Water-based therapies of Bhutan: current practices and the recorded clinical evidence of Balneotherapy

Medical water therapy (also called medical hydrology) is practiced worldwide both for relaxation and treatment of diseases. While this practice is still thriving in Bhutan, there is a lack of proper documentation and critical study. Therefore, the current study reports on the water therapies practiced in Bhutan and their health benefits. We used four-stage process: (1) a review of literature on balneotherapy (both traditional textbooks and scientific papers); (2) listing and surveying the hot springs, mineral, and holy spring waters; (3) reviewing the health records of the patients maintained at the traditional hospitals and interviewing traditional physicians and patients about health benefits; and (4) reviewing available literature to identify existing clinical trials data to provide evidence for hydrotherapies. We found three main forms of hydrotherapies are practiced in Bhutan, which comprises herbal bath therapy, balneotherapy, and spiritually empowered waters.The most popular hydrotherapies are herbal bath and hot spring therapies. Herbal bath therapy needs traditional physicians' prescriptions, while hot springs do not require it. Through field surveys, ten different hot springs (tsha-chu) and 17 medicinal water or mineral springs (sman-chu), and 17 holy spring-waters (sgrub-chu) were identified. In general, medical water therapies are used by the Bhutanese people to treat various ailments, including gastritis, neurological disorders, arthritis, dermatological diseases, and rheumatological and musculoskeletal disorders. Even though a lack of scientific evidence makes it difficult to draw concrete conclusions on their traditionally claimed efficacy and safety, there are clinical evidences documented from other countries

Community-based study on knowledge, attitudes and perception of rabies in Gelephu, south-central Bhutan.

postprintCommunity knowledge, attitudes and practices are important both for prevention of human deaths due to rabies and for control of the disease in animals. This study was a cross-sectional survey investigating the level of community knowledge as well as attitudes and perceptions about rabies in Gelephu, south central Bhutan, a region endemic for rabies. A total of 615 household respondents were interviewed, of which 224 (36%) were males and 391 (64%) were females. The majority of the respondents had high level of knowledge, and attitude and perception of rabies, and has a positive attitude towards the prevention and control of rabies. Multivariable logistic regression model showed that better knowledge about rabies was predicted by gender, educational level and dog ownership status of the respondents, whilst health-seeking behaviours of animal bite injuries were predicted by dog ownership status, presence of children in the household and occupation of the respondents. The majority of the respondents believed that stray dogs are a problem in the community and felt that it was important to control the dog population in Gelephu. These findings also indicate that there exists a knowledge gap about rabies in the community that could be improved by creating an awareness education programme. Keywords: Knowledge, Attitude, Perception, Rabies, Cross-sectional survey, Bhuta

Community-based study on knowledge, attitudes and perception of rabies in Gelephu, south-central Bhutan.

Community knowledge, attitudes and practices are important both for prevention of human deaths due to rabies and for control of the disease in animals. This study was a cross-sectional survey investigating the level of community knowledge as well as attitudes and perceptions about rabies in Gelephu, south central Bhutan, a region endemic for rabies. A total of 615 household respondents were interviewed, of which 224 (36%) were males and 391 (64%) were females. The majority of the respondents had high level of knowledge, and attitude and perception of rabies, and has a positive attitude towards the prevention and control of rabies. Multivariable logistic regression model showed that better knowledge about rabies was predicted by gender, educational level and dog ownership status of the respondents, whilst health-seeking behaviours of animal bite injuries were predicted by dog ownership status, presence of children in the household and occupation of the respondents. The majority of the respondents believed that stray dogs are a problem in the community and felt that it was important to control the dog population in Gelephu. These findings also indicate that there exists a knowledge gap about rabies in the community that could be improved by creating an awareness education programme. Keywords: Knowledge, Attitude, Perception, Rabies, Cross-sectional survey, Bhuta

Preferred Learning Style of Students of Nangkor Central School, Bhutan

Students preferentially absorb and process information in diverse ways. Pedagogy should vary accordingly. The knowledge of teachers on the learners’ preferred learning styles plays a pivotal role in better teaching and learning processes, contributing to a better-quality education. Still, little is known about the preferred learning style of learners. In the present study, the VARK (visual, aural, read or write, kinaesthetic) model version 8.01 survey questionnaire was adapted and given to 215 middle and higher secondary students. Using descriptive analysis of correlation, frequency and percentage, the study revealed that the preferred learning styles of students are aural (A) and kinaesthetic (K) with the smallest preference given to visual (V). The findings showed that male and female participants’ preferences were the same, and that high-achiever learners prefer K. Recommendations from the findings apply to both the classroom and teacher training opportunities

Supporting students with disability in schools in Bhutan:perspectives from school principals

Bhutanese educators are facing the challenge of implementing inclusive education for students with disability throughout their schooling system. Selected schools have started to implement inclusive policies and practices, and it is timely to investigate the progress of inclusive education in these schools. In this qualitative study, 14 Bhutanese principals responded to questions regarding inclusive practices in their schools. Responses were divided into two broad categories: the current status of inclusion in their school; and, inclusion in the future. Principals described barriers such as a lack of specialised teachers, inadequate resources and facilities, and a lack of holistic inclusion. However, they also noted that students were accepted by their peers, that the schools were working well with what they have, and that there was a positive attitude for the future. Changes that are required to progress inclusive education in Bhutan from the perspective of the principals are discussed. The findings of this research will be of interest to researchers and leaders in schools and ministries of education who are working to promote more inclusive schools in less developed countries.</p

Performance of an Emergency Road Ambulance Service in Bhutan: Response Time, Utilization, and Outcomes

Background: An efficient ambulance service is a vital component of emergency medical services. We determined the emergency ambulance response and transport times and ambulance exit outcomes in Bhutan. Methods: A cross-sectional study involving real-time monitoring of emergency ambulance deployments managed by a central toll-free (112) hotline (20 October 2021 to 20 January 2022) was carried out. Results: Of 5092 ambulance deployments, 4291 (84%) were inter-facility transfers, and 801 (16%) were for emergencies. Of the latter, 703 (88%) were for non-pregnancy-related emergencies (i.e., medical, surgical, and accidents), while 98 (12%) were for pregnancy-related emergencies. The median ambulance response and patient transport times were 42 (IQR 3–271) and 41 (IQR 2–272) minutes, respectively. The median round-trip distance travelled by ambulances was 18 km (range 1–186 km). For ambulance exit outcomes that were pregnancy-related (n = 98), 89 (91%) reached the health facility successfully, 8 delivered prior to ambulance arrival at the scene or in the ambulance during transport, and 1 had no outcome record. For the remaining 703 non-pregnancy deployments, 29 (4.1%) deployments were deemed not required or refusals, and 656 (93.3%) reached the health facility successfully; 16 (2.3%) died before the ambulance’s arrival at the scene, and 2 (0.3%) were not recorded. Conclusions: This first countrywide real-time operational research showed acceptable ambulance exit outcomes. Improving ambulance response and transport times might reduce morbidities and mortalities further