How Dawa Founded Bhutan Stroke Foundation

Dawa Tshering heard of stroke for the first time when his 32 years young wife Rinchen Pelmo collapsed on the ground and was rushed to the hospital in June 2019. He knew she had issues with her blood pressure but he has never known the fatality of it until it struck. It caught him completely off guard. Rinchen was on life support in the ICU. Doctors didn't give him any false hope. They told him on the face to be prepared for the worst. 

Dawa Tshering and Rinchen Pelmo before their lives changed

His ignorance of stroke helped him shield against the harshness of reality. He didn't give up. His wife was in deep sleep for over a week. He has done rituals of every kind. He went to every influential friend he had around to get a referral to India. But he was told that there was no use taking her out. Gradually he began to realize how bad it was. He was told by everyone who knew the disease that she will not wake up. 

He went to a researcher friend seeking any information he could gather on stroke in Bhutan. He was given a handful, mostly articles and social media post by some Dr Tashi Tenzin. He managed to get connected to the doctor. Over the phone, he asked in desperation, "Doctor, tell me more about stroke."

Dr Tashi invited him over after hearing how earnestly he wanted to know more. He said, "You are the first person to have ever asked. Come over, let's have a chat."

Dr. Tashi Tenzin, the Guide
Photo Courtesy: Friends of Bhutan Association, Austria

By the third week, he managed to get his wife to blink her eyes in response when we ask her questions. On the 23rd day, he surprised everyone when he took her home and began the long ordeal of nursing her. Within the next few months, he left his job with Tarayana Foundation and dedicated fulltime on her. He was given the option to take a long leave if he wished but he opted to resign because he needed his provident fund to treat his wife. 

He regrettably recollects that despite free healthcare in Bhutan, he emptied his pocket on his wife's treatment; not on surgeries or medicines but on rituals. He went to every odd place any fool recommended and conducted every damn rimdro that came out. He shared that he could have treated her faster had he not desperately wasted his time and money on strange rituals. He declared that it was physiotherapy that put her back on her feet, which was absolutely free of cost. 

He would strap her to the car seat and drive her around knowing she would be so sick of staring at the ceiling all day long. He would carry her on his back like a child and go to all the places they would have gone if she were fine. He said going out helped both him and his wife. 

In less than a year, he succeeded in getting his wife, whom doctors feared won't wake up, out of her bed and make her walk on her own. She is still struggling to relearn everything, starting with speaking and eating. Knowing her love for farming, Dawa has helped setup her mushroom farm and vegetable garden. This has helped her wake up every morning with excitement and looking forward to the day.

Rinchen Watering Her Plants

Looking back at the experience he lived since his wife fell ill and watching her relearning how to do things, he felt that if he knew as much about the stroke he could have done anything to prevent that in his wife. His success at getting his wife walk on her feet is another experience, and now dealing with her disability and keeping her meaningfully occupied are things that he wanted to share with others. Having faced with so much at the prime age, Dawa says that the true battle was fought on two fronts; one with the illness and other with depression, and he hopes to be able to create much-needed awareness among the stroke patients and their families. 

Rinchen in her Mushroom Shed

Dr Tashi Tenzin with whom he had kept in constant touch shared with him how important it was for him to create a formal forum to share such stories to create awareness. As a doctor, he had said that he would love to do it but his hands are full within the four walls of the hospital. The doctor wanted Dawa to be the one to go beyond the hospital to reach out to the people. Thus, Bhutan Stroke Foundation was established. 

Personally for myself, having run to Bajo hospital carrying my mother inlaw in my arms and watch her dies a few days later in Thimphu hospital, and having watched the doctors pull the plug on my brother-in-law who was declared braindead, I have always felt the need for a stroke care organization. An organization that will create awareness to prevent stroke (before), help build efforts in timely treatment toward recovery (during) and create means for the patients to cope with life after stroke through meaningful engagements (after). 

Meeting Dawa Tshering in Punakha

When I met Dawa Tshering in Punakha, introducing his Foundation during the CSO retreat I felt like my prayers were being answered. As he spoke about his wife I couldn't see him well through my teary eyes, I knew he was destined to do this. Having hit the hardest, he has the motivation and determination to take this forward like no other. He says he wants to strive for stroke-free Bhutan, where no one has to suffer like his wife, like him and like his two children.

Every day, JDWNR Hospital alone is said to receives 2-3 stroke cases. Globally 17 million cases are reported annually, out of which 6 million dies and 5 million are left with a disability. 

Bedside Toilet- Dignity and Desperation

Bedside Toilet Borrowing program was created at Bhutan Toilet Org in 2017, almost accidentally. We had four units of portable potty, which were bought to be used as guest toilets during Highland Festival in Laya, but after realising that the potties wouldn’t be suitable for huge public events we kept them in the office corner for quite sometime.


One day, I got a call from Aue Kuenga Tenzin Supe asking me if I could help his dying friend deal with his toilet trouble. His friend was fighting lung cancer and didn’t have the strength to cover the distance between his bed and the toilet. That’s when we discovered where our potty could be used. We sent him a set immediately. His friend called to thank me after receiving the toilet, and I could hear him gasping for air as he struggled between his words. He told me how the toilet next to his bed had solved his nightmare. We felt so sorry to hear about his death after some months but we took solace in the fact that we were able to comfort him in his last days.

From then on we began promoting the potty as “Bedside Toilet” for people who are bedridden due to sickness, disability and old age. We let people borrow the toilets for free, only to be returned when the patient recovers or,god-forbid, dies. On January 30 2017, we put it up on our Facebook Page and by mid day the remaining three sets were taken. We continued receiving calls in the following days, which opened out eyes to one of the gravest problems that is hidden in the corners of many homes.

