Gaden Relief Projects

Helping Tibetans preserve their unique culture.

Minutes

Zadoh Committee Meeting Vancouver
Calhoun's Restaurant, Broadway
February 15, 2004

Present: 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 this.

There was a question about where Adrienne was -- and according to Marianne she is interested in being involved.

REVIEW 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........)

5. Jinpa

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 up clinics.

3. Doctor in Yushu

Sharon 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

Evan thanked everyone for attending.

[Minutes prepared by Patricia]