January 27, 2026
PUNAKHA – Before dawn breaks in Punakha, 37-year-old Kinzang Wangdi is already awake, preparing for another day that leaves little room for rest. By the time the village stirs, he has bathed and fed his 16-year-old daughter, who lives with cerebral palsy, before setting off to earn the day’s wages that sustain a family of five.
His wife, meanwhile, cares for their eight-month-old infant at home.
For Kinzang Wangdi, there is no clear line between work and caregiving, only an unbroken routine shaped by responsibility, exhaustion, and quiet resolve.
Cerebral palsy is the world’s leading cause of childhood physical disability, yet in Bhutan, no comprehensive national data tracks the condition. For families in remote villages, the absence of targeted support turns a lifelong diagnosis into a daily test of endurance.
Kinzang Wangdi’s daughter, Jigme, the eldest of three siblings, has struggled with mobility since birth. Financial constraints and long distances to hospitals meant regular medical care was never an option. During occasional hospital visits, her father learned basic therapeutic exercises, which he continues at home – small interventions that have helped her develop limited movement in her hands.
“In rural areas, families like ours are quietly left behind,” Kinzang Wangdi says. “I have never received support from anyone, and I do not expect I ever will. But that does not mean I will stop caring for my daughter.”
Across the country, caregivers of children and adults with cerebral palsy rely largely on family labour, sporadic charity, and personal sacrifice. Specialised healthcare services remain concentrated in urban centres, physiotherapy is scarce outside referral hospitals, and community-based support systems are almost non-existent.
For many families, cerebral palsy is not only a lifelong condition, but also a constant reminder of a system that does not see them.
The mother of 19-year-old Pem Zam, who has cerebral palsy and has required full-time care for nearly two decades, echoed the same frustration. “Policies exist, but only on paper,” she said. “Nobody has ever come to us. We do not know where to go or whom to approach.”
For six years, a rusted wheelchair donated by the district hospital was the only mobility aid available to 15-year-old Jigme Dem, who was born paralysed from the waist down and has limited finger movement and speech difficulties. As the wheelchair deteriorated, it confined her almost entirely indoors.
Only in November 2025 did an individual donor step in, providing a new wheelchair and a commode, dramatically improving her daily life.
Despite the government’s push for inclusive education, Jigme’s family, like many others, has had to prioritise survival over schooling.
Punakha has two Special Educational Needs schools: Khuruthang Middle Secondary School, which serves 19 students, and Punakha Central School, where only one child receives SEN support. Across the district, 85 children live with disabilities – 25 of them girls. But for many, distance, cost, and caregiving demands make attendance impossible.
Under national policy, persons with disabilities are entitled to assistive devices and support services through public health facilities. In practice, families say assistance is often one-off, leaving them to cope alone until charity intervenes.
According to the 2017 Population and Housing Census, 2.1 percent of Bhutan’s population, about 15,567 people, live with disabilities. A subsequent National Health Survey placed the figure significantly higher, at 6.8 percent, or 48,325 people aged five and above, based on self-reported data across all 20 dzongkhags. The actual number is likely to be higher.
Disabilities affect different aspects of life, with the highest prevalence reported in self-care (2.4 percent), followed by hearing and mobility challenges (2.0 percent each), vision (1.8 percent), cognition (1.5 percent), and communication (0.8 percent).
Health officials say there is currently no consolidated national data on cerebral palsy, though the condition has now been integrated into the Electronic Patient Information System (EPIS), with data expected within six months.
The Ministry of Health (MoH) has put in place several interventions aimed at improving access to services for children with disabilities. These include strengthening early childhood and developmental screening at primary healthcare levels to ensure early identification, timely referral, and interventions.
At all primary healthcare facilities, children aged 0-5 years are screened for developmental delays after birth using the Bhutan Child Development Screening Tool (BCDST) and also Care for Child Development (C4CD) Plus by health workers.
In addition, rehabilitation and follow-up services are being strengthened through district and regional referral hospitals, with physiotherapy and occupational therapy services, and free assistive technology services to enhance the quality of life for persons with disabilities
The Executive Director of the Disabled People’s Organization, Kinley Wangchuk, said responsibility for disability-related services is divided between the Ministry of Health and the Ministry of Education and Skills Development, with the Office of the Cabinet Affairs and Strategic Coordination under the Prime Minister’s Office now serving as an umbrella body.
“Wheelchairs are issued only after professional assessment by a physiotherapist,” he said, adding that limited financial assistance of Nu 1,000 per month is currently provided to 12 persons with disabilities nationwide as interim support.
The Executive Director of the Ability Bhutan Society, Kuenzang N. Tshering, said the organisation focuses on people with moderate to severe disabilities, including cerebral palsy, with emphasis on early intervention and inclusive participation.
Early developmental support, he said, is critical for children with cerebral palsy, but access remains a challenge. Based in Thimphu, ABS acknowledges that children in rural areas face formidable barriers due to shortages of specialised professionals, limited infrastructure, and environments that are not designed for inclusion.
Since its establishment in 2012, ABS has expanded outreach through community surveys, caregiver training, disability assessment camps, and home-based interventions across eight districts. It currently supports 47 children nationwide. Even so, shortages of speech therapists, specialised educators and accessible facilities continue to constrain progress.
For families like Kinzang Wangdi’s, solutions cannot come soon enough.
The establishment of community-based disability care facilities, he said, would ease the crushing burden borne by caregivers who currently provide round-the-clock support with little respite.
