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New challenges in the health sector

A year ago, around this time, the news of 11 babies dying one after another at the neonatal intensive care unit (NICU) in Thimphu shook the nation.

The death of the new-borns was attributed to the failure to institute infection control measures, which caused a bacterial infection outbreak at the NICU of the national referral hospital in Thimphu. In plain terms, hospital-acquired infections (HAI).

This is the one case many Bhutanese can relate to. What is coming is even disturbing. Not to scare people, but HAI is becoming a new challenge in our health system.

A survey report shared at the biannual conference in Tsirang where all the top health officials gathered, found that overall prevalence of HAI at 6.7 per cent. The percentage might sound small, but it is a great cause of concerns.

It is a concern because we are not prepared to deal with it. It is a concern because the national referral hospital has the highest prevalence rate. Hospital-acquired infections like Klebsiella pneumonia accounted for the highest with 24 per cent.

While the survey can be brushed aside for not reflecting the overall HAI in the country, there are enough reasons to worry. Although HAI can be controlled, we do not have the planning or the resources to do so.

This indicates our priorities. Health officials are aware that more resources and attention in preventive efforts could reduce the burden on the treatment part. But our focus is not there.

Studies conducted by health officials have found that poor planning and budgeting for infection control and medical waste management activities, lack of dedicated infection control focal persons and microbiology services, mismanagement of trained infection control focal are the challenges faced in infection control.

A decade ago, a prevalence survey found that surgical site infection was the most common infection at 54 per cent of all HAI cases. This indicates that we are losing our focus.

What are we doing?

HAI is the new global trend. It is a new health problem. Infection control, health officials point out, is secondary. The focus is on patient care. The irony is that those they care are at risk of HAI. Research findings imply that hospitals are the key facilitator of transmission and suggest that diseases are spreading from person-to-person primarily within hospitals.

To a layman, visiting a hospital means treatment and care for the sick or the injured. The last thing they expect is losing loved ones from HAI. It is already happening.

A new challenge in the health field is the so-called superbug, a strain of drug-resistant bacteria. Superbug would be a bigger challenge for those without resources or knowledge to deal with them.

The best way to deal with drug-resistant infections is to avoid getting them in the first place. Good hospital hygiene, which includes early identification and isolation of patients carrying these bacteria, could not only delay the spread of these pathogens, but also successfully control them.

Simple measure like hand hygiene and behavioural change are effective. In our case, one effective way is controlling the crowd at the hospitals. We could start with the simple doable things like good hygiene and avoiding spurious equipment.

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