MoH to introduce vaccine against pneumonia
May 2, 2018

The health ministry’s high-level committee has approved the introduction of pneumococcal conjugate vaccine (PCV) into the routine immunisation services.
This means, the vaccine, which prevents transmission of pneumococcal bacterial diseases such as pneumonia, otitis media, bacteraemia and meningitis in children under 5 years will now be injected to children below one year. The ministry is planning to introduce the vaccine early next year.
Health secretary Dr Ugen Dophu said the ministry wrote to the Bhutan Health Trust Fund (BHTF) on April 3 for budgetary support to introduce the vaccine into the routine immunisation services. “We are discussing with the BHTF on this.”
An economic evaluation was done with technical assistance from Health Intervention and Technology Assessment Programme in Thailand after the National Committee for Immunisation Practice recommended the ministry to introduce PCV into the routine immunisation services.
A study was conducted to determine the cost-utility and outcomes of 10 – and 12 –valent pneumococcal conjugate vaccines (PCV 10 and PCV 13) compared to no vaccination in Bhutan.
The study recommended that both PC vaccines are cost effective and provide good value for money at the suggested threshold level of one GDP per capita equivalent to Nu 176,000.
The study found that compared to no vaccination, implementing either of the vaccines would prevent an estimate of 2,003 and 2,916 episodes of pneumococcal disease in the vaccinated population. Further, 214 and 261 episodes of pneumococcal disease would be prevented in the unvaccinated populations due to herd protection.
The study also found that an estimate of 28 and 42 pneumococcal deaths would be averted by introducing PCV10 and PCV13, respectively.
It would cost about Nu 11.64M (million) to introduce PCV 13 into the routine immunisation services in the first year.
PCV 13 costs a little more than PCV 10. But, health officials said it yields better health outcomes.
The budget analysis conducted over five year period considering the inclusion of PCV 10 or 13 in the routine immunisation services shows that about Nu 206.41M (million) is expected to be spent in the next five years as treatment cost of pneumonia and associated diseases if PCV vaccine is not introduced.
However, if introduced, the treatment cost is expected to decline by 8.5 percent and 13.6 percent respectively for PCV10 or PCV13.
In an earlier interview with Kuensel, director general of the department of medical services, Dr Pandup Tshering, said that the ministry first looks at the disease burden before introducing a vaccine. “Disease burden is based on the administrative data which means we are looking at people who visit the hospital and get treatment.”
According to the Annual Health Bulletin 2017, a total of 3,404 pneumonia cases were reported to the outpatient departments in all hospitals in 2016. Out of this, about 58 percent (1989) were in children below 5 years.
A total of 1,064 otitis media, an ear infection caused by pneumococcal bacteria outpatient cases were reported in children below 5 years. Of the total 160-inpatient cases with the infection, 53 were children below 5 years.
In 2016, about 198 meningitis/encephalitis inpatient cases were reported, out of which about 119 cases were in children below 5 years. A total of 3,150 pneumonia inpatient cases were reported the same year, of which, 2,117 were children below 5-years-old.
Pneumonia has claimed 325 lives while 135 died of meningitis in the last five years. About 76 died of pneumonia and 47 of meningitis in 2016.
A laboratory officer with Essential Medicines and Technology Division (EMTD), Pempa in an earlier interview, said the government spends huge resources on treating of Pneumonia, Otitis Media and Meningitis, especially among the children.
“If we implement PCV 13 we will be able to save more lives and the costs in long run,” he said.
Dechen Tshomo

