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The 30 Dzongkha Alphabets, written by myself.

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Dzongkha was adopted as the national language due to its popularity in dzongs, hence Dzongkha, meaning the language of the dzong. It was founded by Thonmi Sambhota. Dzongkha consists of 30 alphabets similar to the Sino-Tibetean alphabets (Phuntsho, K, 2017).
Phuntsho, K. (2017) Dzongkha: Bhutans national language.https://texts.mandala.library.virginia.edu/text/dzongkha-bhutans-national-language

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Photo of the masked dance GingTsholing taken during Wangdue Tshechu on 2022 by myself.

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In the honour of Guru Rinpochhe, it is celebrated on the 10th day of the month around the year according to the Bhutanese calendar. It is an auspicious occasion where people wear new and vibrant clothes to spectate the traditional songs and the dances, especially the masked dances. The masked dances teaches the crowd about life and death, impermanence, good and bad karma, and the consequences.

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Ema Datshi is one of the most common and famous foods in Bhutan due to its spiciness. The name literally means cheesy chilli, ema as in chilli and datshi as Cheese.
To prepare the dish, the chilli is sliced in four then boiled in water, cheese, oil and salt are added. after 10-15 minutes we let the water dry out creating a mouthwatering blend of cheese and chilli. Finally, we garnish it with coriander or spring onions.

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National Institute of Traditional Medicine, Royal Government of Bhutan. (2011). Perceptions and attitudes of bhutanese people on sowa rigpa, traditional medicine: a preliminary study from Thimphu. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3024923/#:~:text=In%20Bhutan%20traditional%20medical%20practice,%22the%20science%20of%20healing%22.

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Photo taken by myself of my brother Sonam Dorji.

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Bhutanese Archery is a competitive but social activity which is a colourful and noisy event with singing, dancing, drinking and trash talking of opponents, all in good fun.
Components of the Bow and Arrow,
The bow is made of a bamboo species called zhu shing and the arrow from Yangka bamboo reeds.
A nock is carved at one end of the arrow whereas a deuchak(arrowhead) is attached to the other end.
Traditionally, feathers of Bjeda, the Himalayan Monal Pheasant was used for fletchings of the arrow (Choden, J., & Choden, N. n.d.).

Choden, J., & Choden, N. (n.d). Dazo, the art of traditional bow and arrow making in Bhutan. Google arts and culturehttps://artsandculture.google.com/story/dazo-the-art-of-traditional-bow-and-arrow-making-in-bhutan-ichcap/CAUhi-pll2JbJA?hl=en

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Paro Rinpung Dzong. Photo taken by me, Tashi Samdrup in 2022.

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Dzongs are one of the most stunning and monumental forms of architecture in Bhutan. primarily used for defensive purposes in the past now it is a centre for administrative and monastic bodies. Dzongs are also considered as treasure troves housing religious paintings, murals, statues, rare artifacts and texts (Bhutan Architecture Guidelines, 2014).

Ministry of Works and Human Settlement- Royal Government of Bhutan. (2014). Bhutan architecture guidelines. Dzongs. https://www.moit.gov.bt/wp-content/uploads/2010/11/Bhutan-Arch-Guidelines-final-2014.pdf

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Health for me isnt only the state of mental or physical wellbeing but the wellbeing of an individual as a whole. it encompasses;
1. The physical body- being well fed, having strength and the ability to go about our normal daily routine with the absence of  illness and disease caused by pathogens.
2. The mind(mental state)- Not having any mental disorders and being free from extreme stress while having the ability to overcome our challenges in life and making great decisions.
3. Social life- Having a respectful and positive well nourished relationship with our family, peer and the community.
4. The spiritual aspect- Having a sense of purpose in life while exploring and cultivating our own values and beliefs. For some, it means to be a pious person, following the values and path set forth by their gods.
in short, Health is being able to lead a content and fulfilling life for me.

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For me, the most relevant aspect of competency standard 12.3 was person centred care and family focused care. Person centred care means to provide care based on the special needs of the individual, respecting their authority in planning and decision making of their care plan. Family focused care means to include the family of the patient in the planning and decision making through effective collaboration, communication and relevant information.

This helped enhance my understanding of the importance of a family and support system and individuality has on the well-being of the patient.

By understanding the importance of this knowledge, I would be able to provide optimal care to my patient while respecting their right, collaborate with the patient and family on the process of care and hear out their grievance and doubts while providing emotional and moral support, and helping them in their decision making regarding the nursing care plan and method.

