SDG 6The 2030 Agenda for Sustainable Development was established in 2015 and contains seventeen goals. These goals, known as SDGs, were developed to improve global health and well-being. Bhutan was one of the many nations to adopt this agenda. Although they have been specifically focusing on SDG 1 (no poverty), SDG 13 (climate action) and SDG 15 (life on land), this South Asian country is also heavily focusing on SDG 6. SDG goal 6 primarily focuses on water sanitation and management being universally accessible. In fact, billions of people currently do not have access to safe drinking water or sanitation. As of 2017, only 58% of Central and South Asian countries had the ability to use soap and water to wash their hands at home. However, Bhutan has been making positive progress in their SDG goal 6.

Government Initiatives for SDG Goal 6

In 2018, Bhutan’s government launched its 12th National Five Year Plan. The agenda contains many SDGs in order to reduce poverty levels. Within the plan, the government has also developed National Key Result Areas (NKRA) to maintain accountability for its initiatives. There are three NKRAs that center on safe drinking water. NKRA 17 specifically targets sustainable water by focusing on maintaining proper irrigation and sanitation for quality water. The agenda plans to create at least six new programs dedicated to this goal, including a flagship program that will prioritize this issue.

While the Bhutan government has increased its focus on SDG 6, there is still room for improvement. According to the Annual Health Bulletin 2017, 4.1% of its citizens experience open defecation due to no access to hygienic toilets and proper water sanitation. Inequalities within this country also result in unequal access to clean water, especially in rural areas. However, more than 90% of rural homes in the country have improved water quality.

Global Partnerships

Bhutan works with many global organizations to improve clean water within their country. The organization Sanitation and Water for All is a multi-national partnership that focuses on achieving universal access to water sanitation by working to implement the SDGs. Bhutan joined this organization in 2017 and is currently upgrading older toilets and developing a map for accessible safe water.

Bhutan also partners with the SNV Netherlands Development Organization (SNV), a nonprofit organization that focuses on the SDGs and global poverty. SNV, Bhutan’s Public Health Engineering Division and Ministry of Health developed the Rural Sustainable Sanitation and Hygiene Programme (RSAHP). Their mission is to develop more water, sanitation and hygiene (WASH) protocols in the Bhutan government. This program has increased sanitation to almost 99% in certain districts.

The Water for Women initiative is a program by the Australian government that works with Bhutan. The program also partners with SNV. Both organizations developed Beyond the Finish Line – Sustainable Sanitation and Hygiene for All to improve rural water sanitation in Bhutan. This project focuses on the impact quality sanitation can have on many factors, including decreasing poverty levels and increasing gender equality.

Bhutan is making headway in its work to achieve the SDG 6. Although there is always room for improvement, Bhutan’s governmental policies, programs and its global partnerships will further aid their positive progress toward more accessible water sanitation. The drive can be heard in statements made by the King of Bhutan, Jigme Khesar Namgyel Wangchuck, who said, “Where we live must be clean, safe, organized, and beautiful, for national integrity, national pride, and for our bright future. This too is nation-building.”

– Mia Banuelos
Photo: Pixabay

Sanitation in BhutanAccess to functioning sanitation is critical for maintaining a healthy population and increasing lifespans worldwide. Countries facing sanitation challenges are more susceptible to health challenges, and Bhutan is no different. Here are 10 facts about sanitation in Bhutan.