We learned the desperation of the family members who had to deal with bedridden people at home, some for as long as ten years. They shared how dealing with toilet troubles causes all the awkwardness and resentment over a period of time, especially when daughter is the caregiver of a father, a son for mother. Besides the health hazards due to poor hygiene the most painful part is losing dignity and self respect as one become incapable of managing their own toilet routine, and people around show signs of disgust at you.

Our initiative was to empower them to manage their own toilet by taking toilet right next to their bed, so that even in the worst case at least it can be handled with little assistance from the caregiver. The toilet set has its own flush system and an airtight waste tank that can serve for a week without having to empty. It’s completely odourless one it’s flushed and the valve is closed.

Training Jojo Dorji how to use it

With assistance from some well-wishers, ShaMa Foundation, Pema Seldon and Dasho Sangay R Dorji, we brought five more units in the following months, but like the first batch they were taken almost immediately. We then started compiling list of requests we received. The numbers were overwhelming and we were helpless. So we submitted project proposals to few organisations, who unfortunately rejected it.

The Five Units supported by ShaMa Foundation Pema Seldon and Dasho Sangay R

Just when we thought we reached a dead end, we received a surprise gift of 10 units of bedside toilets from none other than His Majesty the King. I still wonder how His Majesty sensed our desperation though we haven’t indicated it anywhere. The royal support doubled our program capability overnight and we gladly called everyone on our list. Lives of ten families were bettered thus.

But the list only grew. We have 20 units in circulation that has served over 25 families already. And with growing awareness on the service, we are getting calls each day. Our waiting-list has over 30 people in age range of 23 to 103, and some families are checking in every day to ask if the new batch has come.

I have personally requested three businesses to import bedside toilets from Bangkok and make it available in their shops. I gave them the address in Bangkok. Because their are families who can afford and they want to buy, but it’s not available in Bhutan yet. This too is yet to happen.

With our project proposal reject we began writing to cooperate offices and individuals in Thimphu to sponsor but so far only few offices agreed to help. It’s sad that we receive request calls from very offices that have rejected our request to help. It’s a paradox. With growing numbers of calls from children of aged parents I can see that we are all going to need Bedside Toilet someday. It’s time we invest in it now, so that it’s there when we need it ourselves.

We owe it to OGZ for helping us in transporting the toilets from Bangkok from the beginning of the program and Mr. Kinley in Bhutan Embassy in Bangkok for helping us from there.

Now, we charge Nu.300 per month to ensure swift return of the toilets when they are not used anymore. Of course, we don’t charge that fee if the family can’t afford. 

Please call 3012 to donate to this cause, to inquire about this service or the product.  If you want to buy yourself from Bangkok, here is the link and number of Handy Toilet 0990593956

In partnership with ShaMa Foundation we are fundraising on GoFundMe. You can be a part of this by donating at least $5. 

Rice Cooker Disease?

Before electric rice cooker was introduced in our kitchen cooking rice was an art. Not many could boast about knowing the art. Even pro mothers could land up with bad pots once in a while. I remember how my mother would be on her toes once the rinsed rice was poured into the boiling water. She would keep stirring it and from time to time she would spoon out few grains and feel them between her fingers.

Once she got the right feel, which was when the grain was soften all around except a tiny bit in the centre, she would remove the pot from the oven and drain out the thick rice soup that was half the content of the pot. Then the pot was put back on the oven with low heat. I always wondered how my mother knew how much longer to wait after that because I mostly landed up with either uncooked or burnt rice.

That short story on the art of cooking rice can be a history lesson for young Bhutanese born after 90s. Because after electric rice cooker came cooking rice literally became a child's play. All you have to do is rinse the rice, along with some water pour it in the cooker. Put your index finger to see if the water level is at the first line of your finger above the level of the rice. Close the cooker. Pull the light down to 'cook' and go to sleep till mother comes home to prepare the curry. Of course some can't even do that much.

Besides the art and history of cooking rice there also seems to be solid science involved in it, which is gradually surfacing in the form of a disease. The deadly disease is called diabetes. It's sugary but not at all a sweet disease it mess with. We understand that it is to do with excessive sugar in our blood that our pancreas can't handle. But how did this happen?

Bhutan didn't have this disease before, perhaps there were some cases that we were ignorant about but now it has become so common. Well, the answer could be in the rice cooker. A research in Singapore ( Story published in Strait Times) has shown that a plate of rice is as bad as two cans of sweetened soft drink. Ask yourself how many plates you eat in a day.

We Bhutanese always ate rice, so before you ask me why I blamed rice cooker here let me tell you that before rice cooker we boiled rice till it gave away whatever it contained and drained out the soup. Remember the history lesson. So the rice we were eating didn't contain all the sugar it came with but now we are taking in every bit of sugar it contains because there is no draining out of soup.

We started using rice cookers in 90s and in the last two decades we must have forgotten how to cook rice without rice cooker but we have produced enough diabetic parents to relearn the art of cooking rice the old way.

Courtesy: Strait Times, Singapore 

Do You Give a Shit?

Today is my beloved wife's birthday and it gave me double joy to discover that it coincides with World Toilet Day. We have been working on the idea of Bhutan Toilet Organisation ever since I became a member of World Toilet Organisation, but this year we didn't have time enough to do anything grand, though the constant effort to change the relationship between us and our toilets will keep happening.

So on my dear wife's birthday and on the world toilet day I would like to humbly launch Bhutan Toilet as an informal organisation for now. Following are the pictures of toilets people sent us and we would like to seek your support in advocating the WTO's messages through a simple campaign- i.e. Send us your toilet picture.  Or your workplace. 

Chhukha Dzong Gate

Lobesa Restaurant 

Royal Academy Paro

Rinchengang School

Zangdopelri Building Thimphu

Email the pictures to passu@passudiary.com or join us on our Facebook Page to interact with us.

Our Cup of Pesticide?

