The Bhutanese Leading the way.
With the introduction of radiation therapy, chemotherapy and other services in Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), patients referred outside has reduced, especially for cancer patients.
The patients with major diseases, like cancer, heart diseases including both adult and pediatric, and renal diseases including transplants were referred outside including others.
In July 2018 to June 2019 financial year (FY), there were 1,081 patients referred outside for treatment, followed by 1,129 patients in 2016-17 FY, 1,416 in 2016-17 FY and 1,326 patients in 2015-16 FY.
The total amount of treatment for 2018-19 FY is around Nu 225 mn followed by Nu 224 mn in 2017-18 FY, Nu 198 mn in 2016-17 FY and Nu 195 mn in 2015-16 FY.
Around 99 cancer patients were referred outside including 61 heart patients and 18 renal diseases in 2017-18.
In the year 2016-17, 137 cancer patients were referred outside including 132 heart disease and 14 renal patients.
Medical Superintendent, Dr Gosar Pemba, said although there is a reduction in number of patients referred outside, however, the cost will keep on increasing because every year there is 10 to 15 percent cost increase, as there are newer technology and newer drugs, etc.
Due to absence of brachytherapy in the hospital, the patients with cervical cancer are referred outside. The cervical cancer and other related to cervical can be diagnosed in the hospital, said Dr Gosar.
Brachytherapy for cervical cancer is a type of internal radiotherapy that gives treatment directly to the cervix and the area close by.
He said some of the cancers which are diagnosed and operated in the hospital and some cancers diagnosed in a last stage, the hospital provide them radiotherapy and chemotherapy.
He said although referring cancer patients has reduced, however, patients with heart disease are still referred outside because there are no services in JDWNRH. The hospital only provides with medical treatment for the patients with heart diseases.
Dr Gosar said the hospital lacks cardio surgeon or specialists to do operations of patients with heart diseases. The most common heart diseases is congenital in children and newborns.
There is also reduction in referring kidney patients. In the past, the hospital used to refer patient with kidney stones but now urologists can handle a lot of kidney cases. Only the complicated cases are referred outside, said Dr Gosar.
Every year, the government spends more than Nu 120,000 on each patient. The package rate starts from Nu 120,000 but the cost may increase depending upon the types of treatment. The package includes hospital stay, operation and some part of the investigations.
As of today, there are about 15 hospitals identified in India for the treatment of patients referred from Bhutan. There are 13 hospitals in Kolkata. There are two in Chennai, the oldest referral centers for the treatment of patients.
Dr Gosar said there are plans to reduce the number of hospitals in India to 10 or below. In every two to three years, they re-access the hospitals in India where the patients are referred.
The ministry will also reduce the number of hospitals in Kolkata to 7 or 8 hospitals to ensure that the patients are not scattered all over different hospitals.
He said many patients scattered all over different hospitals in Kolkata has made very difficult for the liaison officers to monitor and provide assistant to the patients. If the number of hospitals could be reduced further to hospitals which has many of the services under one roof, the officer in-charge can have better contact with the patients and the hospitals in India, he added.
Royal Civil Service Commission (RCSC) will also provide with enough liaison officers to monitor the patients referred outside.
Meanwhile, the hospital will start with Cath lab by the end of 12th Five Year Plan (FYP).
Cath lab is an examination room in a hospital or clinic with diagnostic imaging equipment used to visualize the arteries of the heart and the chambers of the heart, and treat any stenosis or abnormality found.
