Health Information

Country Health Profiles

Background

Geography

Bhutan is a 46,500 square kilometer country tucked up in the rugged shoulders of the Eastern Himalayas. With India bordering it in the west, south and east and China (Tibet) in the north, the country is completely landlocked. The terrain starts from the rolling Indian plans to the snow-capped, Himalayan mountains of over 24,000 feet above sea level. Because of the wide range in the heights of places, there is a great variation in the vegetation and climatic conditions in the country. The thick tropical forests of low lands give way to variegated deciduous trees at a higher level. This is followed by mixed coniferous forests that extend to the barren snowy peaks intermingled with glacier valleys. One can expect an equal variation in the fauna that lives in such varied forest environment.

Bhutan enjoyed peace and political stability since the establishment of present line of hereditary monarchs with the enthronement of King Ugyen Wangchuck as the first king of the country in 1907.

Development History and Health Services

From a traditional agrarian society, Bhutan embarked upon the road to modernization in the early sixties with the starting of the First Five-Year Plan. Before the introduction of modern medicine and health care system in Bhutan, the country solely relied on its traditional system of healing. 

Traditional medicine was first introduced into Bhutan around the 17 th century after the arrival of Zhabdrung Ngagwang Namgyal in 1616. Tibetans had always referred to Bhutan as Lhomenjong or the land of medicinal herbs because of the enormous variety of medicinal herbs that grew richly at different altitudes of the country.

Those days, the Bhutanese people went to Tibet to learn medicine. Most of the trained doctors would return to Bhutan and set up their own practices in monasteries or dzongs . Traditional medicine was greatly supported especially after 1885 when the Penlops and Dzongpoens patronized the profession. The courts of these high officials privately employed or kept at least one or two physicians.

In 1967 the Government formally recognized the scientific and cultural importance of traditional medicine. Thus it became a part of national health system and today the patients have equal choice for traditional or modern medicine from the same hospital in the districts.

Modern allopathic system of medicine was formally introduced in Bhutan during the first Five-Year Plan with the initiative of King Jigme Dorji Wangchuck, the third king of Bhutan. Bhutan had trained the first national MBBS doctor by 1954.

During the First Five-Year Plan Bhutan had two hospitals and 11 dispensaries. During that time, several paramedics (compounders) were trained in India.

By 1974, the Royal Institute of Health Sciences, then known as the Health School, was established to train Bhutanese paramedical personnel. It marked an important step in the development of self-reliance in human resource for health in Bhutan. For the training of medical personnel, Bhutan continues to rely on medical schools in the neighbouring countries.

At the center the Department of Health Services was carefully organized and strengthened over the years so as to be able to guide Bhutan's health development along the right path. Required health programmes were started for prevention, promotion, and control of diseases that were of public health concern. As a signatory to the Alma Ata Declaration in 1978, Bhutan adopted the primary health care approach in its health care delivery system. Today it has one of the best-organized primary health care systems in the Region. Even as a late starter in the modern health care system, Bhutan managed to cover over 90% of the population with basic health care service, despite the extremely difficult terrain with scattered and inaccessible population.

Development Philosophy and Health and Health Policies

After ascending the throne in 1974 at the young age of 17, The Fourth Monarch, His Majesty King Jigme Singye Wangchuck has skillfully steered the country through unprecedented development. The development partners of Bhutan have often called Bhutan's development documents as "Happiness Documents" as the king has guided the country to strive for "gross national happiness" rather than for mere gross national product. By being a late starter in the modernization process, Bhutan has learned a lot from the experiences of the other countries that are ahead of it.

It became evident for Bhutan quite early that for a holistic development of the society, it was essential that development must be both social and economic and that it was necessary to give equal importance to the spiritual, emotional and cultural needs on the one hand and the material well-being of society on the other. It was also recognized that at the heart of society is the individual whose welfare and well-being must be provided by the society and that the economic growth is essential to support and nurture the spiritual and social needs of the community. This has led the country to clearly stipulate that economic growth, while essential, is not an end itself but is one among many means of achieving holistic development. This has led to the declared objective of viewing development as a continuous process towards a balance between material and non-material needs of individuals and society.

The concept of health in Bhutan must be seen in the context of the overall development strategy that, as stated just above, defines development as the preservation of spiritual and emotional, as well as economic well being. Therefore, the health sector policy objectives reflect the national ones: equity, social justice, sustainability and efficiency, in the context of preservation of national culture. The long term objective of the health services is to "facilitate, through a dynamic professional health care, the attainment of a standard of healthy living by the people of Bhutan to lead a socially, mentally and economically productive life, and within the broader framework of overall national development, enhance the quality of life of the people in the spirit of social justice and equity".

Till the end of Eighth Plan (June 2002), the focus of health sector has been to increase the accessibility to health care. Basic health care service and essential drugs are provided free of charge to all the patients