Investigator(s)
| Submitter |
Jigme Singye National Center for Traditional Medicine Services Jigme Singye 
|
| Principal Investigator |
Jigme Singye National Center for Traditional Medicine Services Jigme Singye
|
| Co-Investigator(s) |
Kuenzang Chophel Traditional Medicine Unit, Central Regional Referral Hospital, Gelephu, Bhutan Kuenzang Chophel
|
| Co-Investigator(s) |
Jigme Jigme Centre for Bhutan and GNH Studies, Thimphu, Bhutan Jigme Jigme
|
| Co-Investigator(s) |
Tashi Tenzin Ministry of Labour and Human Settlement, Thimphu, Bhutan Tashi Tenzin
|
| Co-Investigator(s) |
Tashi Chophel Traditional Medicine Unit, Central Regional Referral Hospital, Gelephu, Bhutan Tashi Chophel
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| Co-Investigator(s) |
Sonam Lhendup National Center for Traditional Medicine Services, Thimphu Sonam Lhendup
|
| Co-Investigator(s) |
Thinley Dorji Central Regional Referral Hospital, Gelephu, Bhutan Thinley Dorji
|
Title(s) and abstract
| Scientific title | Patient-reported benefits and ethnopharmacological beliefs regarding balneotherapy in Gasa and Gelephu Hot Springs in Bhutan: a mixed-method study |
| Public title | Patient reported benefit of hot spring |
| Background | Natural hot springs, known as Tsha chhu in Bhutan, form through geothermal processes where groundwater interacts with molten rock, minerals like calcium and magnesium, and volcanic gases, emerging with therapeutic mineral content. Globally prevalent in regions such as the USA, Japan, India, Nepal, and Bhutan, these springs support balneotherapy, a practice used for centuries to address musculoskeletal disorders, skin conditions, gastrointestinal issues, and respiratory ailments. In Bhutan, sites like Gasa Tsha chhu (at 2,100 masl near Mo Chhu River, with 10 ponds of varying temperatures) and Gelephu Tsha chhu (at 230-332 masl in Sarpang, attract thousands annually, including 5,606 visitors to Gasa and 2,100 to Gelephu in recent years, peaking in winter. |
| Objectives | This study describes the therapeutic benefits and ethnopharmacological beliefs of balneotherapy at Gasa and Gelephu Tsha chhu among visitors in 2026. Specific objectives include: (1) describing sociodemographic profiles to characterize user diversity across local, national, and international groups; (2) outlining clinical profiles of pre-existing Sowa Rigpa conditions, such as arthritis, skin disorders, and digestive issues, to map disease prevalence; (3) evaluating patient-reported outcomes on symptom relief using the Numeric Rating Scale (NRS) pre- and post-seven-day immersion, quantifying improvements in pain and function; (4) exploring perceptions of ethnopharmacological benefits, traditional beliefs, and practices tied to healing properties, including spiritual attributions and cultural rituals. |
| Study Methods | This concurrent triangulation mixed-methods study integrates quantitative cross-sectional data with qualitative in-depth interviews at Gasa (located in northwest Bhutan, 137 km from Thimphu) and Gelephu (in south-central Bhutan, 258 km from Thimphu) Tsha chhu. Quantitative data will be collected through face-to-face structured interviews using a pro forma to capture sociodemographic information and clinical symptoms at two time points: before immersion and after a 7-day follow-up, using the Numeric Rating Scale. Participants will be selected through proportionate systematic random sampling stratified by months, weeks, and days. Data collection and entry will be facilitated using REDCap software hosted at Khesar Gyalpo University of Medical Science of Bhutan, while data analysis will be performed with STATA version 13. Descriptive statistics will include frequencies and percentages. For qualitative data, participants will be selected using maximum variation sampling from the two sites to interview using open ended questions in private settings with prior informed consent. The interviews will be transcribed into English and a manual thematic analysis will be done. Ethical approval will be sought from the Research Ethics Board of Health under Bhutan’s Ministry of Health, as well as from the administrations of the two dzongkhags. Participant data will be anonymized and securely stored, with confidentiality maintained through locked storage and password-protected files, will be retained for five years. Study results will be disseminated to policymakers, academic conferences, peer-reviewed journals, media outlets, and local communities to guide the development of safe balneotherapy practices. |
| Expected outcomes and use of results | The expected outcomes of this study include a comprehensive profile of visitors using Gasa and Gelephu Tsha chhu, detailing demographic variables such as age, sex, ethnic background, and income levels, to better understand the diversity and characteristics of users seeking balneotherapy. It is anticipated that a significant proportion of visitors will report relief from common ailments such as musculoskeletal pain, skin conditions, digestive disorders, and respiratory issues, as assessed by improvements in the Numeric Rating Scale (NRS) scores pre- and post-immersion. Qualitative findings are expected to elucidate the cultural, spiritual, and ethnopharmacological beliefs held by visitors, highlighting how traditional healing practices are intertwined with therapeutic use of the hot springs. The findings will contribute to public health planning and the preservation of Bhutan’s cultural heritage by supporting informed decision-making among policymakers. |
| Keywords | Balneotherapy, Ethnopharmacology, Sowa Rigpa, Tsha chhu, Therapeutic benefits |
Research Details
| Student research | No |
| Start Date | 01-Jan-2025 |
| End Date | 30-Apr-2025 |
| Key Implementing Institution | National Traditional Medicine Hospital |
| Multi-country research | No |
| Nationwide research | No |
| Bhutan | |
| Research Domain(s) | Non-communicable diseases & Healthy Lifestyles |
| Research field(s) | Health Care Seeking/Utilization |
| Involves human subjects | Yes |
| Qualitative Study | |
| Data Collection | Primary data |
| Proposal reviewed by other Committee | No |