National Referral Hospital (Thimphu)
Encyclopedia
The National Referral Hospital (full name Jigme Dorji Wangchuck National Referral Hospital) is the main hospital in Bhutan
Bhutan
Bhutan , officially the Kingdom of Bhutan, is a landlocked state in South Asia, located at the eastern end of the Himalayas and bordered to the south, east and west by the Republic of India and to the north by the People's Republic of China...

, located in the capitol, Thimphu
Thimphu
Thimphu also spelt Thimpu, is the capital and largest city of Bhutan. It is situated in the western central part of Bhutan and the surrounding valley is one of Bhutan's dzongkhags, the Thimphu District. The city became the capital of Bhutan in 1961...

. Since it was established in 1972, the hospital has been supplying free basic medical treatment as well as advanced surgeries and emergency services to citizens from all over the country. It provides the most sophisticated health evaluation and management services in the country. Recently the hospital has added CT
Computed tomography
X-ray computed tomography or Computer tomography , is a medical imaging method employing tomography created by computer processing...

 and MRI
Magnetic resonance imaging
Magnetic resonance imaging , nuclear magnetic resonance imaging , or magnetic resonance tomography is a medical imaging technique used in radiology to visualize detailed internal structures...

 diagnosis equipment and improved lab services. The hospital has a library with many current textbooks.

The hospital is one of five medical service centers within Thimphu. The others are two Indian hospitals (DANTAK hospital at
Semtokha and IMTRAT hospital in the main town), the BHU in Dechencholing and the Outreach Clinic in
Motithang.

Health Issues

In 1991 the most prevalent diseases in Bhutan in order of seriousness were respiratory tract infections, diarrhoea/dysentery, skin infections, worm infections, malaria, conjunctivitis, peptic ulcer syndrome, otitis media, tooth and gum diseases, urinary tract infections and nephritis, childhood diseases, sexually-transmitted diseases, diseases of the female genital tract and complications in pregnancy and childbirth puerperium.

The Obstetrics and Gynaecology Department handles about 3,000 deliveries annually. However, with growing demand, the existing worn-out equipment is insufficient in quantity and quality. Difficulties of proper monitoring and timely intervention has led to avoidable caesarean operations and stillbirths on rare occasions. Recently, assisted by the government of Japan
Japan
Japan is an island nation in East Asia. Located in the Pacific Ocean, it lies to the east of the Sea of Japan, China, North Korea, South Korea and Russia, stretching from the Sea of Okhotsk in the north to the East China Sea and Taiwan in the south...

, the department has been able to obtain new equipment including vacuum sets for delivery, phototherapy machines, infant warmers, foetal dopplers, CTG machines and ultrasound.

Alcohol-related liver disease has been a major cause of death in Bhutan during recent years. Health ministry statistics showed that 98 of 1,471 patients in Thimpu Referral Hospital died of this cause in 2007. The hospital admitted around the same number of patients in 2008, but better medication helped lower the death rate.

Between four to ten cases relating to domestic violence affecting women from all walks of life are reported to the hospital everyday. Jealousy, intoxication, and financial problems seem to be the main causes.

In October 2008, the hospital detected the first case of dengue fever of resident of the capital in a 63-year-old woman. The woman was admitted to hospital on September 2 with fever and pain in the limbs.

Replacement Facility

In the late 1990s, a plan was launched to upgrade the 175-bed Jigme Dorji Wangchuck Hospital to a national referral hospital with assistance from the government of India
India
India , officially the Republic of India , is a country in South Asia. It is the seventh-largest country by geographical area, the second-most populous country with over 1.2 billion people, and the most populous democracy in the world...

. After study, the existing structure was found to be too weak to upgrade. The planners proposed a new 350-bed hospital. By 2002 a lab building, compound wall, gift shop, doctors and nurses quarter and internal road has been completed. The project was planned to be complete by the end of 2007, but there have been delays in construction.

The hospital’s congested maternity ward, with limited staff and space, will have a better working environment once the new hospital is opened with a larger maternity ward with more staff and better technical facilities. This was funded in part by the government of Japan.

Royal Institute of Health Sciences

The Royal Institute of Health Sciences
Royal Institute of Health Sciences (Bhutan)
The Royal Institute of Health Sciences is one of two main medical education centers in Bhutan, the other being the Institute of Traditional Medicine Services. The RIHS was established in Thimphu in 1974 as a member college of the Royal University of Bhutan, and is associated with the National...

 (RIHS) is one of two main medical education centers in Bhutan, the other being the National Institute of Traditional Medicine. The RIHS was established in Thimpu in 1974 as a member college of the Royal University of Bhutan
Royal University of Bhutan
The Royal University of Bhutan , founded on June 2, 2003 by a royal decree is the national university system of Bhutan....

, and is associated with the Thimpu Referral Hospital. The RIHS offers diploma and certificate programmes for nurses, medical technicians and other primary health care workers.

Planned Medical College

A medical college is planned to provide training for doctors at the hospital, assisted by the All India Institute of Medical Sciences
All India Institute of Medical Sciences
All India Institute of Medical Sciences is a premier medical college and teaching hospital based in New Delhi, India. The Institute operates autonomously under the Ministry of Health and Family Welfare ....

. The college will offer MBBS courses, and have an intake capacity of not more than 50 students. About 20 subject departments will be needed. Bhutan does not yet have anatomy, physiology and biochemistry departments. The health ministry is working on the process of linking post graduate programmes for the students and to ensure that the medical college is widely recognized. Health officials said that the government should also look at remuneration and incentives to attract more doctors and specialists to take up the extra work of teaching and practising medicine.

JDWNRH Welfare Home

Patients from rural areas seeking treatment often have trouble finding an affordable place to stay. The JDWNRH Welfare Home was established by Her Royal Highness Ashi Kesang Wangmo Wangchuk to provide free shelter for poor patients from distant places. The home accommodates an average of 30 patients daily. It is supported by the Bhutan Foundation, which provides beds, linens, curtains, basic furniture, and hot water facilities.
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