I know that there are many good doctors and health workers in Bhutan with excellent service records. I deeply respect and honor them for their whole-hearted dedication to the service of Bhutanese people. These people are highly professional in their approach to working with patients and take their responsibilities seriously and professionally. I have met many of them in my life. I would like to say that these individuals do not only make diagnosis and prescribe drugs, but they also seek to provide corrective emotional support which is an equally important component of a healing process for the patients. You may not believe me but simply talking to them makes you feel better because their words and tone carry a magical spell. But unfortunately, not everybody in the health-care sector has these qualities. Just as the good must be followed by evil, there are people in our hospitals and health facilities who do not seem fit well to be in a helping profession, because firstly, they don’t have the heart to own the problems of their patients and secondly, they don’t have the right attitude to deal with their clients. They seem to be doing their job just for the sake of earning a living. As a health-care provider, I feel all health professionals must be able to take ownership of their patients’ concerns and provide appropriate support in a professional manner. The following incidents would explain why I decided to write this article.
In 2010, my wife’s elder sister noticed a small lump in one of her thighs. As days passed by, she realized that the lump was growing bigger and she began to feel some pain. After the treatment at Sibsoo hospital did not show improvements, she decided to come to Thimphu to consult the medical specialist. In Thimphu, she was assessed by an orthopedic doctor who diagnosed that her lump was a benign tumor which could be removed by a minor surgery. . She was operated and the lump was removed. But in 2011, almost a year after the first surgery, even larger lump evolved just around the same place. This time, it kept growing vigorously bigger and she experienced unbearable pain. She could not even walk properly. By the time she came to Thimphu, the size of her lump was almost as huge as my one-year-old son’s head. We immediately rushed her to Thimphu hospital and went looking for the same doctor who operated her before. When we got inside his chamber, he blankly refused to own her as his patient when we explained to him what had happened. We gave him all the medical papers we had with us. He simply said, “I had removed the lump completely last year and now I don’t know anything about how did it come up again”. When I asked him what should we do next, he just advised us to see Dr. Lotay once. I don’t know why she was referred to the Urologist after all. Even then, we went looking for Dr. Lotay but the nurse at his chamber sent us back saying it was nothing to do with Dr. Lotay. We then went back to the Orthopedic doctor and this time, he asked us to consult Dr. Tashi Wangdi, the Oncologist. Dr. Tashi Wangdi was a very professional and nice doctor. He also wondered why the Orthopedic doctor referred his patient to him. When we showed him the patient’s MRI report, Dr. Tashi got shocked. He said if she gets late for the treatment, she might have to lose her leg. So, he remarked on the prescription “Please treat her if you can. Otherwise, refer her”. Dr. Tashi advised us that since the Orthopedic doctor had performed the surgery before, she was his patient and that he should be responsible for her further treatment. We once again returned to the Orthopedic doctor’s chamber and only this time, he agreed to refer her to India. But all these things did not happen in a single day. We spent almost a month running up and down, from one doctor to another. It was quite frustrating at times. Finally, my sister-in-law was referred to Kolkata where the doctors diagnosed that her lump was a malignant tumor (cancer) and advised that she needs to be amputated as she was late for the treatment. After consulting her husband and other family-members, my sister-in-law had to make the hardest decision of her life: to lose one of her legs. She was amputated and when she was discharged, she was advised to return for a medical review after six months. But when she came back to Bhutan and reported this to her doctor, he refused to send her for the review saying it was not necessary. Then after a year or so, the cancerous tissues had regrown and this time, they had entered her body. She could not be saved although she was brought to Thimphu for treatment. She died a painful death in April 2012. I still feel if her doctor could have given her more attention, things would have been bit different for her.
In December 2009, my wife was in the hospital after the delivery of our youngest son through caesarian birth. There was this young woman a few beds next to my wife’s who had also given birth to a healthy baby-boy by caesarian. A few hours after the caesarian, the attendant of the woman complained to the nurse on duty that the woman was bleeding profusely. But the nurse just underestimated the seriousness of the situation and did not even bother to check the patient. She said “Who would not bleed during child delivery? Everybody would bleed for sometime” and she left. My wife told me that after sometime, the woman began to violently wince with pain as the effect of the anesthesia she was induced during the surgery gradually faded. She was losing a lot of blood. Only then the doctor was summoned. The doctor who had done caesarian on her immediately ordered that she be taken to ICU from where she never returned. She had died of excessive bleeding. The nurse who had ignored the complaint earlier had already finished her duty and she was not there when the patient she could have saved died due to her negligence.
Likewise, we have many incidents that could have been caused by mere negligence on the part of concerned health professionals. But the sad thing is that it seems we don’t have a proper avenue to seek justice. The hospital management board, which people mostly report to with complaints, often ends up defending the accused with so many technical explanations instead of launching an internal enquiry into the problem. Some victims have attempted to do this before but nobody has ever succeeded in their fight for justice so far. The most appropriate option will be to drag the accused to court but can we really do that in Bhutan? Till date, nobody has ever dared to do this simply because it’s a very hectic and costly process. It seems as of now, many victims are stuck in a deadlock. Until a more vibrant system falls in place to clean up the entire sector, we must survive at the mercy of those so-called very professional and kind-hearted health workers who are not yet influenced by evil minds.