More and more Bhutanese mothers, who have the means, are opting to deliver abroad
Wangmo is worried, anxious and obsessed. She is two months due to deliver her baby. But this mental syndrome has been allayed to an extent, with her husband deciding she deliver in Bangkok, instead of a hospital in Bhutan.
“I’m not very comfortable with the medical facilities at home,” she said. “I’m not saying it’s bad, the doctors are well-trained, but you never know if you have complications.”
“Deliveries can happen any time, and what if doctors aren’t around, which sometime happens,” she said. Incidence of jaundice after birth is also fairly common in Bhutan.
In Bhutan, where health care is free and institutional delivery is still being encouraged as an option against home delivery, there are no personalised doctors to attend to a single patient’s beck and call.
Mothers have to share rooms in hospital, unless they choose to pay for cabins, and make do with basic medical infrastructure and limited health staff. As of last November, the country had 10 gynaecologists in the country, including three non-Bhutanese. About 12,000 babies are delivered annually in hospitals across the country.
As against this, hospitals in Bangkok boast of offering a wide range of delivery options, including normal, with epidural, (a pain relieving injection), which makes delivery almost painless, water birth and c-section. “In Bhutan, we’re unable to offer painless labour option due to shortage of staff, not because we don’t have money,” gynaecologist Dr Ugyen Tshomo said in an earlier interview with Kuensel. “We don’t know why women go to Bangkok for delivery, but most do seem to get caesarean section in the end.”
In Bangkok, mothers are provided a single room and constant nursing for the baby, besides advice on proper food and health habits, before and after delivery.
These facilities are attracting Bhutanese mothers, who have the means to deliver in Bangkok, which is growing as a destination for medical tourism as well.
A senior international marketing manager with Phyathai hospital, Norachan Malakul, said the hospital saw 26 Bhutanese women last year deliver in the hospital. Phyathai is the most popular delivery hospital for Bhutanese and, since 2003, around 600 Bhutanese babies have been born there.
At the Phyathai hospital, there were no long queues in the huge lobby that had smiling ladies at the assistance counters and several places to eat.
“Hospitals in Bangkok are becoming increasingly popular, not just for Bhutanese, but for several other countries,” Norachan Malakul said. “We cater to international patients, and we have spokesperson and interpreters for many countries, including Bhutan, the Middle East, and all the South Asian neighbouring countries.”
Sonam Phuntsho is an international relations officer, who had worked in the hospital for the past seven years. He said he came to Bangkok to study but, most times, he assisted Bhutanese visiting Bangkok for medical treatment. “I can speak Thai pretty well, and I cater not only to Bhutanese but all international patients,” Sonam Phuntsho said. “The hospital then offered me a job.”
Many Bhutanese prefer Phyathai hospital, because it has a Bhutanese staff.
Wangmo and Tobden, a Bhutanese couple, who were in the hospital last week, said they chose Phyathai because it was easier with a Bhutanese staff around.
Both holding hands with their three-year old toddler, born in Bangkok, the couple said they chose Bangkok because doctors are readily available, and the safety of the child and mother is ensured.
The couple had spent around 72,000 baht for delivery, 30,000 baht for living expenses and another 50,000 baht for travel.
The fee for delivery ranges from 45,900 to 73,000 baht, depending on whether it is normal, with epidural or a C-section.
“It was amazing, my whole body opened up and it was almost painless,” Dechen, another mother, who delivered her baby in Bangkok, said. “After delivery, I went to the United States and got pregnant again, but I again chose to deliver in Bangkok, although medical facilities are much better in the US.”
Bangkok, she said was like a hub, anyone could go in and out any time and, since it was closer to Bhutan, it was possible to have family around.
She spent USD 5,000 (around 150,000 baht) for a delivery, including travel expenses.
Most mothers visit Bangkok before two weeks of delivery and leave after a week.
Bhutanese also visit hospitals in Bangkok for complaints like stomach ulcers, cancer, hair transplant, gallstone surgery, sore throat, red eye and backache.
The more affluent visit hospitals like Bumrungrad and Samevitej, where they charge a relatively higher fee.
Karma, a corporate employee in Bhutan, said she took her grandfather to Bangkok to treat his severe backache because, no matter how many times he visited the hospital in Bhutan, the complications never stopped.
Yeshey, who is thinking of getting married this year, said, she has started saving money, so she could also deliver her baby in Bangkok.
“It’s very important to provide proper care and good facilities, because it influences a mother’s anxiety level,” a health expert with Phyathai hospital said. “If the anxiety level is influenced by poor care and attention, pain level during delivery could be very high and that’s where it becomes too risky both for the mother and the baby.”
Bhutan’s infant mortality rate is 40.1 per 1,000 live births, and maternal mortality rate is 146 per 100,000 live births, according to the government’s recent state of the nation report for 2012.
By Nidup Gyeltshen in Bangkok