Burns care team in MRRH

Mongar Hospital was fortunate to host a Burns Care team from USA recently, which included two plastic surgeons .  The team visited MRRH and performed two surgeries on children with burn conjectures.

A dinner was hosted for the visiting team from the hospital side. Dasho Dzongdag, Mongar was also present at the dinner attended by over 30 staff from Mongar Hospital.

Beginning October 2013, the team will make annual visits to Mongar Hospital and perform surgeries on children with clefts(lip and palate), burns and other reconstructive surgeries.

Mental Health Day Observation: Pictures

Nurses presentation

The new GNM nurses  jointly presented  on " 'Clinical Procedures"
on 10th October. They discussed the  procedures involved in

1. NG tube insertion
2. Catheterisation
3. IV canulation
4. Bandaging methods.

The presentations were combined with practical demonstrations and where relevant and feedbacks from the  participants and doctors. 

Lyonpo"s Visit to MRRH

The Honorable Minister of Health , Lyonpo Zanglay Dukpa, visited Mongar Hospital recently and met with the doctors and staff. He had a two hour long meeting during which he discussed on the following areas:

• HAMT
• Reducing waiting times.
• Doctor and nurses shortage
• GNH health workers!
• Measures he is taking to improve the over all health services in the country.

Dr  Sonam Gyamtsho, the officiating MS gave a brief account of the state of things at MRRH.

Infection Control

A team from the MOH, headed by the Clinical Microbiologist from JDWNRH, conducted  a 3 day Infection control training for health workers in the east recently. Various levels of nurses and focal persons for infection control activities participated in the training.

A brief sensitization on  "Hospital Acquired Infections" was also done for the clinical doctors.

Emergency Medicine

A group of  senior specialists from JDWNRH are currently in Mongar conducting  a five day training for the general doctors from various parts of the country. It is supposed to be an intensive training with both theory and practicals . Specialities include:

• Medicine 
• Trauma and surgery
• Pediatrics
• Obstretics
• Anaesthesia.

Following this, a similar training will be conducted at Phuntsholing.

Scenes from Inter Unit Football

NICU Case Presentation

NICU nurses collectively presented the case of a  Premature Baby with multiple problems on 9th August. They did an excellent job with the presentation and the audience was also packed and participating!

Last week , we also had a good discussion on Oxygen Therapy , presented by Dr Aye, Burmese GDMO.

Nurses Presentation: COPD

Wednesday, 25th  July: Mr Mohan Singh, GNM  from Casualty Unit , presented  on COPD and Asthma. The discussion was moderated by Dr Kesang Medical specialist and attended by all the specialists and doctors apart from the nursing staff.

This is one the few presentations made by nurses and it surely is a good beginning for the nursing fraternity to participate in academic activities to update themselves and their colleagues. We are looking forward to have similar presentations from other units.

Clinical Case: DKA

A Case of Diabetic Keto-acidosis was  presented on Thursday, 5th July , at the conference hall. Dr Aye, Burmese GDMO, did the case presentation.

There was  a good discussion involving the participants, mainly nurses.

Clinical Case Presentation

Dr Aye, Burmese GDMO, currently attached to the Department of Medicine here in MRRH, presented a case of 14 year old child with Meningitis.

It was attended by more than 30 staff , mainly from the nursing fraternity. It was an educative and interactive session with the medical specialist asking questions to the audience.

In pictures seen is the audience and Dr Aye demonstrating Kernig's sign in the evaluation of meningitis.

TOT on Newborn Care

The Reproductive Health Program organized the national TOT on Newborn care at RIHS , Thimphu for Pediatricians, Doctors and Nurses from across various districts in the country.The four day intensive training occupied the participants from 8 AM t o 8 PM.

It covered major aspects of newborn care including the demonstration of some of the common equipment used in neonatal set up. The Program is funded by the SAARC Development Fund , with an aim to overall reduce childhood mortality in the country. Myself and Sonam Deki( NICU) had the privilege to present the participants views during the Valediction function.

In the pictures from top to bottom:

• Resource persons from Inidia( Safdarganj, Lady Hardinge, Ganga Ram Hospital and Sikkim Manipal).
• Release of the Training Manual at the Valediction Ceremony.
• Sis Sonam Deki( NICU, MRRH) presenting the participants view at the Valediction Ceremony.

Pediatric Staff Get Together at Thimphu

I was lucky to be amongst the Pediatric family at JDW on 16th June over  a dinner and some fun. The Previous HOD, Dr KP Tshering, now the Medical Director of JDWNRH, was also amongst the gathering. He thanked the staff for their great support and promised to work hard to make the national hospital better than ever before.

Present at the gathering were some foreign volunteer Pediatricians and their families .

Seen in the picture are five of the country's only 8 Pediatricians( though Dr Tandin is no more in the MOH). 

