Bhutan Country Report
Bhutan's new DNT government is likely to be stable. Although the government is unlikely to move away from Bhutan's emphasis on protecting local culture from globalisation – which has driven protectionist regulations – it will probably increasingly seek foreign investment to develop the country's infrastructure, particularly roads, civil aviation, and digital connectivity; alternative energy sources, almost certainly renewables, are also likely to be developed. Moreover, widening healthcare provision is likely to be central to the new government's policy agenda. Bhutan is likely to remain closely allied with and dependent upon India for diplomatic and military assistance. Armed conflict is unlikely, but growing India-China rivalry will drive the risk of borderconfrontations, which most recently manifested in the Doklam territory in 2017. Militant groups have been inactive since 2008.
Foreign investment is increasingly permitted, notably in the tourism and hydropower sectors, although investors must strictly observe the country's regulations aimed at preserving its culture, environment and architecture. Bhutan's infrastructure is poor, having remained relatively isolated from the outside world for most of the 20th century. However, more recently, communications, the road network, flight access, and labour skills have improved substantially. Although corruption levels are the lowest in the region, it is a growing concern domestically and was a key electoral issue during the October 2018 general election.
Terrorism is a moderate threat. The primary risk is posed by ethnic-Nepali Maoist insurgents connected to a similar movement in Nepal. In the run-up to Bhutan's first general election in 2008, these groups conducted a series of low-level improvised explosive device attacks in four different locations, injuring one person. However, Nepalese Maoists have since joined mainstream politics, and it is unlikely that they will seek to instigate unrest in Bhutan. Indian militants based in Bhutan pose an additional threat, because they could seek to target security forces and state assets in retaliation for the government's co-operation with India.
Armed conflict is generally unlikely. However, the growing rivalry between Bhutan's larger neighbours, India and China, drives a long-term risk of largely non-violent incidents on the Chinese border. While India guarantees military protection for Bhutan, China claims 10% of Bhutan's landmass. Most recently, in June 2017 China and India rapidly increased military deployment in the Doklam territory after Indian soldiers stopped a road construction project in the territory disputed by China and Bhutan. Any violence is likely to be limited to scuffles between Chinese and Indian soldiers, but both sides are likely to seek to de-escalate border incidents diplomatically.
Vaccines Required to Enter the Country
Yellow fever: There is no risk of contracting yellow fever in Bhutan. However, the government requires proof of vaccination for travelers arriving from countries with a risk of yellow fever transmission. A single dose of YF vaccine is sufficient to confer sustained life-long immunity against the disease.
Vaccines Recommended for All Travelers
Routine vaccinations: Consult your doctor to ensure all routine vaccinations - such as for diphtheria, tetanus, polio, tuberculosis, influenza, measles, mumps, pertussis, rubella, varicella, etc. - are up to date (include booster shots if necessary).
Vaccines Recommended for Most Travelers
Hepatitis A: The vaccine is given in two doses, six months apart, and is nearly 100 percent effective. The WHO recommends the vaccine be integrated into national routine immunization schedules for children aged one year or older.
Typhoid fever: The typhoid fever vaccine can be administered via injection (administered in one dose) or orally (four doses). The vaccine is only 50-80 percent effective, so travelers to areas with a risk of exposure to typhoid fever, a bacterial disease, should also take hygienic precautions (e.g. drink only bottled water, avoid undercooked foods, wash hands regularly, etc.). Children can be given the shot beginning at two years of age (six for the oral vaccine).
Vaccines Recommended for Some Travelers
Hepatitis B: The WHO recommends that all infants receive their first dose of vaccine as soon as possible after birth, preferably within 24 hours. The birth dose should be followed by two or three doses to complete the primary series. Routine booster doses are not routinely recommended for any age group.
Japanese encephalitis: Japanese encephalitis is typically only present in rural areas. Discuss travel plans with your doctor to decide if you need the JE vaccine, which is administered in two doses spaced over a month. The last dose should be administered at least ten days prior to departure for an at-risk area to be fully effective.
Malaria: There is currently no malaria vaccine. However, various antimalarial prophylactics are available by prescription and can reduce risk of infection by up to 90 percent. Different medications are prescribed depending on the risk level and the strains of the virus present in the destination. Antimalarial tablets need to be taken throughout the trip to be effective and may need to be taken for as long as four weeks following the trip.
Rabies: The rabies vaccination is typically only recommended for travel to remote areas and if the traveler will be at high risk of exposure (e.g. undertaking activities that will bring them into contact with dogs, cats, bats, or other mammals). The vaccination is administered in three doses over a three-to-four week period. Post exposure prophylaxis is also available and should be administered as soon as possible following contact with an animal suspected of being infected (e.g. bites and scratches).
Many roads are in poor condition. There are no railways within the country and no airlines operating domestic flights. Visitors can arrive in Bhutan by road (passing through the southwestern town of Phuentsholing on the Indian border) or by air (from New Delhi, Katmandu, Dhaka, or Bangkok with the Bhutanese airline Druk Air). The border with China is closed to the public.
Bhutan is a mountainous country and its climate varies considerably by elevation. The climate is subtropical along the Duars Plain, in the south, with high levels of humidity and rainfall. The valleys in the center of the country are drier, with distinct seasons: summers are hot and winters cold.
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