I love tea, I love it best without milk because milk spoils the true color and aroma of the tea. I prefer slipping it from a transparent cup because seeing the color makes it more tastier. I had all the reason to believe that I was drinking the healthiest drink until I read a Kuensel report on how imported tea could contain pesticides. 

My Cup of Pesticide (?)

Bhutan Agriculture and Food Regulatory Authority (BAFRA) is soon going  to conduct tests on all tea brands coming to Bhutan, which is not very late yet. Despite worrying if we have the technology and capacity to undertake the test I am very hopeful that lives will be saved across generations. Going by the Green Peace India's report as given in that Kuensel article, pesticide residues were found in all 49 brands tested, of which 29 brands contained mix of more than 10 pesticides. Out of the 34 different types of pesticides found in different tea brands, 68 percents are not approved to be used in tea cultivation at all. 
Then are the tea brands coming to Bhutan among those 49 tested? Perhaps all of them are, which means we were consuming pesticides all our lives. If it were vegetables or fruits, which definitely contain high deposits of chemicals from pesticides, we could partly wash them before consuming but how can we wash tea? Therefore we could be sipping huge amount of toxic chemicals from tea than anything else.
That perhaps answers why cancer has become a common disease in Bhutan? It's increasingly becoming common for people who never smoked or drank to die of cancer and we silently take it as a disease of fate. If we do a serious research on the cancer patients, we might reach the conclusion that they were heavy consumers of tea. I have seen so many deaths in my Dzongkhag Haa caused by cancer, while there could be several other chances but more than anything we Haaps are tea addicts. Just in one sitting one Haap would drink more than a regular family could drink in whole day. Tea begins the day and tea ends it. Imagine the amount of pesticide they are consuming. 

I have always been a proud black tea drinker but now I feel like I was drinking the most refined cup of pesticide all this time. While it's early to conclude before BAFRA completes their test, I think there is no surprise left given the results in Green Peace India's compilation. Therefore, it's time to ask, is it safe to drink as much tea as beer? 

Tea Plantation in Assam

Southern Hills of Bhutan are most ideal for tea cultivation considering the popularity of Darjeeling tea but god knows why we never made an attempt to grow our own tea!

Lunch for Dr.Lotay and Team

Dr.Lotay's team began their voluntary surgical camp in Bajothang on 4th Nov 2013. The next day my wife underwent the surgery. During my two days in the hospital I have witnessed the finest human qualities and absolute sacrifice. He ran from one end of the hospital to another with bright smile on his face, between two surgeries he sees 10 to 20 patients, still there are people waiting to take chances on his way to the OT. He shows no sign of disgust, he rather walks them to the bench and ask them to wait there until he finishes his next case. This continues from 8 in the morning to late into the night. In the following day the team spent over 18 hrs straight, completing record 32 cases in a day, and calling it a day only at 5AM in the morning.

Dr.Lotay doing his last surgery in Bajothang on 13th Nov.

 I was so proud to see my school mate and adopted sister Nime Chunda in the team. She always had that caring nature in her and this time she has found the right team to work with. She hides her shy smile behind the mask and deals with hundreds of patients with consistent softness. I offered to bring her meals but she declined saying she eats with the team in the hospital itself and that's when I learned that they were eating at the hospital mess. I know the food there isn't so bad but for the team that's doing so much I felt it would be an honour to offer them good meals.

I made a casual post on Facebook about offering lunch to the team and suddenly I received a message from a Bhutanese living in New York. Ugay Wangmo supports various causes in Bhutan and this time she asked me to offer lunch to the team and has sent me Nu.10,000. I was so motivated that I offered to serve them lunch throughout their stay here. Even my school and my friends promised their help. By 10th Nov morning my wife recovered enough to help me and together we worked on menu for 13 member team and over 6 helpers. We ordered the lunch from the best hotel in the town.

It's interesting to observe that the team has no set lunch break, they run for lunch in twos and threes as they get time and rush back. Dr.Lotay himself had less than 20 mins to finish his lunch before the next case was ready. But I love it so much when he looked at his menu and commented: "Someone must have told you that I love fish." Yes he loves fish. He was so pleased to see my wife standing and working. Later in the evening when we went to serve them tea and momo, he took my wife in front of the crowd of anxious people and said, "See, there is nothing to worry about. She had her surgery and now she can even work, she is our cook." She was made to show her healing wounds.

Patients consult Dr.Lotay during the Lunch Break

That night they went on till 5AM in the morning to complete 32 cases. After few hours of rest on 11th Nov they conducted 80 endoscopy and still managed to work on seven surgeries which took them till 2:30 AM, this morning. During the lunch I expected to see everybody exhausted but not surprisingly they were full of energy. They were relaxed and had little more time to spare. They say that jokes keep them awake and give them energy but at the end it's the passion that drives them to extremes.

I got a call from a young entrepreneur, Chencho Dorji who wants to help me in offering lunch to the team and he contributed the additional amount of Nu.2000 for yesterday's lunch. For tomorrow a close friend of mine, and an inspiring young leader has offered his hand. He said said, his is not rich but he can do so much for Dr.Lotay. He will send me Nu.5000. He chose to be unnamed. At the end I may have to contribute only a small amount but experience of doing it is an honour for my family and all thanks to three of you.

The following is a poem that has inspired Dr.Lotay and I hope it does the same to all of us. Thanks Tshewang Rabgay for sharing it.

Do it Anyway

People are often unreasonable, irrational, and self-centered. 
Forgive them anyway.

If you are kind, people may accuse you of selfish, ulterior motives. 
Be kind anyway.

If you are successful, you will win some unfaithful friends and some genuine enemies. 
Succeed anyway.

If you are honest and sincere people may deceive you. 
Be honest and sincere anyway.

What you spend years creating, others could destroy overnight. 
Create anyway.

If you find serenity and happiness, some may be jealous. 
Be happy anyway.

The good you do today, will often be forgotten. 
Do good anyway.

