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This paper describes the socio-economic characteristics of three rural communities living inside or close to protected areas in Bhutan and examines possible ways to improve their living standards through ecotourism for sustainable development. Face-to-face interviews, supported by structured questionnaires, were conducted to determine 1) sources of livelihood; 2) the impact of tourism; and 3) the readiness of rural communities to participate in income-generating activities. Farmers were keen to take up ecotourism and wanted to use the proceeds to increase their livestock herds. However, this would increase pressure on natural resources, causing land degradation. Additionally, income from ecotourism may also lead, in the long run, to social inequality in remote communities. To prevent environmental stress in protected areas, social inequity and potential land degradation, newly generated wealth from ecotourism needs to be appropriately invested by the stakeholders.In this paper, recognizing ecotourism as a niche market with its unique feature and potential to balance economic development of rural communities with nature conservation, we explore the livelihoods of three rural farming communities in two protected areas and in one valley nearby -to fi nd out whether ecotourism could supplement the subsistence agricultural economy of the rural population to improve their living standard. We examine people's livelihoods and incomes, the communities' interest in ecotourism development and anticipated ways of spending the new wealth from ecotourism. In addition, we look at the impact of trekking tourism on rural livelihoods, people's expectations from ecotourism and farmers' perception of trends in natural resources. Because tourism development in Bhutan has been carefully guided and ecotourism is relatively new -considering that trekking tourism is not necessarily analogous to ecotourism -our approach in this case study is exploratory.Brunet et al. (2001) and Rinzin et al. (2007b) discuss that the Bhutanese approach to tourism development has been cautious because of the country's desire to balance the economic benefi ts of tourism with ecological integrity and cultural cont inuity. The approach might have been infl uenced by the theory of the Himalayan environmental degradation, which is strongly challenged by Ives and Messerli (1989). The emergence of this theory, which postulates that loss of forest cover in the Himalayas has contributed to fl oods in northern India, coincided with mass tourist activities of the 1970s and 1980s in the Nepalese Himalayas. Forest degradation in the region was partly explained by unregulated tourism (Bhatt, 2006), which also risked erosion of local traditional values with the arrival of the 'tourist-hippie' culture. That culture was short lived, and the community-based resource management approach to reconciling development and conservation has since helped ease concerns over forest degradation, especially in the Annapurna conservation areas of Nepal (Bajracharya et al., 2005). Moreover...

Background Published information on snakebite is rare in Bhutan although remarkably higher number of snakebites and associated deaths are reported from other South Asian countries. Aims and methodology Structured questionnaire was used to collect knowledge of health workers in snakebite management and health seeking behavior of snakebite victims as observed by health workers. Study was conducted in purposively sampled 10 Dzongkhags (district level administrative units) with higher incidence of snakebites. Result Heath workers scored 27–91% (with an average of 63%, SD = 14) for 52 questions related to snake identification and snakebite management. Among 118 health workers interviewed, 23% had adequate knowledge on snakes and snakebite management while 77% had inadequate knowledge. Among 32 Doctors, 63% of them scored above or equal to 75%. Health workers from Sarpang scored higher (76%, SD = 11) than those from other Dzongkhags. Snakebite victim's visit to local (traditional) healers prior to seeking medical help from hospital was observed by 75 (63%) health workers. Fifty one percent of health workers observed patients treated with local methods such as the use of black stone called Jhhar Mauro (believed to absorb snake venom), application of honey, rubbing of green herbal paste made up of Khenpa Shing (Artemisia myriantha Wallich ex Besser var. paleocephala [Pamp] Ling) and consumption of fluid made up of Neem leaf (Azadirachta indica Juss). Use of tight tourniquet as a first aid to snakebite was observed by 80% of the health workers. Conclusion Health workers lack confidence in snakebite management. Snakebite victims are likely to suffer from harmful local practices and traditional beliefs on local treatment practices. Empowering health workers with adequate knowledge on snakebite management and making locals aware in pre-hospital care of snakebites are needed to improve the pre- and in-hospital management of snakebite in Bhutan.

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