About 150 patients from across the country were screened in the last two days for the plastic and restorative surgical camp at the national referral hospital in Thimphu.

Interplast Australia and New Zealand in collaboration with the health ministry and Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) are conducting the camp at the referral hospital in Thimphu. The week – long camp began from October 18.

A seven-member team, led by Dr Tim Proudman, comprising of two plastic and reconstructive surgeons, an anesthetist, two nurses and two hand therapists from Interplast along with JDWNRH doctors will conduct the surgical and hand therapy services.

Orthopaedic surgeon, Dr Sonam Dorji, said people continue to register for the surgery and the number may increase. “Not all screened patients will be operated on,” he said. “The team identifies appropriate patients and prioritises them for the surgeries.”

Dr Sonam Dorji said that the national referral hospital doesn’t have a full-fledged plastic surgery department, which is why the team visits Bhutan to not only take up complicated plastic and reconstructive surgeries but also assist in developing local plastic surgery capacity as they work in close coordination with local surgeons.

“They are here to help operate on all these difficult cases together with local counterparts and in the meantime, we pick up skills from the team. As a result, we will be able to handle most of these cases ourselves,” Dr Sonam Dorji said.

Interplast is a not-for-profit organisation in Australia, which organises reconstructive plastic surgeries in developing countries in the Southeast Asia region. This is the sixth Interplast visit to Bhutan.

Dr Sonam Dorji said the team starts surgeries from 9am and goes on until 8pm. However, because of shortage of operation rooms as some rooms are currently under maintenance, the team this time will operate after 3pm every day. “The local surgeons have to carry out their routine surgeries which are equally important, during the usual working hours from 9am to 3pm.”

He said the camp is conducted at the national referral hospital in Thimphu because, in case of major surgeries, the patient will be admitted and it’s convenient for them to follow up.

“Especially in case of hand surgeries, it’s important that patients have access to hand therapy facility. We have a well set up hand therapy facility at the hospital since the camp in Bhutan was started by a hand therapist,” Dr Sonam Dorji said. “A hand therapy training is also going on where two hand physiotherapist train health officials from the districts and follow up on the cases together.”

He said plastic and reconstructive surgery doesn’t necessarily mean beautifying but to make any deformation caused by bear mauls, burns or any congenital anomalies as normal as possible and functional.

A memorandum of understanding (MoU) was signed between the health ministry and Interplast Australia and New Zealand where two more parties, the Khesar Gyalpo University of Medical Sciences of Bhutan (KGUMSB) and JDWNRH are involved.

With the signing of the MoU, Interplast visits the country twice a year to conduct plastic and restorative surgical camp.

“Since local surgeons are also involved in operating, post-operative care is assured after the team departs. Moreover, the team visits every six months so they can follow up on the cases,” Dr Sonam Dorji said.

The team has also been conducting lectures for the residents and interns in KGUMSB. Acting programme manager at Interplast, Thomas Loporto who coordinates the programmes in Bhutan said the team sees a lot of upper limb trauma (mainly hand injuries), burns and some head and neck procedures. “Wild animal attacks such as bear mauls are some of the common difficult cases in Bhutan.”

Thomas Loporto said that the surgeons, a nurse and a hand therapist have been on previous trips to Bhutan. He said Interplast also has a strong focus on training, mentoring and building the surgical capacity of in-country medical personnel.

Dr Sonam Dorji said that the number of surgeries the team operates on a day depends on the complexity of cases. “Sometimes a difficult case takes more than five hours in the operation room. Not so complicated cases take about an hour or two.”

The team brings all necessary medical equipment and supplies to reduce the burden on local resources.

Dechen Tshomo