Tashi Dendup, EpiC Consultant, Save the Children, Bhutan
Karma Doma Tshering, Project Manager, Save the Children, Bhutan
Sumita Taneja, Director, Country Programs, FHI 360, India

Dr. Ujal Pradhan is a young and enthusiastic anesthesiologist who works in the COVID-19 Intensive Care Unit (ICU) of the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) in Thimphu, Bhutan. When the USAID-supported Meeting Targets and Maintaining Epidemic Control (EpiC) Emergency Care and Ventilator Technical Assistance project started in Bhutan in March 2021 to support the Ministry of Health’s COVID-19 response, Dr. Ujal was nominated by JDWNRH to serve as a member of the project’s Technical Working Group (TWG). Since then, he and other members of the TWG have been involved in reviewing technical resources on COVID-19 and adapting them to address the clinical training needs of doctors and nurses in Bhutan.

“I completed my post-graduate degree in anesthesia from Thailand, and this was my first involvement in a national-level technical working group and clinical trainings on COVID-19 management. I was very excited but also anxious since I was required to facilitate clinical trainings for other doctors, and to coordinate a series of trainings in the country—something I had never done before.”

To prepare, Dr. Ujal received instruction to become one of the master trainers on COVID-19 Adult Case Management from Dr. Lundy Campbell, a critical care specialist from the University of California San Francisco (UCSF), one of EpiC’s COVID-19 technical partners, and Dr. Kesang Namgyal, an intensivist at JDWNRH and the only physician who is a specialist in ICU care in the country. EpiC’s COVID-19 technical assistance is funded by USAID, managed by FHI 360, and delivered through Save the Children. EpiC also covered the fees for Dr. Ujal and other providers in Bhutan to register for the renowned instructorship course on Fundamentals of Critical Care Support (FCCS) offered by the Society of Critical Care Medicine (SCCM).

“Participation in the internationally recognized FCCS course helped me to further improve and update my knowledge and skills on critical care. More than 300 doctors, nurses, and even intern doctors who are to be posted to different facilities across the country have enrolled for the course.”

Dr. Ujal at one of the COVID-19 clinical trainings supported by EpiC (Photo credit: Sonam Lhamo, AICU nurse, JDWNRH)

In a span of five months, Dr. Ujal, with support from Dr. Kesang and other colleagues, has organized and led several clinical trainings on COVID-19 critical care and ICU management, including how to use the Medtronic PB 560 ventilators donated by the U.S. Government to the Royal Government of Bhutan. More than 340 doctors, nurses, and intern doctors from almost all hospital-level facilities in the country have been trained, and expansion is planned to all districts in red zones as a part of COVID-19 preparedness.

“The role required me to work with several stakeholders including the Ministry of Health. The experience not only boosted my critical care competency but also helped improve my communication and coordination skills. I have developed a keen interest in teaching. I plan to enroll for a fellowship in critical care now.”

As a member of the TWG, Dr. Ujal has recently been involved in drafting key ICU protocols for the management of critically ill patients, including severe COVID-19 cases. In addition, during India’s COVID-19 surge in April 2021, he was sent to Delhi by the Ministry of Health to support the aeromedical evacuation of COVID-19 patients from Delhi to Bhutan. With funding from EpiC, Dr. Ujal will continue training and teaching doctors and nurses from other districts in COVID-19 clinical case management.

I am really glad to be part of the EpiC-supported COVID-19 trainings and technical support. Though I am not an intensivist, I have always been very interested in critical care. This project has exposed me to a wide range of aspects of COVID-19 case management. Bhutan has only one intensivist nationwide, and in emergency times such as this, this project has been timely and has offered doctors like me the opportunity to build our knowledge and skills in critical care.”

Dr. Ujal (far right) with other members of the Technical Working Group that developed ICU Protocols (Photo credit: Tashi Dendup, national coordinator for EpiC with Save the Children, Bhutan)

Main Photo: Dr. Ujal Pradhan, on COVID-19 ICU duty at JDWNRH, Thimphu, Bhutan (Photo credit: Sonam Lhamo, Adult ICU [AICU] nurse, JDWNRH)