Dr Kinley, Dr Tashi and Dr Tulsi were not present in the gathering.

Social Forestry

Following normal duty hours, the hospital staff volunteered to plant saplings in the hospital compound on the occasion of the National Social Forestry Day that is observed on 2nd June every year.

Dr Ugyen Thinley, Orthopedic Surgeon co-ordinated  the event in which many staff took part. More than 150 saplings were planted in the hospital compound.

Hospital Based IMNCI

The Hospital based IMNCI training was recently conducted in the entire country. ACOs , nurses and doctors were trained in the five day modular training Program that basically focused  on standard managment of Pediatric Emergencies and major causes of morbidity and mortality in the developing world.

Mortality Meeting

In the second mortality meeting today ( 4/5/2012), a case of 57 year old who died of suspected aortic dissection , was discussed by the Medical Specialist. Doctors and Nurses participated in the meeting.

The patient had been referred from Pemagatshel hospital with severe chest pain.

A Day in the Life of a Solitary Specialist

Went to work at 8 AM instead of  9 AM   expecting a heavier load on Monday as usual. Completed ward round of 15 inpatients, made the discharges and updated the patient files. Did a lumbar puncture and a  bone marrow. Went to Echo Lab and did 7 Echo-cardiograms in half an our(patients with prior appointments) and then reached the OPD to see a huge heap of prescriptions....it was 11:20 then....and in the next few hours( had no time to peep into my watch afterwards), managed to score a CENTURY! Meaning that I had to see exactly 100 patients( don't ask me how much time I gave to each patient). It was 2:30 PM then!( Thanks to my loving wife, she managed to send me a cup of tea in between).Obliged to a Echo request from the medical ward during which  another echo request came all the way from Trashigang Hospital. Did that also...Then some one reminded me of another Echo waiting in Maty ward. Did that also. It was 3:30 PM and I called it a day!

Summary:  one and half hours extra! Rounds, OPDs, Clerking, Discharges, Procedures , all by one man.

Hundred OPD patients ( with several phone interruptions in between !) Ten Echos in between!

And oh , forgot to mention: At least 4 telephone calls last night that robbed my sleep off!

Must think again before we talk about quality of services we can provide!

Specialist Clinic at Lhuntse Hospital

A team of four specialists ( Gynecologist, Pediatrician, Radiologist and Orthopedic Surgeon) conducted clinic at Lhuntse Hospital from 9 AM to 12 :30 PM at Lhuntse Hospital. A crowd of over 100 patients turned up for the clinic. Both ward  and OPD patients were seen. 

More than 15 patients also had an Ultrasound Scan, which otherwise is not possible at Lhuntse.

Specialist will be visiting the hospital every alternate month as per the instructions from the Ministry of Health.Similar clinics will be conducted in other district hospitals in the region.

Annual Hospital Rimdro

The two day Annual Hospital Rimdro was organized from 25th to 26th April at the hospital compound. This has been  a regular annual event for the last few years .It saw an excellent participation and contribution from the staff members.

Mortality Meeting

In the first of its kind(Mortality Meeting) at MRRH, the Medical Specialist Dr Kesang Namgyel, presented a case of  possible Pulmonary Embolism that took the life of a patient recently.The patient was initially referred from Kanglung to the Ortho Unit here.

The attendance was good with mainly nursing staff. Some other useful topics like IV Canulations, Catheters were also discussed.

The officiating MS, Dr Sonam briefed the meeting on the rationale of organizing such a meeting and plan to continue in the future.

General Body Meeting

The first meeting , after the Officiating MS, Dr Sonam Gyamtsho, took over the charges, was conducted yesterday ( 4th April) for almost three hours. A wide range of issues were discussed and the attendance to the meeting was good with a packed hall. Some of  the issues discussed were:

• TA/DA claims and tour proposals
• Hospital Quarter Allocations.
• Dress codes
• Lab issues
• Training nominations and many more!

Meeting on Sweepers !

The entire hospital sweepers and some of the administrative officials including some doctors had to meet to sort out some of the issues related to hospital cleanliness and  gardening. It was found that the gardening aspect had been neglected after the departure of the previous MS, who was particular with cleanliness and flower garden around the new hospital.

The relevant staff were instructed to sincerely work towards making the hospital clean, beautiful and patient friendly.

Friendly Khuru

The doctors team, this time, was  defeated by the Nurses/Tech team in the friendly Khuru match organised as usual , as a time pass , on Sunday, the first of April. Despite a larger "BAH', there was a paucity of Kareys overall. 

The loosing team sponsored the lunch and drinks served during the match

Specialist Round at Lhuntse Hospital

Five specialist from MRRH visited Lhuntse Hospital and saw various kinds of patients there. They also conducted a thorough round of indoor patients with the doctors there.

