I will be working as a volunteer Psychiatrist with Health Volunteers International from September 1st through December 1st, 2019. My responsibilities will be both clinical and educational, working with physician extenders and community practitioners to enhance care. There are only two resident Psychiatrists in all of Bhutan and the needs are great for both basic mental health care and substance abuse treatment. As Bhutan is a predominantly Buddhist country and I am a Buddhist practitioner, I believe I am particularly well suited to incorporate the principals of Western Psychiatry with traditional, Tibetan, medicine.
In addition, my wife, a clinical social worker, will be volunteering in the development of a palliative care program for terminally ill cancer patients.
Population served with be both the urban occupants of the capital city of Thimpu and rural residents who come to the capital, often after several days journey, for consultation and treatment. I hope as well to travel to more remote areas for consultation with primary medical providers.
Expected immediate impact is the successful treatment of patients who have not previously had access to care. Intermediate impact will be enhancement and addition of skills to mid-level and community providers. Long term impact will be that of those skills added and enhances.
Of particular interests to me are training others to recognize and guard against adverse medication effects in patients who may only see a psychiatric provider yearly, if at all after their first consultation, and integrating the bio/psycho/social model into the traditional Tibetan model of psychology. The overlap of the traditional model with Cognitive Behavioral Therapy is great and I am hopeful of helping others appreciate this as well.
My wife, Margaret, and I worked for three months at the Jigme Dorji Wangchuk National Referral Hospital in Bhutan. Margaret introduced the role of a Social Worker to Palliative Care, Pediatric and Physiotherapy departments. I worked in the Department of Psychiatry, supervising and instructing Residents and Interns in the fledgling Psychiatry Residency and lecturing students in the undergraduate counseling program at the School of Nursing and Public Health. There are only two practicing psychiatrists in Bhutan and my services were much appreciated. Additionally, I presented at the Bhutan 5th International Medical Conference, the theme being Mental Health.
It was a wonderful experience with a warm and welcoming people, dedicated staff and bright, engaging students. Bhutan's health system is resource poor. Standards of care are limited by inadequate resources and not really comparable to the US, but care is uniformly available to all and improving all the time. Health Volunteers Overseas has had a presence for over 30 years in Bhutan as the primary medical volunteer organization. HVO volunteers have been essential and instrumental in getting numerous residency programs off the ground, including Psychiatry. HVO has a special place in the hearts of the Bhutanese.
