A mixed report for the Health sector

Health:

Chimi Dema

It was a healthy year for the health ministry with lots of development in the health sector.

The government, which prioritised health in its election campaigns, fulfilled its commitment of ensuring  access to specialist services by deploying medical specialists in the district hospitals. Notwithstanding the criticism on hiring specialists, the government brought in 20 medical specialists from Bangladesh.

This comes as an outcome of Prime Minister Dr Lotay Tshering’s state visit to the country last April.

The health sector is grappling with a shortage of 2,201 medical professionals at various categories. This is made worse by number of workers leaving the profession and a few specialists attaining their retirement age. In this light, the government’s effort to bring in specialists comes as a huge relief.

One of the overarching goals the health sector achieved in the Pig year was getting the country’s first eye hospital. The Gyalyum Kesang Choeden Wangchuck National Eye Centre as the first standalone hospital for eye was opened in October.

In an effort to eliminate cervical cancer in the country, the first phase of comprehensive package of cervical cancer screening camp is underway in three dzongkhags -Punakha, Bumthang and Mongar.

The package including non-communicable diseases (NCD) screening, cervical cancer screening, clinical breast examination, screening for Pelvic organ prolapse, STI (sexually transmitted infections) screening and information on gender-based violence prevention so far covered more than 10,000 women.

The health sector saw the upgradation of grade II Basic Health Units to grade I, revision of allowances and better incentives for health workers and increasing additional five slots for Bachelor of Medicine and Bachelor of Surgery (MBBS) considering the need of health professionals in the country.

The year gone by will also be remembered for the tragic deaths of eight babies at the Neonatal Intensive Care Unit (NICU) at national referral hospital in Thimphu between March and April.

Parents blamed negligence and attributed hospital-acquired infection (HIA), hospital officials claimed otherwise.

The incident got the hospital to assemble several sets of medical equipment to ensure that each baby had a dedicated set.  It was a measure taken by the hospital to prevent the transfer of infection from one baby to another.

The ministry also came under severe criticism when an ambulance without fuel couldn’t attend to an emergency in Dagana and resulted in the tragic death of a six-week-old baby.

Another black mark in the sector was the newly inaugurated Gelephu hospital making headlines for the wrong reasons. Less than a year after its inauguration, noticeable damage to the physical structures has emerged at the hospital.

Following the discovery of multiple cracks on the walls, the ceiling in various parts of the hospital has started to fall off. The CT scan machine remained non-functional for months. 

Several BHUs operated without doctors. The BHU I in Gasa and Dorokha did not have doctor for four months and Panbang BHU I was without a doctor for seven months.

While the country still has a significant burden of infectious communicable diseases, a disease pattern of an underdeveloped country, the year saw a rise in NCDs like diabetes, hypertension and other lifestyle-related diseases.

The health sector was also shaken by the outbreak of dengue fever in the south, especially Phuentsholing.

The first case of dengue fever was reported in May 2019 in Pasakha, Phuentsholing. By August 20, the town that shares a porous border with Indian town of Jaigaon had registered 1,239 dengue fever positive cases. The number increased to 1,468 towards the end of month.

Control measures like mass cleaning, thermal fogging, spraying, and awareness did not sort the problem. Numbers kept increasing.

By mid September 2019, although the number of positive cases had declined, the Phuentsholing General Hospital (PGH) had seen a record 2,451 dengue positive cases. This was without including the positive cases detected in the private clinics.

Dengue fever was also reported in November even after four months from the time of outbreak. By November 18, 2019, a total of 4,300 positive cases were reported across the country. About 77 percent of the total cases were reported from Phuentsholing.

Since the July 5 outbreak in Phuentsholing, more than 4,000 dengue positive cases were reported in the hospital. This included two maternal and other six deaths.

Except for Lhuentse, all dzongkhags reported dengue cases.

Although it took the ministry almost a month to react to the outbreak of the disease, it comes up with some kind of a plan to tackle the fever in the future.

Even as we were nearing the end of the Pig year, the coronavirus outbreak in China, posed a threat to the ministry. However, the ministry focused on prevention and put in place stringent measures starting from managing formal and informal entries into the country and taking precautionary steps and to avoid all possible risks. The ministry also assured all system in place to tackle the Covid-19.

At Thimphu referral hospital, patient isolation rooms and critical units have been identified. The old Mother and Child Health unit with the hospital has been converted into the isolation unit.

Since January 15, infrared fever scanning and respiratory symptom screenings were initiated at the points of entry, the primary one being Paro International Airport.

The Prime Minister also informed that in the event of an outbreak, the government has identified Gidagom hospital in Thimphu to function as an interim hospital to treat all those who are infected.

Teams consisting of management staff, and health personnel were formed to ensure quick response in case of an outbreak.

The year of the Pig ended on a positive note with the health minister launching the patient Referral by Air. The Prime minister announced the change from Changlimethang coinciding with the 40th Birth Anniversary of His Majesty The King, yesterday.

This could benefit to an average 12000 patients and attendants annually.

In an effort to initiate mass specialisation beginning this June, the government is sending 56 individuals this year to undergo specialisation in general surgery including 12 persons to be sub-specialised in Oncology, Nephrology and Cardiology, among others.

This could ease the acute shortage of specialists that the country is facing today.

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