A regular such visit would benefit the public of Lhuntse immensely.

Drugs to Vaccines!

We had been tolerating the shortage of essential medications for almost a year now. Before it found a solution, now it is time for vaccines. Most of the essential primary vaccines are out of stock and clinics are compelled to send back parents who come on schedule to immunise their children.

Hopefully, this will not last long!

From the Farewell dinner for Maki and Br KJ (30.1.12)

Mass Farewell!

Eight staff who have been transferred out of MRRH were given a farewell dinner at Lotus Pond on the evening of 28th January. It was attended by more thatn 40 staff from the hospital.

The outgoing staff include Dr Namsa, Dr Kuenga, Lab Tech Tshering, Sonam ( dental), Karma( drug store), Lhadon( lab) and few others.

Plenty of farewell speeches there!

One GDMO and Three Assistant Nurses Join MRRH

We would like to welcome them all to Mongar Hospital  Family.

However , the shortage of nurses will continue despite this and we would have preferred to have atleast one more GDMO from this batch. It is learnt that most of the ANs were retained at JDW.

Hospital Staff enjoy KHURU on Chunipa Losar

Happy Chunipa Losar to Everyone!!

Kuensel Headline on nursing shortage!

Today (17 Jan, 2012), there is a Kuensel headline highlighting the shortage of nurses in the country , leading to inability to utilize many of the available beds/units in the hospitals. I agree to that.

There are some rumors that about 30 nurses who passed out from India have not yet been employed ! Can Kuensel  investigate why that is so? 

Congratulations Dr Bhim B Rai( Vitreo-Retinal specialist)

Our Ophthalmologist, Dr Bhim B Rai , has recently returned to the country following a 18 months fellowship in Retina( Super-speciality). He was in US ( Utah) for sometime and then subsequently in Tilganga Eye Institute in Nepal.

Our heartiest congratulations to the first  and only Retina specialist in the country and the first super-specialist from Mongar Hospital!

We are proud of you and  the country will greatly benefit from your services.

Why the BSc conversion criteria is not fair?

Because:

1. 1985 near graduated nurses will have few years to serve and will be least beneficial for the nursing services in the long run.
2. Senior the nurses, less likely is the probability of passing entrances!
3. High Chances that required seats will not be filled in one go.
4. Demoralises other junior nurses.
5. Everyone should get equal oppurtunities, atleast to sit for entrance!
6. What is the point of having English,  General Knowledge etc. when the field is purely Technical and not administrative?

Just my thoughts!

MRRH website hacked?

Looks like our hospital official website has been hacked! Mr Omapati, I hope you will notice this and do needful soon.

Dentist couple to Join MRRH

Dr Manjunath , a Prosthodontist and his wife Sunitha, Periodontist, will be joining MRRH from 9th Januarry . The Indian specialist couple is in the country for about 2 years  and had been working at JDW until now. There is also information that one more national dental surgeon will be coming to MRRH after transfer of Dr Kuenga Penjore to Bajo.

Incidentally, Dr Manjunath and his wife were interested to come and work in Bhutan after they came across this blog  of mine in the internet...:)

Who will head MRRH?

With news that the current MS, Dr Tapas Gurung being transferred to Gelephu, there have been no appropiate guesses as to who will replace him. Dr Gurung has been serving at MRRH for about 6 years and is one of the senior administrators in the Ministry.

Any one coming to MRRH should have some credible qualifications and experience as it is a Referral Hopital with more than 350 staff.

I don"t have any particular guesses as well!

State of Pharmacy in the Hospital!

This is what  a patient had to face today!


Normal   Saline:     To purchase!


NAHCO3 drops:  To purchase


Cetrizine:              To purchase


Vaseline:              To Purchase!


So all of us can imagine where we are heading in terms of  pharmaceutical supplies that is seriously affecting the entire country for almost a year now.

Scenes from the New Year Party at MRRH!

Nyelop and Khuru!

As usual, a day long Khuru match was organized between the doctors team and team from the maintenance unit with 9 players in each team. While the weather was not so supportive, the match saw an intense battle, with the maintenance team finally beating the doctors with one point, in the deciding game. Seen in action is the Gynecologist, Dr Sonam Gyamtsho!

Farewell to Senior Staff

Sister Taumo, senior MCH staff resigned from her job with effect from Jan 2012. An overwhelming number of hospital staff came for the farewell at Druk Yul Hotel. He served the Ministry of Health for over 30 years!

About a month ago, her husband and the Administrative Officer of this hospital, superannuated.

We wish the couple a great life ahead of retirement.

CME on Neonatal Resuscitaion

Practical Session

An hour long interactive session on Neonatal Resuscitation was organised today at the hospital conference hall.
Ms Sonam Choden and Br Thinley were  the resource person, supported by the Pediatrician.


Some of the newer recommendations were highlighted as well.