The Rich Country Poor Country Fallacy: How Bhutan Used Resilience To Fight Covid-19
Are you as flabbergasted as I am at the management of this pandemic in ‘affluent’ nations? With Trump going so far as to dispute Science and Europe’s numbers fluctuating, we have all pondered upon the abilities of these nations and their high GDP levels.
Let’s cross a few oceans all the way to the borders of Bhutan. Nestling peacefully between China and India, this country, with its population of 760,000 and GDP per capita of $3,412, has confounded the world.
The curious case of Bhutan
On January 7th of this year, Bhutan recorded its first ever Covid-19-related death since the pandemic started. This ‘poor’ nation, which only had 337 physicians (only one had advanced training in critical care), barely 3,000 health workers and all but one PCR machine to test viral samples, had defied all odds in keeping the pandemic from engulfing its lands and people.
A recent feature by The Atlantic relayed how Bhutan’s swift and effective measures ensured its success in maintaining a low case and death count.
A country driven by its policy of Gross National Happiness, which balances economic development with environmental conservation and cultural values, Bhutan ensured that its plans for dealing with the pandemic considered all aspects of well-being.
Elements of this include an attentive leadership, ensuring the financial and provisional needs of citizens in order for them to follow guidelines and a deep-rooted understanding that this pandemic required large sacrifices by communities and individuals.
But how did Bhutan keep all these elements afloat? The answer to that is their sheer resilience. This is the very core of their identity as a people.
They knew that if this virus were to overwhelm the nation, it would be catastrophic on so many levels of governance. In fact, King Jigme Khesar Namgyel Wangchuck told government leaders that even one death from COVID-19 would be too much for a small nation which considers itself a family.
The moment China reported a pneumonia outbreak of unknown cause to the WHO on December 31st, 2019, Bhutan spared no time in drafting its National Preparedness and Response Plan. By January 15th, authorities began screening for respiratory ailments and utilising infrared fever scanners at the international airport and other points of entry.
They managed to steer clear of cases right up until March 6th, when a 76-year-old American tourist tested positive. In just 6 hours and 18 minutes, authorities had rounded up 300 people who had come into contact with the patient. Beaming with pride, Minister of Health Dechen Wangmo, told reporters that this must have been some kind of record.
And we agree! Even the most developed countries struggled with such rapid contact tracing efforts so early on.
Meanwhile, the American patient was airlifted back to the US, where his doctors in Maryland told him, “Whatever they tried in Bhutan probably saved your life.”
From then on, in a series of calculated measures, Bhutan truly began its resilient fight against this pandemic.
With schools and public institutions closed, entertainment centres shut and tourists barred from entering the country, the administration did not hesitate to implement, what most developed nations, at the time considered “drastic measures”.
They issued accurate daily updates and helpline numbers as well as implored the public relentlessly to wear face masks, practice good sanitation and social distancing measures.
As soon as the WHO officially declared Covid-19 as a pandemic, Bhutan issued a mandatory quarantine for close contacts and expatriates returning home. They provided free accommodation and meals, as well as psychological counselling. The same was given to asymptomatic positive cases who were isolated at medical facilities.
While most of us were unhappy about the 14-day quarantine recommended by WHO, Bhutan realised that this period was insufficient as there was still an 11% chance that a person could be incubating the infection and eventually become contagious after 14 days. Their solution was to introduce their own 21-day quarantine period.
In late August, the first national to contract the virus outside of quarantine was detected. Without hesitation, the country moved into a three-week lockdown, with testing and tracing amplified. Food, medicine and essentials were delivered to every home in the country.
Similarly, in December, when a positive case of community transmission was found, they immediately went into another lockdown.
To reinforce their widespread testing and tracing initiative, Bhutan’s administration also created a contact-tracing app. Its leaders orchestrated a prevention initiative called “Our Gyenkhu”—“Our Responsibility,” featuring influencers, to enhance public adherence and morale.
Rather than waiting for cases to reach the hundreds and thousands, which was the situation in many countries, Bhutan’s administration understood that their nation and its people would not survive an uninhibited super-spreader incident.
