerosis, and periodontitis.

4. Bacterial infections

When food particles remain in the oil, they encourage the growth of bacteria, says nutritionist Ayush Adhikari. He says, “If used oil is not stored properly, it can lead to the growth of bacteria like Clostridium botulinum, which causes botulism. This is a serious food poisoning that can cause muscle weakness, difficulty breathing, and other complications.”

5. Increase in cholesterol and acidity

According to a study published in the European Journal of Lipid Science and Technology (2023), the amount of saturated fat and oxidized lipids in repeatedly heated oil increases.

These compounds increase cholesterol levels, which harm the heart and blood vessels. In addition, the use of such oil can cause acidity, gas and digestive problems in the stomach, said Adhikari.

Ways to avoid reusing oil

Adhikari says that reusing oil can be avoided by cooking less. He says, "Do not use more oil than necessary and cook in small quantities. This reduces the chances of oil remaining."

You should try to use fresh oil every time you cook. If oil remains, he suggests storing it properly. After the used oil cools down, it should be carefully filtered to remove food particles. This prevents the growth of bacteria, said Adhikari.

"If oil is left over while cooking, it should be stored properly," says Adhikari. "The oil should be stored in a cool and dry place, away from sunlight and heat. Keeping it in the refrigerator reduces the growth of bacteria."

To avoid health problems caused by reusing oil, nutritionist Baniya suggests staying away from fast food and packet food. “These foods should be consumed less frequently as heated oil is frequently used in roadside stalls and restaurants,” says Bania.

He also says that it is important to avoid heating oil for a long time while cooking.

“When cooking, use mustard oil, olive oil or other oils with low saturated fat,” suggests Bania. “These oils are less harmful to heart health.”

Different oils have different smoke points. For example, olive oil is suitable for use at low heat, while sunflower or canola oil can be used at high heat. He also suggests paying attention to these things.

According to Bania, if there is a change in the color, smell or texture of the oil, it should be discarded. No. Such oil may contain high levels of harmful compounds, so the quality of the oil should be checked before use.

What are the key benefits of insurance? What are premiums?

 What are the key benefits of insurance? What are premiums?

# **Understanding Insurance: Key Benefits and the Role of Premiums**

Insurance plays a vital role in financial planning, providing protection against unexpected risks and fostering peace of mind. Whether it’s safeguarding your health, life, property, or business, insurance serves as a safety net when uncertainties strike. In this blog, we’ll explore the **key benefits of insurance** and break down an essential concept: **premiums**.  

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## **What Are the Key Benefits of Insurance?**

Insurance offers numerous advantages, making it a cornerstone of financial security. Here are the most significant benefits:

### **1. Financial Protection**

Life is unpredictable, and unexpected events like illnesses, accidents, or natural disasters can result in substantial financial burdens. Insurance mitigates these risks by covering the associated costs, ensuring you don’t have to drain your savings or incur debt.

- **Example:** Health insurance covers expensive medical treatments, while auto insurance pays for repairs and liability after an accident.

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### **2. Peace of Mind**

Knowing you are financially protected allows you to focus on your goals without constant worry about “what if” scenarios. Insurance brings emotional security, reducing stress about potential future losses.

- **Example:** Life insurance ensures that your family’s needs will be met even if you are no longer there to provide for them.

---

### **3. Legal Compliance**

Certain types of insurance are mandatory by law. Compliance with these requirements not only protects you but also safeguards others who may be impacted by your actions.

- **Example:** Auto insurance is required in most countries to cover liability for accidents. Similarly, businesses may need workers’ compensation insurance to protect employees.

---

### **4. Risk Management and Sharing**

Insurance operates on the principle of risk pooling. By spreading risks across many policyholders, insurers can compensate those who experience losses without overwhelming financial strain on any one person.

- **Example:** When a natural disaster damages homes, homeowners’ insurance allows those affected to recover financially while others in the pool continue contributing premiums.