Give the best you have, and it will never be enough. 
Give your best anyway.

In the final analysis, it is between you and God. 
It was never between you and them anyway.

~Mother Teresa

Dr. Lotay- The Healing Buddha

Dr.Lotay is known for his extraordinary medical wisdom and pair of divine hands but what makes him the greatest is what he does with them. We have seen him reach out to people through BBS when he was still working for Health Ministry and now that he is free from regular service he is using his freedom to heal people right at their doorsteps.

Dr.Lotay in Thimphu Gyedagom, Photo by Nima Tshering (Seen with Him)
Click on the Pic to read What Nima Tshering wrote in his Facebook journal.

I have heard about him doing voluntary gallstone removal surgery on over 140 people, all at free of cost, in Thimphu Gyedagom in the past month. And now he is in Bajothang working over 12 hours everyday. He runs between operation theatre and chamber no.8 every twenty minutes, and even at 9PM at night walks and talks like it's in the first hour of the day. While his team readies the next patient for surgery he attends to queue of people in chamber no.8. During the whole two days I was attending to my wife in hospital I couldn't help watching this great human being with wonder.

My wife needed this surgery ever since the conception of my daughter but since hers wasn't giving problem we ignored it until we knew that it could cause cancer in long run. We went to Thimphu Hospital some months ago only to get appointment in March 2014. This time the blessing has come to our door, Dr.Lotay's arrival in Bajothang is a blessing to my family and hundred others like us.

Healing Buddha

It was only 11 AM on 5th November when my wife was taken into OT, she was his fourth case for the day already. As he began the surgery it appeared on the screen in the waiting room, I could literally see the inside of my wife. At first I was anxiously shivering but soon I told myself "Come on, it's Dr.Lotay" and all the fear is gone. The procedure is very complicated, having to separate gallbladder from the liver with no room for error but when he does it everything seems easy. In 15 mins a brother came out with the stones and handed over to me. There was more than a palmful of stones in my wife's gallbladder, some as big as marble. The gallbladder was fully swollen and if we hadn't removed then serious problem was waiting.

It was 8PM when Dr. Lotay finished his 13th case for the day. It was on my principal. Before leaving he came around and soothed many patients. He didn't even looked tired. That day hospital was running out of bed and they had to keep at 13. But I heard they have done 15 to 16 every day since. Sometimes it was at 11PM the team leave for night.

Everyday people are pouring in, and some are coming from as far as Bumthang, even some people from Thimphu have followed him here. People come with all sorts of disease. Dr. Lotay has promised that no one will go back unhealed and thus extended his stay in Bajothang. I heard he is going down to Phuntsholing after here.
O' forgot to mention, you don't have to have any connection whatsoever to receive warm smile and best treatment from him. May god take care this compassionate soul.

Update 12 Nov. 2013: The number of patients coming increased by the day and Team Lotay had to extend a day more in Bajothang. In the last few days I have witnessed even greater power in the compassionate doctor and his team. His skills and spirit of volunteerism on one side and his energy on other side makes the man out of the world. His team began the first case of 10th Nov at 10AM and continued across the night till 5AM of Nov 11th to finish 32 surgeries. After few hours of rest they completed 80 endoscopy and seven surgeries that took them till 2:30 AM this morning. They are back in action again at 9AM today. Impossible is nothing for a willing heart!

Three Medical Discoveries

Some of the greatest scientific discoveries were accidental, coincidence or unexpected therefore trust me on the following three personal discoveries I have made over the years. But don't ask me about the scientific logics behind my theories because I was never in good terms with science subjects since high school.

1. Kezang used to have a strange skin disease. The moment she exposes her skin in sun it begins to itch and she would scratch until her arms and neck swell and turn red. She would then have fever and sleeplessly painful night. This disease kept her indoor most of the time and when we had to go out she had to wear full sleeve shirts.

Safi

We showed it to the best of dermatologist in the country, and one of them even gave her a ointment he personally ordered from abroad. But it didn't help. Finally it was concluded that she was allergic to sun, and only remedy was to avoid it. Can you imagine a life like that?
One day she had some tummy problem and a friend recommended SAFI. It's herbal syrup meant to purify blood. God knows how this would help tummy problem, however she tried it obediently for a week. I don't know if it oked her tummy but the next time she went out in sun she was surprised that her skin didn't itch. We tried staying in the sun for a longer time and still she was fine. We brainstormed for hours to find what helped her and it was finally the herbal syrup. We tested it again to confirm and now it's almost two years and she is fine. But she always keeps a bottle of safi handy.

2. It's rather a funny discovery, and I hope the company doesn't sue me. Dabur Red tooth paste is also herbal and gives out very good aroma of familiar herbs. The red color and the roughness in the paste really make us feel that it can whiten our teeth, often it appears to do its job well. It became popular when I was in college and I believed in it strongly.

Dabur Red

One day my sinus got infected and it became really bad. It was always bad in the morning. My nose was always on the run and it didn't need reasons to block the air passage. Soon smelly discharge started coming out and I thought my head was rotting inside. I took tonnes of medications. It took me over five years to finally get rid of the disease with a set of medicine from Taiwan.
In last few years with my good nose I had discovered that when I brush with Dabur red toothpaste my nose suddenly becomes itchy, it runs and sneezes and I could feel the sensation I had when I first fell ill. I tried it again and confirmed that this toothpaste has something in it that is not good for nose.
Later I talked with many people who had bad nose and many of them were Dabur Red fans, I suggested them to change the toothpaste and I received good feedback. But if you have strong nose please keep using the toothpaste because I don't want to be sued by the company.