Inconsistent legal actions in sexual abuse of minors: NCWC
April 30, 2018

Sixty percent of the perpetrators involved in sexual violence against children are someone known to the child, according to an assessment on minor rape cases by the National Commission for Women and Children (NCWC).
Of the 60 percent, 15.56 percent of the perpetrators were found to be incest, which means it includes biological father, relatives and siblings. The rest of the perpetrators were neighbours, family friends, or people whom children looked up to for guidance or as role models.
The assessment reviewed 45 cases of sexual offense against children that were with the Office of the Attorney General (OAG). It found that there were not only discrepancies in the legal actions taken against such cases, but were also not strong to deter such actions.
The 45 cases were from 2009 – 2015 and prosecuted by the OAG across 20 dzongkhags. The case includes rape, attempt to rape, statutory rape of minor, molestation, and sexual harassment.
Works and human settlement minister Dorji Choden, who is also a chairperson of the commission, said that a small assessment was carried out to see the actions taken on the minor rape cases.
“Although the felonies have been enhanced during the amendments, we felt that the rape of child should be very stringent,” she said. “There is a need to improve the way cases are prosecuted including the forensic services.”
Lyonpo also said that NCWC is looking into instituting women and child welfare committees and appointing protection officers in all dzongkhags where such cases could be reported. “This is going beyond prevention and precautionary measures where society should also be a watch dog.”
However, stating the sensitivity of the findings, the commission did not share the report and its findings of the court procedures and legal actions. The commission’s senior legal officer, Ugyen Tshomo, said that it was an in-house assessment conducted to find out the lapses.
She said that the main purpose of the assessment, which was conducted sometime in 2016, was to see the existing gaps in the law and its implementation.
The commission’s director, Kunzang Lhamo, in an article that was recently published in Kuensel, said that the country’s preventive and protection system is weak with many gaps and challenges. “But if supported with adequate financial and human resources, the efforts spent in developing legislations, policies, guidelines, SOPs and coordination mechanisms will not be wasted.”
Ugyen Tshomo said the assessment also found lack of awareness and ignorance especially on the consensual age, but there were perpetrators who have also used consensual age as an excuse.
The assessment also revealed that sexual offenses against children are committed in both urban and rural areas where most of the victims are from low-income families.
“With such assessment as an intervention and based on the findings, we’re working on a national plan of action for childcare wellbeing to ensure protection of a child,” Ugyen Tshomo said. “We’ve also started a central management information system linking other agencies to capture details on violence against women and children.”
However, the assessment has not looked into the probation period of security clearance for a convict after serving the sentences.
At the education dialogue on April 19, NCWC director, Kunzang Lhamo said that a study on violence against children conducted by the commission found that more than 60 percent of children aged 13-17 years have experienced physical violence including bullying and corporal punishment once in a lifetime.
“When we look at the result, it is not really a question of whether our ministries or the government or CSOs are doing their job or not,” she said, adding care and protection of a child boils down right to the households.
She said the outside body cannot impose intervention but it should start from home because there is only so much institutions, the government and schools could do.
“I think it all comes out from how children are brought up and this is something that we really want to insist on, the environment, in which a child grows up,” Kunzang Lhamo said. “I am not saying institutions and government should stop doing the good work that is being done. Although people are being reactive to such incidences, we have to also open a window of opportunity to strengthen the efforts that we are doing.”
The NCWC is currently dealing with 31 cases received from January to April this year, which includes children in difficulties, destitute, rape victims, sexual harassment, violence against women, children in conflict with the law, matrimonial cases, and trafficking in person.
The commission would also initiate the Toll Free Helpline Services (1098) in October this year to provide 24/7 counselling and immediate referral services for women and children in need of care and support.
Yangchen C Rinzin

No red panda caught on cameras
May 2, 2018

Red Panda

Sightings of the red panda in the highlands have decreased in recent years
Almost two years after officials of the Sakteng Wildlife Sanctuary (SWC) installed 10 camera traps, not a single red panda has been caught on the cameras.
Highlanders of Merak and Sakteng used to see the extremely elusive red panda frequently a decade ago.
The highlanders say portions of their winter pasturelands were home to the endangered species in the SWC.
Given the red colour of the animal, locals believe red pandas were the reincarnation of a monk and encountering the rare mammal was considered a good omen.
SWC officials also say that the sightings of the red panda in the highlands have considerably decreased in recent years.
The park officials installed 10 camera traps in Shetaymay and Chebaling areas, where red pandas were spotted occasionally.
Officials said habitat fragmentation and degrading land due to overgrazing and other natural phenomena like landslides are some of the biggest threats to the endangered species.
In order to review and discuss red panda research and conservation strategies in Bhutan, a three-day workshop on red panda conservation with the theme “Ensuring the future of red panda landscapes through national and regional collaboration” began in Trashigang yesterday.
One of the participants, Pema Dendup, a forest officer with the Jigme Dorji National Park, said that the presence of livestock had a direct correlation to the red panda habitation. “Since bamboos are the main food for the red pandas, the presence of cattle that also feed on the bamboo creates intense competition which is why livestock disturbed areas is avoided by the species.”
He also said that livestock are often allowed to stray in forests without restraint, unaccompanied by herders.
Pema Dendup in one of his researches conducted on Red Pandas in Phrumsengla National Park (then Thrumshingla National Park) found that besides the livestock disturbed areas, red pandas avoided human settlements and areas with timber disturbances.
“Human settlement is generally associated with the presence of dogs and dogs are one of the main threats to the red pandas,” he said. Activities such as logging and collection of bamboo were also some of the reasons cited in the research as threats to the red panda habitat.
The research recommended livestock grazing practice be minimised in protected areas where red panda conservation is a priority.
Bamboo restoration activities could offset damage or loss of bamboo as a result of anthropogenic activities (timber harvesting), he added.
“Until the impacts of anthropogenic activities are accounted and mitigated, protected area coverage should not be considered an adequate measure of the conservation of red panda,” said Pema Dendup.
Joanne Millar (PhD) with the Charles Sturt University in Australia said that Bhutan lacks coordination among stakeholders in understanding red pandas and the need to conserve the endangered species.
“There is a lack of information on red pandas among the Bhutanese. They do not see the red pandas as an iconic species,” she said. “Globally the number of red pandas are declining and the animals in Bhutan are also faced with similar threats.”
Joanne Millar said that in an effort to conserve the species in the SWC, a three-year project called ‘sustainable rangeland management for red panda conservation and herder livelihoods’ was initiated last year.
The project funded by Darwin Initiative, a UK government grant scheme, focuses on improving the degraded rangelands by planting bamboos, providing fences around the protected area and improving the pasturelands.
The project is currently working on improving the winter grazing land of Shetaymay and Chebaling in Merak. “People used to spot the red pandas in these places a decade ago. Today it is all degraded due to over grazing,” she said.
Joanne Millar said that at the end of the workshop, a draft national conservation action plan for red panda would be developed. “We can then discuss ways to link Bhutan to wider international conservation networks,” she said. “Designing projects and availing funds for red panda conservation activities could also be enhanced once the action plan is developed.”
A total of 30 participants including park managers, researchers, representatives from WWF (Bhutan and India) and officials from the Department of Forest and Park Services are attending the workshop.
Meanwhile, of the 10 parks identified in the country, seven (thirteen dzongkhags) of them house the endangered red panda. Officials said that a study on the number of red panda in the country has not been conducted yet.
Categorised as endangered on International Union for Conservation of Nature (IUCN) Red List, an estimated 10,000 matured red pandas are distributed among five Asian countries of Bhutan, China, India, Myanmar and Nepal.
The workshop is organized by Sakteng Wildlife Sanctuary.
Younten Tshedup | Trashigang

