Health and Happiness in the Himalayas: Supporting Bhutan’s Healthcare Landscape

The ceremonial launch of World Telehealth Initiative’s program at Eastern Regional Referral Hospital in Mongar, Bhutan.

Bhutan is a small country in the heart of the Himalayas that stands apart with its deep spiritual heritage and living traditions, shaped by its long period of isolation until 1974. Traditional dress, still worn daily, and the striking architecture of dzongs and monasteries highlight Bhutan’s unique approach of integrating spirituality with everyday life. Called the ‘Land of the Thunder Dragon’, Bhutan is famous for measuring success by Gross National Happiness, a holistic approach that prioritizes the well-being of its citizens over economic growth.

The country has achieved universal health coverage and a well-distributed network of healthcare facilities, ensuring that 90% of the population can access primary care within a 3-hour walking distance. Despite these successes, Bhutan faces some significant health challenges. There is a shortage of specialized physicians, with only 2.9 surgical specialists per 100,000 people. Additionally, access to specialized healthcare is unevenly distributed, with disparities between urban and rural areas. Services such as cervical cancer screening and mental health support are notably limited at primary care facilities.

World Telehealth Initiative’s growing impact in Bhutan

WTI’s program in Bhutan began at Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) in Thimphu. This year, we’ve expanded our support to include two additional hospitals: Central Regional Referral Hospital in Gelephu and Eastern Regional Referral Hospital in Mongar. Eastern Regional Referral Hospital, situated in the growing district of Mongar, serves the seven eastern regions of Bhutan, representing a third of the country’s population. Mongar, the fastest-growing dzongkhag in eastern Bhutan, is a hub of diverse economic activities, including lemongrass production and hydroelectric power.

Eastern Regional Referral Hospital (ERRH) recently celebrated the launch of WTI’s program on His Majesty the King’s birthday, a national holiday marked by colorful decorations, traditional dances, music, and prayer. Central Regional Referral Hospital (CRRH), located in Gelephu along the Bhutan-India border, also hosted its first WTI telehealth session earlier this year. CRRH is one of the oldest hospitals in southern Bhutan and has expanded to 150 beds. Serving the second-largest patient load in Bhutan with over 280,000 outpatient visits and 3,000 admissions per year, CRRH plays a crucial role in the region’s healthcare system.

Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) struggles with high patient volume and the influx of individuals traveling from across the country. Often, patients at Bhutan’s referral hospitals need specialized care only available at JDWNRH. However, traveling to the capital can be lengthy and arduous due to Bhutan’s rugged mountainous landscape.

Local clinicians at Central Regional Referral Hospital in Gelephu, Bhutan with the telehealth device.

WTI’s program aims to reduce these referrals by bringing specialized expertise directly to ERRH and CRRH and building the skills and knowledge of local clinicians in various specialties. Our international network of volunteer medical specialists collaborates with local experts to deliver education and training on topics requested by the hospital. The educational telehealth sessions cover a wide range of topics, from neonatology to orthopedic surgery. Earlier this year, the first WTI telehealth session at CRRH focused on dialysis guidelines led by a nursing expert. This coming month, there will be a greater focus on ultrasound training. Clinicians participating in these sessions can also apply for Continuing Medical Education (CME) credits, which encourages professional development.

Looking ahead: A healthier future for all in Bhutan

Currently, international experts are supporting the hospitals in Bhutan via telehealth. As the program grows, medical experts at JDWNRH will support the regional hospitals to upskill local clinicians and reduce referrals to the overburdened hospital in the capital. WTI is honored to support the dedicated clinicians at CRRH and ERRH and to contribute to the well-being of the communities they serve.

Through ongoing education and collaboration, we’re empowering Bhutanese clinicians to help them deliver quality care within their communities. As the program evolves, the expertise shared will continue to ripple outward, enhancing healthcare across the nation and reducing the strain on the capital’s healthcare system. WTI is dedicated to supporting Bhutanese clinicians in their mission to build a healthier future for the Land of the Thunder Dragon.