Bhutan Train the Trainer Programme

Bhutan, officially known as the Kingdom of Bhutan is a landlocked country in the Eastern Himalayas. Bhutan has a population of nearly 800,000 in a country about 50 times the size of Singapore. Healthcare is mainly provided by the government and there are no private hospitals. Cancer is diagnosed in the late stages for most patients (~75%) where cure is unlikely. Following a feasibility study in April 2018, the Bhutan Lien-Collab programme kicked off in July 2018, with the first training module completed to build up the palliative care services and staff of  the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH).  The Lien-Collab Training modules, to be spread over few years, are likely to be supplemented by a one-year mentoring programme along with site visits in between modules by smaller faculty teams to bolster service development. The 2nd Module of the Lien Collaborative for Palliative Care Training in Palliative Care Bhutan was conducted from 28 January to 2 February 2019, at JDWNRH in Thimphu,

This programme took the form of a train the trainers course  with continued government support and growth of medical support to achieve the following outcomes:

Capacity building of OPD services, consult services, and staffing of trained practitioners.

Opioid availability (Uninterrupted Oral Morphine Supply)

Self training education capabilities

Sustained advocacy and policy support 


Latest Updates

Palliative Services have started and expanded at:

- Till date the Train the Master Trainer Programme has gained substantial traction with 22 trainees, 1 Institution, 1 state, and 6 faculty members supporting the effort.

- 3rd teaching module planned in Apr 20 has been postponed due to Covid-19 situation.

- Re-engagement might be needed due to recent change in JDWNRH leadership.

- Jigme Dorji Wangcchuck National Referral Hospital
- Thimphu (started Hospice home care service)


Project Milestones


The Palliative Care Training programme for Desuung is currently at its proposal stage

Sustained growth from donors and trainees

Home visits by 3 Palliative Nurses were started on Mar’18. Also, palliative services became available in JDWNRH. 

Morphine Availability

Morphine is available in the hospital but rarely used.

National Strategy

A National Strategy was proposed by JDWNRH and supported by MOH.