BBS Laya to receive 3G by October
Sherub Dorji, Laya
Apr 30, 2018

Mobile network made its way into Laya in 2010, five years before electricity did. The highland community is now only months away from getting 3G service.
The service is expected to be introduced by October this year.
Teachers at Laya Lower Secondary School believe access to faster internet will help bring about a sea change in the teaching and learning process.
“It will be beneficial for both the teachers and the students,” Phub Gyeltshen, a teacher at Laya Lower Secondary School said.
“It will help the teachers in expanding our knowledge, which will have positive impacts on the quality of education.”
Thinley Rabgay, another teacher, echoed the same feelings. “Access to internet in our school would aid teaching and learning process immensely,” he said.
“Students can explore on their own to gain a broader understanding of the topics taught in classes. Teachers can do the same, which will help us teach better.”
Young people in the village too are looking forward to receiving 3G service. “We will be able to keep track of all new things,” Leki Om said.
Bhutan Telecom (BT) is the only mobile service provider in Laya. “We have transferred all the fibre cables to Laya, and after July, we will procure all required equipment and start installation works,” BT’s Gasa Officer In-Charge Penjor Gyeltshen said.
“Our work will complete before the Royal Highland Festival.”
Bhutan Telecom will carry out the works with support from the Department of Information Technology and Telecom.

Managing waste along Thimphu-Phuentshogling highway gets tougher
Sonam Penjor, Phuentshogling
Apr 29, 2018

Managing waste along the Thimphu-Phuentshogling highway is becoming increasingly challenging by the day.
Despite several cleaning campaign and awareness programmes, the litter problem along the highway never seems to be addressed.
Yesterday, over 4000 students, civil servants, DeSuups, business communities and residents cleaned the route from Chudzom till Rinchending.
They collected about 150 metric tons of trash
The clean-up exercise was held following the resolution of last month’s Dzongkhag Tshogdu session.
The Geling Gewog’s Gup, Phub Dorji told BBS: “People who travel along the highway through empty juice bottles, water bottles and other waste. Such habit really makes the places nearby the highway dirty.”
The Road Safety Transport Authority (RSTA) in Chhukha had done a survey to determine the targeted litterers. “They are travellers by bus and taxis, and regional tourists who throw trash carelessly along the way,” said Nado, the RSTA Representative in Chhukha.
The Chhukha Dzongdag, Minjur Dorji said the wastes thrown at places near the highway have hampered the otherwise pristine nature of the district.
“I request the commuters and motorists to not to throw wastes along the road. Please bear in mind that the waste will not make the surroundings look unpleasant but poses health risks too.”
Thousands of people travel along highway daily. The dzongkhag administration along with the stakeholders is finding suitable ways and measures to address the litter issue along the highway to a great extent.