YEARENDER:

Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) dominated the health sector in the year of the female rooster.

The specialist retention strategy that the health ministry had proposed to the Cabinet snowballed into an issue that pulled the national referral hospital’s status into the limelight.

Health minister Tandin Wangchuk, during a meet the press session in August said the government had directed the hospital to come up with a strategy to make the hospital a corporate entity. He said this move could be explored as a way to retain specialists, to improve service delivery and to provide financial benefit.

This move got the opposition writing to the government to stop its vested interests and hypocritical move to corporatise and privatise public health services. The opposition moved a motion in the National Assembly and through a majority vote, the house decided to not corporatise the hospital.

However, the committee that was reconstituted in September last year to study the move continued. A report was submitted to the health minister in December, who claims that he is yet to submit it to the Cabinet.

It doesn’t end here. The health sector found itself dragged into more controversies in the rooster year.

After Cabinet members came under fire for frequently using helicopter services, the Prime Minister’s Office reported that a majority of the helicopter services was used for emergency evacuation. A total of 213 patients were airlifted between November 2015 and September, last year.

Audit’s findings on longer waiting time for patients at the JDWNRH and patient meals not meeting nutritional requirements also troubled the health sector.

After several attempts to fulfill its target to post a female health assistant in all 184 Basic Health Unit (BHU) grade II by January this year, the health ministry was able to post 23 female nurses. Five BHU II are yet to get a female health assistant.

Mother and child health continued to receive priority in the rooster year.  The construction of a 150-bed Gyaltsuen Jetsun Pema Mother and Child Hospital is nearing completion. Various interventions were also taken to improve maternal health and under-nutrition status with the health ministry issuing executive order to address wasting and stunting.

It was reported that inadequate dietary diversity, lack of care during pregnancy and breastfeeding practices in Bhutan cause stunting, wasting, underweight and anemia in children.

Action plans were also instituted to prevent newborn deaths and stillbirths and ensure rational use of antibiotics.

While no maternal mortality was reported in the dzongkhags in the last six months, reducing infant mortality remains a risk. The health ministry, after much deliberation during the biannual health conference, revised the infant mortality target for the 12th Plan as the zero target was not achievable.

Bhutan also set high targets to eliminate mother-to-child transmission of HIV, Syphilis and Hepatitis B by 2020, a decade before the regional target.

Media reports on a mental health patient in Phanas, a remote place in Mongar, and in Darchhargang, Tsirang gave the invisible public health issue a face and brought mental health issue into the limelight.

Of the total 24,257 patients reported to health facilities for having mental and behavioural disorders in the last five years, anxiety is the most common mental disorders at 7,194, according to annual health bulletin 2017.

Prime Minister Tshering Tobgay in a meet the press session last year, said to strengthen mental health care services, the regional referral hospitals in the country will have a psychiatrist and a clinical counsellor each in the 12th Plan.

More than two years after the implementation of a suicide prevention action plan, preventing suicides in the country still remains a challenge.  Last year, the country recorded 89 suicides as of November.

The Prime Minister’s comment on suicide at the Parliament received much flak, when he said that people have no reason to commit suicide in a country like Bhutan.

The rooster year also saw frequent outbreaks of diseases like dengue fever, chicken pox, malaria, rabies, influenza and typhoid in dzongkhags. Despite these challenges, the health sector continued to work to address health issues by introducing new services like radiation therapy at the national referral hospital. Kidney transplant will also be done in the country soon.

Last year, a total of 1,500 patients were referred to India for Nu 200 million (M). Of the total referrals, 550 were cancer patients while about 20 were sent to India for a kidney transplant.

Bhutan became one of the first two countries to eliminate measles in the WHO South-East Asia Region (SEAR) before the regional target of 2020 in June 2017. This remains a major public health achievement and in recognition of this, Bhutan received the Citation as an appreciation from the WHO SEARO in the Maldives.

The WHO also conferred the 2017 World No-Tobacco Day Award to health minister Tandin Wangchuk on May 30 for Bhutan’s initiative in implementing measures to ban production and sale of tobacco in the country.

Another milestone for the health sector in the rooster year is the beginning of the work to construct the Gyalyum Kesang Choeden Wangchuck National Eye Centre in Thimphu.

Until November this year, a total of 55 HIV cases were detected, taking the total number of cases detected since 1993 to 570. With the two women who went public with their HIV positive status last year, there are now 10 people including four women who have gone public with their HIV status.

A survey conducted by the health ministry last year showed that about 68 percent of health care providers in Bhutan are satisfied with their job.

The health trust fund doubled to Nu 3.3 billion, eighteen months after the Prime Minister announced that the fund would be doubled from Nu 1.5 billion in October 2016.

The female rooster year also brought recognition to the health sector for its services.

His Majesty The King awarded Druk Thuksey (Heart Son of Bhutan) to three individuals that include a surgeon, 18 National Order of Merit Gold, and meritorious awards to 47 health officials during the National Day celebrations in Haa, last year.

Dechen Tshomo