In 1821, the German-Jewish poet, Heinrich Heine suggested an intrinsic link between mass human slaughter and attacks on cultural heritage when he wrote “Where they have burned books, they will end burning human beings” Ironically, his own books were burned by the Nazis more than a century later in defense of Volksgeist, the spirit of German nationalism. That clearly set the stage for the holocaust. 

Decades later, Nepali and Sanskrit books were burned in Bhutan, in defense of the Drukpa national spirit: One Nation, One People. This homogenizing nationalism led to expulsion of about 20% of the country’s citizens, mainly the Nepali speakers followed by Sharchops.

Although the term genocide was coined to represent “the methodical, merciless butchery” of the Jews- the holocaust- and similar others, attack on or obliteration of culture(s) is still “a crime without a name.’’  

Characterized by a number of genocidal incidences in history, the April month has a historical signification towards understanding the crime of genocide in all its ramifications. It is therefore marked as Genocide Awareness Month.

The Armenian genocide began in April of 1915 as the Ottoman regime began its extermination campaign of ethnic Armenians. In April 1933, the Nazis legislated its first anti-Semitic policy leading to the holocaust. Likewise, in April of 1975, Khmer Rouge captured Cambodia that followed the massacre of about two million people in the course of the next four years. Most part of Anfal genocide that slaughtered about 182,000 Iraqi Kurds fell in April of 1988.

In the meantime, the siege of Sarajevo in Bosnia in the April of 1992 subsequently witnessed the massacre of 10,000 people including 1,500 children. The Darfur genocide that oversaw the gory carnage of over 400,000 Darfuri civilians began in April of 2003 marking the first instance of this (in)human barbarism of the 21st century. 

Ironically, genocide continues being perpetrated despite the international community committing on preventing its recurrence after the lurid holocaust experience. Distinguished as the first human rights treaty adopted by the General Assembly of the United Nations on December 9, 1948, the Convention on the Prevention and Punishment of the Crime of Genocide (Genocide Convention), reflects the intent of the World community to prevent its recurrence. With 152 state parties as of 2019, the Genocide Convention is treated as peremptory norm of international law, one among few other treaties considered inviolable, from which no derogation is permissible. 

The Convention defines the crime of genocide as certain “acts committed with intent to destroy, in whole or in part, a national, ethnical, racial or religious group.” The phrase “acts committed with intent to destroy” consists of two separate elements of crime for an act to amount to genocide: mens rea (guilty mind) and actus reus (guilty act). Therefore, commission of mere ‘acts’ is not sufficient if the “intent to destroy” is not established in a competent court. 

Article II of the convention lists certain ‘acts’ that would amount to genocide if the ‘intent’ element is met. The ‘acts’ include killing members of the group; causing bodily or mental harm; deliberately inflicting conditions of life calculated to bring about physical destruction in whole or in part; imposing measures to prevent birth within the group and forcibly transferring children of the targeted group to another. 

The convention definition is restrictive, confining itself to deliberate physical destruction of the target group as against attack on the group’s existence involving persecution on its culture or even ‘acts’ of ethnic cleansing.

The statutes of ad hoc tribunals for the former Yugoslavia and Rwanda as also Rome Statute of International Criminal Court consign to this restrictive definition.

However, the term genocide was originally meant to be expansive. Raphael Lemkin, a polish Lawyer of Jewish origin who coined the neologism ‘genocide’ combining Greek ‘Genos’ (tribe, race,) and Latin ‘Cide’ (killing) intended a broad definition. In his capacity as an expert and advocate in negotiating the Genocide Convention, he proposed three constitutive elements as essential to the crime of genocide: physical, biological and cultural.  

The physical and the biological aspects reflect in different degrees of precision in the Genocide Convention. The cultural aspect, however, was altogether excluded in the treaty and discussions on reasons thereto go beyond the scope of this paper. Suffice it to say that some states that wielded power during the negotiation and drafting process of the convention had their fair share of sins to conceal.

