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Lien Collaborative for Palliative Care Training in Bhutan

Overview

Bhutan, officially known as the Kingdom of Bhutan, is landlocked in the Eastern Himalayas. Bhutan has a population of nearly 800,000 in a country about 50 times the size of Singapore. The government mainly provides healthcare and there are no private hospitals. Cancer is diagnosed in the late stages for most patients (~75%) where a 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 Bhutan Home Care team which consists of 3 nurses, 1 doctor, and 1 lama was set up after the Lien Collaborative training in 2018 and has been operating well to provide home care for the villages. They are trained under the Lien Collaborative for Palliative program in 2018 and 2019.  The Lien-Collab Training modules, to be spread over a few years, are likely to be supplemented by a one-year mentoring programme and 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. 

Dr. Shirlynn Ho, the Country Lead for Bhutan, plans to re-engage Bhutan in 2023 after Dr. Kinley Bhuti's training in Singapore for approximately three months. As part of the home care visit in Bhutan, a volunteer Faculty consisting of Dr. Shirlynn Ho, Dr. Ednin Hamzah, and Sister Nandar Nwe is involved. The Faculty team has established a close collaboration with the local team and has made significant progress, having served around 576 homecare patients up to this date. The APHN Bhutan- Lien Collaborative for Palliative Care Faculty team aims to return to Bhutan in the coming years to train more participants.

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. 

Overview

Project Milestones

Morphine Availability

Education

Sustained growth from donors and trainees

Morphine is available in the hospital but rarely used.

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

Home visits by 3 Palliative Nurses were started on March 2018. Also, palliative services became available in JDWNRH. 

National Strategy

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

Milestones

Latest Updates

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

  • The home care team, which consists of 3 nurses, 1 doctor, and 1 lama was set up after the Lien Collaborative training in 2018 and has been operating well to provide home care for the villages.

  • 3rd teaching module planned for April 2020 has been postponed due to the Covid-19 situation.

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

  • Dr. Kinley Bhuti is coming to Singapore for a 6-month Resident Specialty Training with the National Cancer Centre Singapore starting in December 2022.

  • The Ministry of Health in Bhutan has designated two palliative care specialty positions at their referral hospital. Dr. Kinley Bhuti has been assigned to one of these positions and will also serve as the anchor person, as well as be trained as the Faculty for future Bhutan training.

  • Dr. Shirlynn Ho, the Country Lead for Bhutan, plans to re-engage Bhutan in 2023 after Dr. Kinley Bhuti has been trained in Singapore for about 3 months.

  • Home care visit in Bhutan with our volunteer Faculty includes Dr. Shirlynn Ho, Dr. Ednin Hamzah, and Sister Nandar Nwe is ongoing...

Palliative Services have started and expanded at:

Latest Updates

Gallery

  • Photos
Gallery
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