The Bhutanese Leading the way.
The case of an expired drug being supplied to a child with a rare heart problem from the JDWNRH once again brings to the fore the issue of safety and quality of drugs supplied by the Ministry of Health.
The fact that MoH officials agreed that expired drugs are being given after ‘tests’ is a cause for concern especially when the autonomous Drug Regulatory Authority itself under MoH says this goes against laws and good practices.
With Bhutan spending hundreds of millions of Ngultrums every year for procurement of drugs, one would expect that the MoH would take precautions to procure drugs that have a longer expiry date or procure them in regular intervals to avoid expiry of drugs.
The problem of supplying expired drugs to patients basically shows two major problems. One is that drugs are being purchased in such unnecessary bulk that they become expired and the second problem is that drugs with a short shelf-life are being purchased.
These issues were earlier highlighted in the 2008 June -2009 June financial year report by the Royal Audit Authority on the procurement of drugs by MoH.
The RAA found that in just one year there was Nu 127 mn in irregularities in the procurement of drugs which included purchasing drugs far in excess of what was needed and also purchasing drugs with very short lives or well on the way to expiry.
The current government cannot wash its hand of the corruption in the MoH procurement of both drugs and medical equipment. Though it is true that corruption in the procurement process in MoH started before the current government came in and as such was mainly a high level bureaucratic nexus, but it is also true that some of the biggest scams in medical procurement also took place under the watch of this government after 2008.
Though this current government did transfer and post some people it was only after much prodding and exposes from the Media, ACC and RAA.
Even the detailed and ongoing investigation of the MoH procurement scam was an ACC and RAA initiative after a series of media reports on irregularities in procurement and also of bidder funding the procurement committee member’s trips abroad.
In short the current government never asked for an investigation, never held people accountable, has still not come out open on the damage that institutionalized corruption in the MoH has done and clearly has issues to tackle in the MoH.
Though it must be acknowledged that MoH has made some structural adjustments real accountability and transparency on the whole issue is still lacking.
Instead the role of the MoH and its minister has been to unkindly blame the ACC and its investigation for cases of drug shortages in the past. The ACC had never suspended drug procurement but rather it was the shortsightedness on part of the MoH relying on a few suppliers and not bending its back that led to drug shortages.
The government’s response so far on problems in the MoH and health system has been to blame it on the ‘past’. This is a highly peculiar explanation from a government which has held the reins of power for so long with the next elections coming up soon.
The MoH and the government must acknowledge that it slipped in not cracking down on corruption in MoH fast enough and instead waited for the media and ACC to do it. This government’s role in the MoH procurement scams has been to let corruption thrive in the MoH in a helpless way for a few years and rather wait for the media and ACC to get cracking. The government’s role at best has been non-interference given that no political risk is involved but even that is questionable with constant and one sided media reports quoting MoH officials blaming shortage of medicines and doctors on corruption investigations.
In what can only be described as an ill thought out approach the MoH has instead spent all its energy in ensuring that medicine counters of nearly all private pharmacies supplying quality and branded international medicines are half empty putting up bureaucratic and unrealistic requirements. With government pharmacies having access to only limited brands and qualities of drugs, several patients in Bhutan living with anything from Asthma to heart problems have to face a harrowing time getting the drugs they need.
Though big promises were made and some changes have been made some of the big problems plaguing the MoH from wrong diagnosis to supply of expired medicines and many more still continue.
The ministry is run by HAs and we cannot expect miracles from them.I am wondering why all the DHOs and progam officers at MoH has to be HAs.There are many handpicked DHOs in the districts who are not at all capable enough. But they are very good at siphoning money allocated for different activities.There are many nurses with masters in public health with research back ground. They can be a better mangers,POs and DHOs.
I heard there are many beautiful nurses running the programs in MoH. No wonder public health in all spheres has been lagging.
1.Drugs with short shelve life probably bought at low price and when billing they must be putting up the bill for the longer shelve life price… well a good area for collusion for the seller and buyer both win a handsome amount but it’s the 3rd party the users who have to bear the brunt…..
2. MoH and DRA speaking on different tone about a same thing is a cause of concern as far as we as commoner are concern… going by the book i would listen to DRA they are the agency entrusted to deal with drugs quality etc etc….
3. I hope they will not blame ACC for this one also like they did in the past. ACC, i am sure has nothing to do with short shelve life drugs procured by MoH.
4. Unless there is massive clean up at all level in MoH like any other organization, the situation will not improve. Even if the water is a 100% pure water, when stagnant for long time, it’s bound to get spoil. Reshuffle and transfer in massive range is necessary now.
5. The need for a medical knowledge/background secretary (who is the head of a Ministry, since Minister is a politician, the person filling that post will come today and go tomorrow) would have been much better for MoH but it’s beyond control, it’s all high level politics. This days who looks for public welfare, it’s self welfare first and rest are all secondary.
6. We saw few doctors being exposed in media for their travel to China and Germany but the real people who pocketed millions are still at large and roaming freely…..
How can people who risked the life of many with poor quality drugs, risk the lives of many children by poor quality equipments to build buildings be still roaming and telling others on serving tsa-wa-sum. What an irony? in the land of GNH….
7. Whatever said and done, the hospitals have improved a lot compared to the past. i am sure many things will improve further with time and good management.