3. Silagee is a local mineral extracted from some sort of soil/rock found in Dawakha in Paro Dzongkhag. People drink solution of Silagee for various disease but what amazed me was how it cured ulcer in my brother in-law's mouth and throat. By now you must be wondering how many sick people I have in my family but that's the reason why you should believe me, because only the sick knows what helps best. lol.
My brother in-law's mouth ulcer is really ugly, it begins in his throat and covers his tongue and even the lips. When he falls sick he can't even talk well let alone eating. Hospitals helped him recover but it kept relapsing until one of my aunties gave me a bottle of silagee. He tried it and believe me it worked magic. He was fine until last time when he ran out of stock. He called me up to find where he could get this medicine from.
I called my aunty and found out that a lady called Aum Gyem sells it from her home somewhere behind Changlam Square in Thimphu and I was given her phone number (it's 17636459, in case you need). I went there and called her and she made the delivery. The small bottle shown in the picture costs Nu.700, but it's worth the cost I tell you.

Silagee

***Disclaimer: The above three discoveries are not to be treated as absolute facts because firstly it was based on an ordinary man's knowledge, who failed in science in school, and secondly human bodies are different in many ways and what worked on us may not necessarily work on you. But because the products are herbal there is no harm in trying if you have similar diseases.

Little Boy-The Victim of Fails

Kezang went to hospital this morning and was calling me and telling in deep anxious voice that my friend's child was hospitalized. I had heard the news of a young boy being attacked by pack of stray dogs in Khotokha about a week ago. The boy had gone beyond the fence to play when the pack of dogs attacked him. He was rescued by a monk who was passing by. And that boy happens to be my friend Damchoe's three year old son, who is now nursed back to health at Bajothang Hospital. It took 84 stitches on his head, back and arms to close his wounds. The boy is doing well now.

The repaired scalp 

The Dog Issue:

However, it's time we pay serious attention to stray dogs. Some half hearted dog rehabilitation attempts have separated dogs from human population and now many dog-compounds are shut down. Homeless and hungry the abandoned dogs are now roaming forest and villages attacking cattles. And this year alone we have reports of two incidences where humans were attacked- one was in Haa last months and the other my friend's boy. What measures can be taken to reduce the risk of dogs attacking humans? Who should be taking care of this issue? How long should we wait until we start taking action?

Drug Shortage Issue:

Another problem that surfaced today was the shortage of Anti Rabies Vaccine (ARV), which is a must take vaccine for dog bitten victims. Even a smallest wound from dog bite requires this injection and in this case the little boy was bitten by around seven dogs and literally peeled off from head to back. Unfortunately ARV ran out of stock. Tencholing didn't have it, Thimphu only has enough for their patients and was waiting for the new stock to arrive in two weeks. My friends was asked to find it on his own. Medical Shops are handicapped by new policy. 

It was boy's luck that Punakha Hospital had some doses left. He was taken to Punakha for the first dose but there is no guarantee if there will be any left when he goes for the second dose, which is on 17th May. I took the issue to Twitter and I was inspired by the support and concern shown by fellow Bhutanese. Some even offered to send from Delhi and another from Gelephug. Thank you to all the people who answered to my tweets this morning.

In such time we must awake to the reality that something in the system is not going good. Such emergency medications should be readily available in every corner of the country. I am hopeful this concern will be considered seriously by whoever is responsible. And if it's very difficult to pave through tedious Bhutanese procedures then why not allow private pharmacies to sell them?

Congress Grass and Bad Nose

Sinusitis is a very common disease among Bhutanese and most common among people living in Wangdue. This is based on no formal research but every other person around me has the infection, including myself. The local medical pharmacy tells me that thousands have come to him with the problem because he is known for his ability to treat this disease with his own combination of medicine. People trust him more than they trust hospitals.
Depending on the severity of the infection people go to extremes to free themselves from the suffocation disease, and like a myth this disease has strange treatments; Smelling the stinking waters in Gasa Hotspring, smoking cigarette filled with fragments of samba deer's horn, inhaling smoking from burning human body at the cremation ground, and of course the regular medical treatments at hospitals and indigenous hospitals.
People have come up with various causes of the disease in the region, (of course we can't expect our hospitals to do this out of their box), some say it's because of our water source that carries dirt from several villages from Samtengang to Boelangda, while others say it's the strong wind that carries all sorts of dust in the air we breath in daily. However, the water and wind story prevails across the country and attributing Wangdue's mass infection to it comes with little logic, that's when I heard and discovered the story of a toxic grass.
Santa Maria Feverfew or Whitetop Weed is originally from American tropics. It became widespread in Asia through contaminated wheat that the Congress Party of India imported from the US, which is why now the plant is known as Congress grass. It doesn't take much intelligence to find out how the grass made it to Wangdue. The grass is invasive and can spread at epidemic proportions triggering pollen allergy in human and even livestock. Due to toxic parthenin it contains it causes dermatitis and respiratory malfunction in humans, which explains why so many of us are struggling with out nose every day. 

