Alcohol continues to burden health system

Yearender | Health: The year of the Monkey began with the Cabinet endorsing a strong alcohol policy to address the top killer in the country.

The Cabinet on December 2 endorsed the National Policy and Strategic Framework To Reduce Harmful Use of Alcohol (2015-2020), four years after work to frame one began in June 2011

According to the policy, the per capita adult (15 years) pure alcohol consumption among Bhutanese at 8.47 litres higher than the global consumption of 6.2 litres.

It was found that drinking among the Bhutanese was not only pervasive but that those who drink consumed alcohol in a hazardous manner involving heavy episodic drinking, which is described as more than six standard drinks on any occasion.

With one death in every two days, alcohol liver disease (ALD) continues to be the top killer disease in the country.  From 1,217 ALD cases in 2005, health centres across the country recorded 3,140 cases in 2014.  Records indicate a steady increase in both ALD cases and deaths since 2005.

Mother and child health continued to receive priority in the year of the Monkey.

As Her Majesty The Gyaltsuen’s gift to all the mothers of Bhutan, the health ministry introduced epidural labour analgesia to ensure painless childbirth. The service is available only at the Thimphu referral hospital for all pregnant women who opt for it or are suitable for free.

The health sector also found itself dragged into a few controversies.

The health sector was the subject of much public scorn when a family accused a doctor of the Nganglam Basic Health Unit (BHU) in Pemagatshel for negligence that led to the death of a farmer who suffered a snakebite in May.

Five months later, the doctor and two nurses were transferred for professional misconduct after the Medical Council found that negligence led to the death of the snakebite victim.

This was not the only allegation against the medical professionals in the year.

In May, an aggrieved father wrote to the Medical Council requesting a review of the emergency medical service provided to his late three-year-old son who suffered a broken leg. He alleged negligence on the part of the surgery team, claiming that most of the health practitioners appeared to be young trainees.

However, the council’s investigation revealed that a reasonable standard of medical procedures were followed while providing treatment to the three-year-old boy on May 21.

As part of the health ministry’s vision to move away from paper-based medical records and enhance use of Information and Communications Technology, an electronic Patient Information System was introduced in Paro in July.

As WHO declared the Zika virus a public health emergency of international concern, the health ministry intensified existing vector borne disease control programmes in the malaria prone areas in the southern belt.

Although the health sector continued to work to address health issues in the country with the introduction of new services, the Monkey year bogged down the health ministry with a rising number of health issues.

Although Bhutan achieved leprosy elimination phase in 1997, a significant number of new cases detected over the years has left health officials worried. This year from January until May, the Gidakom hospital recorded seven new cases of leprosy.

Meanwhile, the drastic increase in chronic kidney disease cases in the country is fast emerging as a major burden on the health ministry’s coffer. With some 146 new cases recorded in 2015, the ministry spent about Nu 20.70 million for 23 successful kidney transplants conducted in India, last year.

Similarly in 2013, 17 patients had successful kidney transplants for which the ministry spent about Nu 15.30M. In 2014, 16 patients underwent kidney transplant.

Outbreak of hand, foot, mouth disease affected more than 100 children in a few dzongkhags including Wangdue, Thimphu, Trashigang and Monagr.

Even in the Monkey year, shortages of health officials remain one of the issues in the health sector.

To help resolve the issue of shortage of doctors and specialists in the country, 30 undergraduate scholarships in Bachelor of Medicine and Bachelor of Surgery (MBBS) were allotted this year. The health ministry planned 30 MBBS scholarships annually, to meet the shortage of doctors in the country.

Dechen Tshomo 

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