Bhutan could buckle under the triple burden of non-communicable diseases, an aging population and for being a low-income country
Health: Bhutan needs to urgently address the rising burden of non-communicable diseases (NCD), which account for more than half of all deaths in the country.
The country’s status of rising NCDs and challenges were shared at the third biennial conference with health officials from across the country at the Paro College of Education yesterday.
Records with the health ministry show that as of last year, 50,064 people suffer from various NCDs like cancers, hypertension, diabetics, heart and alcohol liver diseases.
Chief of NCD division at the health ministry, Kinga Jamphel said that between 2013 and 2014, the country recorded an increase of about 26 percent in NCDs while a significant percentage of population are exposed to NCD risk factors.
“Prevalence of diabetes and physical inactivity in Bhutan is the highest in the South-East Asia region,” he said. All types of cancer cases are also increasing every year and comprising 30 percent of all referral cases to India. Among the women, cervical cancer is the most common.
Themed, “NCDs and healthy ageing,” the conference saw participants recommending a multi-sectorial approach, patient-client centred health care and access to health to address the growing burden of NCDS.
NCDs being the number one killer in the region, health officials said Bhutan is no exception even though adequate measures were in place besides improving and strengthening existing activities and policies.
Speaking on ageing programmes that the health ministry has in place, the director general of department of medical services Dr Ugen Dophu emphasised on the need for collaborated effort to further strengthen them.
Dr Ugen Dophu said there is a misconception on healthy ageing even among the health workers. “Healthy ageing programmes start from the time of conception until death, from the womb until the tomb,” he said. “It is important that you live healthy until you die.”
National Statistic Bureau’s records show that Bhutanese age at the rate of about six percent while the population growth rate is about 1.3 percent. This, health officials said would result in various economic and social issues. Among the elderly, depression and dementia  the highest health problems followed by disability.
Public health department’s director Dr Pandup Tshering talked on the innovative approaches to NCD prevention and control.
In addressing NCDs, Dr Pandup Tshering said, old ways of doing things no longer worked and that there was a need for more innovation. “People no longer have time to watch or listen to advocacy programmes on television or radio like they did in the past,” he said.
Some of the ways to connect to people, he said was using social media, mobile apps besides community-based approaches. “We shouldn’t be waiting for people to come to us,” he said.
Health minister Tandin Wangchuk said that NCDs have been recognised as one of the leading causes of preventable death and premature mortality. “However, if we do not address these issues, it could negatively impact socio-economic outcomes,” lyonpo said.
Lyonpo also informed the gathering that the Cabinet recently endorsed the National Action Plan for prevention and control of NCDs. “I would like to call upon strong collaboration among various agencies in effective implementation and monitoring of the action plan,” lyonpo said.
Given the rising burden of NCDs, the minister said that there is a strong need to revitalise primary health care delivery. “Bhutan’s primary health care system seems to be losing focus on health promotion and disease prevention as per the Alma Ata declaration of 1978,” lyonpo said.
Lyonpo said that like any developing country, ageing occurred rapidly in Bhutan but often without the social changes such as improved living conditions, better nutrition, and better excess to health services.
With the screening of all elderly citizens to identify NCD risk factors, lyonpo also stressed on the need to provide care and treatment including referrals and integrating elderly care activities into the primary health care system.
Health secretary Dr Dorji Wangchuk said that the increasing number of elderly and high incidence of NCD is an interesting combination for a focused increase in national resource for health.” It is impacting health system in the most unprecedented way,” he said.
High occurrence of NCD and increased number of pensioners is expected to have direct and more serious consequences for low-income countries especially like Bhutan.
“This can be labelled as a triple burden,” Dr Dorji Wangchuk said. “While we tackle NCDs, the fear of communicable diseases still looms high.”
By Kinga Dema, Paro