Lemkin, who viewed attack on cultural heritage as a form of genocide, and precursor thereof, lamented echoing Heinrich Heine: “first they burn books and then they start burning bodies.”

Emphasizing on the cultural aspect, Lemkin argued that genocide was effected by a synchronized attack on eight aspects of the targeted people’s lives: political, social, cultural, economic, biological, physical, religious and moral. Cultural aspects of genocide, as Lemkin suggests included “prohibiting or destroying cultural institutions and cultural activities…forbidding the use of the (target) group’s language…banning or discouraging liberal arts in education…rigid control of all cultural activities,” among others.

The objective of such acts was to ensure “disintegration of …culture, language…religion and economic existence of national groups, and the destruction of the personal security, liberty, health, dignity and even the lives of individuals belonging to such groups.” 

How does Bhutan’s “One Nation, One People” philosophy relate with Lemkin’s idea of cultural genocide? The Drukpa regime did effectuate a “synchronized attack on different aspects” of the life of Nepali speaking Bhutanese, to borrow Lemkin’s terminology. 

The Drukpa regime began its first formal interference on the religious life of the Nepali speaking Bhutanese, mainly Hindus, in the very first session of the Bhutanese parliament in 1953. The parliament’s resolution stated that “His Majesty was pleased to command the establishment of a Monk Body…in the Nepali villages in Southern Bhutan,” “with an aim of converting the Nepalese of southern Bhutan into Buddhism.” 

While the international standard on religion is based on individual freedom as the Universal Declaration of Human Rights (UDHR, 1948) or International Covenant on Civil and Political Rights (ICCPR, 1966) envisage, Bhutan’s regime began its first legislative stint by invading that very freedom of a religious group. Seen from an American perspective, this 1953 resolution of the Bhutan’s parliament legitimized what the first amendment to the US constitution prohibited in 1791. 

What began as a soft policy in 1953 became the cornerstone of Bhutan’s nationalism by the 1980’s. Bhutan’s Drukpa nationalism thrived on obliterating the ‘other’ through state sponsored coercion, assimilative measures, outright marginalization, exclusion or even expulsion. It is a formally proclaimed national agenda, that Bhutan being the ‘Druk’, every other culture had to be subsumed within the Drukpa culture: One Nation, One People. 

Lemkin’s warning is prophetic in Bhutan’s case. The Drukpa regime did actually burn Nepali and Sanskrit books and banned the language from school curricula. All forms of cultural attires are prohibited and replaced by Drukpa national dress. Driglamnamzag, ‘a national culture’ based on Drukpa values warrants observation of a homogenous social protocol while replacing values and cultures of the ‘other.’

The Drukpa architecture has wholly invaded most of the few Hindu temples as names of places symbolic of Nepali culture have been assigned Drukpa nomenclature. Through a massive population transfer, the Northern Bhutanese is also the new ‘Southern Bhutanese’.

The Constitution is not free of institutional bias. Although Druk Gyalpo is envisioned as the protector of all religions under Article 3 (2) of the constitution, the Drukpa religious institutions receive preferential treatment under Article 3(7) where the “Zhung Dratshang and Rabdeys…” receive “adequate funds and other facilities from the state.” This is just one case of the constitution institutionalizing Drukpa nationalism.

By forcefully exiling at least half of the Nepali speaking citizens, the government has effectively silenced the rest to submission. The Nepali speaking Bhutanese is thoroughly deculturized and de-historicized. As the situation stands currently, the new Nepali language is now ‘Lhotshamkha’, as the ‘Lhotshampa’ -the ultimate remnant of the cultural Nepali in Bhutan- submits helplessly to the Drukpa juggernaut of One Nation, One people. 

It is relevant, as April draws to a close, to understand genocide in all its forms, including its softer, subtler, cultural dimensions. To do so in the case of Bhutan, now a puritanical Drukpa nation, one must focus beyond the façade of the orchestrated image of an infallible hermit kingdom. 

