Tibetans preserve their unique culture.
Calhoun's Restaurant, Broadway
February 15, 2004
Deborah Simpson, Didi Zasep, Sharon Gretzinger, Evan Zaleschuk,
Marianne Rev, Helen Weiss-(Alex), and Patricia Healey.
OPENING THE MEETING
Evan opened the meeting by thanking everyone for coming and then
suggested the first item on the agenda was to review the minutes
of the last meeting -- Conrad's version with Sharon's changes.
Before reading the minutes there was some discussion about the
book - Disabled Village Children; discussion ensued about
the book -- Where There are No Women Doctors - Question
about where the book could be located and if it was buyable. Deborah
agreed to do a search on the web re: the book. She also suggested
that Tenzin Tsering may be able to do a translation of Where
There are No Women Doctors -- it may be useful to go through
the book and highlight sections for him. It was also suggested
that he be sent a copy of Disabled Village Children. It
was also suggested that Zadoh have a copy and it would be good
to find out who the publisher is. Deborah agreed to look into
There was a question about where Adrienne was -- and according
to Marianne she is interested in being involved.
OF MINUTES - Evan
1. Needs Assessment
Evan began the review of the minutes with a focus on the needs
assessment -- the last meeting circled around this topic especially
in relation to Child and Maternal needs. Deborah raised a concern
about who is doing the needs assessment -- women asking women;
Dr. Laydar is one resource that can be used for needs assessment,
should get more resources. Dr. Laydar is the "Jamseng guy" and
he is in Zadoh. There was some discussion about who is the full
time doctor in Zadoh -- and it was determined that Dr. Laydar
is part-time, with the full time doctor in Zadoh being the monk-doctor.
2. What Happens to Leftover Medication
A question was raised about where "our medicine" is going
-- particularly the left over meds. It is said that they are taken
to Yushu -- although there is no certainty about what happens.
Helen expressed concern about (and has heard), that some left
over meds may be dumped in the river and this is not a good thing.
It is important to get a conversation going about the medications
and what happens to them and how they are used. It was suggested
that ROKPA could leave their meds for Zadoh and Zadoh could leave
theirs for ROKPA. Evan agreed to follow up on this -- make contact
with the general list to find out exactly what happens to meds.
Around the issue of how medications are monitored Didi expressed
concern that, for example, someone with diabetes needs consistent
medication -- it is no good if they take it only for six months
-- so the question is -- how is the medication for patients monitored
and by whom? It was suggested that Lee in Beijing might be able
to be involved in some way.
3. Resource List
Isaac agreed to do the resource list -- it was suggested that
he be reminded of this -- find out what his ideas are. (Didi suggested
that it is important to consider the politics of how things get
done in Zadoh -- it is important to keep under the radar and not
make a big noise about what we are doing. She spoke about the
example of her home for the old people -- told by officials that
it would cost $200,000, but it was done for $25,000.
4. Women's and Children's Health
Deborah reiterated the importance of needs assessment in this
area -- particularly looking at problems with infant mortality,
maternal care, pre and post natal, birth control issues, problems
resulting from IUDs - there is little information at the moment
about these issues. It was suggested that Candace be asked about
what she would be doing or would be prepared to do re pelvic exams,
IUDs. Around the issue of IUDs it was stated that there is a problem
with old IUDs, IUDs implanted too soon after giving birth, removal
of IUDs. The feasibility of bringing a supply of IUDs was mentioned
-- perhaps this could be suggested to Candace. Sterilization was
next discussed and the use of a pressure cooker was recommended
as a way to sterilize instruments. The source of heating a pressure
cooker was discussed and Didi said they cook with charcoal, outdoors.
It was suggested that they could use a propane stove, but then
they would have to have a source of propane which could be a problem.
(Nothing definitive here about how this would be done....)
(Side-bar discussion - It was mentioned that antibiotics are given,
but it only treats conditions temporarily as the people continue
with the same habits that caused or exacerbated the problem in
the first place.....)
Ron Greenberg -- report on mortality -- Deborah will go through
this and Lee's report after the review of the minutes...... Evan
brought up Hands Across Borders -- chiropractors, physios, OTs,
massage therapists going to other countries to help -- we could
talk to them and see what they are doing and what they know........)
Evan will follow up when he gets Jinpa's e-mail address.
6. Health Education
Evan had a brief word with Rinpoche -- he really likes Dirty
Padma book. Rinpoche thought it would be good to use -- have
someone read it when the family is sitting around in the evening,
do this on a nightly basis. This is an important time, after the
evening meal -- it is considered family time where they sit around
and tell stories -- could be used to educate and sow seeds.
