Nima Wangdi 

Patients who require radiotherapy services at Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) in Thimphu continue to be referred to India for treatment.

Radiotherapy services at Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) in Thimphu were suspended in August 2021 due to some problems.

Sources confirmed that the cancer patients requiring the services, except for the palliative patients, are still being referred abroad.

In June 2021, following the high mortality rate among cervical cancer patients, the oncology department conducted a three-day mortality data analysis. It was noticed that patients with deep-seated Stage III rectal tumours, who were sent for tumour downsising in preparation for surgery, were not obtaining the optimal response normally seen after radiation.

This was first observed in 2019 in 12 rectal cancer patients, almost one year after the introduction of the services.

In March last year, the hospital management was informed about the increasing mortality (death) among cervical cancer patients. The investigation had found that radiotherapy machine needed upgradation.

Concerns regarding the quality of radiotherapy service at JDWNRH were first raised to Care Australia,   an international aid organisation operating the radiotherapy services at JDWNRH. Care Australia then said that the service was as per-international standards.

Several other issues were also found when the Ministry of Health and JDWNRH reviewed the service agreement between Care Australia and the hospital management on the introduction of the services.

A possible scam was also sensed in the process of service installation.

As per an investigation report, it was found that the basic requirements for the establishment of new technology in the country were not followed. Section 8.4 of the National Health Policy 2011 states that no new health technology should be allowed until assessment and evaluation for its safety, efficacy, quality, indication, and cost-effectiveness are conducted by the health technology assessment panel.

It was also found that due process for executing any memorandum of understanding or agreement with external agencies in line with the Rule of Treaty Making Procedure 2016 was not conducted. It lacked due diligence as per the Procurement Rules and Regulation.

The service was introduced in light of several referral cases, which was both expensive for the government and a major hassle for the patients. People with rectum, oesophagus, lung, cervical, and head and neck cancers required radiation therapy.

Radiation therapy uses high-energy radiation to shrink tumours and kill cancer cells.

The introduction of the radiation therapy service at the hospital in Thimphu was aimed at making the lives of cancer patients convenient.