After studying nursing through His Majesty’s scholarship, Dema returned home (Lunana) to serve her community

Phurpa Lhamo | Gasa

Tucked in high mountains at over 3,700m above sea level is Lunana gewog in Gasa. With routes covered in snow for half of the year, the gewog remains isolated for the better part of the year.

Because of remoteness and total absence of exposure, women here prefer not to discuss menstrual health and intimate health issues. Although home to over 800 highlanders, less than 10 percent of women in Lunana have undergone Pap smear tests. Women continue to deliver at home and intimate health issues aren’t discussed until they become serious.  

Dema was also part of the health team that visited villages in Lunana for the week-long vaccination drive

 This is expected to change with Lunana’s first female nurse.

Dema joined Lunana Primary Health Centre (PHC) in November last year.

Recognising the difficulties the women in Lunana face in discussing personal health issues among women in Lunana, local leaders in 2015 recommended Dema to study nursing.

“After completing Class 12, I was staying home. Many students drop out in Lunana. That’s when the local leader came up with the idea of nursing scholarship,” Dema said.

Because of remoteness, difficult access, and lack of basic necessities, Lunana is not the favoured destination for civil servants.

“So I pledged that I would return home when I got the scholarship. Lunana is home. My grandparents, my cousins, everyone is here,” Dema said. 

In 2015, Dema travelled to Thimphu to look for a scholarship to study nursing. Her sister supported her financially but without relatives to live with, she struggled for many months.

“For about a month, it was really difficult. In the end, MP Sangay Khandu (former NC Gasa representative) helped me,” Dema said. 

She approached the Office of the Gyalpoi Zimpoen and landed a nursing scholarship to study nursing in Bangalore, India. 

As the only female staff at the Lunana PHC, Dema hopes that women will be comfortable to discuss health matters and issues with her. Lunana PHC has plans to screen all women in Lunana for Pap smear.

“I have further studies in mind but I want to return to Lunana,” Dema said. 

According to health assistant (HA), Dhan Kumar Rai, only around four women in Lunana used intrauterine device (IUD)—a piece of T-shaped plastic— for birth control. “In the past, they never opted for IUD. Now they are opting for it because we have Dema. Now they are coming forward. One just made an appointment with her.”

The health staff and the education sector are also promoting the usage of sanitary pads in gewog.

“We have asked the Food Corporation of Bhutan Limited (FCBL) outlet in Lunana to make sanitary pads available,” Dhan Kumar Rai said.

Conducting safe child delivery is also a challenge in Lunana due to difficult terrain. Women prefer to deliver at home rather than at a health facility.

“With chopper service, now some choose to go out of the district to Punakha or Thimphu. And facility delivery isn’t always possible. When the person is in labour pain, they cannot walk for hours to the PHC,” Dhan Kumar Rai said.

Apart from 13 households in Lhedi, the nearest village is located about 20 minutes walk away from the Lunana PHC.

With two HAs and a nurse, the health team conducts a monthly outreach programme. 

The health staff also visit patients at home in serious cases.

Last year, four home deliveries were conducted in Lunana with assistance from health staff. 

“I am sure nurse Dema can change the lifestyle of women in Lunana,” Dhan Kumar Rai said.