Traditional Medicine in Bhutan

Living abroad tends to take one out of their comfort zone in a multitude of ways. During my time in Bhutan, eating has been one of those things which has been simultaneously both immensely rewarding and challenging. I left behind many of the nourishing comforts of home (no more quinoa, sourdough barley bread or organic almond butter) and wholeheartedly dove into the culinary wonders of Bhutanese food. All was well until a couple of weeks ago when my digestive system let me know, in no uncertain terms, that it was unhappy. Perhaps it was all of the chilies (I admit it, I am now totally addicted) or the abundance of dairy products (a main staple in Bhutanese cuisine which doesn't always 'agree' with me), or maybe it was some type of microorganism wreaking havoc on my insides. Whatever it was, balance had to be restored and I needed something stronger than the probiotic supplements which I had brought with me from Canada.

As a temporary resident here in Bhutan I am fortunate to have access to free healthcare. There are two distinct streams of medicine present in the country, the modern allopathic system and the traditional model; Bhutanese citizens are free to choose between the two as they see fit, and will often utilize both to fulfill their healthcare needs. Given my personal interest in traditional medicine and holistic approaches to wellness, I took the opportunity to visit the National Traditional Medicine Hospital to seek help for my digestive distress. The hospital is part of the large Institute of Traditional Medicine that also includes a medical school which trains doctors in traditional medical services, and a facility which is dedicated to researching and producing traditional medicines which are distributed to health centers across the country. Bhutan has been historically referred to as Lho Men Jong (Land of Medicinal Plants), a name bestowed by it's Tibetan neighbours as a reflection of the countries abundant flora, long a source of a myriad of plant medicines.

The history of indigenous medicine in Bhutan is inseparable from the nations spiritual heritage, and the traditional approach to healthcare is deeply and intrinsically linked to Buddhist cosmology. TSo-ba Rig-pa ("science of healing") has it's roots in Tibet where a medical system took shape in the 8th century influenced by the arrival of the Buddha's teachings. According to Buddhist tradition, upon attaining enlightenment the Buddha also implicitly realized and mastered the art of healing; the insight he gained into the nature of suffering and illness, and liberation from it, form the foundation of the Buddhist approach to healthcare. According to Dr. Tandi Dorji in the book The Medical History of Bhutan: "The core Buddhist teachings form the basis of Buddhist medical doctrines that influence traditional medical practice not only in Bhutan and Tibet, but throughout the region where Buddhism has a major influence." (It is no surprise then that Buddhist lamas have long been considered the countries primary practitioners of healing, and that monasteries have traditionally been repositories of medical knowledge.) In addition, other great systems of established medical thought inspired Tibetan and Bhutanese medicine in it's formative years; the Ayurvedic tradition of India provided much of the theoretical basis, and Chinese sources are said to have played an integral role as well.

 

Traditional approaches formed the foundation of localized healthcare within the country until the early 1950's with the establishment of a nationalized medical system, centered on the western allopathic model which had been steadily gaining popularity in Bhutan since it's arrival in the earlier part of the century. In 1967 the government acknowledged the scientific & cultural importance of traditional medicine within Bhutan and officially made it a part of the universally accessible national healthcare system, giving people the choice of both allopathic and traditional options. Talk about complementary healthcare!

Bhutanese traditional medicine is multi-layered and complex, and I have only just begun to scratch the surface in understanding it's philosophy and application. What I do know is that the three tools of diagnosis (visual - such as looking at the tongue, touch - listening to the pulse, and interrogation - asking lots of questions) are used to identify areas of disharmony within the three humours (air, bile and phlegm). Areas of imbalance are then addressed via the four pillars of treatment...food/diet, behaviour, medication (made of materials such as medicinal plants, minerals and even a few animal parts) and therapeutic approaches (such as herbal steam baths, cupping and gold needle acupuncture).