---

### **5. Encouragement to Save**

Certain types of insurance, like life insurance, combine protection with savings or investment benefits. These policies accumulate cash value over time, which can be used for future needs like retirement or education.

- **Example:** Whole life insurance offers a death benefit along with a savings component that grows over time.

---

### **6. Coverage for Businesses**

Insurance is crucial for businesses to protect against risks such as property damage, liability claims, and employee injuries. It ensures business continuity even in adverse situations.

- **Example:** Cyber insurance shields businesses from financial losses caused by data breaches or cyberattacks.

---

### **7. Tax Benefits**

In many countries, insurance premiums and payouts can provide tax advantages, making it an attractive financial tool.

- **Example:** Life insurance premiums may qualify for tax deductions, and the death benefit is often tax-free.

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## **What Are Premiums in Insurance?**

At the heart of any insurance policy is the concept of **premiums**—the price you pay for coverage. Understanding premiums is crucial to making informed decisions about your insurance needs.

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### **1. Definition of Premiums**

A premium is the amount of money a policyholder pays to an insurance company in exchange for coverage. Premiums can be paid periodically (monthly, quarterly, or annually) or as a lump sum, depending on the policy terms.

- **Example:** If you pay $100 per month for car insurance, that amount is your premium.

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### **2. Factors Influencing Premiums**

Insurance premiums are not one-size-fits-all. They are determined by several factors that assess the level of risk you represent to the insurer:

- **Type of Insurance:** Different policies have different cost structures (e.g., health insurance premiums are based on medical history, while auto insurance considers driving records).  

- **Risk Profile:** Age, health status, occupation, lifestyle, and geographic location affect premiums.  

- **Coverage Amount:** Higher coverage limits and broader policies result in higher premiums.  

- **Deductibles:** Policies with higher deductibles (the amount you pay before the insurer covers the rest) often have lower premiums.  

- **Claims History:** A history of frequent claims may increase your premiums.  

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### **3. Why Are Premiums Necessary?**

Premiums fund the insurance pool, enabling insurers to pay claims when policyholders experience losses. By collecting premiums from a large group of people, insurers ensure they have the financial resources to cover risks.

- **Example:** In health insurance, premiums paid by all members of the pool help fund medical expenses for those who require treatments.

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### **4. How Are Premiums Paid?**

Premiums can be structured to suit the policyholder’s preferences:  

- **Regular Payments:** Monthly, quarterly, or annual payments.  

- **One-Time Payment:** Single-premium policies for long-term coverage, such as specific life insurance plans.  

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### **5. Can Premiums Change Over Time?**

Yes, premiums can fluctuate based on:  

- Changes in risk factors (e.g., health deterioration, aging).  

- Market conditions or regulatory changes.  

- Adjustments in coverage or deductible levels.  

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## **Conclusion**

Insurance is a cornerstone of financial stability, offering protection, peace of mind, and risk management. By understanding the role of premiums and their importance in the insurance process, you can make better decisions about the coverage that suits your needs and budget.  

Insurance is not just about managing risk; it’s about building a secure future for yourself and your loved ones. Whether you’re insuring your health, life, car, or home, having the right coverage ensures you’re prepared for life’s uncertainties while safeguarding your financial well-being.  

What are the 4 basic types of insurance? How does insurance work?

 What are the 4 basic types of insurance? How does insurance work?

### **The Four Basic Types of Insurance**

Insurance can be categorized into several types, but four basic types are widely recognized as essential for individuals and families. These are:

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### **1. Life Insurance**  

**Purpose:** Provides financial support to your family or dependents in the event of your death.

- **How It Works:**  

  - The policyholder pays premiums to the insurer.  

  - If the policyholder passes away while the policy is active, the insurer pays a death benefit to the beneficiaries.  

  - Policies can be **term-based** (covering a specific time period) or **permanent** (lifetime coverage with savings/investment components).

