The Bhutanese Leading the way.
The Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) in Thimphu is facing severe bed shortages, particularly in its surgical ward on the third floor and the medical ward on the fourth floor. These shortages are primarily due to the high number of patients with chronic medical conditions.
A chronic medical condition is a long-lasting health condition that persists for a year or more and requires ongoing medical attention or limits daily activities. These conditions often develop slowly and can last a lifetime, though their symptoms may vary in severity. Examples of chronic illnesses include diabetes, hypertension (high blood pressure), asthma, and heart disease.
Similarly, the medical ward typically handles a wide range of illnesses, from chronic conditions like diabetes and hypertension to acute issues such as infections, respiratory problems, or heart conditions.
According to sources within the hospital, these wards are the primary focus of overcrowding, as they handle a high volume of patients suffering from chronic conditions and those requiring surgeries.
While the situation is a pressing issue, it is also indicative of more profound challenges facing Bhutan’s healthcare system, including the adequacy of hospital infrastructure and long-term planning.
JDWNRH, which serves as the country’s main referral hospital, has been under increasing pressure to manage the rising number of patients, particularly in its medical and surgical wards.
One of the sources explained that these wards often have the highest patient inflow, especially due to the chronic conditions seen in the medical ward.
“Patients in this ward typically require prolonged stays for treatment, which further exacerbates the shortage of beds,” said the source.
He emphasized that the medical ward, which usually accommodates around 30 to 40 beds, is at capacity almost every day. “Patients with chronic medical conditions remain in the ward for extended periods, sometimes for months, which means there is little room for new admissions,” he said.
This is compounded by the fact that chronic diseases are prevalent in the country, placing even more strain on already limited resources.
Meanwhile, the surgical ward, which deals with patients requiring surgeries or treatment for trauma, faces similar challenges.
According to a hospital staff member, the surgical ward admits five to ten new patients daily. However, the need for post-surgery recovery means these patients often remain in the ward for several days or weeks. “Patients who have undergone surgery or need trauma care take up beds for much longer periods than those in other wards,” the staff shared.
Given the nature of these admissions, beds quickly fill up, and it becomes increasingly difficult to accommodate new arrivals, even in emergency cases.
In an attempt to manage the bed shortages, hospital staff are asked to adopt a somewhat flexible approach, temporarily admitting patients to other wards. “Whenever there is a shortage of beds in one ward, we communicate with other staff and try to find an empty bed,” the staff said.
This arrangement helps relieve some pressure, but it is not a long-term solution. “The reality is that we’re constantly juggling beds, moving patients around, and making do with what we have,” he added.
During a recent ground reporting visit, this paper observed some beds placed outside the Emergency Room (ER), where patients were being attended to due to the lack of space inside the hospital.
This sight further emphasized the severity of the situation, with patients being placed in temporary spots while waiting for beds to become available in the already overcrowded wards.
The eye ward at JDWNRH does not face the same level of congestion as other departments. The staff said, “We usually only have about three patients a day, so there is not much pressure in the eye ward.”
The shortage of space directly impacts the quality of care, particularly in high-demand areas like surgery and chronic care. With a growing population and an increase in chronic illnesses, the hospital’s infrastructure has been unable to keep pace.
Another health worker said that while there have been efforts to improve hospital resources, such as adding staff or temporarily relocating patients between wards, there has been little indication of a comprehensive long-term strategy to address the underlying causes of overcrowding. “We can’t just keep shifting patients around indefinitely. Eventually, we need a bigger and better-equipped hospital,” said the health worker.
In response to these ongoing challenges, the Ministry of Health has announced plans to refurbish JDWNRH into a Multidisciplinary Hospital. The Health Minister revealed, in a statement, that efforts are underway to transform the hospital into a more specialized facility, with enhanced infrastructure and improved capacity to meet the growing healthcare demands of the population.
This plan will focus on creating additional space and resources to better accommodate patients, particularly those in high-demand wards like surgery and chronic care. The Health Minister expressed that this initiative would ease the pressure on JDWNRH’s overburdened wards and create a more efficient healthcare environment in the long term.
The proposed refurbishment aims not only to address the bed shortages but also to ensure that JDWNRH can provide more specialized care.