Few doctors were exposed while others who pocketed millions are at large free? I think the others are also doctors. Dr. Gado was a doctor, who ran away thinking that all will be forgotten but I hope someday he will have to face the court. And the other inefficient guy Dr. Dorji is also a doctor and he should be held accountable. ACC does not have to go witch hunting. Get hold of these two people and it will be taken care of. And if necessary ACC must also get hold of former ministers Jigme Singye and Sangye Ngedup. No other witch hunting.
what more can the citizens of our country expect from MoH???though everyone is aware of the corruption level on the country’s most important ministry,,it is not trying to improve in any cases but rather compromising with lives of poor citizens of the nation,whit this weak faith of the citizens will the citizens risk their lives on health issues?? citizens are aware of all the corruption going on..and the funny thing is that every corrupted person on power always has an excuse to make..its time that people on power change their cheap attitude to just fill their pockets while they are in power and start contributing towards the nation and its hopeful citizens…..people are also aware of the dark side of DVED and the seeds it is sowing…..and it is surprising to know our anti corruption commission is waiting to act after the climax…when poor citizens are made victims,,,plz think and act ahead of such situations,keep an eye on those who take the nations issues as there source of income….so that the generations to come might still hold respect and faith on the government…they just cant demand respect..its a matter of earning it through rightful actions in right times.,,,,may god bless BHUTAN
and the story of mismanagement in MOH continues…this is no good for our comfort. Health is the most important thing in life. without it no GNH.
People working for the health of people are the most suppressed ones in the country in every possible terms……
Be it number of hours of working…
Be it grading system
Be it seniority
Be it climbing the ladder in the service except few few who lick the boots of biggies…
I am talking of our nurses and doctors….
With the coming in of democracy and the right to freedom of expression, everyone seems to be trying make the best use of opportunity and showering their opinion and showering their anger on MOH. Let us also express my opinion as a person. All people have to deal with MOH – from birth to death. All of us cannot be happy – all of our sick people cannot be cured of all the deadly diseases. We cannot live more than a certain number of years and no amount of effort by people in health can save our beloved ones. There have been corruption scams and all news papers were filled with the news. But I do not understand why there is so much focus on health alone. There were corruption scam in almost every agency. There is risk of corruption at every level. People in the town talk of corruption in all forms happening at many levels – transfer of land, issuance of permit for trade and forestry products, ticket booking, hotel arrangements, travel and tours, appointments and transfers, selection of candidates, promotions, reservation of seats, procurement works, procurement goods, procurement of consultants and the list can go on. There is corruption at each and every level. A person who is selection or appointed based on nepotism ends up benefiting the whole life. If one tries to investigate how some people have come to occupy some posts, we get to know the connections – related to this and that. We have seen how selections happen behind the curtains. People with low marks go for professional trainings and courses by hook or crook – they enter from the back door.
It may be true that there were lapses in MOH and the ACC and RAA are studying the facts and doing their job. But there are such lapses everywhere. Not only in MOH. If some in MOH had their share from suppliers, others are having their share from the unnecessary travels, from the extra-cutting of trees, from the extra bills on procurement, from appointing their relatives and giving them higher salary, from registering the govt. land, etc. At the end of the day, the means of corruption is not important but the impact of that corruption. Sometimes a person as low as an office assistant can benefit from repeated but small scale corruption. The property people own speak volumes.
People who like commenting so much on MOH should also learn to see the hardships Health people face. May be they should try and understand how many long hours of study they undergo in training, how much less time they spend with their spouses and children, what kind of dirty and risky job they undertake. Try cleaning your own shit, urine, wound and so on. Imagine how hard it would be to clean such disgusting materials of others. Try working in DVED dealing with millions worth of orders of thousands of different things. Anyone would love to pass an easy time traveling, claiming TADA, attending meetings, eating and shitting without slightest of fear for audit memos. Many have ruined their lives working in Health. They had their dreams and wishes for their kids and themselves like anyone. Working in MOH is not like sleeping on a bed of roses. There are bosses who put pressure at every level. There are deadlines after deadlines. There is hue and cry and tense moments in MOH. Only the friends, relatives and family members of those who work in MOH truly understand their problems. That is why Health is full of vacant posts. That is why people are running away from Health.
I would like to comment on the paragraph below which reads as
“In what can only be described as an ill thought out approach the MoH has instead spent all its energy in ensuring that medicine counters of nearly all private pharmacies supplying quality and branded international medicines are half empty putting up bureaucratic and unrealistic requirements. With government pharmacies having access to only limited brands and qualities of drugs, several patients in Bhutan living with anything from Asthma to heart problems have to face a harrowing time getting the drugs they need’.
I think the writer is a little confused on the roles of DRA and MOH. It may be informed here that the medicines are regulated by the DRA as an autonomous regulatory body. It is not true that DRA is under MOH. It is independent. The other point is MOH has nothing to do with the unavailability of branded medicines in the private pharmacies. MOH has not ‘put any bureaucratic and unrealistic requirements” to impede their import into the country. The DRA a regulatory authority to ensure the quality of medicines implemented certain registration and import measures. If we want quality we need measures. Medicines are not like any goods and need to be regulated for the public safety. So we need to bear little inconvenience.