The Political Grass- Imported from India

Endoscopy of Health Ministry

My brother had a painlessly bad stomach for years, which won't keep anything beyond an hour. He was gradually losing weight and getting tired of running to toilet after every meal, and we were deprived of our regular toilet visits, since we only have one toilet. His so many hospital visits neither satisfied his disease nor him, not even me. I knew something was seriously wrong.
During his long toilet occupation he would finish a whole newspaper, and by the beginning of 2011 he was reading Business Bhutan passionately because it had 24 pages to last longer than his toilet ordeal. Those days Health Ministry Corruption was just a news for him in the toilet. The following series of stories on the ill health of health ministry by Tenzing Lamzang went on shocking us. But at the end of the day it was just a news and often I saw the newspaper lying wet on the toilet window.
Last month I took my brother to Thimphu with a referral from Wangdue hospital for endoscopy, to have a photographic view of his funny stomach and to clear all our doubts. It was a smooth sail until he was sent for endoscopy appointment, though we waited for hours, But he was given his appointment two months later. I didn't believe, I triple-checked the date. Later I learnt that this has been the process for quite sometime, and everybody has learned to follow it.
My brother wanted to return home right away but I didn't want him to live any longer with the disease we didn't understand yet, and land up hearing 'it's too late now' later. Then a friend on Twitter rescued us by mentioning about the private clinic that has the endoscopy machine, she also share about the price of the service. It was expensive but life is priceless. He went there the next day and got it done. It was discovered that his stomach was invaded by bacterial colonies, which has matured enough and if it was left untreated for some time more it could have caused Cancer! Damn I knew that. I always feared that but didn't want him to worry. However we made it there on time and he has stared his new course of medication, which is showing good results now.
After all this was over I was there at the hospital attending to my mother in-law and I chanced to know why endoscopy service is taking so long. There used to be three machines and two broke down, which is obvious after having read the procurement scams. And when job of three machines are left for a single machine we can't expect things to happen as quickly.
So the whole news on health ministry corruption my brother read on his toilet pot finally boiled down on a common man like him. But we were smart and we made it through on time. He paid the price, in cash and not with his life. What about the so many people who are lined up for as long as three month to have endoscopy done? What about so many who waited and found that they were a little late? Were they late? How many may pay with their lives for the greed of some highly educated frauds? When will the two other machine be fixed? Common men are paying price every day.
Thanks to Tenzing Lamzang and ACC for doing the endoscopy of the Health Ministry and removing the cancerous cells dancing on money its stomach. Hope things will be better with time.

Simple Rules Bhutanese Break Every Day

More than often we see people smoking in a room where there is 'No Smoking' written in bold, a car parked right on the 'No Parking' space, people talking aloud in the area where it's clearly written 'Silence Please', pile of rubbish around the sign that reads 'Do Not Litter' and worst of all there is no 'Do Not Spit' place without thick bloody read doma spit. Can't we read these simple words? Forgive the people who can can't read, but what about the literate folks who are often the ones breaking these simple rules.

Bulls don't get it! We do.

During my week long stay in JDWNRH I have been an observer to many conflict between sick attendants and G4S guards, sick attendants and nurses, and visitors and G4S. In all these fights I saw how our people find themselves at right after breaking numerous hospital norms. First they come when it's not visiting hour, and when G4S guards stop them they pick up fights. Inside 'one patient one attendant' rule is broken, and when nurses remind them they find the nurse bitchy. When the patient is in agony people crowd over it and won't let nurses do their job, nurse grow furious and shout at them to leave some space for air, and then these people counter. After visiting hour is over, no visitor leaves, not until the G4S boys come around thrice to chase them off. It's not a happy ending either. There is a big dinning room in the hospital and people eat and throw their waste in the space where clothes are meant to be dried.Wash basins are filled with food waste, when there is a separate dustbin to dispose leftover food.
I didn't see a space for problem if at all we could follow the simple rules written all over in Dzongkha and English both. Have I been perfect? No, I arrived late but I greeted the guards with apology and if they asked me to wait I would wait. My visitors left late too and they were shouted at by G4S but I have gone close to them and explained and apologized. But I have spent the rest of time entertaining the sick, clean the toilet, and at one time I have self appointed myself to investigate on a person who was smoking in the ward toilet. I failed to find him but nurses have flashed the message that if he is caught both the smoker and his patient will be kicked out of the hospital.
These people working at hospital at strange hours taking care of our people have their own family sleeping without them at home, and they get their hands in our shit and blood, which our own people won't do. Some of our folks won't even visit us at the hospital because they believe in 'Dhrip'(bad energy that comes with birthing and dying), and I say nurse and doctors would have died of that then. Hospitals are our gateway to the world and exit from the world and these people are the ones who help us at these critical hours.
I wish to send my deepest gratitude to the people working in Thimphu hospital and hospitals across the country for doing the dirty job for us and still tolerating our unending demands. I also pay respect to their frustrations,(after all there is a human inside those angels as well) which many great nurses have brought under their control. I also hope that those unreasonable, biased and arrogant people also change themselves so that one day everybody looks at hospital as a place of worship.

Mothers Suffering Silently

Today my mother in-law is undergoing a surgery to remove her uterus, and our joy is beyond our anxiety because we are finally removing a part of her body that has bothered her for years and couldn't share with anyone. The womb that has brought my wife and her two siblings to this world has threatened to take her own live had we not known it before it became too late.
Her uterus had prolapsed and had been hanging out through her vagina for years but because of the nature of the disease she has hidden from everyone, even from her daughter. It was during the melom chembo in Haa that her son's sister inlaw sighted it when they toileting outside. She inform my brother inlaw, who in turn took her to the doctor.
This is a common risk among elderly women who give birth at home without the assistant of medical staff, meaning many of our village mothers could be suffering silently. The woman on the next bed is awaiting the same surgery, and shockingly she has hidden the disease for 25 years.
These two ladies are lucky that theirs didn't turn into cancer, which has high probability. But not many will be lucky like them, there for I urge all daughters and educated women to check on your mothers and other elderly women in your family for any secret disease such as this if they are hiding. Your one action in time could save their lives and free them from their worse discomfort. I visited my sister last evening and asked her to check our mother though I have asked her myself without hesitation. She says she doesn't have it but I still want my sister to verify. Please verify your mothers.

To all the friends on Twitter who sent in your wishes, thank you very much, your prayers are very important for us at this hour.


