Gaden Relief Projects

Helping Tibetans preserve their unique culture.

Trip Report


Seva Eye Camp Report – September 2001
Received November 14, 2001

By Dr. Tenzin

A REPORT ON A VISIT TO LHASA AND YUSHU BETWEEN SEPTEMBER 6-25, 2001

[Includes Zadoh eye camp held in cooperation with Gaden Relief Projects. ‘Dzatoi’ is the Chinese rendering of ‘Zadoh’]

The Planning:

Seva planned to conduct an eye camp in July 2001 at Jiegu town in Yushu. The objective of the eye camp was to provide service to the cataract blind patients and also to evaluate the performance of the surgical team of the Yushu prefectural hospital and also to help them plan eye care in Yushu. Mr. Geyong from Tibet Development Fund (TDF) contacted the local health bureau and other authorities and informed Seva that a large eye camp had been conducted in May 2001 by China Sight First Action group and about 300 patients had been operated at Yushu prefectural hospital. And moreover, in July 2001 there was the 50th anniversary of the communist regime and hence we decided to postpone the eye camp to September 2001.

On the 3rd of July 2001, Mr. Tashi Tshering from Jinpa project based in Nanghen county made a trip to Dzatoi on behalf of Seva and confirmed that there will be enough number of patients for an eye camp in September.

The Event:

Dzatoi county government head office sent an invitation letter to the Chinese Embassy in Kathmandu. With that letter, myself and Narayan B.K. from Lumbini eye hospital could obtain the visa to visit Tibet.

Narayan was asked to bring the necessary medical supplies and a portable scanoptics microscope, gowns, dresses and two cataract sets from Lumbini as per the recommended eye camp list of Lumbini eye hospital. From Seva Kathmandu we took one more surgical microscope, an autoclave and two drums and 100 pairs of Aphakic glasses as requested by Mr. Tashi Tshering.

Thanks to Mr. Karimulla (Osman’s brother) that we did not have to pay for excess baggage.

Qn the 6th of Sept. 2001 we reached Lhasa safely and met Mr. Geyong la at the airport. He helped us check into Keychu hotel. Immediately after that we went to the bank and changed the 3000US$ sent from Seva Kathmandu office. Geyongla gave us a receipt of the same. After that we went to the Chinese southwest airlines office to buy tickets for Chengdu for the five team members.

On the 7th of Sept. 2001 we visited Menzhikhang and operated on two cataract blind patients. From Menzhikhang they could send Dr. Phubo Chodren and Dr. Deven la to attend the eye camp at Yushu with two cataract sets. We asked them to bring 25 eye towels too. Dr. Yangki la and Dr. Nawang la ofMenzi Khang had to leave for an eye camp at Shigatse. The new building for the eye department at Menzi Khang looks impressive. It looks well furnished and ready to function.

On the evening of 7th Sept. 2001 TDF invited us to a dinner. We met Dr. Suman and his team from Tilganga eye center who had just finished an eye camp at Lhasa eye center. We also met the officials of the Nepalese consulate. Mr. Tseten dorjee and Dr. Suman impressed everybody with their Hindi and English songs.

On the 8th of September 2001 Geyongla, Phubu Chodrenla, Devenla, Narayan and myself reached Chengdu safely. Sombody from TDF branch office in Chengdu received us and helped us check into a hotel where foreigners are generally not allowed. After that Geyongla went to hire a mini bus to take us to Yushu.

On the 9th of September 2001, we were taken in a tourist coach by a Chinese driver who made sure that we had a comfortable journey. That night we reached Dartsendo.

On the 10th of September 2001, we reached Ganze prefectural town.

On the 11 th of September 2001, we reached Sichu around 5pm. The Chinese driver told us that the road condition from Sichu to Jiegu town is not good and hence we need to hire another vehicle.

A young Tibetan driver with his assistant (a monk) took us in their very old looking Toyotajeep which needed to be fixed twice on the way. The road was very muddy at places because of the rain fall hence an experienced and skilled driver like the one we had could help us through the deep pits and crevices. Around mid night we reached Jiegu town and thanked the driver and God for our safe arrival.

On the 12th of September 2001, Mr. Tashi Tsering met us and advised us to proceed to Dzatoi county. We asked for Dr. Souna Yangzom, Ms. Dolma and Dr. Muma from Yushu prefectural hospital to accompany us to Dzatoi county bring their Scan Optics portable microscope too. The three of them and Dr. Jumei had received training on Seva's sponsorship at Lumbini eye hospital in Nepal. Dr. Jumei who was trained on eye care management at Lumbini was very sick this time.

