Published By Berghahn Books
Bhutan is a landlocked country nestled into the foothills of the Himalaya. It's relative isolation from international influence in turn with progressive governing policy over the last century has ensured its rich cultural, religious and environmental continuity. This opening chapter introduces this fascinating country, looking specifically at some of the major cultural, institutional and economic contexts that inform the patient experiences discussed later in the book.
Patients in Bhutan often use the multiple types of healthcare practices available to them, including biomedical services, traditional medicine and alternative practices. With this breadth and diversity of knowledge and practice, how do patient's remain cohesive and fulfilled in their search for meaningful healing? The book begins by answering this question with a new theoretical approach to conceiving patients in such a medical plural context.
Bhutan's Ministry of Health, from early in its inception, insisted on a two option healthcare service that offers modern biomedical services and a traditional form of Bhuddist medicine. In hospitals around the country, patients have a choice to visit either state sponsored healthcare option. This chapter explores this traditional medicine service and its growing impact on both patients and national health policy and reporting.
Patients in Bhutan are faced with complex decision-making tasks when seeking healthcare. They may opt between the biomedical, traditional and alternative practices. They may also be influenced by contextual factors such as finances, geography, logistics, family and social pressures, religious beliefs or education - the list goes on. How are patients making decisions about which practice to use and when? And what are some of the repercussions of these critical choices?
The world of Bhutan's alternative healthcare practices is rich and diverse, steeped in history and cultural tradition, and meaningful to patients. These non-institutional practices are availed by countless patients who complement their healing with these often localized and religious practices. This chapter explores these alternative practices, while also introducing some of the tensions between their advocates and critics, using a specific ethnographic description of one such practice.
As Bhutan opens more to the international world and improves it's biomedical services, the relational dependency between patients and healing materials grows stronger. Never before have patients in Bhutan had such access to healing materials. This is changing the way patients think about health, services and healthcare access. New horizons of health are emerging. This chapter explores what this looks like for patients in their every-day healthcare seeking experiences.
With patients understood as calling to multiple practices, healths, and bodies, we can begin to conceive of patients as multiples themselves. Viewing them this way in the Bhutanese context can then aid health administrators to design and implement healthcare services that speak to this multiplicity and complement the patient experience. The book concludes by offering some actionable ideas about how to better meet patients in their meaningful experiences of healthcare seeking.