THIMPHU, Bhutan – The Lunana region of Bhutan is remote, even by the standards of an isolated Himalayan kingdom: it covers an area about twice the size of New York City, bordering western China, includes glacial lakes and some of the highest peaks in the world, and is inaccessible by car.
Yet most people living there have already received a coronavirus vaccine.
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Vials of the Oxford-AstraZeneca vaccine arrived by helicopter last month and were distributed by health workers, who passed from town to town through snow and ice. Vaccinations took place in the 13 settlements of the area, even after yaks damaged some of the field tents that volunteers set up for patients.
“I first vaccinated to prove to my villagers that the vaccine does not cause death and that it is safe to take,” Pema, a town leader in Lunana who is in her 50s and mentions one name, said said. “After that, everyone here took the jab.”
Lunana’s campaign is part of a silent success story of vaccines in one of the poorest countries in Asia. Bhutan, a Buddhist kingdom emphasizing its citizens’ well-being over national prosperity, administered the first vaccine dose to more than 478,000 people, more than 60% of the population, as of Saturday. The Ministry of Health said this month that more than 93% of eligible adults got their first shots.
The vast majority of the first doses of Bhutan were administered at the end of March and early April at about 1,200 vaccination centers. According to the New York Times database, the vaccination rate of 63 countries per 100 people was the sixth highest in the world.
The rate was higher than that of Britain and the United States, more than seven times that of neighboring India and almost six times the world average. Bhutan is also ahead of a number of other geographically isolated countries with small populations, including Iceland and the Maldives.
Dasho Dechen Wangmo, Bhutan’s health minister, attributed his success to the country’s king’s leadership and leadership, public solidarity, a general absence of vaccination by vaccines, and a primary health care system that ‘enabled us’ to take the services to the best remote parts of the country. ”
“Being a small country with a population of just over 750,000, a two-week vaccination campaign was feasible,” Dechen Wangmo said in an email. “There were minor logistical problems during the vaccination, but they are all manageable.”
All the doses used so far have been donated by the Government of India, where the drug is known as Covishield and manufactured by the Serum Institute of India, the world’s largest vaccine producer. The Bhutan government has said it plans to administer second doses about eight to 12 weeks after the first round, in line with the guidelines for the AstraZeneca vaccine.
Will Parks, the representative of UNICEF, the United Nations agency for children in Bhutan, said the first round was a “success story, not only in terms of coverage, but also in the way the vaccination was carried out jointly, from the planning to the implementation. ”
“It involved participation of the highest authority in the local community,” he said.
The campaign was based in part on a corps of volunteers, known as the Guardians of the Peace, working under the authority of Bhutan’s king, Jigme Khesar Namgyel Wangchuck.
In Lunana, eight volunteers pitched field tents and helped transport oxygen tanks from town to town, said Karma Tashi, a member of the government’s four-vaccination team there. The tanks were a precaution if villagers had adverse reactions to the shots.
To save time, Tashi said, the team administered vaccines during the day and walked between villages at night – often 10 to 14 hours at a time.
The yak damage to the tents was not the only hiccup. Some villagers did not initially vaccinate because they were harvesting barley or because they were worried about possible side effects. “But after we tell them about the benefits, they agree,” Tashi said.
On April 12, 464 of Lunana’s 800 residents received a first dose, according to government data. The population figure includes minors who are not eligible for vaccines.
Healthcare in Bhutan, an enclosed country slightly larger than Maryland and bordering Tibet, is free. Between 1960 and 2014, life expectancy there more than doubled to 69.5 years, according to the World Health Organization. Immunization levels have been above 95% in recent years.
But Bhutan’s health system is ‘barely self-sufficient’, and patients in need of expensive or sophisticated treatments are often sent to India or Thailand at the expense of the government, Drs. Yot Teerawattananon, a Thai health economist at the National University of Singapore, said.
A government committee in Bhutan meets once a week to make decisions about which patients to send overseas for treatment, Yot said. He said the committee – which focuses on brain and heart surgery, kidney transplants and cancer treatment – is informally known as the “death panel”.
“I do not think they can cope with the increase in serious COVID cases if this happens, so it is important for them to prioritize COVID vaccination,” he said, referring to Bhutan’s health authorities.
Bhutan has reported fewer than 1,000 coronavirus infections and only one death. Its borders, which are still ahead of the pandemic according to global standards, have been closed for a year with a few exceptions, and everyone entering the country must be in quarantine for 21 days.
These include Prime Minister Lotay Tshering, who received his first dose of vaccine last month while in quarantine following a visit to Bangladesh. He has been supporting the vaccination effort over the past few weeks on his official Facebook page.
“My days are littered with virtual meetings in many areas that need attention because I am following the vaccination campaign on the ground,” Tshering, a surgeon, wrote in early April. “So far, your prayers and blessings are going well.”
The economy in Lunana depends on livestock farming and harvests of a so-called caterpillar fungus that is sought after in China as an aphrodisiac. People speak Dzongkha, the national language and a local dialect.
Last year, the drama “Lunana: A Yak in the Classroom” became the second film ever selected to represent Bhutan at the Academy Awards. It was filmed with solar batteries, and locals were among the cast.
Lunana’s chief, Kaka, who mentions one name, said the most important part of the vaccination campaign was not on the ground but in the air.
“If there was no helicopter,” he said, “it would have been difficult to use the vaccinations because there is no access road.”
This article originally appeared in The New York Times.
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