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.
Palliative Services have started and expanded at:
- Jigme Dorji Wangcchuck National Referral Hospital
- Thimphu (started Hospice home care service)
-Till date the Train the 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 April 2020 has been postponed due to the Covid-19 situation.
- Re-engagement might be needed due to the recent change in JDWNRH leadership.
Morphine is available in the hospital but rarely used.
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 March 2018. Also, palliative services became available in JDWNRH.
A National Strategy was proposed by JDWNRH and supported by MOH.