Mr. Tashi Tsering tried to call Mr. Nima Rinchen the headmaster of the Tibetan school to enquire about Dr. Isac Sobol but failed to contact him.

Mr. Pie Tri Jee the Director ofDzatoi county hospital drove us to Dzatoi. Ms. Donchi and Governor ofHealth and Education in Dzatoi county came with her friends to receive us and invited us to a dinner that night where she thanked us for making such a long and hazardous journey for the benefit of the patients in her county.

She informed us that there were 600 people waiting for us. That night after dinner we visited Dzatoi county hospital and helped set up the operating room, the anaesthesia room etc. The locals were most helpful in providing us the necessary assistance.

On the 13 th of September 2001, Ms. Donchi and her team helped line up the patients so that we could carefully examine them and post them for surgery if needed. While we were examining the patients our friends were setting up the operating room and sterilizing instruments, drapes etc. That evening we operated on 30 patients.

On the 4th of September 2001, we provided post operative care in the morning and Narayan examined outpatients while the rest ofus were busy in the operating room. That day we operated on 54 patients.

On the 15th of September 2001, we operated on 49 major cases and 5 minor cases. In these three days we would have seen about 600 patients and operated on 133 cataract patients and 5 patients with minor diseases. The details of the patients operated are given below. That night we had a dinner together where we thanked each other. We were very impressed with the kindness and hard work the local people of Dzatoi county put for the benefit of the patients.

On the 16th of September 2001, we did a post op examination and towards the end of the post operative round there was a moment of emotional exchange when the patients and their relatives buried us in piles of white scarfs to express their happiness and to mark their gratitude to Seva and others who helped restore sight to the blind people in Dzatoi county. Mr. Tashi Tsering had interviewed and taken pictures of a 16 year old girl who had left school because of her poor sights due to cataract. After the operation in her both eyes she felt so happy on being able to see again. When Tashi Tsering asked what she would like to do next, she said she would like to go to school and become a doctor someday. Mr. Tashi Tsering kept telling this story time and again and said he would like to send the girl’s story and her picture to Alexa. After the post operative round Mr. Pie Tri Jee drove us back to Jiegu town.

On the 17th of September 2001, we were asked to meet the vice director of the Yushu prefectral hospital. The lady vice director told us that there are 6 prefectures in Qinghai province. She said Yushu is the first prefecture were intraocular lens implantation surgery is done. She thanked Seva for that. Eye doctors from other prefectures come to Yushu to see how IOL surgery is done. On behalf of Seva I also thanked her for sending Dr. Sonala and her team to Dzatoi county. We are impressed by their kindness and had work and felt extremely happy to see that all the patients operated by Dr. Sonala had no complications during the operation. Postoperatively also the did very well. We requested the vice director to come up plans so that Seva can support Dr. Sonala and the team to provide more service to the blind patients of the Yushu.

That day we examined about 100 patients in the morning and operated on 30 cataract blind patients. That day Dr. Isaac Sobol came to see us and two students from Tibetan school saw cataract surgery with Intraocular Implanatation. Later that evening we had a lively and enjoyable dinner at Mr. Tashi Tshering'sfriends house in the company of Dr. Isaac Sobol and his friends.

On the 18th of September 2001, we operated on 29 patients and saw a few other out patients. Two patients could not be operated due to conjunctivitis though they had accompanied us from Dzatoi county. We asked Dr. Sona la to operate on them once the

On the 22nd of September 2001, we took Dr. Devenla to the renowned Quasi Medical College and showed her at the orthopedic department. The Doctor advised X-ray again. Being a Saturday that day we were asked to come back on the 24th of September 2001 Monday.

On the 24th of September 2001, Mr. Geyongla collected the X-ray report and the prescription from the doctor. The report states a small fracture on the right side of the hip bone. X-ray films were not given. The medicine prescribed consisted of Chinese medicines to improve healing of the bone. Not knowing Chinese myself I felt like a fool and could not understand the actual diagnosis of Dr. Devenla’s condition. That afternoon we left for Lhasa. Dr. Devenla cannot lift her right leg and still cannot walk. She can extend her knee but cannot flex her right hip joint. She has been advised bed rest for 45 days.

We left the remaining IOLs, vescoelastic material, sutures, medicines a portable autoclave, three drums, remaining aphakic glasses and one bipolar cautery with Menzhikhang. They have been asked to make a list of the things received and send it to us.