On the morning that I visited the hospital (a day clinic really), I was impressed to find it filled with people of all ages patiently awaiting appointments. When it was finally my turn, I was admitted to see a doctor who proceeded to ask me a plethora of questions regarding my current symptoms as well as my health history. After checking my tongue and listening to my pulse for quite some time, I was then sent to the dispensary to receive the series of medicines I was advised to take for the next week. 

 

 

As I walked home from this hospital I was reminded of a conversation which I had with a Bhutanese woman early on in my time here. She was explaining to me (in simple terms) the role that different Buddhas and Bodhisattvas play within the Bhutanese Buddhist universe, and how each is sought in prayer in different situations based on the specific attributes and energies which they embody. According to the The Medical History of Bhutan, "Medicine Buddha (Sangay Menlha) embodies healing and is worshipped to cure all ailments that affect mankind. He is recognized as the Buddha doctor, or Bodhisattva physician of vitality. He is an enlightened being who protects living beings from physical illness, mental illness, dangers and obstacles."  It was explained to me by my Bhutanese friend the importance of saying a prayer to Sangay Menlha prior to taking medicines, as it is the Medicine Buddha which will bring relief from suffering, not the medications themselves...the pills and powders are merely a channel through which the Buddha works.

Sangay Menlha ~ Medicine Buddha

I have been following this sage advice, keeping Sangay Menlha in mind as I partake of the healing medicines of Bhutan...sourced from her mountains and valleys, and swallowed down with her cool, soothing water. It has been nearly a week now and, whether it's the herbs or Medicine Buddha's intervention (or a combination of both), I am feeling much better...for this I am most grateful.

The Land of Gods and Goddesses

 
I have been extremely fortunate during my time in Bhutan to travel out of the 'big city' of Thimphu into it's outlying areas quite frequently. I have hiked up mountainsides and though valleys, driven across high mountain passes, visited many sacred and important sites such as Taksang monastery and Punakha Dzong and passed through numerous small towns and villages, catching a glimpse of Bhutanese life outside of the urban center. Recently I had the opportunity to travel further afield, out of the western region of the country with which I had become somewhat familiar and into the east. And what a wonderful journey it was!

The adventure began by traveling along the "Lateral Road", as the the main highway connecting east and west is known, from Thimphu to the town of Mongar in eastern Bhutan. For the record, I use the term 'highway' loosely. The roads here are all very similar...windy and narrow, with sheer drops of many hundreds (if not thousands) of feet. Not for the faint of heart, nor the queezy of stomach - there's a reason the local long distance buses are referred to as 'vomit comets'. Thankfully Kevin and I were in a car, and neither of us suffer from motion sickness :)

From Thimphu to Mongar was a very long ride indeed, taking two days with an overnight stop in a region known as Bumthang, but it was well worth it for the breathtaking scenery along the way. It amazed me the way in which the landscape changed as we ascended and descended mountains, the trees and plants varying according to the numerous micro-climates we passed through at different elevations. Dwarf bamboo, wild strawberries, countless species of conifers, a multitude of rhododendrons. The most dramatic by far was the change I saw after the Thrumshing La, the second highest mountain pass in Bhutan, which connects the central and eastern regions of the country. In a matter of hours we descend from elevations of approximately 12,500 ft down to less than 2,200 ft, transitioning from alpine forests into a semi-tropical valley dotted with banana, orange and mango trees.

Mongar is a beautiful spot, and quite unique in comparison to other towns I have visited in Bhutan. Whereas the villages in the western part of the country are all built in the depths of the valleys, Mongar, like most towns in the east, is built on the top of a mountain, positioning it's residents at eye level with the clouds and commanding magnificent views of the landscape below. I only had one afternoon and evening to enjoy wandering around this town, but I am so glad that I had the opportunity to experience it's charms!


Mongar Street Scene

The following morning I headed back to Bumthang, a district (or dzongkhag) consisting of the four neighbouring valleys of Chhume, Tang, Ura and Choekhor (a.k.a. Jakar); when most people say they are going to 'Bumthang', they are refering to Jakar valley/town, and this is exactly where I was headed.