10 Facts About Sanitation in Bhutan

  1. The Royal Government of Bhutan recognizes sanitation as a right, and its constitution obliges it to provide a safe and healthy environment for its citizens. However, only 71 percent of people in Bhutan had access to improved sanitation as of 2016 according to a government report. The report also notes that safety management is necessary to maintain basic sanitation even in these areas. UNICEF reports that 63 percent of the population has access to basic sanitation facilities.
  2. Many girls in Bhutan miss school due to hygiene and sanitation concerns. A recent study reported that around 44 percent of adolescent girls missed school and other activities due to menstruation. They listed a lack of clean toilets and water as one of the primary reasons.
  3. Bhutan has a WASH (water, sanitation and hygiene) program to increase access to sanitation in schools. By working with UNICEF, Bhutan was able to provide 200 schools with improved sanitation as of an evaluation in 2014. During this evaluation, 90.8 percent of respondents surveyed reported that the program improved students’ health.
  4. As of 2016, all schools in Bhutan had at least one toilet. However, 20 percent of schools did not have working toilets, and 11 percent did not have access to improved sanitation. Furthermore, only about one-third of schools had toilets specifically for girls.
  5. Monastic institutions in Bhutan frequently do not have basic sanitation facilities. About 65 percent lack water supply, while 34 percent do not have proper sanitation. This leads to skin infections, worm infestations and other health issues in monasteries and nunneries.
  6. The most common type of sewage treatment in urban Bhutan are septic tanks that discharge into the environment with no treatment or containment. All urban landfills in Bhutan are used as open dumps and are not sanitary landfills capable of containing and treating solid waste. In rural areas, pit toilets are the most common.
  7. Twenty-four sub-districts in Bhutan have access to 100 percent improved sanitation. These sub-districts are located within nine of Bhutan’s 20 districts. A health assistant in Mongar district said that, with 100 percent improved sanitation, the number of cases of diarrhea is falling.
  8. Many people need to be treated for illnesses that could have been prevented with improved access to sanitation. Poor sanitation was responsible for 30 percent of reported health cases in 2017. Healthcare facilities themselves also suffer from sanitation challenges, as 40 percent of district hospitals reported severe water shortages.
  9. According to a report in 2015, over 50 percent of people living in urban areas only had access to an intermittent water supply; a supply that delivered water six to 12 hours per day. Additionally, this water did not meet quality guidelines. In rural areas, only 69 percent of water supply systems are functional.
  10. As of 2017, only 32 percent of the poorest households in Bhutan had access to improved sanitation. This is about three times less than the richest households, of which 95 percent had access to improved sanitation facilities. Government reports recognize that there are disparities in access to sanitation relating to various factors; income, disability, gender and geographic variables can all contribute.

Overall, these 10 facts about sanitation in Bhutan demonstrate that the sanitation, water and hygiene conditions are quickly improving in the country. Initiatives by the government, UNICEF and other nonprofits in the country have led to substantial positive changes. However, inequality in access to improved sanitation services remains a major issue, and Bhutan still has a long way to go to provide improved sanitation throughout the entire country.

Kayleigh Crabb

Photo: Pixaby

Tourism in Bhutan
The curious case of Bhutan has puzzled social and economic scholars for decades. In 1972, the king of Bhutan, King Jigme Singye Wangchuck, declared that Gross National Happiness (GNH) was more important than Gross Domestic Product (GDP). It is the first and only country in the world to use GNH as a measure of socio-economic development rather than GDP. Bhutan conducts measurements by evaluating nine domains.

Nine Domains of Gross National Happiness:

  • Psychological Well-being
  • Health
  • Education
  • Time Use
  • Cultural Diversity and Resilience
  • Good Governance
  • Community Vitality
  • Living Standards
  • Ecological Diversity and Resilience

The last domain listed above (Ecological Diversity and Resilience) has been the cornerstone of Bhutanese Buddhist ideology for centuries. As such, the Bhutanese government has devoted a large portion of its policy agenda toward the conservation of native wildlife. It is the only country in Asia to have over 50 percent of its natural land guaranteed preservation at all times under its constitution. However, with the recent democratization of the country in 2007 and the subsequent onset of globalization, the young generation that makes up over 60 percent of the population would rather “spend time in front of televisions… instead of at the Buddhist temples or in the forests.”

Youth and Urbanization

The more technological interests of the new generation have sparked concern among the traditional older generation in Bhutan. The youth are moving to the cities in droves and will likely live their lives more disconnected from nature and religion than previous generations. As of 2017, 48.7 percent of the population born in rural areas had migrated to cities in search of education, jobs and a more modern lifestyle. Most of these domestic migrants are between the ages of 25 and 29.