Migrant and Women`s Health Partnership. (2019). Culturally Responsive Clinical
Practice: Working with People
from Migrant and Refugee
Backgrounds. https://moodleprod.murdoch.edu.au/pluginfile.php/3573073/mod_resource/content/1/Culturally-responsive-clinical-practice-Working-with-people-from-migrant-and-refugee-backgrounds-Jan2019.pdf

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Three common health concerns of Afghan refugees

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Three common health concerns of Afghan refugees

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1. Mental health

Refugees often grapple with mental health issues like post-traumatic stress disorder (PTSD), anxiety, and depression due to their exposure to highly traumatic events before, during, and after their migration journey. Furthermore, their mental well-being is further strained as they adapt to life in a new country, contending with language barriers, economic challenges, and potential stereotyping (Australian Refugee Health Practice Guide).

For effective treatment, it's crucial to reduce the stigma around seeking therapy and ensure that refugees are willing to participate in therapy sessions. This can be achieved by making mental health services affordable, accessible, open-minded, nearby, and by garnering trust through referrals from humanitarian community groups and organisations. It's essential to approach both individuals and the entire refugee community with cultural competence (Tomasi et al., 2022).

2. Hepatitis B (HBV)

Due to unsanitary conditions and exposure to contaminated bodily fluids in their home country and refugee camps, as well as unsafe injection practices in Afghanistan, many Afghan individuals face a high risk of contracting the HBV virus. It has been documented that the Afghan population has the highest prevalence of HBV (as reported in the Kirby Institute Surveillance Report, 2015).

To address HBV, it is essential to assess the vaccination history of individuals. If they do not have a vaccination record, they should begin a catch-up schedule to receive all the necessary doses. Additionally, it is crucial to educate refugees about HBV, emphasizing the importance of vaccination and informing them about where they can access vaccination services. To proactively prevent this infection, it is also necessary to implement mass screening and testing, taking appropriate and timely prophylactic measures
3. Human Immunodeficiency Virus (HIV)
Refugees, due to the significant stress stemming from their circumstances, are at a heightened risk of engaging in drug use (specifically injection drugs) and engaging in unsafe sexual practices with multiple partners. This heightened risk of HIV transmission is exacerbated by the absence of regular medical screenings and reluctance to undergo screening due to the stigma associated with HIV.

This can be addressed by:

• Delivering tailored information, education, and communication
services
• Dispensing sterile needles and syringes • Advocating for and
distributing condoms
• Offering services for the management and prevention of
sexually transmitted infections
• Providing access to basic healthcare,
including abscess care
• Referring drug users for opioid substitution therapy
and voluntary HIV counseling and testing
services

Australian Immunisation Handbook. (n,d). Vaccination for migrants, refugees and people seeking asylum in Australia. https://immunisationhandbook.health.gov.au/contents/vaccination-for-special-risk-groups/vaccination-for-migrants-refugees-and-people-seeking-asylum-in-australia

Australian Refugee Health Practice Guide (2023). Australian Department of Health. https://refugeehealthguide.org.au/category/common-health-issues/

Kirby Institute. (2015). Annual surveillance report of HIV, viral hepatitis, STIs. https://www.kirby.unsw.edu.au/research/reports/annual-surveillance-report-hiv-viral-hepatitis-stis-2015

Siddiqui, J. A., Vohra, L. I., & Essar, M. Y. (2023). HIV in Afghanistan: challenges, efforts and recommendations. Annals of medicine and surgery (2012), 85(4), 1291–1293. https://doi.org/10.1097/MS9.0000000000000096

Tomasi, A., Selwan-Younan, S., Narchal, R., & Rioseco, P. (2022). Understanding the mental health and help-seeking behaviours of refugees. https://aifs.gov.au/resources/short-articles/understanding-mental-health-and-help-seeking-behaviours-refugees

United Nations. (n,d). Scaling up HIV-related services for Afghan refugees who use drugs. https://www.unodc.org/unodc/en/hiv-aids/scaling-up-hiv-related-services-for-afghan-refugees-who-use-drugs.html

Ward, W. J., & Averhoff, F. (2011). Refugees, Mass Casualties, and Hepatitis B Transmission, The Journal of Infectious Diseases, Vol 204(3), Pages 338–339, https://doi.org/10.1093/infdis/jir371

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1. Social inclusion and non-discrimination.
2. Unemployment and job insecurity.
3. Income and social Protection.

Rezaei, O., Adibi, H., & Banham, V. (2021). Integration Experiences of Former Afghan Refugees in Australia: What Challenges Still Remain after Becoming Citizens? International Journal of Environmental Research and Public Health, 18(19), 10559. https://doi.org/10.3390/ijerph181910559

World Health Organization. (2023). Social determinants of health. World Health Organization. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1