RAA performance report uncovers a host of ailments plaguing the health ministry
19 September, 2009 - A royal audit authority (RAA) performance report released in September 2009 on the ministry of health (MoH) has found medical equipment worth millions lying unused.
Four kidney dialysis machines, worth about Nu 8 million, were never used since being procured by MoH for the Mongar regional referral hospital and Gelephu hospital.
Meanwhile, there are only four dialysis machines in the national referral hospital in Thimphu for kidney patients and they get only 4 hours of dialysis (kidney purification) a week, while they require between 8-12 hours of dialysis a week, according to medical experts.
RAA analysis shows that, due to the above situation, there is a high incidence of impurities, increasing the risk of death with patients.
This is also in the backdrop of an increasing number of kidney failures in Bhutan, with around 50 patients in JDWNRH today, up from just 8 in 1998 when the dialysis unit opened.
Similar cases of non-use of expensive and important machines were also found in other hospitals, where X-ray machines, sterilisation units, ultra sound machines, diagnosis machines, among others, were kept idle.
MoH has spent around Nu 300 million in the purchase of equipment for the new JDWNRH in Thimphu and the new hospital in Mongar. Another Nu 80 million has been tendered this year for medical consumables and equipment.
The audit report points out that poor planning is responsible for such a situation, where MOH bought the equipments but did not train people to use them. The report in fact says that the few trained people, who could operate these machines, were sent to hospitals, where these equipments did not exist instead of the hospitals that required them.
It was also found that, despite the standards for medical equipment being drafted, they were not followed in any of the health centres. Equipment of different standards had been procured for different hospitals because of which even trained technicians could not use them.
RAA also found poor storage conditions for the country's drugs and equipment in the medical supply depot, Phuentsholing, that is the main supplier all the country's medical units. "Drugs and vaccines are required to be kept under certain conditions to retain their curing capacities, however, there is no warehouse with proper storage facilities to retain the strength of these drugs and vaccines," says the report. The RAA team came across instances of poor storage of drugs in hospitals and BHUs.
Though diet is considered almost as important as medicines in recovery, especially for diabetes, tuberculosis, hypertension, it was found that the JDWNRH prepared a diet that was the same for all patients.
Despite having large budgets for awareness programs, RAA found a low level of awareness, stretching between 25 percent to 14 percent only on the 6 main health programs like HIV/AIDS, among others. The vector borne diseases program, despite enjoying multi million-dollar funding, was found to be housed in a rented building with lack of proper infrastructure and research facilities. There was ineffective destruction of vectors (mosquitoes) and the program had even failed to coordinate with the ministry of education to create awareness on vector borne diseases.
RAA found that most of the 29 health programs launched in the 9th five-year plan were not monitored and compared to the set target of the plan period. Even the annual health bulletin, highlighted only the overall indicators undermining the importance of the program wise achievements of its targets.
Except for the Trashigang hospital, other dzongkhags did not have performance indicators to monitor the quality of health care services and programs of hospitals and BHUs.
RAA pointed out that, despite its report in June 2008, corrective action had not been taken by MOH on the safe disposal of medical waste.
The audited officials named in the report are the health secretary Dasho (Dr) Gado Tshering, DG (Dr) Dorji Wangchuk and health director (Dr) Ugen Dophu.
This report comes in the backdrop of an ACC investigation into allegations of corruption in procurement.
RAA will comeout with a separate performance audit report on the Drugs, Vaccine and Equipment Division (DVED).
1. Equipments worth millions lying in disuse
2. Equipments of different standards procured so even technicians could not use them
3. Poor storage condition for the country's drugs and equipments
4. Most of 9th five-year programs not monitored and compared to targets
5. 71 percent of medical staff feel overworked
By Tenzing Lamsang
Source: Kuensel
