Jonathan Taee - The Patient Multiple: An Ethnography of Healthcare and Decision-Making in Bhutan

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T HE P ATIENT M ULTIPLE

Wyse Series in Social Anthropology

Editors:
James Laidlaw, William Wyse Professor of Social Anthropology, University of Cambridge, and Fellow of Kings College, Cambridge
Maryon McDonald, Fellow in Social Anthropology, Robinson College, University of Cambridge
Joel Robbins, Sigrid Rausing Professor of Social Anthropology, University of Cambridge, and Fellow of Trinity College, Cambridge

Social Anthropology is a vibrant discipline of relevance to many areas economics, politics, business, humanities, health and public policy. This series, published in association with the Cambridge William Wyse Chair in Social Anthropology, focuses on key interventions in Social Anthropology, based on innovative theory and research of relevance to contemporary social issues and debates. Former holders of the William Wyse Chair have included Meyer Fortes, Jack Goody, Ernest Gellner and Marilyn Strathern, all of whom have advanced the frontiers of the discipline. This series intends to develop and foster that tradition.

Volume 1
Sociality: New Directions
Edited by Nicholas J. Long and Henrietta L. Moore

Volume 2
The Social Life of Achievement
Edited by Nicholas J. Long and Henrietta L. Moore

Volume 3
The State Were In: Reflecting on Democracys Troubles
Edited by Joanna Cook, Nicholas J. Long and Henrietta L. Moore

Volume 4
The Patient Multiple: An Ethnography of Healthcare and Decision-Making in Bhutan
Jonathan Taee

T HE P ATIENT M ULTIPLE

An Ethnography of Healthcare and Decision-Making in Bhutan

Jonathan Taee

Published in 2017 by
Berghahn Books
www.berghahnbooks.com

2017 Jonathan Taee

All rights reserved. Except for the quotation of short passages
for the purposes of criticism and review, no part of this book
may be reproduced in any form or by any means, electronic or
mechanical, including photocopying, recording, or any information
storage and retrieval system now known or to be invented,
without written permission of the publisher.

Library of Congress Cataloging-in-Publication Data

Names: Taee, Jonathan, author.

Title: The patient multiple : an ethnography of healthcare and decision-making in Bhutan / Jonathan Taee.

Description: New York : Berghahn Books, 2017. | Series: WYSE series in social anthropology ; volume 4 | Includes bibliographical references and index.

Identifiers: LCCN 2016053205 (print) | LCCN 2016055843 (ebook) | ISBN 9781785333941 (hardback : alk. paper) | ISBN 9781785333958 (ebook)

Subjects: LCSH: Medical Anthropology--Bhutan. | Traditional medicine--Bhutan. | Traditional medicine--Technological innovation--Bhutan.

Classification: LCC GN296.5.B47 T34 2017 (print) | LCC GN296.5.B47 (ebook) | DDC 306.4/61095498--dc23

LC record available at hips://lccn.loc.gov/2016053205

British Library Cataloguing in Publication Data
A catalogue record for this book is available
from the British Library.

ISBN 978-1-78533-394-1 (hardback)
ISBN 978-1-78533-395-8 (ebook)

This book is dedicated to the patients
and healthcare practitioners of Bhutan.
May you long find hope and healing from one another.

Contents

Maps, Illustrations and Figures

Maps

0.1. Map of Bhutan: Cities, Towns and Roads

Illustrations

0.1. Young Woman Receives Treatment

1.1. Pema and a Drungtsho

2.1. Traditional-Medicine Patient Record

3.1. Traditional and Biomedical Integration

4.1. A Returner of Lost Souls

5.1. Blood Flows through Humans and Machines

Figures

An online collection of colour photography accompanying
this book is available at: www.jonathantaee.com

Acronyms

I have avoided using acronyms in the body of the text. Acronyms are used in parenthesised references and are spelled out in their full form on first appearance.

BBC	British Broadcasting Corporation
BBS	Bhutan Broadcasting Service
BHU	Basic Health Unit
BST	Bhutan Stretchable Time
DDC	Dzongkha Development Commission
DRA	Drug Regulatory Authority, Royal Government of Bhutan
DVED	Drug, Vaccines and Equipment Division, Royal Government of Bhutan
FTM	Faculty of Traditional Medicine
INR	International Normalised Ratio
MLHR	Ministry of Labour and Human Resources, Royal Government of Bhutan
MoAF	Ministry of Agriculture and Forests, Royal Government of Bhutan
MoH	Ministry of Health, Royal Government of Bhutan
MSP	Menjong Sorig Pharmaceuticals (Formally known as PRU)
NSB	National Statistics Bureau, Royal Government of Bhutan
NITM	National Institute of Traditional Medicine
NTMH	National Traditional Medicine Hospital
OCC	Office of the Census Commission, Royal Government of Bhutan
PRU	Pharmaceutical Research Unit (Now called MSP)
RGoB	Royal Government of Bhutan
WHO	World Health Organisation

Notes on Language, Transliteration, Transcription and Translation

Dzongkha (rdzong kha) is the national language of Bhutan, one of twenty-seven active languages. It is spoken by approximately 160,000 people, most of whom live in the western part of the country (Ethnologue, ISO 639-3, 2013). The second most common non-English language is Sharshop (shar phyogs pa), also known as Tshangla Lo (thangs la lo, Driem 1998: 2729), used primarily in the east of Bhutan; however, this particular language is further broken down into different dialects and subgroups (see Phuntsho 2013: 5162). My informants would often clump these eastern languages together using the umbrella term Sharshop, literally translated as [the language of the people of] the eastern direction. Dzongkha has roots in Classical Tibetan, known in Bhutan as Chke (chos skad). These languages share the same script, yet they are definitively different. George van Driem, one of the leading experts on Dzongkha and other Himalayan languages, notes, The relationship between Dzongkha and Chk in Bhutan is reminiscent of the role Latin used to play as the language of learning in Mediaeval France where the spoken language had long since evolved into a language different from that spoken by the ancient Romans (1991: 4).

The relationship between Dzongkha and modern Tibetan is complicated historically, linguistically and politically, yet a cursory introduction is necessary to present a sound methodology for handling Dzongkha in this book.

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