THIMPHU, Bhutan – The Lunar Zone 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, borders western China, includes glacial lakes and some of the highest peaks. of the world, and is inaccessible by car.
However, most people living there have already received a vaccine against coronavirus.
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The bottles of the Oxford-AstraZeneca vaccine arrived by helicopter last month and were distributed by health workers, who went from village to village through snow and ice. Vaccinations took place in the 13 settlements in the area even after the yaks damaged some of the field tents that the volunteers set up for the patients.
“I was vaccinated first to prove to my fellow villagers that the vaccine does not cause death and is safe to take,” said Pema, a leader in the village of Lunana, who is over 50 years old and named. “After that, everyone here took the jab.”
The Lunana campaign is part of a quiet success story of the vaccine in one of the poorest countries in Asia. As of Saturday, Bhutan, a Buddhist kingdom that emphasized the well-being of its citizens over national prosperity, administered a first dose of vaccine to more than 478,000 people, more than 60 percent of its population. The Ministry of Health said this month that over 93% of eligible adults received the first blows.
The vast majority of the first doses in Bhutan were administered to about 1,200 vaccination centers over a one-week period in late March and early April. As of Saturday, the country’s vaccination rate of 63 doses per 100 people was the sixth highest in the world, according to a New York Times database.
This rate was ahead of those in the United Kingdom and the United States, more than seven times higher than in neighboring India and almost six times higher than the global average. Bhutan is also ahead of other geographically isolated countries with small populations, including Iceland and the Maldives.
Dasho Dechen Wangmo, Bhutan’s health minister, attributed the success of the king’s “leadership and guidance” to public solidarity, the general absence of vaccine hesitation and a primary health care system that “allowed us to take services even and in the most remote parts of the country. ”
“Being a small country with a population of just over 750,000 people, a two-week vaccination campaign was carried out,” Dechen Wangmo said in an email. “Minor logistical problems were encountered during the vaccination, but they were all manageable.”
All doses used so far have been donated by the Indian government, where the drug is known as Covishield and manufactured by the Serum Institute of India, the world’s largest vaccine manufacturer. The Bhutanese government has stated that it intends to administer secondary doses approximately eight to 12 weeks after the first round, in accordance with the guidelines for the AstraZeneca vaccine.
Will Parks, the representative in Bhutan for UNICEF, the United Nations children’s agency, said the first round was a “success story, not only in terms of coverage, but also how the vaccination was carried out collectively, from planning until implementation. “
“It involved participation from the highest authority in the local community,” he said.
The campaign was based in part on a body of volunteers, known as Peacekeepers, operating under the authority of the King of Bhutan, Jigme Khesar Namgyel Wangchuck.
In Lunana, eight volunteers set up camp tents and helped transport oxygen tanks from village to village, said Karma Tashi, a member of the government’s four-person vaccination team there. The tanks were a precautionary measure in case any villager had adverse reactions to the fires.
To save time, Tashi said, the team administered vaccines during the day and walked between villages at night – often for 10 to 14 hours at a time.
Damage to the yacht at the tents was not the only hiccup. Some villagers did not show up initially to be vaccinated because they were busy harvesting barley or because they were worried about possible side effects. “But after I told them about the benefits, they agreed,” Tashi said.
As of April 12, 464 of the approximately 800 inhabitants of Lunana had received a first dose, according to government data. The population figure includes minors who are not eligible for vaccines.
Health care in Bhutan, a landlocked country that is slightly larger than Maryland and borders Tibet, is free. Between 1960 and 2014, life expectancy there doubled to 69.5 years, according to the World Health Organization. Immunization levels in recent years have been over 95%.
But Bhutan’s health care system is “difficult to sustain”, and patients in need of expensive or sophisticated treatment are often sent to India or Thailand at the government’s expense, said Dr. Yot Teerawattananon, a Thai health economist at Singapore National University.
A Bhutanese government committee meets once a week to make decisions about which patients to send abroad 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 don’t think they could cope with the increase in severe COVID cases if that happens, so it’s important for them to prioritize COVID vaccination,” he said, referring to health authorities in Bhutan.
Bhutan has reported less than 1,000 coronavirus infections and one death. Its borders, tightened by global standards just before the pandemic, have been closed for a year, with few exceptions, and anyone entering the country must be quarantined for 21 days.
Among them is Prime Minister Lotay Tshering, who received his first dose of vaccine last month while in quarantine after a visit to Bangladesh. He has backed the vaccination effort in recent weeks on his official Facebook page.
“My days are littered with virtual meetings on many areas that need attention, as I follow the field vaccination campaign closely,” Tshering, a surgeon, wrote in early April. “So far, with your prayers and blessings, everything is going well.”
Lunana’s economy depends on animal husbandry and the harvests of a so-called caterpillar mushroom that is considered an aphrodisiac in China. 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 using solar batteries, and its cast included local villagers.
Lunana’s chief, Kaka, whose name is only one, said the most important part of the vaccination campaign was not on the ground, but in the sky.
“If there was no shredder,” he said, “getting vaccines would have been a problem, because there is no access.”
This article originally appeared in The New York Times.
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