Some expect more rapid urbanization to take place due to this large and sudden influx of people to Bhutanese cities. If the rate of movement remains consistent, Bhutan will have to more than double the amount of land available for urban expansion to have adequate housing to accommodate the influx. Along with housing, Bhutan will also have to expand sanitation facilities, electrical infrastructure, transportation infrastructure, public transit and education facilities. These are factors that many Southeast Asian countries have struggled to expand sustainably. However, this does not mean that environmental factors will become obsolete in order to make these developments.

 Tourism in Bhutan

Tourism is one of Bhutan’s largest industries and it is still growing. According to the Bhutan Tourism Monitor from 2016 to 2017, the country experienced a 22 percent growth in tourist arrivals. Tourism generally sparks an increase in globalization in countries that have largely disconnected from international developments, such as modernization, especially among the youth. As tourism ramps up, cities begin to develop more to entice and accommodate additional tourists. This also creates more jobs and draws in domestic migrants from the countryside, just as Bhutan is experiencing now. However, the cities are not the only attraction for tourists. Tourism in Bhutan consists mainly of ecotourism – people want to experience the beauty of Bhutan’s preserved countryside. Tourism in Bhutan is prompting greater urbanization and interest in modern amenities among the youth; however, it also emphasizes the importance of environmental preservation to Bhutan’s economy.

 Improvements in Rural Communities 

Bhutan has implemented the Remote Rural Communities Development Project (RRCDP) in order to lessen the negative impacts of the youth’s migration to cities. This project “promotes the increase of agricultural productivity development of communities’ access to markets, irrigation, agricultural technologies and community infrastructure” in Bhutan’s six most remote districts. Completed in May 2018, this project has provided roads to communities that have never had them before. The roads give these communities better access to health facilities, schools and markets. Farmers are now able to use trucks to transport their goods rather than walking for days to the nearest market. This development has also contributed to the empowerment of women as a byproduct. Some women, who have never been able to make a single-day trip to the market, are even learning how to drive.

Placing greater importance on the accessibility of rural communities may be a solution to the drain of the countryside. By providing access to more modern comforts like roads and markets, the youth may be less hasty to move to the city. Greater access to these communities also helps tourism in Bhutan and creates more jobs in the countryside. The country is building more retreats and farms are expanding the variety of crops. Nonprofits like the World Wildlife Fund are working with the Bhutanese government to better fund advertising for tourism in Bhutan and make it easier for tourists to access the countryside.

Graham Gordon
Photo: Pixabay

Technological Access in Bhutan

A mountainous landlocked kingdom of 766,000 people, Bhutan has been traditionally been isolated and disconnected from the outside world for a number of centuries, with previous rulers keeping the nation as a “hermit kingdom” prior to the legalization of television and Internet in 1999. Bhutan‘s economy relies heavily on its agriculture and forestry alongside the budding hydroelectricity industry, which has proven difficult due to the mountainous terrain of the country. The country’s main trade partners are India and Bangladesh, with no known relationship with the U.S. or other major U.N. members. The legalization of the Internet in 1999, as well as investments in technological advancement in the mountainous country, is a turning point for the kingdom as the developing technological access in Bhutan is expected to bring the country to the modern era.

Internet Development

Since the Internet’s introduction in 1999, Bhutan quickly was able to quickly build its telecommunication infrastructure and have much of the country connected. Cell phone services began in 2003, with 80 percent of the population owning a cell phone as of 2018, which includes 70 percent of the population that consists of farmers, making Bhutan one of the most connected countries in the world. This jump from the days of being isolated from the world allows the people of Bhutan to communicate both within and outside of the country’s borders.


The continued developing technological access in Bhutan has also seen growth through Bhutan’s own investment into its communication networks. Bhutan‘s internal ICT development includes:

  • implementing protection lines for consumer purchases
  • building stations for mobile carriers and broadcasters and expanding upon broadband connections for wireless connections and private access for citizens
  • investing in cybersecurity and strengthening the overall connection quality

The investments in the internal network lines have allowed Bhutan to quickly connect the nation at a rapid pace. However, challenges remain in terms of developing the rural areas of the country within its mountainous terrain. That said, the government is actively looking at ways to change the status quo.

