No abstract

This study focuses on globalization and preservation of traditional language. The Bhutanese government has promoted higher education to be taught by English; however, there are ongoing initiatives for college students to learn their major subjects not only in English but also in their national language, Dzongkha. The researchers developed interview questions, drawn from their research on Bhutanese education, education in southeast Asia, and other topical sources; this provided a contemporary framework for these educators to discuss their current perception of Bhutanese education and influences felt from external forces (e.g. global assessments) as well as internal goals and economic and political motivations. Results of the interview will be analyzed in the context of educational progress on the GNH, discussion of issues in Bhutan that challenge the GNH perception, such as multiculturalism, and how these teachers feel Bhutan will embrace the ever increasing swath of global assessments.

Modern society has seen a rapid shift toward biomedicalization. However, there is now an increasing trend of using complementary and alternative medicine for holistic treatment. Bhutan promotes the physical, mental, and spiritual well-being of its citizens through its universal healthcare system, production of herbal medicines, Buddhist practices, and governmental policy of Gross National Happiness. Patients can choose one or a combination of modern, traditional (Sowa Rigpa), and local healing practices for treatment. For this study, in-depth, semi-structured interviews were conducted among randomly-selected patients (N = 20). Interviewees were categorized based on demographics, past medical experiences, upbringings, and expectations for medical care providers. All participants were found to rely on modern medicine (n = 20), many used traditional medicine (n = 13), and some had experienced local medicine (n = 9). Only a fraction had solely relied on modern medicine (n = 5) and a select number relied on all three practices for treatment (n = 7). In addition to determining patients' reliance on one or a combination of healing practices, this study identified their perceptions of the strengths and limitations of each method. To this end, the participants' reasonings for relying on certain practices over others for particular ailments were investigated. A key finding was that patients believe the flexibility in the reliance of one or multiple treatment types optimize their health and facilitate access to medical resources. Further collaborations between modern medical practitioners and complementary and alternative medical care providers are necessary to advance the integration of these three practices and ensure patient well-being. Key messages Bhutan provides universal health coverage to access basic public health services in both modern and traditional medicine, giving patients the freedom to choose their own modes of treatment. Referrals and communication between modern medical practitioners and complementary and alternative medical care providers are necessary to ensure patient health and well-being.

In modern times, the main disease structure has changed from infectious disease to chronic disease, and many people are now living with illness. Despite the patients' current situation, society still expects people with disease to behave consistently with the “Sick Role”, which Talcott Parson's previously defined. Once people are diagnosed, for example, as cancer patients, they may lose their jobs and social participation opportunities and their hope to live. To change this situation, people living with disease do a variety of things, for instance, changing their illness image and repelling social stigma, by collaborating with other stakeholders such as medical and health professionals, persons from the workplace, fellow patients, and their community. The actions undertaken by patients in cancer and ME/CFS support groups and prefectural Medical Councils in Japan as well as patients' collaboration with various stakeholders can be seen as a form of health governance. Patient-led initiatives are critical for the overall amelioration of healthcare.