Update 8th Spet 2012: 
There are various causes to this sort of disease and not just unassisted birthing. One woman who underwent the same surgery the next day had left copper T inside for 12 years. It nearly took her life. But all stories in JDWNRH this time had happy ending but not many will be so lucky if they are late in seeking medical help. Therefore please take this issue seriously and do whatever is possible within your capacity to help free women around you from such disease.
My mother in-law is doing great at home now, she is recovering very fast. Thanks for all the support and prayers during our hard times. We will "Never forget the people who help you in your difficult times"

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Location:JDWNRH Thimphu

Florence Nightingale in Punakha Hospital: Golden Gift from Burma

That wasn't my first encounter with rude nurses, I have seen enough of them before. But after coming to Bajothang everything changed. I shared intimate relationship with people in our hospital. They have their children studying in my school and some of them studied here themselves, that made all the difference and I was soon pampered. It made me think that all the rude nurses have either changed or have disappeared.
But last four days gave me the chance to wake up from my fairy tale and see the unchanged reality and untamed nurses. My mother in-law had her womb prolapsed  and was due to undergo a surgery to remove it. But an ulcer somewhere on her cervix needs to be healed first. She needs dressing and packing on daily basis and I could think of no place better than Bajo.
I was waiting outside the hospital and my wife was taking forever. When she finally came out she was almost crying. She said the surgeon would pay any attention, though she presented all the document from Thimphu. The Dressing room nurses send her to ward, and ward nurses send her back. She had to walk the length of hospital several times with her sick mother. She could finally get it done at the ward, though they kept mentioning that it wasn't their job. We thought things are settled but the same ordeal continued the next day and the next. I then understood how ordinary patients are struggling everyday. I noticed that there were many new faces and sadly wondered why do we have to know each other to receive good treatment when their only job is the nurse the sick. On the fourth day the nurse who knew how to do packing wouldn't look at us. She was free but angry with us. She directed two first-timers to deal with it and despite their best effort they landed up bleeding my mother in-law.
That's what took us to Punakha Hospital. The gynecologist there wasn't a Bhutanese either but the moment we saw her it felt like we were breathing fresh air after a long time. She is a Burmese and speaks soft English. It was afternoon when we met her but she was full of energy and smile, something very new to us. That morning she had conducted two Cesareans and if there is anyone who has to be tired and frustrated it's her but she was ready for more. That makes Punakha Hospital the safest place for giving birth.
She took in my mother in-law and educated my wife on all aspects of the problem, which was when my wife got to understand the disease for the first time. The Burmese then instructed my wife to come with plastic bangle - the one we used to on our wrist in high school- so that she could device a way to hold up the womb in its place, by which not only infection could be prevented but also quicken the natural healing of the ulcer. Seeing my wife confused, the lady came out of her chamber and check every visitors' hand, laughing and apologizing, to find a sample and she succeeded. She took my mother in-law in and used the ring.

Florence Nightingale

In Bhutan we are never used to so much attention and care, unless we are related or connected or special. And the Burmese changed my mindset all together; we don't have to be special to be cared for. She knows we come there to seek her help and she helps with whole her heart. I always thought Florence Nightingale was fairy tale character but she made me believe that it's possible to have such people. She herself is a living Florence Nightingale, a golden gift from Burma.
She is the second woman I know from Burma, first one being Aung San Suu Kyi, whom I honour so much for doing their job so well. Thank you so much for coming to Bhutan.

Aung San Suu Kyi, only lady I knew from Burma until I met Ms. Swe Swe

Update 8th August 2012: The kind lady from Burma is Ms. Swe Swe. Her contract with Bhutan will end this year. I only wish if our health ministry could request her to stay for some more year. She is an extraordinarily dedicated expert who has attained greatness beyond rudeness and frustration at work. Please Stay.

My Business Idea

Bhutan Innovation and Technology Center organized The Business Idea Competition of Bhutan 2012 from April to June 2012 and I walked out of my comfort zone to take part along side some 50 of them. Well it was one totally different and comfortable experience dealing with cooperate people. And on top of the experience my idea of Indoor Menchu Service made it to the top ten Business Idea "for its Excellence".

Thank you Thimphu Tech Park and Bhutan Innovation & Technology Centre for the recognition. I will come with crazier idea next year.

 

Friendly Road For Walking

Of all the changes that happened in recent times I loved the idea of walking to office on Tuesdays. And I loved the way many people received it. We were walkers until recent times, our ancestors walked all their lives, and our living parents walked the best part of their lives. We have walking DNA in us, which should still be very much there. It's only Tuesday we are going to acknowledge our DNA, and I hope we don't cheat ourselves by taking cabs and buses. If two cars meet on the road its called accident but when two persons meet on the road the story is different. Walking together will provide long opportunity to interact and form relationships and some day we will look at Tuesdays as vacations.

Chimi R Namgyal on BO

I walked the best days of my life, and it was a day in 2009 that I finally bought a car and became lazy. Cars are like pampered kids, they suck through our pockets day in day out and we still love them. And I love my car best because I have some really bad experience with walking. I wanted my revenge on the once-upon-a-time of my life. Those first two years in Bajothang gave me a few occasions to visit Wangdue Dzong, that was when I asked if we really had 72% of forest cover because that wasn't one tree on the entire road from Bajo to Wangdue Dzong. After having baked and roasted three times on that road I put together all my guts and bought a car.

Typical Treeless road in Bhutan

We have hell lot of trees but they are all in the jungle where monkeys live, if we are to encourage walking we have to have tree by the roadside and make walking a pleasure. I love the road from Paro Town to Nemizampa, we could replicate that very easily. I prefer walking over driving if only roads are friendlier.

Mission Possible

I hope to see the Pedestrians’ Day become very popular throughout the country, and I hope to see green roads where everybody loves to walk. Because in Walking we can regain our lost tradition of social interaction and relationships. 

Tattoo: The Permanent Character Certificate of Temporary Mischief

Written for Student Digest April-July 2012 Issue.

Tattoo is a design on the skin, achieved by changing pigments of skin. The process is done by repeatedly pricking ink into the skin using sharp needle.  And because it is done inside the dermis layer of the skin it can’t be erased unless done surgically. The technology of removing tattoo hasn’t yet been introduced in Bhutan and therefore to have a tattoo removed could cost fortunes.

