Bhutan Medical Service – Wrong Diagnosis?

PCM

I do not regularly tweet, but I regularly follow. On 31/08/2015, as I logged-in to Twitter, I read the following tweet:

“I’ve heard so many terrible incidents of wrong diagnosis happened at JDWNRH costing lives of the people. Pls support to evidence it.”

My response to this tweet was this:

“Hear the same story. Bhutanese being too compassionate they let things go off. Need awareness on this ground.”

In this post, I do not intend to write on what tweepple got to tweet, but my mind instantly called me to write on the medical services that thousands of Bhutanese people consume every day. To pen down this alarming issue is not new, but a long time thought, and eventually I made my mind to share this major concern although nothing could substantiate my argument. This exclusively therefore is my individual opinion and I believe that the readers will certainly stand with my argument.

On Sunday Evening (06/09/2015), I was attending a death body which was reportedly said to have died after the medical staff injected with a dose of drugs. The story goes like this: – On Saturday, the deceased was referred to the Hospital and the medical person who attended the patient declared everything as normal. Next day, (i.e. on Sunday 06/09/2015), again he was referred to the hospital in the Emergency Ward and the patient was given a glucose kind of injection, which I perceive, is the normal and first instant procedure for the hospital to do so. The moment after patient was given an injection, he became unconscious for almost six hours and eventually gave his last long breathe.

I talked with the deceased family and sent my condolence. Some members of the family expressed their repent for referring their son/brother to the hospital and some said that their son/brother was killed. So, I ask this question: was the cause of death because of wrongful medical prescription? I do not know, and neither do I like to term it to be. It may be and it may not be. And I do not want to reiterate and write based on the above facts and circumstance, but a very general assessment of what I perceive the medical services that we consume on daily basis. We hear, almost on daily routine, a series of allegations from the service consumers that things are not as what they expect. In a long run, upholding legitimate trust and confidence is necessary, be it public or private organization, and that requires inhaling public’s feedback and allegations constructively.

I would like to begin by sharing my personal happenstance. Generally, patients are referred to Chamber No.1 to 5 which are located in the Old Building. I am not saying that medical staff who sits in these Chambers are less competent or are unqualified for medical treatment but I must say they, I believe, are general medical staff. The drugs they would prescribe most is Paracetamol (PCM). I have a strong feeling that these Chambers are deployed for general/normal checkup which they believe requires no special attention. In this way, many patients who genuinely in need of special treatment and attention does not avail timely medication which gives further complication.

I would like to relate this to my own story. My five year old daughter needed a medical checkup and accordingly we went to the hospital. The receptionist referred me to the Chamber No. 5 of the Pediatric Ward. The medical staff of the Chamber No. 5 just looked at her body and prescribed with PCM and advised to undergo a Blood Test. Next morning, I visited again with a blood test report, and interestingly, the medical staff of the Chamber No. 5 did not understand the report and asked me to show it to any other Chambers. Waited in queue, and finally met the Doctor in Chamber No. 1 who was a Pediatrician. The Doctor diagnosed that my daughter has a Hand Foot and Mouth Disease (HFMD), which is a viral disease. The doctor advised me not to send my daughter to the school for seven days and was about to prescribe another PCM which I stopped to do so. Upon coming back home, I researched, asked Google on HFMD, and read that HFMD is a viral disease and it does not have any medication; and that it is common for children below five years of age to get HFMD. This viral infection will automatically get cured within 7-10 days and therefore no medication is necessary. The PCM is usually prescribed, however with proper instruction to consume only if children suffers from high fever and pain. Upon reading these facts about viral HFMD, I asked myself: why did the Doctors not tell me these facts? Was there adequate information and advice? I was also had a full doubt and ask this: was a blood test necessary to diagnose HFMD? Perhaps yes, maybe No? Since blood test was advised by a general medical staff and not by the pediatrician, this I believe was a wrong advice.

This is just a minor incident. Possibly, there could be several other major cases. For instance, when one of my friends was receiving his treatment for major medical incident (surge), the medical staff repeatedly said that the damage was just below 30%. However, upon referring to one of the Delhi Hospitals, we heard that the damage caused was more than 70%. In such conflicting situation, we are made to confuse more.

In other jurisdictions, to prescribe any drugs, the doctors would undergo a series of debates, dialogues, and study the consequences therein. Just to prescribe the antibiotic and PCM, there will be a series of hot discussions and dialogues between co-doctors, and patient will be well informed of. This does not happen in Bhutan. Rather PCM is one cheap drug that every medical staff will instantly prescribe. Interestingly, knowingly or unknowingly, Bhutanese are also fond of this particular drug, and I start thinking how many tones of PCM would have been consumed by the Bhutanese people annually. However, I do not encourage my family to consume any kind of drugs before I get convinced of its impacts. The PCM that the doctor prescribed me for my daughter is lying on the table.

Another interesting fact that I observe is that there are so many medical students, apprentices and trainees in the hospital. They are learning to treat patient while the senior doctors teach them. I have a feeling that human beings are put for practical learning experience in Bhutan. Medical trial with human beings is very inhumane activity which curtails basic human rights principles. This ultimately led to wrong diagnosis. What I also often hear is that Bhutanese doctors become expert in surgery from his or her early years as a doctor. This is because they get an opportunity to do a surgical job even when they are just a general doctor. While this can be applauded, however, in a course of making them expert, many would have been either killed or risked the life. Therefore, it is evident how human beings are subject of practical trial for the medical student putting human’s life into danger.

As I said, I don’t have any evidential proof. Whatever I post here is a very short summary of what I hear on daily basis. Thus whatsoever statements provided in this post remains very subjective. Some may agree and some may disagree, but the truth remains that the medical service have so many scope for its improvement. Healthy people don’t go to hospital; only sick people does. They need more energy to receive annoying and harsh words. Every patient would wish to get well soon. They would not like to deteriorate their health because of wrong diagnosis. Therefore, if ever these statements are true, it is necessary for the organization to recognize the fault and do necessary care and correction. Also, compassion, sympathy, and empathy are core values of Buddhism, however moving for the cause of larger society does not mean you are atheist or anti-Buddhist. If no one moves, many patient will return home breathless. It is also our duty to make service as it ought to be.

Disclaimer: – As I have repeatedly mention throughout this essay, everything that I write is purely my individual thoughts. I intend not to offend the sentiment of any person or organization. If the statements were not true, please ignore it. If statements are correct, necessary changes are expected.

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2 thoughts on “Bhutan Medical Service – Wrong Diagnosis?

  1. 100% true.i too ve a numerous incidents to share though I ve visited hospital only for a few times.
    Of course I ve a lot of respect n appreciation to those who are genuine care givers n service providers . I ve seen them as well.
    But many do not seem to b wearing the attitude that their profession demands which if otherwise cud make all the difference in the quality of service they provide.

    Like

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