The National Rehabilitation Program (NRB) and the Common Minimum Program are two examples of initiatives focused on building new facilities and roads as well as easier access to electricity and supplies. Mountain Hazelnuts, a company headquartered in Eastern Bhutan has also made major tech investments for its farms, increasing employment and supplying smartphones for hired farmers that help with directions on the road and improve communication.

Henry Elliott
Photo: Flickr


Using the Internet for DevelopmentIf you are reading this, you are lucky enough to have something that 4.1 billion people go without every day- internet access. And while the internet may be used for a variety of frivolous and silly things like cat videos, memes and gifs, it has also become an indispensable part of daily life in the developed world. The internet also has the potential to drastically improve life for the world’s extreme poor. One study estimated that guaranteeing internet access for everyone would lift 500 million people out of poverty and add over $6 trillion to the global economy. Some people are already taking action. Here are six countries that are using the internet as the most important mean for development.

  1. Colombia.  Thirty-nine percent of Colombia’s citizens live under the poverty line, with the poorest living on under $2 a day. In response, the government has taken steps in using the internet for development by ensuring internet access for 96 percent of this tropical nation’s population. In three years, this infrastructure development raised at least 2.5 million people out of poverty. As the Minister for Technology, Diego Molano, said in an interview with The Guardian: “When we connect, for example, a rural school to Internet, when we connect a small school in the middle of the jungle to Internet, those kids in the middle of nowhere have effectively the same opportunity to access the whole of information society — just like any kid in New York, London or Paris.”
  2. China. While crowdfunding is common in the United States, it is usually not used on a such a wide scale as in China. The Chinese government has recently released an online program called Social Participation in Poverty Alleviation and Development, designed to lift at least 47 million people out of extreme poverty. Essentially, it uses social media platforms such as WeChat to allow normal citizens to help struggling families. At least $3.45 million has been raised for various projects that cover education, agriculture and more important social and economic issues, using the internet as the basis for development.
  3. Kenya. Private industry can make a difference as well. In Kenya, online banking systems such as M-PESA have helped to lift citizens out of poverty. Tavneet Suri, an economist at MIT decided to study the impacts of this phenomenon. She found that for 10 percent of families living on less than $1.25 a day using a mobile banking system was enough to lift them out of extreme poverty. The effect was even more marked amongst women. The mobile system allowed female-led families to save 22 percent more money than before.
  4. Bhutan. The small country of Bhutan located high in the Himalayan mountains has been isolated from the outside world for most of its history. The onset of the digital age changed that. The government has actively encouraged its citizens’ adoption of the internet by moving bureaucratic processes. With the support of the World Bank, information communications technology will continue to expand. In 15 years alone, the number of internet users in Bhutan grew by over 300 thousand.
  5. Rwanda. Though Rwanda may still be known in the international community for its horrific ethnic genocide, in recent years, the country has taken multiple steps towards development. The government has launched an effort called Vision2020 to cultivate an entrepreneurial, tech-savvy middle class. Internet connections are widespread throughout the country and are used for innovative purposes. One philanthropist started the Incike Initiative, an annual crowdfund that provides health care for the survivors of the genocide. Another entrepreneur started a platform called Girl Hub that allows women to give their opinions to local news sources. Rwanda fully utilizes the internet for development.
  6. Peru. With support from the international community, the Peruvian government is making efforts to connect more than 300 thousand people in rural areas to the national electric grid and, through this, to the internet as well. This connection has wider implications, especially for education. Students in these isolated areas can now be exposed to ideas in the wider world. This encourages engagement. A teacher in one of these villages, Teresa Uribe says that the kids now want to learn more, thanks to the technology.

These stories show the power of the internet to enact positive change in the developing world. If you too are interested in using the internet for development, take this opportunity to email your representatives about anti-poverty legislation. The internet’s potential should not go wasted.

– Lydia Cardwell
Photo: Flickr

The Development of South Asia Through Integration
South Asia is considered one of the least integrated regions across the globe; yet in recent years, international organizations, such as the World Bank, are implementing strategies to unite the nations economically.

Understanding South Asia

South Asian countries consist of Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka. South Asia is considered one of the fasting growing regions within the world today, and the region is home to two very fast-growing economies.