Why am I talking about removing tattoo, when everybody does it for keeping? Well I have learnt from experience that at one point in life you would die to get them removed. You would look at it each day and wish if you had never done it. I know you won’t believe me today, because I didn’t believe them then.

I was just like anyone of you, if not naughtier. I was full of energy, energy waiting to explode and there were always choices ahead of me. I made many wrong ones amidst my youthful excitements. And you could land up doing your share of wrongs too, which as you grow up and as you realize, time will forget and forgive. But there are certain wrongs that would last beyond our realization, beyond our righteousness and beyond our repentance.

One such wrong is getting into drugs. It’s addictive and destructive. It gives you an illusion of happiness and stops you from growing. It clouds your judgment and forces you to multiply your wrongs beyond your intentions. Every morning you wake to find that one more person has left your life, and yet you keep moving away from your family and friends. If you are lucky to receive a timely help you may be able to jailbreak but I have seen how the ghost of the past visits your happy home in future. Just when you finally overcome the addiction and decide to settle down, have family and play with your kids then you realize you aren’t left with much life. You had already damaged so many vital organs in your body to live a normal life. Then you feel the unforgiving grip of your youthful wrong holding you back.

While drugs problem is talked about enough there is a subject equally important that didn’t receive much attention. The aggressive love for tattoo is another youthful folly, which literally last forever. At one time you don’t find anything wrong with tattoo because you see so many celebrities showing off their designs, you see all your friends having them and because you probably think you will never grow up. But you have to grow up and you have to know that those celebrities have millions of dollars and that your friends are wrong too.

Technologies with which celebrities create their tattoos are medically safe and the tattoo makers are professionals, they know what they are doing. Do we have professionals? What type of tools are we using? Last year a student of mine tried a tattoo on his neck and landed up infecting some nerves inside. He couldn’t move his neck and had hard time talking; it took over a month of treatment to regain his speech. He was lucky that it was just a normal infection and not tetanus. There are other infections associated with careless pricking that could ruin your life.

Surviving the infection is just the first stage; living with tattoo is another challenge. My tattoos didn’t give me infection because I sterilized the needles I used but tattoo itself is an infection, more so when you are someone responsible in society. People associate tattoo with drug addicts and gang members but I am a teacher and I don’t like to be assumed that way. How could I change that way people think?

When you are young you don’t care a thing about the world. Tattooing your body is just another mischief you try among hundred others. To gain little extra attention you tattoo strange designs and shamelessly find it cool. I have seen arms and legs filled with vulgar words, phrases and signs displayed openly in public. But someday you are bound to change, and you can’t read your future. Look at me; I never thought I would hold this respectable position in the society. All my youthful follies are forgotten with time except these tattoos on my arms but I am very grateful to myself for not having filthy and disrespectful symbols and words.

Your future is waiting for you with greater opportunities and you could be someone everybody looks up to. And from where you are then you can’t afford to show your tattoo and escape wrong assumptions. Future can’t lie in the tattooed arms. Even if you choose to lead a quiet life you have to become a parent someday and when your little child points at the sign of middle finger on your arms and ask you questions, how would you explain the vulgarity of your designs? Therefore, if you don’t yet have a tattoo, don’t bother about having one. You don’t have to keep a permanent record of your temporary mischief. 

Why should women have all the breast?

This week the focus is all on the breast and therefore men are out of focus. All these months I have had good nights because both the workable breasts are on my wife's chest. I feel sorry for all the babies whose mothers are working but my daughter enjoyed all the luck. Though a housewife, my wife had her own share of tiring days and sleepless nights, and I hope all her sacrifices will reflect in our little girl. I shall always remain so thankful to my wife for giving up almost everything for our baby.
My baby became a year and eight months on 29th July, and she is still enjoying full-time breastfeeding. But there are many babies born around here who had to be trained to survive without breast milk before their third month in the world because their mothers wouldn't have time to feed them once the maternity leave finishes.
There are lots of awareness campaigns on "6 months compulsory breastfeeding" and working women are given  only four months leave. The irony began right at the gates of heaven- why should God plant both breast on the mother?
When I see the lives of my lady colleagues, who have to sooth their babies on one end and please their boss on other end, I can't help wondering how different the world and the system be if one of the two breasts were on father's chest. I just wish if men could put a breast on their chest or just imagine it at least when they decide how long should the Maternity Leave for Mothers be!

Wisdom Teeth- the pain without gain

Why is this painfully useless tooth called wisdom tooth? Is it because it grows when we become adult? or is it the sign that we have become wise? Then how painful it is to become wise! The pain is unbearable, and I have been drinking for the last three days to escape it, and starting this morning I am forced to fast. The swelling in my gums won't let me chew anything at all. Everybody says I should remove it surgically- I have just become wise and removing it would mean I am denying the change.
I have to do a little research before I let it go, for what is pain without gain?

Rabies Story- Don't Trust Doctors

If you are bitten by a dog, you should rush to hospital. But don't think TT injection will take care of everything. You must ask for ARV- Anti Rabies Vaccine. That's when your doctor will ask you to observe the dog for next ten days, because they don't want to waste the expensive vaccine if the dog is not infected.
 However, it's your life at stake. You must insist on having yourselves vaccinated, because recent cases in Phuntsholing and Gelephug proved medical theory of wait-for-ten-days wrong. The boy in Phuntsholing dies a week after he was bitten -are you going to wait for ten days now?, and the lady in Gelephug observed the dog for ten days, nothing happened. Three months later she died. Can you trust the theory anymore?
I had my experience a few weeks ago. I came home relaxed having received TT injection and blogged about it. Thanks to my blog, some comments there worried my wife and she insisted me to go back and start ARV, which saved my life, perhaps.
P:S: It's not just dogs, any animal bite must be treated the same. Man in Trongsa died of Rabies because he was bitten by his horse.