We reached Lhasa safely and were asked to attend a dinner hosted by TDF. During the dinner Jigyuanla showed Alexa’ s letter. As we discussed the eye care planning we felt that Seva and TDF should come up with a three or five year plan with focuses on clearing of the backlog of cataract by engaging the trained cataract surgical teams and improving access for the patients especially women and children, by building the capacity of the primary health care workers at county and village level to screen blinding diseases which are curable.

Dr. Chunhua from Ngari was present in the dinner. She has been asked to submit a proposal for prevention of blindness in Ngari. Similarly, Mr. Geyongla was asked to contact the other Seva sponsored trained cataract surgical teams to submit their respective plans. Mr. Tseten Dorjee was asked to submit a proposal ofLhasa eye center. The initial drafts of the proposal made by Tibetan doctors will be improved by inputs from Seva and TDF. It was expressed that TDF could playa key role in mobilizing the international support to restore sight of the blind people of Tibet.

That night Dr. Yangki la came to the hotel to give khatas on behalf of the Director of Menzi Khang. She said they operated on 200 cataract blind patients at Shigatse. She herself did about 100 cataract surgery.

On the 25th of September 2001, Narayan and I reached Kathmandu safely.

Conclusion:

1. The road to Yushu is hazardous. It is more hazardous for the patients who live far away and travel through more difficult roads.

2. We could only provide cataract surgery this time. A more comprehensive eye care is needed. We have piles of donated spectacles at Canada and but have no time to do refraction at the eye camp site.

3. The local team at prefectural hospital of Yushu is competent enough to do cataract surgery and provide primary eye care. But they lack the resources to do outreach activities.

4. We hope that the federation of the disabled, the health bureau and the local government can capitalize on the strengths of the local team and send proposals to Seva and other interested groups within China so that the patients at Yushu can get good eye care.

5. Mr. Tashi Tshering could be a linkage for Seva and TDF to the local authorities. His understanding of the local conditions and the INGO’s interest makes him a good contact person for all concerned.

6. Under TDF’s initiative we started the training of the Yushu doctors and conducted a successful eye camp in 1997. TDF's continued interest and support is called for .

7. This time the eye camp at Yushu was successful with no major complication during the operation or postoperatively. The local authorities of Dzatoi county seem very motivated to serve the blind in their county. We hope they will continue to conduct eye camps on a regular basis and called the doctors from Yushu prefectural hospital.

8. Yushu prefectural hospital rendered their kind support by sending its team and proving that they can do a good job. We hope more of such eye camps and training of village level doctors and county level doctors be done at Yushu prefectural hospital.

9. The only major difficulty we faced was the need to arrange for good conditioned vehicles on the spot for our traveling. Geyoung la tried very hard and we all felt his anxiety through out the journey. We escaped from a major accident. Hope, Dr. Deven la recovers soon and shows us the Tibetan Dance steps she is famous for .

10. The lesson we learnt is that the interest of the foreigners alone to help the people in Yushu is not enough. The locals have to be motivated too. After all it is in the hands of the local authorities to assemble patients and provide other logistic supports and make traveling safe for patients and staffs alike. With these words, we wish to acknowledge the help of all the people who gave us this opportunity to serve the blind nomads of Yushu. Please forgive us if we have excluded any name which should have been included

Acknowledgements

A: Yushu

1. Dzatoi county government head office for sending us the invitation letter.
2. Ms. Donchi Governor ofHealth and Education
3. Dzatoi county hospital director Mr. Pie Zhi Jee
4. Mr. Tashi Tsering, Director Jinpa project
5. The Vice-Director and the surgical team from Yushu Prefectural hospital
6. The PSB office at Yushu allowing us to visit Dzatoi without any fees

B: Chengdu

The officials from TDF branch office for receiving us and arranging the travel permit for us to return to Lhasa.

C: Lhasa

1. Mr. Jigyuan la and Geyong la from TDF for his hard work
2. The Director and the doctors from eye department, Menzhikhang

D: Lumbini Rana-Ambika Eye Hospital

1. For sending Narayan who packed all the medicines and worked so hard

E: Others:

Shravan Choudhary, Bishnu Choudhary from Kathmandu Seva Office. Mr. Karimulla from Kathmandu-Lhasa Tours and Travels. Ms. Alexa Wilkie for continuosly inspiring us to visit Yushu, Mr. Michel Davidson and Dr. Isaac Sobol from Seva Service Society, Canada