G R O S S N AT I O N A L H A P P I N E S S A N D H E A LT H In Bhutan, happiness is considered a public good and a government duty. Indeed, the constitution directs the state “to promote those conditions that will enable the pursuit of Gross National Happiness.” Unlike in a nation that gauges progress solely by economic gains, Bhutan’s GNH-based model rests on the idea that society benefits most when material and spiritual development unfold side by side. “Bhutan is not a country that has attained GNH. Like most developing nations, we are struggling with the challenge of fulfilling the basic needs of our people,” explained Prime Minister Jigmi Y. Thinley at a UN meeting in April 2012. “What separates us, however, from most others is that Patients wait for treatment at the Bali Basic Health Unit, in the Haa District of western Bhutan.
we have made happiness, the foundation of human needs, as the goal of social change.” Not only does the government survey the nation’s Gross National Happiness every other year, but all major policy proposals must pass a formal
GNH screening before they are enacted. GNH’s nine measurable domains encompass not only health, but also psychological well-being, balanced use of time, education, cultural diversity and resilience, good governance, community vitality, ecological diversity and resilience, and living standards.
(she in global health, with a focus on health systems; he
for JDW National Referral Hospital in the capital,
in health care management), they have fashioned them-
Thimphu. The hospital has no emergency medicine
selves as a public health team in their volunteer assign-
doctors—a situation reflecting a dearth of special-
ments abroad. After projects in Cambodia and Thailand
ists throughout the nation. This past September, the
to deliver advanced eye care surgery, they brought their
education module was used to train some 20 physicians
expertise to Bhutan in 2004—drawn as much by its
managing emergency and trauma care. The training
spiritual culture as by its pressing public health needs.
will pay off not only with accident victims, but also with
Michael set up Bhutan’s first laser surgery equipment
victims of other common emergencies, such as children
to treat diabetic retinopathy, and the couple collabo-
choking or women suffering from ruptures caused by
rated with the WHO on a Rapid Assessment Avoidable
ectopic pregnancies.
Blindness survey. More recently, the Morleys have joined forces with
FEAR OF SEAT BELTS
the nongovernmental organization Health Volunteers
In Bhutan—where subtropical southern lowlands rise to
Overseas to buttress Bhutan’s emergency care system.
sacred, unclimbed peaks exceeding 24,000 feet—many
The collaboration, funded by the Washington, DC–based
grievous injuries occur when cars veer off the country’s
Bhutan Foundation, includes physicians at the University-
narrow, vertiginous roads. Bhutanese dislike wearing seat
wide Harvard Humanitarian Initiative.
belts, fearing the belts will trap them in falling vehicles.
With traumatic injuries—often the result of road
Kathy Morley wants to conduct a study to see if that tena-
accidents—a major cause of death in the country, Kathy
cious cultural belief is valid. “You need data to change
helped develop a National Emergency Medicine Course
people’s minds,” she says. “And when it comes to research, continued
17 Winter 2013