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Kidney transplant service to start soon in Bhutan

In an effort to address the challenges faced by patients requiring specialized medical treatments abroad, the Ministry of Health (MoH) in Bhutan has announced plans to initiate kidney transplant services within the country. Collaborating with medical experts from Thailand, the ministry aims to alleviate the burden on patients who currently have to travel abroad for treatment due to the unavailability of certain medical services in Bhutan, such as kidney, cancer, neurological, and cardiac treatments.

The Minister of Health, Dasho Dechen Wangmo, stated that the kidney transplant service is scheduled to commence in August, 2023, provided everything goes according to plan. She emphasized the importance of establishing multidisciplinary hospitals in the country to cater to a wide range of diseases. However, until the establishment of such hospitals, the ministry has decided to initiate selected services to address immediate needs.

The minister highlighted that some services have already been introduced to address specific problems.

“ For instance, chemotherapy, which is required following cancer surgery, is now available in Bhutan. This development allows patients to return home and access the necessary treatment locally, rather than prolonging their stay abroad.”

“Furthermore, services related to cardiac treatment, such as pacemaker and cranial implantation, have also commenced,” said the minister.

She also added that catheterization services will soon be available within the country as well.

Meanwhile, the issue of prolonged stays abroad and the associated economic strain on patients and their attendants remains a concern.

While the government covers the cost of referrals, it currently lacks sufficient funds to provide dedicated service apartments for patients and their attendees. Health minister acknowledged this challenge and stated, “Although the cost of referrals is covered by the government, the lack of funds prevents us from offering comprehensive accommodation services. We are making the best use of our available resources.”

Meanwhile, the news of the initiation of kidney transplant services in the country has been warmly welcomed. Tashi Namgay, the founder of Bhutan Kidney Foundation, expressed his enthusiasm, stating, “This is excellent news for everyone, not only for kidney patients but also for the country’s economy. Moreover, for civil society organizations (CSOs) like ours, there will be an increase in organ donors.”

He further explained that although there are currently many potential donors, they are hesitant to travel abroad as it consumes their time. “Therefore, with the introduction of kidney transplant services locally, more donors will be available,” he added.

Tashi Namgay also highlighted the challenges faced by referral patients, including social obstacles, cultural barriers, climatic variations, and altitude issues, when they have to travel abroad for treatment. “The availability of kidney transplant services within the country will help alleviate these difficulties,” he concluded.

Meanwhile, addressing concerns about delays in referrals, the health minister clarified that there is no delay in sending patients for treatment abroad. However, numerous procedures and tests must be conducted before a patient can be referred. Once all the necessary tests and reports are completed, patients are promptly sent for treatment.

The minister shared this information while responding to questions posed by National Assembly (NA) Member of Parliament (MP), Norbu Wangzom, from the Jomotsangkha–Marshala constituency, on June 23, 2023. The MP inquired about current challenges in the referral system and the measures being implemented to improve it. The issue of accommodation problems in India was also raised by the MP.

In response, the health minister explained that although concerns arose about sending patients abroad for referrals due to delayed budget release for the fiscal year, consultations with the Prime Minister and the Ministry of Finance resulted in a positive response, prioritizing public health.

Regarding the accommodation issue, the minister emphasized the need for funding. “To provide service apartments for referral patients and their attendants, we require adequate funds. Currently, we are fully utilizing the resources available, and the introduction of health services within the country is expected to address this problem,” she said.

Additionally, concerns regarding the attrition of health professionals and the measures to address this issue were raised in Parliament yesterday by MP Passang Dorji from the Bartsam Shongphu constituency.

In response, the minister stated, “Currently, the ministry is focused on short-term strategies such as recruiting resigned health professionals on a contract basis and remobilizing the existing health staff.” The minister further mentioned that the majority of staff members leaving their positions are from Jigme Dorji National Referral Hospital (JDWNRH).

If the attrition rate of health staff exceeds 5%, the ministry will call upon the health professionals scattered throughout the country to fill the gap.

The minister emphasized the need for staff remobilization, as some areas have more staff than the number of patients they serve.

 Another strategy mentioned by the Lyonpo is the temporary halt of service expansion, prioritizing existing services in the event of high attrition. However, as of May 2023, the health attrition rate stands at 4.46%, with doctor attrition at 1.74%, nurse attrition at 4.46%, dental attrition at 2.53%, and health assistant attrition at 2.4%.

Tshering Pelden from Thimphu