Healthcare lessons from 20,000 feet: Bhutan’s eye care pioneer

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In Bhutan, there are only eight ophthalmologists.  With a population of roughly 750,000, that’s about 90,000 patients for each eye doctor.

At Thimphu’s primary hospital, Jigme Dorji Wangchuk Hospital, cataract and retinal patients crowd the opthalmology unit.  They’re waiting to see Dr. Kunzang Getshen, fondly known as the “father of eye care” in the country by his colleagues.

Dr. Getshen is keenly aware of the limited scope of eye care in Bhutan.  But the answer, he says, lies not in just greater funding. Throwing money at the problem doesn’t solve it, he says.

Dr. Getshen is a part of the fashionably-termed group of “social entrepreneurs” – though he’s been improving eye care in the small Himalayan kingdom for the past 30 years, long before the term was coined.  He’s an unusual example of a government-employed civil servant (medicine is socialized in Bhutan) who is keen to work with the right partners, not just dole in cash from any donor.

This is refreshing.  The rage around social entrepreneurship has been growing exponentially.  Up-and-coming entrepreneurs are readily receiving high-profile recognition for their “good works” from corporations (in the form of handsome grants) and from the media (in glossy features).  The focus of these “do-gooders” may have drifted, though.  The unglamorous process of toiling for years before finding solutions has been cut short by social enterprise bootcamps, single-term courses, and hackathons.

But in Bhutan, there is no shortcut.  From the capital city of Thimphu to neighboring Punakha in the east, it’s a 70 km drive that takes three to four hours each way, depending on road closures and construction.  Simply reaching the patients, Dr. Kunzang says, is a challenge in such a mountainous country where peaks reach 20,000 feet, and communities are nestled in them.  It’s an age-old dilemma of reaching the so-called “last mile.”

Rather than just training more doctors, Dr. Getshen is relying on a network of technicians in remote locations to do the “grunt” work: consult patients, perform basic diagnoses, treat simple cases, and catalog data for monthly eye-camps.  About 53 such technicians have been dispersed nationwide.  They operate out of small hospitals and clinics with barely 20 beds.  Once a month, ophthalmologists such as Dr. Getshen make the trek to do eye camps, performing up to 30 surgeries a day easily.  With all the prep work completed, Dr. Getshen can perform on more patients in a single day.  And the costs are kept low: for instance, a cataract surgery is roughly 500 Rupees, 300 of which is spent on lenses  (that’s under $10 for surgery, and $6 for lenses).

Read the full article at Forbes.com

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