Surmang Foundation

We work in a place that is 97% ethnic Khampa Tibetan. Our mission is to promote health among the ultra-poor, those who earn less that US 14/day, in remote Qinghai Province, China. With few roads, cars or electricity, creating access to services is a high priority.Our goal is to create greater access to health care and earlier intervention, applied to mother and child health. He hope to overcome world-record high maternal and infant mortality/morbidity. We have accomplished this with a regional medical center, a model for rural health care delivery among the ultra-poor that is being prototyped in the Yushu Public Health System.
Jul 5, 2012

Postcard: Project Site Visit

Dr. Drogha treating a patient
Dr. Drogha treating a patient

Charlene Chan is an In-The-Field Representatives for GlobalGiving. She is visiting projects throughout China. Here is her most recent "postcard" from Yushu, China:

Recently, Mari and I visited the project site of Surmang Foundation, a clinic in the remote Tibetan plateau providing free medical services. The project also aims to train local women to become midwives or as the clinic calls them, CHWs (Community Health Workers), with the objective of reducing infant and maternal mortality. 

Upon arrival, we were warmly greeted by the two doctors running the clinic, Dr. Phuntsok Dongdrup and Dr. So Drogha, as well as a translator, Janis Tseyongjee. The two doctors live at the clinic, housed in temporary housing after the devastating earthquake that hit the region in 2010 destroyed their homes. The clinic itself was established in 2000, and while the CHW project is relatively new, the two doctors have been treating patients from all over the Tibetan plateau for a long time. 

The next day, Dr. Drogha very kindly allowed Mari and I to observe while she treated patients. She saw about 20 patients that day, with ailments ranging from arthritis to tumors. Throughout the day, Dr. Drogha patiently answered all our questions and her patients kindly consented to us being in the room while undergoing treatment. I was most impressed by the patience, warmth and dedication the doctors displayed toward their patients despite their busy schedule - their patients were like family to them, and many of them stayed after receiving treatment to chat and play with Dr. Drogha's young daughter. When asked, they expressed fondness and gratitude for the clinic. Besides the free medical treatment, the clinic provided a more effective alternative to the traditional Tibetan medicine that most Tibetans resorted to when sick. Many patients had also traveled from afar to seek treatment, some as far as four hours away by motorcycle! 

While we were not able to observe the CHW project in action, we managed to see a patient who was under the care of a CHW, and had come to the clinic for her free ultrasound. Dr. Drogha explained to us that each CHW was expected to perform 3 prenatal visits, deliver the baby and perform 3 postnatal visits to check on both the mother's and the infant's health. The CHW would be paid 200RMB (about 30 USD) per patient. There has been great demand for CHWs in neighboring villages, and while Surmang Foundation is looking to expand the program, funding has become their main obstacle. 

Both Mari and I were sad to leave the clinic, its beautiful surroundings and the warm and wonderful people that run the clinic. We hope the clinic will be able to obtain more funding to expand its program and operations, to improve the lives of the inhabitants of the Tibetan plateau! 

We met a really shy CHW on the way to the clinic
We met a really shy CHW on the way to the clinic
The entire team!
The entire team!
Apr 11, 2012

So Far this Year

CHW training Surmang
CHW training Surmang

At the Clinic

In the last 3 months, Surmang Foundation has continued the training of Community Health Workers in the area within a 50-mile radius of the Surmang Clinic. At the same time, the CHWs have continued to treat pregnant women, attend to births, do well baby examinations and refer patients that demand more complex services to the Surmang Clinic. We are continuing the momentum gained last year, when maternal mortality was reduced to zero.

Clinic use continues to be busy – with about 1000 patient visits per month.

 

Expanding the Catchment to include a Nunnery

Surmang Foundation has also taken the first steps in a strategic partnership with a large Nunnery in Yushu Prefecture.   This nunnery has experienced high levels of TB and hepatitis in the past year. The extension of services to this nunnery and the nearby village will comprise an extension of our strategic  government partnership. These first steps in this direction included sending our lead doctor, Phuntsok Dongdrup, and our Mother and Child Health Director, So Drogha, both ethnic Tibetans, there to conduct a preliminary assessment.  Their drive from Surmang took over 14 hours.