As genocide awareness month, April must summon our attention towards understanding genocide in all its manifestations and invoke our conscience against the savagery it constitutes. 

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The author is a Juris Doctor candidate at Drexel University’s Thomas R Kline School of Law and serves as the research director at The Bhutan Research and Information Network (The BRAIN), a Pennsylvania based non-profit Organization. The opinions expressed herein are author’s personal. BNS welcomes diversity of opinion. 

In February, I received a call from my second brother in Nichula, Bhutan, telling me that my father was experiencing another manic episode – a condition he has suffered from for more than 23 years without receiving any medical attention.

This time was different. My brother said my father had escaped into the forest and had made his way to the border and the cattle ranching site where he had lived for years. He had no sense of the restrictions on cross-border movement at the Indo-Bhutan border, so had, unintentionally, breached the Covid protocol in place.  

His unauthorised journey had attracted the attention of a group of government officials, including the new dzongda (chief district officer) of Dagana district, Duba Yonten, who travelled to our family home and saw my father’s condition. The authorities considered the matter seriously and took him to Kalikhola hospital for isolation. My youngest brother escorted him.

A year earlier, my father lived in Gelephu where he was able to visit a doctor on a regular basis and receive treatment. Despite displaying the symptoms of bipolar disorder, he was not admitted to the hospital. Instead, he was prescribed medicine for chronic gastritis and high blood pressure. Such medication didn’t help his condition because his mental disorder was not considered to require treatment. 

 In 2016 my second brother took my father to visit the psychiatrist and gastro specialist, Dr. Damber Nirola, in Thimphu who referred him to Dr. Guru Dhakal who carried out an endoscopy. His diagnosis was that my father’s ailments were more to do with his mental health than his digestive system. 

Visiting doctors in Thimphu hospital is difficult  for villagers living in isolated hamlets such as Nichula. There is little health awareness in such remote rural areas, and follow-up appointments are usually carried out verbally. If a patient does not return for follow-up the doctors or health care workers do not have an obligation to call them back.

Thanks to the free healthcare system in Bhutan, access doesn’t depend on the economic status of those needing help, but much depends on the patient’s ability and knowledge to seek medical help.

In illiterate societies there is often prejudice and ill-informed gossip when it comes to issues to do with mental health. Rural life in Bhutan is rife with such prejudice and stigma about mental health in the same way that people used to fear leprosy. 

Many in the village thought my father was arrogant, belligerent, and a man who had a bad mouth. No one understood that his bipolar disorder made him act the way he did. His relationship with the overpowering Gup (the village head) and with some relatives deteriorated during this period.

After a month-long stay in an isolation ward and general ward, my father was discharged in March. Doctor Chhimi made an appointment for him to return in a week. Using medication such as Sodium Valproate and Risperidone his manic episodes have abated. But it is the beginning of a long process aimed at keeping his mental state healthy. Our family also needed help understanding what they could do to help my father, along with counseling to help them understand, manage and take care of episodes. Doctor Chhimi told me, “Limited resources are available locally for alternative care like psycho-social counseling and cognitive behavioral therapy. Those are available only in Thimphu”

A complete lack of understanding about the episodes my father was experiencing, the early symptoms, his adult life characteristics, and his bipolar syndrome leaves the uninformed thinking he has “gone mad”.   

Psychiatric care remained out of bound for the family, and my brothers and sisters didn’t have the capacity to take him to Thimphu every time the episodes occurred. Some dismissed my father’s condition saying that he had been “like that” from the beginning.

Yes, he had been abusive at times, raising his hands and waving sticks if a person didn’t do what he wanted. And, yes, it was hard to understand why he slapped my mother. We just thought his actions were the result of his uncontrolled anger about small things. My mother always showed  tolerance and patience in coping with her abusive husband despite not knowing why he acts the way he did. 

