SINCE 2018

Bhutan

Building and tailoring palliative care services for the landlocked kingdom

country updates

In developed countries, it has been shown that providing the right treatment for end-of-life patients puts less strain on the emergency and hospital admissions departments. This in turn saves costs, and is what we’re trying to teach in Bhutan.

Dr Shirlynn Ho

National Cancer Centre, Singapore General Hospital, Singapore

Our IMpact

45

Participants

trained in palliative care services

576

Patients

treated by the Bhutan Home Care team

Bhutan Home Care team is a mobile palliative care service that serves the villages in the country’s mountainous rural areas. The team of 3 nurses and 1 doctor are also joined by a lama because seriously ill patients in Bhutan often consult a spiritual leader before seeking medical help.

I was very lucky to have this bursary which enabled me to listen to great and learned legendary speakers, gain knowledge in palliative care, and cater better care to all terminal patients admitted at the hospital I work. Such an opportunity can really help many gain knowledge and experience.

Dr Kinley Bhuti, who received a Lien Collab bursary for training at the National Cancer Centre in Singapore

Life expectancy for Bhutan’s over 770,000 citizens has increased steadily over the years with the country’s economic and social advancements. But its population is also experiencing a growing incidence of death from non-communicable diseases such as cancer. While palliative care can potentially bring relief to the community, especially as cancer in Bhutan is often diagnosed in the later stages when cure is not possible, the medical specialisation is still an emerging field in the country.

We started working in Bhutan from July 2018 through a partnership with the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), the main referral hospital in the country’s national healthcare system. The first module of our Train-the-Trainers programme taught 22 participants, and another 23 of them underwent our second module in the following year. Between the modules, the programme supported mentorships and site visits to bolster service development.

In addition to building up the hospital’s palliative care services, our training enabled the establishment of a Bhutan Home Care team. This mobile palliative care service serves the villages in the country’s mountainous rural areas. The team of 3 nurses and 1 doctor are also joined by a lama because seriously ill patients in Bhutan often consult a spiritual leader before seeking medical help. Together, they have served around 576 homecare patients to date—a testament to how our programme can be adapted to each country’s cultures and contexts.

Bhutan’s health ministry has since designated two palliative care specialty positions in JDWNRH. One of them is Dr Kinley Bhuti, who we awarded a bursary to attend a six-month resident specialty training with the National Cancer Centre in Singapore.

A national strategy for palliative care is currently being proposed by JDWNRH to the country’s health ministry. There are also discussions to expand the palliative care training programme through De-suung, Bhutan’s national volunteering initiative.