Gaden Relief Projects Helping Tibetans preserve their unique culture. Trip Report

Zadoh Trip Report – July 2004
Submitted September 11, 2004

By Drs. Candace Cole and Robbie Chase

In advance of the trip, medicines worth an estimated $6000 were collected, through targeted donations from doctors and pharmacies (e.g. antihypertensives, anti-inflammatories, antibiotics, vitamins); significant contributions were gathered from from Toronto, Ottawa, Duncan, B.C., and Moscow, Idaho. An order for key medications was placed with Can-MAP for purchase at reduced rates for charitable health work in developing countries. Many thanks for the many people who volunteered their time to gather the materials, Conrad for organizing the lists, purchase orders, etc. Altogether the medicines weighed around 100 lbs.

The health team accompanying Zasep Rinpoche on his 2004 trip to Zadoh consisted principally of Candace Cole MD, Rob Chase MD. Eric Field and Anneli Arrak were also on the trip and helped out in various ways, particularly with waiting patients and providing supportive treatments.

When we arrived in Beijing June 30, we were generously helped by Mrs. Bai Ling, aunt of Anna Wong, Vancouver Island dentist and overseas volunteer, to arrange for shipping by train to Xining so as to avoid the heavy excess baggage penalties on internal Chinese flights.

In Xining, the capital city of Qinghai Province, we picked up the shipment at the train station and next day hired a van to take us to Yushu, the head town of Zadoh's prefecture in the southeast corner of the province. Considerable improvements on the long road across Qinghai Province have been made; the trip, which took us 26-30 hours by bus three years ago, took us 15 hours this time.

On arrival to Yushu, we had the very good fortune of meeting up with Choetso Drolma, the young Tibetan woman and Rokpa student, one of the six who were sponsored by Rokpa to come to Vancouver to learn English in 2003. She now studies Tibetan and Chinese medicine. She was able to accompany us throughout our trip and served as a very capable translator throughout.

Medical Clinics

To briefly summarize, we set up our clinic and pharmacy wherever we went. With Drolma as translator, we could function fairly independently from Rinpoche, freeing him up to do his work. Altogether we saw 326 patients. We recorded names, health complaints, examinations, and medications and management advice. The records can be analyzed and classified for further information.

Our locations during the trip included:

1. Neem Do Gompa July 7, 8 (a secluded Kagyu monastery near Jamseng valley, and home to Dr. Shamar the doctor at Jamseng clinic)

2. Zadoh town (July 8-10) we saw a few individuals, particularly some lamas with significant health problems; we did not set up a clinic at the town hospital as in 2001, preferring to focus on providing care in more rural areas.

3. Jamseng Health Centre (July 11, 12, 13) We used the health center for several busy days where we saw as many people as we could.

4. Choensu Gompa nunnery July 14, 15, and August 1,2: seeing nuns and old women

5. Jamdak's camp (Rinpoche's brother) July 16,17, 18, 19 for local nomads

6. Tashi Lapug July 20,21,23,24,25. There was a large gathering of local people who came to attend the Vairochana initiation. For three mornings we ran a clinic out of a separate tent, seeing all the monks with health problems on the first day. One of the head lamas of the monastery is Lo Chu Rinpoche, who is a Tibetan and Chinese doctor. We were able to provide him with and teach him about the basics of hypertensive diagnostic equipment and treatment. Patients will be able to follow up with him. There is a building in the monastery compound that can be converted into a clinic; Lo Chu Rinpoche is interested in providing health care to the community on an ongoing basis; plans are to provide him with more medicine supplies. Eighteen of the 20 monks seen with health complaints had stomach problems, likely related to poor water quality and sanitary conditions with respect to food preparation. We made a general presentation to the abbots and monks about our concerns and the potential for prevention of health problems with a secure water source, waste hygiene and hand washing. It was the first time this issue had been raised and we felt prospects were good that they would find ways to improve sanitary conditions and ultimately train the surrounding communities in these areas.

