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Bhutan

Bhutan Part 2

Everything not nursing!


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So Bhutan wasn't all healthcare, hospitals and nursing, we also spent some time sightseeing, exploring and generally having a grand old time.
We did a day trip to Punakha, the old capital, stopping on the way at the Dochula Pass to watch the sunrise over the Himalayas. Despite the fog failing to lift, it was absolutely beautiful and extremely atmospheric, an unexpected highlight of Bhutan.
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In Punakha we walked across a massive bridge, across a river, covered in prayer flags that was honestly the most unstable thing I've ever seen..so much fun! We also explored their Dzong which was really impressive.
At the end of the day we walked up to a monastery through local villages. The general consensus was that the highlight here was seeing the famous 'protective penises.' Images covered houses and there were status everywhere. Very safe lucky..maybe? Kinda immaturely hilarious...definitely!
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Another day was spent around Thimphu at the giant Buddha (gold and huge) and the Takin (national animal of Bhutan) Zoo. Possibly the ugliest animal ever..so ugly it's almost cute. We were lucky enough to have a picnic lunch on a hill surrounded by prayer flags and overlooking Thimphu. Never have I eaten somewhere so picturesque!

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One night we headed out with the students. It was the funniest night, starting with scarily (when we saw the photos) sober karaoke and dancing at club desiree. Topped of with Rosie's traffic directing skills it was an awesome night.

On our last morning in Paro RIHS hosted a lovely farewell morning tea. We all dressed up in kiras and ghos and shared experiences, thanks and stories with those who has been so kind and worked so hard to host us and help us throughout our time in Bhutan. There were tears and we all knew how indebted we are.

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We spent a couple of nights in Paro at the end, mainly to hike up to tigers nest, the quintessential Bhutanese experience. The walk was as hard as you'd expect, on tracks for about 4hrs consistently uphill at altitude, we (really) took our time though and it was absolutely worth it. We had l seen photos but typically nothing matched it. It was the most beautiful sight and touching place and I'll let the photos speak for themselves.
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Our final night was one none of us will ever forget. We had drinks around a bonfire, presented gifts and songs to the incredible staff who had worked and travelled with us and embraced the last night in Bhutan we would have together. It really struck me how much love and experience I was surrounded with and I couldn't believed we'd met at the airport not even two weeks ago.
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I'm writing this about a month after leaving Bhutan, and I still can't get over how lucky I am. It's the most amazing, beautiful and interesting place and I got to experience it with a bunch of incredible people. It's a place and time I'll look back on fondly, and forever be so so grateful I handed in my application to go last minute on a whim.

Posted by isabellepurcell 19:28 Archived in Bhutan Tagged travel himalayas backpacking bhutan paro thimphu Comments (1)

Nursing in Bhutan #2

all seasons in one day
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Between our hospital shifts we were also exposed to many other areas of Bhutanese healthcare. We spent a morning at the traditional medicine hospital, an outpatient service for treatments such as needle therapy, hot compression therapy and steam therapy. Herbal medicines are dispensed by specialised traditional medicine doctors. This is very popular in Bhutan, often as either a first or last resort. It is often utilised for chronic pain, however doctors will not treat anyone currently receiving treatment of another method (usually western medicine) for risk of incompatibility. One interesting thing was the claim that their medicines have no side effects as they mix herbs and other natural products to cancel out the side effects of others. Although good in theory, I had to wonder where they stopped, eventually something would have to give. We walked through the 'museum' of the different products used and it was fascinating to see things that are grown all over he world, often classed as weeds having such varied uses. There is an allegorical tree of medicine, following much the same outline as western medicine with branches of assessment, pathophysiology and treatment. Treatment is then based on diet, behaviour and medicine. Currently a new hospital is being built that will have the capacity to treatment people differently depending on the season, another aspect of traditional medicine.
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Another morning was spent at a basic health unit on the outskirts of Thimphu. This is essentially a very basic version of primary healthcare. It consisted of one tiny room, with one desk and table. Staffed by basic health workers the majority of cases were family planning, vaccinations, peri natal checks, coughs and conguntivitus. Workers here can distribute some medications, and contrary to the hospital setting, I have never seen so much panadol handed over. The level responsibility compared to their level of training though was questionable with one child being diagnosed with pneumonia based on just respiratory rate and a newborn baby being given amoxicillin (a very strong antibiotic) to take at home with no information, assessment or monitoring. Overall it was an incredibly positive experience, the workers interaction with the community is extremely vital and beneficial and for the most part it is a viable alternative to hospital. The documentation was fabulous and care was much more patient centred than I'd seen anywhere else.
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We visited the community health clinic focussing on child and maternal health, the separate psychiatric ward and the HIV/AIDS and health information drop-in centre. All of these provided valuable insight and were much more developed than I expected. One major difference was the role of family, this is prevalent all through the system, with family taking a major role in patient care. All patients have an attendant there 24/7 who look after all their personal care, assist nurses and in terms of mental health are the primary carer. In Australia, family is often viewed as annoying, demanding and just getting in the way and it was important to see how valuable they can be in a patients recovery, as well as how useful they are in a human resource poor healthcare system.