Outside our home my father still arouses stigma within the family. In 2018, we met in Jaigaon and planned a cultural tour to Kathmandu. My mother refused to go. During his interaction with the relatives we met my father was blurting out accusatory words against my brothers and my mother. I too felt the stigma, because he wouldn’t stop shouting at and disparaging his own children. He came to meet me at the height of his psychosis, and, fortunately, I was able to spot the signs and understand what he was going through. With the medicines prescribed by Dr. Nirola, we were able to make a success of our trip.

The stigma probably caused my second brother to shy away from seeking medical help even when my father needed it. During regular conversation over messenger he reiterated, ‘treatment doesn’t help our father’. This frustration left him with less empathy. 

The cause of my father’s bipolar disorder is still unclear. Perhaps suffering two stressful attacks contributed. 

In 1993/94 a group of armed robbers assaulted him, almost stabbing him to death. My father wanted to die in his country, not leaving it for no fault of his and not heeding the threats. This led to family separation, with children not able to go school, and the pressure to go three months of ‘gongda-woola’(conscripted form of labor) along with the armed Indian separatists roaming around the village. Another time he was assaulted by a neighbor who was an influential man in the village. As always, stigma has prevailed. 

My brothers don’t have the time and resources to take my father to visit the psychiatrists in Thimphu. He lives on a cattle ranching site in the  Phibsoo Wildlife Sanctuary and Assam Forest, and my brothers have been unable to convince him to take his regular medications. He did not go back to see a doctor or health worker even in Kalikhola when they asked him. Interestingly, no doctors or health care workers in Kalikhola or Gelephu hospital felt it necessary for him to be offered inpatient services. Even Dr. Nirola, the psychiatrist in Thimphu, did not suggest he be admitted when they visited him in 2016. Perhaps my father’s condition was not considered to be urgent at the time.

When I talked to Dr. Chhimi in Kalikhola hospital, she assured me that they would take responsibility for my father if he ever escaped to the jungle or reached the border again. That gave me some relief that they have taken his illness seriously. I tried to help my family understand  that they must follow the instructions of medical professionals, continue to ask questions, and seek alternative ways for care.

For people in Nichula, commuting to Kalikhola for government service or medical care is an economic hassle. In fair weather, bolero pick up charges Ngultrum 1200 to 1800 for a mere 14 km of reserved travel. Sick people definitely need a reserve vehicle to reach the hospital on time. Given this exorbitant rate of travel, chances are high that people avoid such medical care unless there is an emergency. Access to free health care sponsored by the government is presumably restricted for those living in isolated villages like Nichula. My brother told me he could bring father home at no cost on transportation thanks to the gewog vehicle available on March 9, but paid 2400 for two segments of the trip for follow-up appointment on March 16. 

Last July, my aunt, my father’s only sister, died while being carried on shoulders to reach the nearest available transportation.

The Nichula gewog (a village constituency) falls within the protected area system. People are living in harmony with nature, but they are not without disease, or illness. The physical, social, spiritual and emotional well-being of that small rural population is probably not on the agenda of local development committees. 

The local leaders get handsome perks from the government, but for nothing to take responsibility for the welfare of constituencies. The Nichula gup ( the village headman) lives in Kalikhola, the Tshogpa (the assistant headman)gets Ngultrum 1000 daily allowance for attending one-day meeting. If GNH accounts for the non-material well-being of the people, and if conservation of the natural environment has a positive impact on the lives of people, why do five people in Nichula still suffer mental illness?

It appears the local government has not done enough for the people living under the constant threat of wild animals and there is no consideration for any crop damage caused. There is no health care extended to the village, and the sheer difficulty involved in transporting goods and human beings during monsoon remains an acute problem. As a normal practice, people living in protected areas should be given more incentives for being the stewards of conservation providing health care, education, economic incentives, chronic disease management and empowerment programs through sustainable harvesting of natural resources.