According to the World Bank, the development of South Asia is projected to increase from 6.9 percent to 7.1 percent in the upcoming year.

Bhutan, alone, is currently the fastest growing economy — the nation reports that it will grow at a staggering annual rate of 11.1 percent. India is also one of the fastest growing economies as well, with a growth rate at about 7.73 percent from 2017-2019.

The World Bank emphasizes the importance of cooperation and trade among South Asia, and they believe that the growth rate is predicted to increase if these nations work together in harmony.

Path to Progress

Regional, economic entwinement is the way in which development of South Asia progresses — the World Bank recognizes such measures and has initiated plans in order to unify this region.

As one of the first steps, the World Bank brought approximately 100 students together at the Fourteenth South Asia Economics Students’ Meet (SAESM). Economic undergraduates discussed their academic and experimental research about regional integration and its advantages.

They also explained how to attain economic prosperity through cooperation and trade, and students developed long-lasting friendships that should unequivocally encourage future relations among South Asian countries.

‘One South Asia’

Not only has the World Bank encouraged millennials, but they also have a twofold program called “One South Asia,” which directly forms connections among South Asian countries. The first objective is technical assistance, which will offer economic opportunities to strengthen trade connections. The second goal is to increase conversation about regional integration and local investments.

They are also trying to work with both the public and private sectors. The development of South Asia begins at the engagement of all levels of the economy.

There has been many obstacles to achieve “One South Asia,” yet the World Bank is determined to merge these nations together so they are successful economically, politically and socially. The development of South Asia as a whole will be difficult, yet it is possible and can occur if the region continues on this trajectory.

The World Bank’s Influence and Steps to Development

The World Bank has many projects within South Asian nations — particularly Afghanistan, Bangladesh, Nepal, Sri Lanka and Pakistan — to improve their economies individually. Most of these initiatives create jobs and opportunities for their citizens.

Regional integration is also crucial to the development of South Asia. The only way to reach prosperity is for countries to form a union — if South Asia mirrored the European Union, the opportunities for growth within each nation are endless.

This is a challenge, yet if international organizations, governments and the citizens of South Asia work tirelessly, they will surely reach their Sustainable Development Goals.

– Diana Hallisey
Photo: Flickr


Bhutan, also known as the Kingdom of Bhutan, is a picturesque country bordering India and China and situated in the foothills of the Himalayas. The country has transformed from an absolute monarchy to a constitutional monarchy under the rule of King Jigme Singye Wangchunk. To protect the environment as well as its culture from the outside world Bhutan remained in isolation for a long time. In June 1999, the country legalized television and the internet, slowly moving towards modernization.

Instead of using Gross National Income (GNI), the indicator of socio-economic development, Bhutan measures the quality of life with Gross National Happiness (GNH), a unique way of valuing the country’s self-worth.

Although Bhutan has a lot of potential in tourism, the infrastructure in Bhutan still remains a question. Due to the mountainous terrain, road construction was a challenge for a long time. The few options for transporting goods were porters, ponies or cantilever bridges built over rivers. To overcome this problem, in 1961 a large share of the National budget was invested in constructing a safe and reliable road network. From 1961 to 2002, almost 1231 miles of surfaced road and 102 suspension bridges were built.

With help from the Government of India, Bhutan has so far constructed two national highways, 337 bridges and 409 trail suspension bridges thus creating access to different remote areas of the country. Bhutan Airlines and Druk Airlines connect internationally with India, Thailand and Nepal. In 2005, an agreement was signed between India and Bhutan which provided the opportunity for Bhutan to connect with north-east India. This development is a cornerstone of improving infrastructure in Bhutan.

Another key feature of Bhutan is the generation and export of hydroelectric power which is possible because of the fast-flowing rivers coming from the mountain range of the Himalayas. Under the U.N.’s Kyoto Protocol, a clean development mechanism, Bhutan is estimated to export almost 10,000 MW of electricity to India by 2020. Five major hydropower projects like Tala, Chukkha, Dagachu, Basochhu and Kurichu, which started in 2015, are currently operational in Bhutan.

