It’s good to know that we are soon going to have a huge building at our JDWNRH complex. Officials are boasting that it will be equipped with advanced state-of-the-art facilities. People expect some drastic changes in health services after the new buidling has been completed. But we doctors feel the new big buidling will be nothing more than a big cave of no hope. This is because the problem of Health in Bhutan is not due to lack of infrastructures but due to poor management. Most of the hospitals in the west and in Australia are small buildings with good facilities and management inside, and warm services. A big building is not necessary. You can see that the authority at our present hospital is already having a tough time managing the day to day business running the “small” hospital. A few days ago, someone complained in the KOL about laboratory investigations in the hospital stopped due to shortage of water. That is not surprising to us. We can not perform many aspects of diagnostic laboratory investigations because reagents are not available. You often hear about shortage of blood at the “national” blood bank. Many of the patients who need urgent blood do not get blood. Operations are postponed due to lack of blood. Empty oxygen tanks in the emergency department is not uncommon. We have cases where asthmatic people have died in the emergency department inspite of the fact that they have made it all the way from Lungtenphu to the emergency department just because there was no oxygen in the oxygen tank! We have asthmatic patients who succumbed to death just because only “one” dose of bronchodilators were available, it’s out of stock!! We have patients who have died in the emergency room because there was no doctor to attend and the nurses wouldn’t bother to attend!! We have nurses who are so worked up that they can sleep standing!! We have surgeons who operate round the clock for 3-4 days continuously, and still there is no break for him. We have doctors in the emergency room being harassed by gangs at nights. Complaints were lodged at the police but nothing was done because these are big shot kids in Thimphu. The existing number of doctors work tirelessly to keep up with the growing number of patients coming to the hospital everyday. They are already busy and worked out. At present we have only about 25 working doctors in JDWNRH.... one surgeon, three medical specialists, three gynecologists,one ENT specialist, one pedictrician, one opthalmologist, three anesthesiologist, one psychologist, four dentists and about five doctors in the casualty department. We have about 120 nurses. Now with the attachment of the new 350-bed hospital complex to the existing old hospital, lives of our health workes at the JDWNRH will go from bad to worse. This is because NO steps have been taken to increase the number of health workers including doctors, specialists, and nurses proportional to the expected increase in the work load that will be there after the completion of the new hospital. Doctors are already racing with time in the old hospital, imagine we will have to run the new 350-bed hospital on top!! At the end, will there be any changes in the services provided by the hospital?. Cleanliness and sanitation at the hospital is like our popular “Hongkong Market”. It is still difficult for the visitors to find a good clean not-over crowded toilets in the hospital. We never had a good parking space. The parking lot in front of the hospital has been so jammed everyday. These are the small things that can make a difference if we manage them properly. I personally believe that no matter how small, if we had a good management of our hospital, the story would have been entirely different; and no matter how big our hospital will be in the future, without enough doctors and nurses and other health workers, a big building with every modern facilities inside will not make any difference. When outsiders see, they will see it as a big hospital. When we see, we see an empty monument.
