Increasing demand for ophthalmology services at the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) in Thimphu has been putting strain on limited human resources at the ophthalmology department.

An ophthalmologist with the hospital, Dr Nor Tshering, said the number of patients making appointments with the department was overflowing and the department was having difficult time to manage.

According to the hospital’s annual report, the ophthalmology OPD (Out-patient department) saw 39,833 patients last year. It treated 10,635 OPD patients in 2016.

The hospital’s president, Lhab Dorji, said the hospital hired a vitreoretinal surgeon from Nepal to address the human resource shortage in the department. “We have very limited options. JDWNRH has no authority to recruit or plan our human resources.”

The surgeon visits the hospital once a week in two months.

Of the 17 staff with the department that includes five ophthalmologists, two doctors are on extra ordinary leave. Dr Kunzang Getshen, was working with the hospital on contract which expired on July 31. Dr Ngawang Tenzin is nearing retirement.

The president said that Dr Nor Tshering, who has been working abroad came back to work with the hospital. Otherwise the situation would be worse, he added.

Dr Nor Tshering said the department had requested the KGUMBS and Dr Kunzang Getshen would be working with the department from next month. “We are also mobilising one resident doctor from Gelephu because the regional referral hospital has three.”

An ophthalmologist from India, who has been with the department for the last two years, will leave December this year, Dr Nor Tshering said. “Within the given time frame, we are managing.”

The emergency cases were referred to India.

Dr Ngawang Tenzin, in an earlier interview with Kuensel, said that the Department of Opthalmology functioned as the tertiary eye care centre for the country and was supposed to have different subspecialities. Tertiary care, he said, did not mean only providing specialised services and that the department should have a team.

“We have to develop our ophthalmic assistants in specialised field and have them trained in glaucoma diagnostic services to operate machines and procedures to assist the surgeons in the OT and OPD,” he said. “Currently, all these lack in the department.”

The proposed requirement of manpower for the new eye centre, Gyalyum Kesang Choden Wangchuck National Eye Centre at JDWNRH, was 56, including the current staff at the department. The construction of the centre is expected to complete by June next year.

Lhab Dorji said: “We can manage the nurses and technicians for the centre by providing training for a few months. But it is difficult to manage with shortage of doctors.”

The hospital depends on the Royal Civil Service Commission (RCSC) and the health ministry when it comes to hiring people, he said. “Even the ministry and the commission would not be able to do much in this case.”

There are many factors to consider like the recruitment procedures and recruiting the best nurses, among others that restrict the number of employment, he said.

“If the RSCS recruits 100 nurses a year, it deploys about 15 to JDWNRH and the rest is deployed to the health centres across the country,” he said. “They give priority to the JDNWRH by giving 15 nurses but even with these nurses we cannot fulfill the shortages.”

Lhab Dorji said JDWNRH must be given full autonomy to recruit people and to manage its own funds so that the hospital can hire doctors from India and Nepal. “We can bring them and slowly develop our own people. We could recruit our own people and send them for training or studies and make a succession plan.”

Dechen Tshomo