Finally was health assessment at the local Chortan. Teamed up with students from RIHS we set up stations to measure height , weight, BMI and blood pressure before using this information to give advice. It was one of the most manic but wonderful things. No one was prepared for how overwhelmed we would be, the community was so involved, we ran out of paper slips almost immediately and there were so many people. Although busy and thus time consuming, everyone was so thankful and patient. It was an amazing morning, that really reiterated the importance of health promotion and community health.
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Immersing myself in Bhutan's healthcare system has been an absolute rollarcoster. There have been incredible and happy experiences but also a lot that I've questioned. I've learnt things that I never imagined, not only facts, but about who I am as a nurse. I've met some amazing people and this last fortnight is something I'll be drawing on well into the future.

Photos from the hospital:
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Flew out of Paro this morning and I'm back in Bangkok. Still loads more of Bhutan stories to come! Already had pad Thai, a Chang and been to pat pong market...couldn't be more cliched but it's good to be back!

Stay smiling xx

Posted by isabellepurcell 07:19 Archived in Bhutan Tagged travel himalayas asia backpacking bhutan nursing Comments (0)

Bhutan #1

all seasons in one day
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It's taken me a while to write this, because I honestly didn't know where to begin. I'm still pinching myself everyday and can't quite believe it's real. Bangkok was dark and sleepy and with a 3am wakeup call our first 18hr day travelling from bangkok-paro-thimpu was a blur of amazing Himalayan views from the plane, naps, markets that turned me into a vegetarian for the next fortnight, dzongs, headaches, decorated trucks and just beginning to get a sense of this incredible place.
The next morning after a solid 12 hours shut eye was the Amazing Race, trying to find out way around Thimphu and managing to go the the new and old cinema and the new and old bank neither of which were the right ones.
The Chorton was definitely the highlight, seeing an entire community come together to pray and immerse themselves in faith amid a kaleidoscope of colour and life was mind blowing. Contrary to calm temples and dzongs it was very evident that the Chorton was a part of people's everyday life with people catching up, sharing meals and watching children play.

That afternoon working on our presentations was a rude reminder that we are actually here to 'study'. Whoops. Also managed to put together the most incredible performance that you will ever see of the anthem, kookaburra sits in the old gum tree (in rounds!) and happy little vegemites, ready for the welcome dinner that night.

Walking into the Royal Institute of Health Sciences I have never felt more welcomed in my life. The staff and students of RIHS organised a dinner and bonfire with traditional entertainment that although important and meaningful, I had chills receiving the traditional white welcome scarf, very quickly became friends singing dancing and learning from each other as though we'd known each other for years.

The next day was back at RIHS in the morning for info sessions on the Bhutanese healthcare system, gross national happiness and public health in Bhutan. We then toured the Thimphu referral hospital where we are doing nursing shifts later in the week.
The following day we visited the HIV and health information drop in centre, drug and alcohol drop in and community health centre focussing on child and maternal health.
I'll leave all the nursing/healthcare things for another post, it's an essay in itself and it's taking me a while to sort out how I feel about it.

That afternoon we visited the school of traditional arts, where students are selected and their entire education is based around either painting, sculpture, woodcarving, mask making or embroidery in an effort to preserve Bhutanese art culture. The attention to detail and skill was incredible, finishing some courses took up to 5 years.

It's very hard to capture what makes Bhutan so special, I could say it's because they've never been colonised, or because of how stunning the landscape and architecture is, how hard they work to preserve their culture or how with a population of under 750,000 people are either related or went to school together, but there's something else I just can't put my finger on so stay tuned.

I am continually reminded how lucky I am not only to be travelling to such an interesting and not so accessible country but also how unique the opportunity to work with and assimilate into such a unknown and protected culture is. The chance to see first hand, learn from and integrate into Bhutan and their healthcare system to this depth is so rare and something that will change how I live and work into the future.

It's currently about day 5..I've honestly lost track and this barely scratches the surface of the first couple of days so there's more on the way! I'll also add some photos when I can, didn't think through the camera to phone logistics without a computer!

Stay smiling xxo

Posted by isabellepurcell 06:39 Archived in Bhutan Tagged travel asia bhutan paro nursing thimphu Comments (1)

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