7. Chipu valley (Rinpoche's childhood valley, a day's horseback ride out of Zadoh town) July 29-31

Jamseng Health Centre and Program

The health center is being well used by local people. Dr. Shamar is quite busy providing both Tibetan and Chinese medical care. With the permission of his abbot Dr. Shamar agreed to stay on as the health center doctor for another three years. Whereas on the 2001 trip there was no suitable doctor at Jamseng to hand over the medicine and equipment, this time we could translate to Shamar the indications, dosages, and cautions for many of our basic medical supplies and equipment, and arrange that patients started on long-term treatment e.g. for hypertension, return to see him for ongoing care.

The books and other resources in Tibetan that the Vancouver committee had gathered from the Kunde Foundation and Hesparian Foundation (Where There is no Doctor) were very welcomed and will be a big help. Plans were discussed to provide better accommodation for very sick people and their families while they stay at the health centre, and to acquire land adjacent to the health center compound for growing vegetables and medicinal herbs.

A major objective of the trip was to ascertain the level of need among rural women particularly issues of maternal health, and access to prenatal care, preventive measures, care at the time of delivery, and for newborns and infants. Candace and Drolma interviewed several women patients in some depth to better appreciate issues of pregnancy, delivery, causes for morbidity and mortality, infant care, birth control, traditional birth attendants and how receptive local women and families would be to improved services.

We and the Jamseng heath committee at Jamseng held lengthy discussions on the subject to enquire these same issues. This was audio-recorded and will be made available to the Vancouver committee. Both Dr. Shamar and Dr. Ledar (head of the Jamseng health committee) agreed that this was a priority area. They welcomed the idea of providing better services, acknowledging that a male doctor-monk is not readily approached by women with gynecological or obstetrical problems, nor does he have complete training in these areas.

Dr. Ledar mentioned that a niece of his, Kazon Palmo lives in a nearby village (1/2-day's horseback ride away) and last year had 3 month's training by Jimpa in midwifery. We subsequently met with her on two occasions to discuss a role for her to help provide data gathering, improved care and preventive education at the Jamseng clinic.

We arranged that she come to the center for one day, twice a month, to see women and infants. Both she and Dr. Shamar will write notes and reports on matters regarding maternal and child health that arise over the next year. Kazon will phone Drolma on a monthly basis to report on her work; Drolma will be in touch by email with Rinpoche, Robbie and Candace.

We also made some progress in sourcing out medicine supplies in China. On the last day in China Robbie spoke at some length to Lee Weingrad, who lives in Beijing and coordinates the Surmong Foundation's health project in the Yushu area. He offered to share his lists and means of procuring Chinese manufactured pharmaceuticals, so that Jamseng and Tashi Lapug clinics can be re-supplied within China, rather than requiring shipments from Canada.

Summary

In summary, this year's health care trip was a great success in many respects:

1. the Jamseng health center is functioning well and provided an excellent place to set up our clinic.

2. In both Jamseng and Tashi Lapug, there were trained doctors with whom we were comfortable to hand over medicine and diagnostic equipment and who could provide ongoing care to patients on their local area. This requires maintaining supplies of medicines to be procured within China.

3. With Dr. Candace on the team and Drolma as translator, the medical team functioned more independently of Rinpoche's duties, and was more conducive to the needs of Tibetan women with health problems.

4. We accomplished a great deal in organizing improved services in the area of maternal child health.

Plans To Do

1. Dub recording of Jamseng maternal health discussion for Vancouver committee to provide them with more detailed information. Candace would be happy to meet with the Jamseng Health Committee in Vancouver in November to show slides and discuss and issues in more detail.

2. Lee Weingrad: Surmong's medicine lists; negotiate how best to buy and ship medicines for Tashi Lapug and Jamseng to Jamdak -- should be done by end of November at the latest.