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Strengthening Systems for Success: The Bhutan Cancer Registry

In November 2013, Narhari Timilshina, MPH – a public health expert and clinical epidemiologist – traveled to Bhutan with an ambitious agenda: to create the country’s first cancer registry.

A cancer registry is an essential tool for gathering information about the causes and effects of different types of cancer. This information, in turn, leads to better decision-making in health care – with more and better information, health care providers can more effectively treat and even prevent cancer.

Thimphu, BhutanIn Bhutan, the Jigme Dorji Wangchuck National Referral Hospital sees numerous cancer patients.  In fact, many providers estimate that cancer is one of the top ten leading causes of death in Bhutan. Of course, without a cancer registry, it is impossible to know exactly what the current burden of the disease is on the Bhutanese people. Health providers have had to rely on inexact reporting and personal accounting to determine the extent of this disease’s impact.

Understanding the necessity of accurate reporting, Mr. Timilshina traveled to HVO’s oncology project in Bhutan. Mr. Timilshina began his work at the National Referral Hospital, which treats the majority of cancer patients in Bhutan. He consulted with officials of Bhutan’s Ministry of Health and National Referral Hospital, administrators at the nearby University of Medical Sciences Bhutan, hospital oncology staff, ASCO’s International Cancer Corps, and other HVO leaders and volunteers. He developed an advisory board and began testing software from the International Association of Cancer Registries (IACR) to store registry data. He reported of his first trip, “We started the baby steps to start a cancer registry while laying a very good foundation.”

After returning from Bhutan, Mr. Timilshina continued his work on the registry remotely through intense communication with the advisory board and project site. He returned to Bhutan in April 2015 to train staff and provide technical knowledge and systematic instruction for the registry. Today, all cancer cases treated at Bhutan’s National Referral Hospital between the years 2005–2010 have been added to the registry. Work is ongoing to enter data for 2011 to present day.

As Mr. Timilshina reported in International Perspectives on the ASCO Connection website, the registry has already revealed the top four cancers plaguing Bhutan and shown the growth in chemotherapy treatments at the hospital. Moving forward, the data could serve to identify ways health workers in Bhutan might prevent cancer and how the hospital can improve treatments.

As Mr. Timilshina reported of his work developing Bhutan’s first cancer registry, “This was a wonderful experience for me. I felt honoured to contribute, which can lead to better planning and improved care for cancer patients in Bhutan.”

Learn more about HVO’s project in Bhutan and other volunteer opportunities in oncology on our oncology program page