Gifts in Kind Medical Equipment Developing Health Care Infrastructure
We initiated and lead a program that seeks a first CT scanner for the Mongar Referral Hospital. We partner with other compassionate organizations, such as RAD-AID International, Project HOPE and other nonprofit culturally sensitive and respectful foundations. We work in close collaboration with the Ministry of Health and World Health Organization. We intend a broader ongoing program of targeted donations of medicines and medical supplies that will help the Ministry of Health increase budget saving and improve the availability of appropriate medical care. The program will work in close collaboration with the Minister of Health himself or designees in every step of the implementation process.
Current National Radiographic Assets and Capabilities
Despite its rugged terrain and limited resources, Bhutan continues to make great strides in healthcare. It declared universal childhood immunization coverage in 1991 and has stayed on course to achieving its health-related Millennium Development Goals by 2015. Life expectancy rose from 37 to 66 years of age from 1960 to 2005, and infant mortality rates have dropped from 103 to 40.1 per 1000 live births from 1984 to 2005. In trying world economic times, Bhutan is now struggling to create cost savings and reduce expenses of health care which is provided by the Royal Government free to all. There is no private practice of medicine in the country.
The mountainous terrain makes access to care challenging despite the launch of the Health Help Center (HHC) in May of 2011. This year, HHC seeks to provide integral care including interventional health and counseling, to 90% of the population within one hour of dialing “112” from a telephone/mobile network. In 2011, there were reportedly 60 ambulances equipped with GPS and emergency medical equipment in the country. The program offers a complaint logger system and aims to reduce prolonged waiting times for health care by early active intervention.
Health challenges include a rise in the prevalence of hypertension (beginning in 2004) and access to care. Health professionals are unable to access many villages, health cost are rising, patient needs and expectations are changing, and new medical technology is badly needed.
Bhutan faces a rise in the number of non-communicable diseases that may be prevented by the installment of CT and digital mammography services.
Currently, Bhutan has only one CT-scanner in the whole country, a single machine based in Thimphu, at the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH). Bhutanese radiologists are competently interpreting these CT images themselves and have internet access for instant communication to other sites or image referral and consultation.
According to a former Head of the Department of Radio-diagnosis and Imaging, Dr. Dechen Nidup, the country urgently needs a minimum of two brand-new CT machines (helical and 16 slices minimum) to be placed, one each, in Mongar (Eastern Regional Referral Hospital) and Gelephu (Central Regional Referral Hospital). Limited access to this communication is available uponrequest. The new hospital in Gelephu will be completed in 2015. The new Mongar Referral Hospital is ready to receive equipment now. JDWNRH and Mongar hospitals both have abundant reliable electric power resources and do not experience frequent outages. Manpower and educational infrastructure for expanding maintenance personnel are also plentiful. The Ministry of Health has given high priority to acquiring CT scanners but its expendable resources are limited and assistance is needed.
Additionally, there are no mammogram services present in Bhutan. Clinical diagnosis is aided only by low quality ultrasound imaging. This absence of mammography makes the installment of new digital mammography machine a moral imperative. JDWNRH has the human resources (with multiple technicians) in place for the installment and maintenance of a machine yet lacks the finances to do so. If donated, diagnostic mammography services and walk-in screening services will be planned for all women at-risk. Already, there are plans to initiate breast health awareness in Bhutan yet the fundamental equipment is still lacking.
In Letter Ref No. MOH/DMS/(42)2012-6454 of 12 April 2013 from the Royal Ministry of Health the Secretary (Acting Minister of Health) and Director General of Medical Services stated in order to reach the final 10% of the population with and improve generally the quality of health services, Bhutan requires two CT scanners, one Mammography Machine, Ultra sound machines and laboratory analyzers. The first priority is a CT-scanner for the Regional Hospital in the East at Mongar that serves 250,000 Bhutanese. This has been the consistent statement of the Royal Minister of Health, other officials, and medical colleagues over the past year. The acquisition of a new CT scanner for Mongar is our current focus but not our only goal.
In Letter dated 12 April 2013 the Governor of the Province of Mongar, Dasho Sherab Tenzin, states again the need for the CT-scanner and that it will go a long way for the saving of lives and costs. The new hospital in Mongar completed in 2011 has a designated room for a CT scanner providing incontrovertible evidence of this priority and an effective consistent planning process and readiness to receive this equipment.