However, they did not leave their people to fend for themselves throughout the pandemic. This was apparent on so many levels. The King, himself launched a relief fund that has handed out $19 million in financial assistance to more than 34,000 Bhutanese who lost their livelihoods. The initiative has been extended to the end of March.
The King’s leadership was akin to the glue that held various forces together. He made sure to be privy to every detail of the officials’ plans, he visited the frontlines on multiple occasions to motivate health workers and volunteers, and he also ensured political parties worked together across partisan lines.
The government and authorities were also always one step ahead, both during the pandemic and prior to its declaration. In addition to the King’s relief fund, 51,000 Bhutanese over the age of 60 received care packages from the government containing hand sanitizer, vitamins, and other items.
In comprehending their severe lack of resources in combating the virus, authorities decided early on to rectify this shortcoming. They added on five more PCR machines, shifted technicians from livestock-health and food-safety programs, as well as trained university students. To deal with their lack of ICU physicians, they trained doctors and nurses on clinical management of respiratory infections and WHO protocols.
Bhutan did not just stand by when the threat of the virus was looming. They took charge and prepared, utilising all their existing resources.
While gender-based violence and domestic abuse has run rampant in several countries, resulting in atrocious home environments for women, Bhutan’s Queen Mother decided to firmly address issues faced by women. She implored all services for sexual and reproductive health, maternal, newborn, and child health care as well as gender-based violence to be deemed as essential.
Their ministers embodied the very essence of determination and drive throughout lockdown periods. The Health Minister, Wangmo, slept in ministry facilities for weeks, away from her young son. Prime Minister Lotay Tshering, who is also a respected physician, continued to perform surgeries on Saturdays during these periods and would sleep on a window seat in his office. Without batting an eye, Members of Parliament gave up a month’s salary for the response efforts.
This form of leadership is truly one of a kind. Imagine knowing that your leaders are also going through as much as you are, and have given up their comforts and family lives to put their all into this fight.
This is why their people have displayed the utmost sense of unity and courage during these trying times. To volunteer for the national corps known as DeSuun, thousands of Bhutanese have left their families and homes in attempts to contribute their efforts towards fighting the virus.
Hoteliers offered their facilities for free quarantine purposes and farmers have donated their crops. As the authorities and officers at the Ministry of Health burned the midnight oil in continuing their duties, locals brought them hot milk tea and homemade ema datshi—scorching chilies and cheese, the national dish.
The Bhutanese monasteries, understanding their impact within the country, have also played a large part in driving public health messages and praying for the well-being of every individual around the world.
Namgay Zam, a prominent journalist in Bhutan, explained in awe to the Atlantic that he has never seen leaders and ordinary people in other countries share such mutual trust as they do in Bhutan. He concludes that this is the main reason for Bhutan’s success.
This country, or as described by its King – this family, has truly left no one behind, citizen or not.
Lessons to be learnt
However, it would be foolish to presume that Bhutan’s exact model of dealing with the pandemic can be applied across the board. Each nation has its own unique political, geographical and socioeconomic terrain to consider, and Bhutan’s approach may not be the best suited.
However, the Bhutanese’s resilience and unity are aspects that can, and should be replicated everywhere else in order to contain the spread of this deadly virus. Without Bhutan’s sense of community, altruism and willingness to come together in fighting this pandemic, all these initiatives would have been futile.
Although Bhutan does face its fair share of challenges in the form of breaches in SOPs, anti-vaxxers and the like, what they’ve accomplished so far is unparalleled to anything we’ve seen in affluent nations.
The Kingdom does have a long way to go in completely resolving the Covid-19 situation within its borders. However, based on the current trajectory, Bhutan’s fight will probably end with victory. And this victorious tale will be told for generations to come.
Based on all we’ve learnt so far, I’d now like to rephrase my initial question – isn’t it truly flabbergasting that this ‘poor’, landlocked nation has shown us all what true resilience could achieve in fighting this pandemic?
Source: The Atlantic