Enough is not done to make people feel they belong to a larger Bhutanese community. My brother often said, “Why didn’t our father opt to leave this place, when all our extended families left.”

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The author is one of the contributing editors of BNS

We are now engaged in the latest phase of the global fight against COVID-19, that of widespread vaccination. Where do we stand with the global Bhutanese community? Let us reflect on this together, and propose strategies to move forward.

As a public health expert working with resettled Bhutanese, I believe vaccination campaigns and efforts will be successful only if they acknowledge and address the barriers to vaccination within the community. 

First, these challenges must be considered within the broader context of barriers to healthcare faced by refugee and immigrant populations more broadly. 

For instance, research suggests that migrant populations often underutilize health care because of a lack of knowledge about the services, legal restrictions to accessing care, and language barriers.  

Additionally, formal care providers tend to overlook, and at times fail to address, the broader issues that can take precedence over healthcare issues among migrant populations, including concerns about safe housing and financial insecurity.  

Finally, health care providers can sometimes lack the skills and expertise to engage with migrant populations who hold culturally specific beliefs about health and wellness.

These dynamics related to access to healthcare among migrant populations intersect with challenges specific to vaccination campaigns. 

For instance, some are hesitant to receive the vaccine because of concerns over its effectiveness, possible side effects, and potential long-term negative health outcomes that are as of yet unknown given the timeline of the development and approval of vaccines. 

Marginalized communities, including migrant populations, might have additional concerns over the overall intention of government-led vaccination campaigns given prior negative experiences with healthcare more broadly.  

These concerns are far from irrational, and should be addressed in thoughtful ways by our public health care system. We need hope and confidence in federal, state/provincial, and local public health care to move forward.  So how do we address these challenges in order to promote the health and wellbeing of resettled Bhutanese? 

Most importantly, healthcare workers need to engage with the Bhutanese about their concerns and fears regarding the vaccine.  

They need to find out what Bhutanese are worried about, provide answers, and be clear about what and what is not known.  For example, elders may ask, “If I become vaccinated, will I be able to finally visit with my children and grandchildren?”  Younger Bhutanese may ask, “If I am pregnant, should I get the vaccine?”  These are all extremely important questions, and the CDC (Centers for Disease Control) are coming up with guidelines, updated weekly, on how to answer these questions based on the best scientific evidence.  

Overall, transparency is the best approach. Those providing health care need to be honest about what is known, why the vaccines have been approved, and why healthcare providers and the government believe vaccination is the best way forward.  

Health care providers also need to understand the barriers to vaccination facing Bhutanese. Many migrant populations lack transportation to formal health care services. Service providers also need to consider language barriers. Providing information on vaccines via written, translated material is insufficient where some members of the Bhutanese community are illiterate.   In short, opening health clinic doors to Bhutanese for vaccination will not make vaccination happen: clinics need to adopt creative approaches to outreach and engagement to make sure Bhutanese are aware of vaccination opportunities.

Vaccine must involve partnerships between healthcare providers and the Bhutanese community. Bhutanese community organizations and leaders need to be consulted and engaged in order to make services more acceptable and accessible.  

Healthcare providers should work with Bhutanese community health workers to act as cultural brokers and conduct outreach efforts with individuals and families. 

The value of community health workers goes beyond overcoming language barriers and includes integrating in-depth awareness and understanding of the needs and strengths of the Bhutanese into clinical interactions with members of the community.

It is also important for Bhutanese who have gotten vaccinated to share their experience with others in the community.  For instance, talk with others who are hesitant to get vaccinated and answer questions about any side effects you had, and why you made the decision to get the vaccine.

There are many challenges ahead in the fight against coronavirus and ensuring widespread immunity to the virus amongst the Bhutanese community. However, I am confident that if the Bhutanese and healthcare providers collaborate and work together, vaccination efforts will be successful.

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The author is a Post-Doctoral Fellow in the Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University, Montreal.