Sharon suggested that we send over 2 dozen books. Books are a
good start -- book needs to be self explanatory -- lots of pictures.
Important for health care providers of Zadoh to teach things like
how to boil water.......(Deb mentioned us sending teachers to
teach the students....)
Another way of educating is through the use of a CD and even DVD.
In Zadoh they do have access to DVDs. Deborah said she would get
a copy of Cynthia Hunt's CD and Evan can look at it.
It was then suggested that we could make a DVD. It would be appropriate
to get Tibetan people in the DVD. Didi suggested it needs to be
done there to have credibility; others suggested it can be done
here, replicating the same scenarios as one would see in Tibet
-- a bucket of water and a ladle in a field. It was agreed that
Didi, Evan, Helen and Patricia would work on a script for such
a DVD -- make it fun, create a teaching story........
7. Resource Materials
Tibetan Doctors Without Borders -- it was suggested that
there is no "Tibetan" in the title. In the minutes there
was also a book title -- Where There are No Doctors --
it was suggested it be corrected in the minutes to read Where
There is No Doctor..... Then suggested that Tashi could translate
Where There are No Women Doctors. Deborah said she will
check to find book before we ask him to translate.
Review of Minutes Completed
NEW ITEMS FOR DISCUSSION
1. Study by Lee
Deborah read through a study by Lee about the Zadoh area. It included
information about the people, ages of children, population, types
of livestock, villages doctor, school attendance, name of villages,
annual income .It was recommended that we get a hard copy from
Lee. It was clarified that this was not a real needs assessment,
rather a demographic of the area.
2. Two Doctors Report
A discussion about the report of the two doctors who spent time
in clinic, in an area close to Yushu in 2002 and what they found
re: the medical conditions, common local diseases. The report
mentions the fact that interviews were conducted with 8 women
-- some were willing to have contraception, some not... (Side-bar
discussion -- it was stated by one of the meeting participants
that some women were too weak -- a result of malnourishment --
to be getting pregnant -- contraception is an important issue).
Socio-economic factors are also discussed in the report. It was
suggested that we could all read through this report, as it would
be both encouraging and re-affirming of what we are talking about.
It was recommended that copies be made of this report.
It was mentioned that Yushu prefecture government was setting
3. Doctor in Yushu
suggested we ask Rinpoche to interview doctor in Yushu when he
goes to Tibet again. Sharon agreed to do this.
4. Child/Maternal Care
Helen read through the list of questions she has generated for
the questionnaire, questions such as how many babies are born
each year, questions involving the health and care of mother and
baby. Didi offered that she could in fact answer a lot of the
questions. It was stated that the questionnaire was a good start
and that it would be useful to send out an email re: the questionnaire
to Candace, Robbie, Zadoh committee members, so that feedback
could be given and we could go through it (to refine the questionnaire).
Important to create a questionnaire where the language is appropriate
-- accessible. Also important to not only look at what is "wrong"
but to also look at what is working -- don't want to come across
looking like things are terrible. It was then suggested that this
be sent to the Big 4 group [Zadoh, ROKPA, TRAS, Seva], they can
add their ideas -- people like Adrienne, Isaac, Ron they are in
the know -- they have been to Tibet. Recommended that this be
sent to Lee to have him go through it -- he is in Beijing and
is a friend of Ron's.
Deborah asked the question: where do women get their support from
pre and post natal. Sharon reiterated the question: who looks
after mother after the birth? -- a concern for the mothers health
as well as the babies.
5. Tashi & Jinpa
Deborah stated that Rinpoche said to write down a list of questions
to ask Tashi. She sent it (the questions) to Rinpoche, Evan and
Helen. Did Rinpoche ask Tashi? It was thought not to be the case.
Evan suggested that it would be important to have an identified
person to deal with Tashi. Evan agreed to do so. We have information
on Tashi's project -- health/sanitation. Some questions around
this: How much would it cost to send people for training? Do they
have Zadoh students involved? Would they want health care professionals
from the West to teach students there?
6. Resource Materials
Tibetan Healing Fund -- there is a pre-natal kit (postnatal?)
and training that has been developed -- out of Seattle and it
functions in the same province as Zadoh. Helen wondered what was
in the kit -- vitamins??? It would be interesting to follow up
on the kit. Also interesting to know if the women used the kit,
how do they use it, what would they like to change about it? Helen
agreed to e-mail and find out what is in the kit.
7. Dr. Lee in Beijing
It was suggested that Dr. Lee in Beijing be asked about: buying
medications in Beijing, what he thinks would be useful, what resource
material he has found useful, and generally what is his take on
things. Marianne agreed to do this.
8. Conclusion of Meeting
thanked everyone for attending.
[Minutes prepared by Patricia]