Jakar Valley

Bumthang is known as the cultural and spiritual center of Bhutan, and it does indeed feel in many ways like the heart of the country. There are many important temples and monasteries which are nestled in these vallleys, particularly Jakar, and many significant events and personages that have roots here throughout Bhutan's fantastic past. Since arriving in Bhutan I have observed that history and mythology often intermingle, and nowhere has this been more evident to me than in Bumthang. The following quote (from the text 'Bumthang: Flower Garden of Celestial Beings' written by Kunkhyen Longchen Rabjam back in 1355), illustrates this nicely:

"A place where many renowned kings and ministers once lived

A place festooned with many awe-inspiring temples and monasteries

A place frequented by many spiritual masters and intellectuals of the past

You! Listen to the description of Bumthang, the land of gods and goddesses"

Guru Rinpoche

I was fortunate to be in Bumthang for a very special event, the birth anniversary of the great Guru Rinpoche, a celebration which spanned several days. Guru Rinpoche, also known as Padmasambhava or "the Second Buddha", is an important historical and religious figure (who also possessed miraculous powers including the ability to subdue demons) credited with introducing Tantric, or Vajrayana, Buddhism to Tibet and later Bhutan. In honour of the great Guru's birthday, a religious festival called a tsechu was held at Kurjey temple in Bumthang, which I had the great privilege of attending. The whole community turned out for the tsechu, all wearing their best kiras and gohs and watching with rapt attention the ceremonial dance~plays that unfolded before us.

A scene from Paro tsechu (photo taken by Kevin earlier in the year...I didn't have a camera with me at the Bumthang tsechu but wanted to give you an idea of what the event looked like)

Another highlight of my time in Bumthang was visiting the Pema Choling nunnery, home to a community of approximately 180 nuns ranging in age from 7 to 73. The nunnery serves as a boarding school where young women receive both secular and spiritual education; we met several of the students and teachers while we were there and I was deeply touched by the way they welcomed my travelling companions and I into their home. After receiving a full tour of the space in which the nuns live and study (including the kitchen which was quite remarkable...imagine how big the pots must be to feed 180 hungry nuns!), we were invited to come back the next day to attend a puja (religious ceremony) in honour of Guru Rinpoche's birthday. So we made our way back the following afternoon, and I must say that the puja was one of the most beautiful things I have ever experienced. The cadence of the nuns voices reciting Buddhist texts in harmonious union, along with the sound of the drums and horns that accompany the ceremony, was enchanting...an experience I won't soon forget.

  

 

In addition to being the spiritual centre of Bhutan, Bumthang is also an agricultural heartland. It's gently sloping hills and wide valleys are often referred to as "the Switzerland of Bhutan", making it oh so fitting that the region is famous for it's European style cheeses, beer and fruit infused liquors, all a result of Swiss influence in the area. In addition to these relatively recent additions to the local food scene, Bumthang is also well known for it's buckwheat production, a traditional staple food primarily eaten in the form of pancakes and handmade noodles. I had a quintessentially Bumthang breakfast on my last morning in Jakar...buckwheat pancakes, local gouda cheese, homemade wild strawberry jam and honey collected from a hive in the neighbouring valley. Ohhhhhhh SO delicious!

On our return journey westward, my friends Angela, Imee, Mia and I spent a night in a traditional Bhutanese farmhouse in the stunning PhobjikaValley where we caught a glimpse of farm life, feasted on homestyle Bhutanese cuisine and took a morning hike through the magnificent valley before making our way back to the urban metropolis of Thimphu.

It was a wonderful journey indeed, one which took me to the heart of Bhutan in more ways than one. While I am aware that there is still so much more to see and experience, I feel that I now know this beautiful country more deeply and intimately than I did a few weeks ago...and for this I am most grateful.