In case of death by a local treatment, there are no laws or rules to hold anybody accountable
The Bhutan Medical and Health Council (BMHC) has notified the general public to seek professional medical assistance instead of seeking help from local healers.
This was following a post on social media by the head and neck surgeon at Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Dr Phub Tshering, where he wrote “goiters are sucked, squeezed and thrashed by the local healers before coming to us for definitive treatment. Not acceptable in a country where modern health care is totally free to its citizens.”
BMHC announced that patients should seek medical assistance when sick or some abnormality appears on the body.
“Sucking of goiters or any other swelling pose risk to patients and the person conducting the unethical practices, which are very dangerous procedures,” states the notification.
It also added that there is a high risk of acquiring infectious diseases and cross transmission of infectious diseases to the patients and person who conduct unethical practices.
Dr. Phub Tshering told Business Bhutan that seeking help from local healers is most common among the rural people as compared to the urban population.
Dr. Phub Tshering narrated the instance when a woman was referred to him from the OPD (Out Patient Department) when he noticed signs of local treatment. There were imprints of sucking and skin discoloration on the neck of the woman.
He said the main reasons for people seeking local healers is their strong faith in traditional healing and also the fear of undergoing surgery at the hospital.
“Sucking of the goiters is dangerous. The main threat is contamination as local healers might not have the concept of sterilization,” he said.
Sharing another case, Dr. Phub Tshering said that in 2015, a woman who had a swelling on her neck sought help from local healers. There were teeth imprints on the neck which had got infected and the infection had spread to her chest. “She nearly lost her life,” said Dr. Phub Tshering.
Similarly, a month back, a woman who was suffering from tongue cancer sought local treatment. Her left side of the neck had a swelling and the local healer put hot compression burning her neck.
“Local treatments leave scarring beneath the tissue and sometimes make operations difficult,” he said.
He also added that though people should respect their culture and religion, anything that cause harm to the body should be avoided.
“If it is a Rimdo or performing mo, it is okay, but anything to do with the body should not be allowed,” he said.
BMHC so far has received four complaints; however, many cases go unreported. The Deputy Registrar of BMHC, Nima Sangay, said that faith in local treatment is much stronger and is the first choice of people in the locality.
Dr. Dorji Tshering of Bajo Hospital, Wangdue, said that on an average, he has encountered about three to four such cases every month.
He said that patients seek delayed medical treatment after going for local treatment, which could sometimes lead to deformity or disability especially in cases of fracture or bone injury.
“After the local treatment, pain turns too severe or results in swelling. Then, patients come to the hospital, but still refuse to come clean about going for local treatment,” he said, adding that patients lie about the duration of sickness and also need to be probed about their treatment history.
People undergoing local treatment for a fracture are at risk of malunion or nonunion.
A malunion is a clinical term used to indicate that a fracture has healed, but that it has healed in less than an optimal position. whereas nonunion is a serious complication of a fracture and may occur when the fracture moves too much, has poor blood supply or gets infected.
“It could lead to restricted movement, loss of function or partial disability or deformity,” he said.
Dr. Dorji Tshering also said that there is risk of infection as well especially in cases of diseases that are transmitted through bodily fluid or blood.
He encountered a case where a patient had full blown septicemia – infection of the blood stream. The patient had to undergo advanced antibiotic treatment.
However, though complaints reach the BMHC, there is nothing much the council can do. “We have no right, and the local healers are not within our Act,” said Nima Sangay, adding that the council can only create awareness through public notifications and general warnings.
In an earlier interview, Business Bhutan found out that though the records maintained with Department of Traditional Medicine Services (DTMS) show the existence of about 500 local healers in the country, a survey conducted in Samtse, Pemagatsel and Samtse in 2015 reveal a new higher estimate of over 3,000 healers across the country.
In case of death by a local treatment, there are no laws or rules to hold anybody accountable.
Lucky Wangmo from Thimphu