Bhutan has about 798,000 people living in an area of 38,394 square kilometres. Bhutan’s life expectancy is 70 years for males and 71 years for females (WHO, 2016) and infant mortality rate is 30/1000 live births (WHO, 2018). The Bhutanese have made significant progress within the health sector in the past few decades, with a remarkable increase in life expectancy and consistent investments in public health over this time. However, rapid environmental, demographic and epidemiological transitions, including urbanisation, have brought with them new challenges to the health of the population, including road trauma and occupational safety issues. While the country provides free primary health care to its citizens, there is a need for further development of specialised skills relating to surgery and allied health care.
Interplast was contacted in early 2014 by a South Australian hand surgeon and hand therapist who have been undertaking volunteer programs in hand surgery and hand therapy to Bhutan for several years. Since 2009, volunteer hand therapists, orthopaedic hand surgeons and plastic and reconstructive surgeons have undertaken five hand surgery and therapy mentoring programs in Bhutan. They have undertaken surgeries on a variety of hand injuries and conditions, a hand therapy clinic has been established and local staff trained in post-operative therapeutic care. These volunteers have established strong relationships and networks within Bhutan, including within the JDWN Referral Hospital, the regional based Mongarr Hospital and the Ministry of Health.
The South Australian volunteers contacted Interplast in order to establish a sustainable program including developing local plastic surgery capacity with a strategic planning focus, supported by the logistical and funding capacity of an established organization such as Interplast. In late 2014 Interplast undertook a needs assessment activity, with the team including the original South Australian volunteers and Interplast representatives. Following this activity, Interplast are now working with the JDWN Referral Hospital, the Ministry of Health and the University of Medical Sciences Bhutan in establishing a Memorandum of Understanding, to formalise the partnership and plans for programs and activities moving forward. To date, Interplast has delivered ten surgical mentoring programs and ten hand therapy mentoring programs to Bhutan.
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