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Bhutan Health
Bhutan's health-care development accelerated in the
early 1960s
with the establishment of the Department of Public Health
and the
opening of new hospitals and dispensaries throughout the
country.
By the early 1990s, health care was provided through some
twentynine general hospitals (including five leprosy hospitals,
three
army hospitals, and one mobile hospital), forty-six
dispensaries,
sixty-seven basic health units, four indigenous-medicine
dispensaries, and fifteen malaria eradication centers. The
major
hospitals were in Thimphu, Geylegphug, and Tashigang.
Hospital beds
in 1988 totaled 932. There was a severe shortage of
health-care
personnel with official statistics reporting only 142
physicians
and 678 paramedics, about one health-care professional for
every
2,000 people, or only one physician for almost 10,000
people.
Training for health-care assistants, nurses' aides,
midwives, and
primary health-care workers was provided at Thimphu
General
Hospital's Health School, which was established in 1974.
Graduates
of the school were the core of the national public health
system
and helped staff the primary care basic health units
throughout the
country. Additional health-care workers were recruited
from among
volunteers in villages to supplement primary health care.
The most common diseases in the 1980s were
gastrointestinal
infections caused by waterborne parasites, mostly
attributable to
the lack of clean drinking water. The most frequently
treated
diseases were respiratory tract infections, diarrhea and
dysentery,
worms, skin infections, malaria, nutritional deficiencies,
and
conjunctivitis. In 1977 the World Health Organization
(WHO)
declared Bhutan a smallpox-free zone. In 1979 a nationwide
immunization program was established. In 1987, with WHO
support,
the government envisioned plans to immunize all children
against
diphtheria, pertussis, tetanus, polio, tuberculosis, and
measles by
1990. The government's major medical objective by 2000 was
to
eliminate waterborne parasites, diarrhea and dysentery,
malaria,
tuberculosis, pneumonia, and goiter. Progress in leprosy
eradication was made in the 1970s and 1980s, during which
time the
number of patients had decreased by more than half, and by
1988 the
government was optimistic that the disease could be
eliminated by
2000.
It was estimated in 1988 that only 8 persons per 1,000
had
access to potable water. Despite improved amenities
provided to the
people through government economic development programs,
Bhutan
still faced basic health problems. Factors in the
country's high
morbidity and death rates included the severe climate,
less than
hygienic living conditions, for example long-closed-up
living
quarters during the winter, a situation that contributes
to the
high incidence of leprosy, and smoke inhalation from
inadequately
ventilated cooking equipment. Nevertheless, in 1980 it was
estimated that 90 percent of Bhutanese received an
adequate daily
caloric intake.
Although there were no reported cases of acquired
immune
deficiency syndrome (AIDS), the Department of Public
Health set up
a public awareness program in 1987. With the encouragement
of the
WHO, a "reference laboratory" was established at the
Thimphu
General Hospital to test for AIDS and human
immunodeficiency virus
(HIV) as a precautionary measure. To further enhance
awareness,
representatives of the National Institute of Family Health
were
sent to Bangladesh in 1990 for training in AIDS awareness
and
treatment measures.
Data as of September 1991
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