The Visit by the Raes Lab Has Successfully Concluded

On 15 October 2025, Dr Raul Yhossef Tito Tadeo from the Raes Lab at the VIB-KULeuven Centre for Microbiology in Belgium, arrived at the Paro airport in Bhutan after a 2-day journey. Normally he was to be joined by the Lab Lead Prof. Dr. Jeroen Raes who unfortunately had to cancel his journey at the last minute. Despite this, we were still able to complete most of the objectives of their visit centered around capacity building at the Royal Centres for Disease Control (RCDC) in Thimphu and having meetings with higher officials to discuss the EATWELL project and future plans.

At the time Dr. Raul arrived, the situation was not looking good for the EATWELL project. Just before his arrival, we found out that several of our research assistants (RAs) were not achieving our highest professional standards despite several warnings. This meant that we had to make tough decisions during the first days of his visit regarding the nutrition/microbiome part, whether to stop or seriously downscale the remaining 5 months from the yearlong longitudinal study. We only had the choice between downscaling or stopping early—a choice between the cholera and the pest—since hiring new RAs was no longer an option as hiring and training them would at least take 4 months. Hence, it would have required much training efforts on our side while the newly hired RAs would not be able to contribute much before the end of the longitudinal part in March 2026. We decided to continue with our two best RAs—Tshering Tashi and Uttam Acharya—and downscale the final stages by decreasing the number and time-points of stool sampling and conducting dietary and integrated surveys of all our remaining participants in Laya and Buli. We decided to go ahead despite many foreseen challenges, as the winter migration patterns are likely to contribute to significant findings in the longitudinal part, which we would have lost if we had stopped early. Yet, we foresee that continuing this downscaled plan will very likely lead to additional logistical challenges, as people will be spread across many different locations and the winter can offer complicated conditions to reach all of our participants who will be spread across many sites as different as winter herder sites in Laya, Gasa, Punakha/Wangdue, Thimphu, Paro and Buli, Zhemgang. To trace our participants across these sites and having the conditions right to meet them at the right times with only two RAs will constitute a large effort and requires a high degree of luck, but more will follow on this in one of the future blogs.

After several days of discussions on this reorganization and downscaling, we could finally get on to the planned work with Dr. Raul. On 20 and 21 October, he conducted a capacity building workshop at RCDC with 7 participants from different disease laboratories at the RCDC. Dr. Neyzang Wangmo from KGUMSB also joined the first day. The workshop treated the entire microbiome workflow, discussing step by step the protocols from sample collection and storage to initial preparations in the lab for the first analyses, gradually moving into more complex processes of DNA extraction and sequencing. The process of data analysis through bioinformatics formed the basis of the second day.

As much of the analyses happen on the computer, Dr. Raul made sure that everyone was ready by sharing exercising files, codes and setup instructions ahead of time so that everything could run smoothly. Yet, on the second bioinformatics day, there were three power cuts, highlighting the sometimes-difficult conditions in which scientists work in Bhutan and many other countries in the global South. The participants adapted quickly, switching to phone hotspots to keep the analyses going.

Despite these challenges, the energy remained high, and participants worked together with determination. The overall atmosphere was open and supportive, with plenty of thoughtful questions and lively discussions. All this turned the workshop into an event which was not just about training or capacity building through transfer of knowledge and technical skills but rather turned it into a shared space for mutual learning and sharing experiences. Through the conversations, we had the important opportunity to learn more about the research questions, views and priorities of our participating Bhutanese scientists, which generated ideas and food for thought regarding possible future collaborations, especially regarding the joining together of local knowledge and microbiome science to make real and culture-sensitive impacts.

During this workshop, we also had an online lecture from Prof. Dr. Jeroen Raes on the role of the microbiome in health and disease which triggered an exciting round of questions and discussions in line with the shared interest for future collaboration.

After the successful workshop, we left to Laya on 22 October to attend the Royal Highland Festival with a larger representation of the EATWELL team, which included Dr. Raul, Dr. Neyzang Wangmo, Dr. Francoise Pommaret, the PI Dr. Wim Van Daele and our two remaining RAs. One of our RAs would stay after the festival to continue the sample collection and surveys, so we carried also the necessary materials for the work, including the portable -80 freezer. Given that all lodging was packed we stayed at another home stay.

The purpose of this visit was twofold.

First, it was important to offer Dr. Raul a better insight into the logistical and practical complexities of the work carried out in Laya and its mountainous surroundings, especially regarding the sample collections and the maintenance of the cold chain, and to anticipate the potential challenges ahead during the winter season with our reduced team and develop potential alternative plans. What has become clear is that there are many factors that we do not control, and this makes planning nearly impossible and we will have to adjust regularly underway. Yet, this has been the case from the start and despite this we have still managed to achieve much exceptional work.

Second, our aim was also to have informal conversations with the higher officials attending the Royal Highland Festival to create awareness of the EATWELL project and the numerous possibilities our work could lead to in future projects. We talked with nearly a dozen higher officials and so this was successful. We are hopeful that some of these conversations may lead to more official meetings in the long run to materialize more future work for which the foundation is laid during the EATWELL project. It was also a good opportunity to inform the local leader of the Laya community about the changes in the team and to apologize in name of the EATWELL project for the lack of professionalism that some of the RAs had exhibited.

These two main aims were successfully achieved and at the same time we could enjoy the atmosphere and the beautiful scenery as well as the nicely decorated animals central to life in the highlands. Also Dr Raul and Dr Wim were dressed up in traditional clothes, which tends to be appreciated by many Bhutanese.

On the final day before Dr. Raul’s departure, we managed also to have a visit to the SORIG Museum focusing on Sowa Rigpa, the Tibetan medical system, which falls under the Faculty of Traditional Medicine under Khesar Gyalpo University of Medical Sciences, who is a partner in the EATWELL project. There we also had an explorative and exciting conversation with one of the lecturers to explore possibilities for future collaboration, especially exploring options for mutual synergies between Sowa Rigpa and microbiome science.

Finally, later in the afternoon, we also had the great opportunity to meet with the Secretary from the Ministry of Health, Dasho Pemba Wangchuk, to appraise the Ministry about the ongoing work in the EATWELL project and discuss future plans and further possibilities for collaboration. It was a hearty and promising conversation.

Notwithstanding the initial challenges in the visit from the Raes Lab, represented by Dr. Raul, to Bhutan, we can now look back with satisfaction and say that nearly all objectives were met successfully. We are looking forward to the continuation of our large pilot and groundbreaking work in Bhutan and look forward to elaborating together with Bhutanese and other partners several possible spinoffs and expansions that may emerge from the EATWELL project! The ground for such possibilities towards the future is being prepared in our current work…