Bhutan - Lindsay Brown [30]
A key aspect of Bhutan’s development plan involves training doctors, engineers and other professionals. Important trade skills in plumbing, construction and electrics are now being taught to both young men and women. In 2003 the Royal University of Bhutan was established to provide tertiary education in Bhutan. All the existing tertiary institutions were incorporated in the new University.
Health
Bhutan has made significant progress in its provision of basic health facilities and provides free health care to all its citizens. The main hospital is the National Referral Hospital in Thimphu, and two further regional referral hospitals. There are smaller hospitals in each district. Rural health care is provided through Basic Health Units staffed with a health assistant, nurse midwife and a basic health worker.
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A survey in 2003 revealed that over 80% of food in Bhutan was imported, including rice and dairy products.
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Child immunisation is now at almost 100%, and iodine deficiency has been eliminated. Infant and maternal mortality rates have decreased. According to the 2005 census, over 80% of Bhutanese have access to clean drinking water.
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TRADITIONAL MEDICINE
Historically, Bhutan was referred to as the ‘Land of Medicinal Herbs’ and exported herbs to Tibet. Bhutanese were trained in medicine, known as So-ba Rig pa. It represents a blending of Ayurveda from India – notably the use of the three humours (bile, phlegm and wind) – with Chinese medicine, in the reading of pulses. The earliest medical works date from the 7th and 8th centuries and the main medical teachings are believed to have been transmitted from the Medicine Buddha, Sangye Menlha. They are contained in four volumes, called the Gyuzhi.
When the Zhabdrung Ngawang Namgyal came to Bhutan, he brought with him a highly esteemed physician, Tenzin Drukey, who spread the teachings on So-ba Rig pa in Bhutan. Although the basic texts are the same, the Bhutanese tradition of So-ba Rig pa developed independently from its Tibetan origins. Since 1967 the Bhutanese tradition has been formally incorporated in to the national health system.
The decision about the kind of treatment necessary for a particular condition is made mainly through reading of the pulses. Unlike modern medicine, which only uses reading of pulses to detect anomalies of the heart or the circulatory system, using the So-ba Rig pa method it is possible to detect diseases of organs through the pulses. The eyes, tongue and urine are also examined for signs that will help with the diagnosis, and sometimes the physician will record the patient’s medical history.
Several forms of treatment are applied in Bhutanese traditional medicine. Hundreds of medicinal plants, minerals and animal parts form the basic medicines used by the practitioner. These basic ingredients are processed and mixed in different combinations to make 300 medicines in the form of pills, tablets, syrups, powders and lotions. The practitioner may also offer advice on, or treatment for, diet and lifestyle.
There are also procedures that include gtar (bloodletting), bsregs (cauterisation by herbal compounds), gser bcos (acupuncture with a golden needle), tshug (cauterisation with instruments of different materials), dugs (applying heat or cold to parts of the body), byugs pa (medicated oil massage), sman chu (stone heated bath), tsha-chhu (bath at a hot spring, such as the springs in Gasa), and lum (vapour treatment).
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Although Bhutan has tackled endemic health problems, it is also facing the emergence of HIV and AIDS. The Bhutanese authorities have taken a proactive stance, emphasising the importance of safe sex and awareness of HIV. Monks