- **Key Features:**  

  - Protects loved ones from financial hardship.  

  - Can help cover debts, education expenses, or daily living costs.  

---

### **2. Health Insurance**  

**Purpose:** Covers medical expenses, including doctor visits, surgeries, and prescriptions.  

- **How It Works:**  

  - The policyholder pays premiums and sometimes additional costs like deductibles or copayments.  

  - The insurer covers eligible healthcare expenses according to the terms of the policy.  

  - Coverage may be for preventive care, emergencies, chronic illnesses, or specialist treatments.  

- **Key Features:**  

  - Prevents financial strain from high medical costs.  

  - Often provided by employers or purchased individually.  

---

### **3. Auto Insurance**  

**Purpose:** Provides financial protection for vehicle-related risks, including accidents, theft, and damage.  

- **How It Works:**  

  - Drivers pay premiums based on factors like driving history, vehicle type, and location.  

  - In the event of an accident or covered event, the insurer compensates for damages or injuries up to the policy limits.  

- **Key Features:**  

  - Liability coverage is often mandatory in most jurisdictions.  

  - Additional coverage options include collision and comprehensive policies.  

---

### **4. Property Insurance**  

**Purpose:** Protects homes, buildings, and personal belongings against risks like fire, theft, and natural disasters.  

- **How It Works:**  

  - Policyholders pay premiums based on the value of the property and the type of coverage.  

  - If damage or loss occurs due to a covered peril, the insurer pays for repairs or replacements.  

- **Key Features:**  

  - Includes homeowners insurance, renters insurance, and landlord policies.  

  - May cover both the structure and its contents.  

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### **How Does Insurance Work?**

Insurance is a financial arrangement where risk is transferred from an individual or entity (the insured) to an insurance company (the insurer). Here's a step-by-step explanation:

#### **1. Application and Underwriting**  

- The policyholder applies for coverage, providing details about their risk profile (e.g., health, property value, driving record).  

- The insurer assesses the risk (underwriting) to decide:  

  - Whether to offer coverage.  

  - The premium amount based on the level of risk.  

#### **2. Paying Premiums**  

- The insured pays regular premiums (monthly, quarterly, or annually) to keep the policy active.  

- These payments form a pool of funds used by the insurer to cover claims.

#### **3. Coverage Period**  

- The policy specifies the terms, including:  

  - What is covered (e.g., medical bills, vehicle damage).  

  - Exclusions (what isn’t covered).  

  - Policy limits (the maximum amount the insurer will pay).  

#### **4. Filing a Claim**  

- If a covered event occurs, the insured files a claim with the insurer.  

- The insurer evaluates the claim to verify if the event is covered and determines the payout amount.

#### **5. Compensation**  

- If approved, the insurer compensates the insured for the covered losses, either by paying directly to service providers (e.g., hospitals, repair shops) or reimbursing the insured.  

#### **6. Risk Pooling**  

- Insurance companies rely on pooling risk.  

  - Many people pay premiums, but only a small percentage file claims.  

  - This allows insurers to cover large losses for those who experience them.  

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### **Key Principles That Govern Insurance**

1. **Utmost Good Faith:** Both parties must provide complete and honest information.  

2. **Indemnity:** The insured is compensated to restore them to their financial position before the loss (not for profit).  

3. **Insurable Interest:** The insured must have a legitimate interest in the item or person insured.  

4. **Proximate Cause:** Only losses caused directly by covered events are eligible for compensation.  

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### **Benefits of Insurance**

- **Financial Protection:** Shields against unexpected costs.  

- **Legal Compliance:** Certain types (e.g., auto insurance) are mandatory.  

- **Peace of Mind:** Reduces stress by providing a safety net.  

- **Encourages Savings:** Some policies, like whole life insurance, also function as investment vehicles.  

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By understanding the types of insurance and how they work, individuals and businesses can make informed decisions to safeguard their financial future.