Quality of water is a major issue for Bhutan especially during monsoons when water contamination diseases like diarrhea take a toll on human lives. In 2005, the Bhutanese government, in partnership with the World Health Organization (WHO), addressed this issue by implementing the Bhutan Water Quality Partnership (WQP) Project. The objective of the project is to provide safe drinking water by giving training and education to the local community, government staff and policymakers. The project has so far been able to improve drinking water for almost 100,000 people.

Bhutan is already considered a heaven for tourists from all over the world who seek peace and tranquility in the tiny Himalayan country. The development of infrastructure in Bhutan will bring more tourists to the country, boosting its economy and increasing its GNI.

– Mahua Mitra

Photo: Flickr

Education in BhutanThe encouraging transition towards gender equality within education in Bhutan has participated in the drastic decrease in their poverty rate from 23 percent in 2007 to 12 percent in 2012. An entire 11 percent has risen above the poverty line, in part because of girls’ greater access to education.

Comparing Genders

Traditionally, it was much more prevalent for Bhutanese girls to participate in domestic labor, such as babysitting and cleaning, while boys attended school. However, from 1992 to 2012 the enrollment rate has more than doubled from 50 percent to 110 percent because of the increase in female attendance. To compare data from 2012, 110 percent of males were enrolled in primary school, while 112 percent of females were enrolled. Not only has education in Bhutan bridged the gender gap, but there’s now a dominance of girls in school. It is important to acknowledge that the percentage rests over 100 percent because of a lack of children completing primary school when they are expected to, creating an overabundance of students.

The 2012 results for secondary school, in regards to gender, are similar to that of primary school, with 50 percent males and 57 percent females enrolled. In this regard, the issue no longer lies between gender differences, but rather with a lack of all children attending secondary schooling, which is defined as grades 7 to 12.


Child labor exists as one of the main deterrents to girls’ education in Bhutan. Although the country declared the legal working age as 18-years-old and provides free primary education, one out of five children are required to work to aid their families. Furthermore, 2012’s child labor rates were higher from females than for males, with 3.1 percent of girls and 2.6 percent of boys participating in any form of labor.

Perhaps the overall low enrollment for secondary school is due to the need for children to work and aid their families, paired with additional school fees and the cost of uniforms and materials. It is also not mandatory for Bhutanese children to attend schooling, allowing families to deny their children the experience if they are needed elsewhere.


A UNICEF representative spoke with a Bhutanese girl named Tsherin, who shared her dream to become a civil engineer and build homes. She tells of her excitement to get to attend school and she plans to advocate schooling to her own children someday. Tsherin has UNICEF to thank for this opportunity because of their successful efforts in closing this gendered gap.

UNICEF advocated ending the discrimination and gendered stereotypes, while also aiding those who could not afford additional school fees. They also addressed the lack of schools in rural areas, which hinders student’s access because of distance, by implementing new schools into these remote areas. Additionally, UNICEF was not alone in this fight. UNGEI (United Nations Girls’ Education Initiative) also sought the construction of new primary schools to meet the higher demand of students. But UNGEI also concerned themselves with advancing the training in which the teachers received, improving the student’s overall education.

With the help of these two organizations, education in Bhutan has undergone a tremendous feat by bridging the gendered gap and allowing all children an equal chance at becoming educated.

– Brianna White

Photo: Flickr

Poverty Rate in BhutanBhutan is a small landlocked country in the Himalaya region of Asia. The country’s remoteness has largely affected its people by preventing economic progress until the 1960s. Until then, the country did not have a currency of its own, telephones, schools, hospitals or postal services, keeping the country completely secluded from the world around them. In 1961, the country’s king decided that the country needed to join the modern world, improving the poverty rate in Bhutan greatly.

In recent years, Bhutan has significantly lowered the number of citizens living below the poverty line. Between 2007 and 2012, the country was able to reduce the number of those living in poverty from 23 percent of the population to 12 percent. While most of the poverty reduction has been in rural areas of the country, these same families are the ones most at risk for slipping backwards.

