Said the health secretary in Merak while observing the World Health Day 

Sherub Dema looks nervous. She is almost shivering.

The 49-year-old is literally being dragged by one of her friends to the gewog basic health unit (BHU) in Merak.

After almost an hour of explanation on the benefits of Pap smear screening by her friend, Sherub Dema is convinced to undergo the screening.

However, the mother of three was deterred looking at the crowd.

“I don’t think I’m ready for this,” she said. “There are just too many people around. I don’t think I can do it.”

Sherub’s friend, Rinchen Yangzom, who recently did the test, persuades her again.

“There is nothing to fear or feel shy about. Everyone is here for the same purpose,” Rinchen said. “I did the test five months ago. I’m here to do it again today because it is for my benefit.”

Sherub Dema hesitantly nods and the two walk towards the registration booth.

Despite the freezing weather and abrupt hailstone shower, more than 100 women from the community gathered for a Pap smear screening at the BHU on April 7, which was held to observe the World Health Day.

Eighty-seven new registrations were made on the day excluding those women who had undergone the screening at least once.

Health secretary, Dr Ugen Dophu, said women generally hesitate to undergo Pap smear screening in BHUs in the presence of male health workers.

He said since all BHU grade-II in the country do not have a female health assistant, it was difficult to provide Pap smear screening service.

He said that currently, 52 grade-II BHUs do not have female health workers.

“As an interim measure, the health ministry is planning to recruit female GNMs. After training them for three months, we will post them to the 52 grade-II BHUs,” he said. “However, female HA would replace them (GNMs) in the long run.”

Meanwhile, more than 200 people from the highlands of Merak and Sakteng gathered to observe the World Health Day that was themed, ‘Universal Health Coverage: Everyone, Everywhere’.

The World Health Organisation’s (WHO) representative in Bhutan, Dr Rui Paulo de Jesus, said ensuring that everyone everywhere could have access to essential health services without facing financial hardship was the idea behind this year’s theme.

“Bhutan provides free health services to its people and by expanding the services to remote parts like Merak, it shows the government’s commitment towards achieving the 2030 Sustainable Development Goals, that has the general theme, leave no one behind,” he said.

He said that given the nomadic nature of the community, the turnout at the programme was commendable. “I’m happy with how the programme turned out,” he said. “WHO ensures that what we preach is practiced as well. For this, we take our services closer to the community as we have just witnessed today.”

As part of the programme, Merak mangmi, Phurpa, presented the gewog’s success with the community-based support system (CBSS).

He reported that within a year of its inception, the programme has brought in several changes to the lives of the people.

With help from the women’s association (amtsu tshogpa) in the gewog, the mangmi said that the gewog administration has managed to spread awareness on the importance of undergoing Pap smear tests for women, getting newborns their regular immunisation shots on time and encouraging expecting mothers to visit BHUs.

“Since we are a nomadic community, awareness campaigns from the dzongkhag health sector do not reach all the people,” Phurpa said.

The mangmi said that it was a collective responsibility of the health ministry, the dzongkhag health sector, gewog administration and other stakeholders to work together to address both health and social issues. “We are already seeing the results from this programme and we would like to provide our constant support to address the problems.”

The CBSS and dzongkhag multi-sectoral taskforce (MSTF) was formed under the Royal Patronage of Her Majesty Gyalyum Sangay Choden Wangchuk.

Younten Tshedup | Merak