The commercialization of agriculture as well as the creation of roads and hydropower projects allowed for more economic stability for those who made their living in the farming industry. While this has created great prosperity for rural areas in Bhutan, the agricultural industry is still the most vulnerable within the country, susceptible to environmental catastrophes.

While the poverty rate continues to decrease and the country’s GNI per capita increases yearly, the Bhutanese government refuses to stop there. The government has recently made a commitment to reduce multidimensional poverty to five percent by the end of 2018. One of the biggest initiatives under this new plan is to give land to 245 households that previously had unusable or no land.

While a good portion of the country’s people still live in poverty, Bhutan has seen incredible progress in the past 10 years. The poverty rate in Bhutan has seen a dramatic decrease and the government continues to implement programs in hopes of providing more opportunities for the people.

Olivia Hayes

Photo: Flickr

Top Diseases in BhutanOfficially the Kingdom of Bhutan, the country of Bhutan is located in the Eastern Himalayas in South Asia, and is bordered by Tibet to the north and India to the south. It has a relatively small population of approximately 775,000 people who are susceptible to both non-communicable and communicable diseases. The good news is that many of the top diseases in Bhutan have declining mortality rates.

Non-communicable Diseases (NCD)

Cardiovascular diseases affect 47.8 percent of the Bhutanese population. The most recent data from 2013 show that the most deadly of these diseases are ischemic heart disease, stroke, and chronic obstructive pulmonary disease. Ischemic heart disease killed 89.2 people out of every 100,000 in 2013, and its mortality rate increased by 66 percent since 1990. By 2015, it remained the most common NCD in Bhutan. Strokes killed 72 people out of every 100,000, and its mortality rate has increased by an alarming 73 percent since 1990. Respiratory diseases like chronic obstructive pulmonary disease, asthma, and pnuemoconiosis saw decreased mortality rates in 2013 by nine percent, 52 percent, and 27 percent since 1990, respectively.

Cancer is the second most common NCD in Bhutan, as it affects 12.4 percent of people in the country. Tracheal, bronchus, and lung cancers claimed the lives of five people out of every 100,000 in 2013, and its mortality rate has increased by 19 percent since 1990. In 2013, esophageal cancer took another five lives out of every 100,000, and the mortality rate has increased by eight percent since 1990. The mortality rate of liver cancer has increased by 60 percent since 1990, and lip and oral cavity cancers are becoming the most prevalent, and the mortality rate has increased by 33 percent between 1990 and 2013.

Communicable Diseases

In 1990, communicable diseases, combined with maternal and neonatal diseases, killed about 555 out of every 100,000 people. By 2013, the mortality rate had decreased significantly, claiming around 137 lives out of every 100,000.

As of 2013, 39.9 percent of people affected by communicable disease suffer from diarrhea, lower respiratory, and intestinal infectious diseases. Fortunately, the mortality rates of these three diseases dramatically decreased between 1990 and 2013, specifically by 84 percent for diarrheal disease, 75 percent for lower respiratory diseases, and 23 percent for intestinal infectious diseases.

As of 2017, the degree of risk for major infectious diseases is high. Three of the most common food or waterborne diseases are bacterial and protozoal diarrhea, hepatitis A and typhoid fever. While a vaccine is available to prevent hepatitis A, typhoid fever is still claiming lives without any preventative measures in sight, and if left untreated, mortality rates could reach 20 percent of those affected. Dengue fever is the top vector-borne disease, and is caused by a bite from a mosquito. It causes death in five percent of cases.

Neonatal disorders affect about 31 percent of the population in Bhutan. The good news is that between 1990 and 2014, the mortality trend in children under five years of age dropped from about 4,000 deaths to 1,804 deaths. In 2013, the most deadly neonatal disorders were neonatal encephalopathy due to birth asphyxia and trauma, preterm birth complications, and other neonatal infections, like neonatal sepsis. Each of these disorders killed less than 18 babies per every 100,000 in 2013.

Though these top diseases in Bhutan are concerning, the consistent decreasing mortality rates seem promising for the population, and it appears that with proper and effective treatment and prevention measures, those affected by these illnesses might see light on the horizon.

Olivia Cyr

Photo: Flickr