According to preliminary reports, the situation is dire:  cramped unheated housing, lack of sanitary conditions.  Our next steps will be to develop a strategic plan to address the more severe problems related to health and health care.  This will undoubtedly result in a CHW-like program there, as well as recommendations related to basic hygiene.  Surmang Foundation has already begun talks with Village People Foundation about the feasibility of bathhouse construction there and at 3 other locations in Yushu Prefecture. 

Finally, Surmang Foundation has acquired the rights to distribute –for free—the Tibetan version of Our Bodies, Our Selves.  This book along with similar references from Jinpa Foundation and One Heart foundations, completes our written Tibetan language resources for village health worker training.

CHW training
CHW training

Links:

Jan 9, 2012

Overview of 2011

Mother and children we treated
Mother and children we treated

Overview.

It is very difficult to communicate the kinds of geographic (think 13,800 ft, bad roads), language and cultural challenges that we work with.  Even the advent of air transport in Yushu doesn’t mitigate that fact.  When I left Surmang in late September, it was 8:30 in the morning.  When I arrived at Beijing it was 1:30 the next morning. It is a shorter ride from LA to Beijing than from Yushu.

Generally in 2011 we continued to go about our business operating a remote/high performance clinic and CHW public health outreach projects. But there was a twist. Unlike previous years, 2011’s activities were framed by strategic objectives defined in our government partnership --because of the Boston Consulting Group (BCG) Strategic Plan.  It was not just a matter of getting doctors or MPHs to our site, it was a matter of looking at our work so that its successes could be exported, where appropriate, to the 4 other clinics we are now partnered with. So our doctor training became prototype doctor training; our CHW training became more of a prototype for Village doctor training in the four townships we are partnered with.

In addition we were lucky to get the hands-on participation of very high-level MD/PH experts such as Ray Yip, Amy Levi, Dawn Factor, Mary Wellhoner, Mariette Wiebenga, Karen Deutsch, Tim and Cat Silbaugh. Joining us from the business community were John Holden of Hill & Knowlton, Jim Zimmerman of Sheppard Mullin, Rachel Lee of BCG, Ed Sun of Milbank, Bill Valentino of Beijing City University, and Julie Hu, Nike.  So we expanded our connection to stakeholders, both in the government, PH profession, and business community. Thanks to all for a remarkable year.

What we tried to achieve.

General: 

  • continued support and expanded capacity of  clinic and clinic doctors continued input and training of CHWs.

  • continued and expanded capacity of CHWs

  • Strategic: a shift from training of Clinic docs and CHWs to prototype training of docs and CHWs to use across our 4 township partner clinics

  • Including broad sectors of stakeholders from public and government

How we went about it.

  • Treating about 1,000 patients per month for free including meds, no questions asked
  • Maintaining low-cost clinic services (about $7/patient visit vs. $35 for government township clinics).
  • Maintenance of Clinic: Repair of Clinic roof and Clinic solar electrical system
  • Gathering information about the catchment from BCG and summarized in their Strategic Report
  • Continued CHW training focusing on maternal risk factors, prenatal counseling, delivery
  • Gathering information on needs and opportunities for our partnership from the on-site work at Xiewu Township Clinic by Ray Yip and Dawn Factor.
  • Gathering 80 people for China’s first Rural Health Festival
  • Using the results and recommendations of the Festival to focus on mobilizing community public health through CHW and Village doctor training.
  • Changing the training of our Clinic docs from pure primary care to managing training of docs (Phuntsok) to managing the training of CHWs (Drogha).
  • Hiring the retired Yushu Director of Public Health to manage Village doctor and the Xiewu Clinic training and Surmang prototype implementation.

History of Success.

  • Generally, advancing the legitimacy and respect among the stakeholders:  patients, CHWs, doctors (our own & at Xiewu), government buy-in (through open-ended participation in transparent process and analysis.

  • 1000 patient visits/month at Surmang Clinic

  •  High number of CHW (home) deliveries:  126

  • Low infant mortality 9.8% vs. 16% for hospital deliveries

  • Low maternal mortality  -- 0%

  • Providing training at the Xiewu Clinic for clinic doctors and village doctors.

Thanks to all our supporters on Globalgiving. 

We could not do this without your help. Your share of support is your share in our success story. Please contact me so that we can get your input and advice on how we can be more successful, and how we can work together to attract wider support.

best wishes for 2012,

Lee Weingrad

Birth of little girl last day of festival
Birth of little girl last day of festival
Mother and Child we treated
Mother and Child we treated
Training of CHWs at Zatch
Training of CHWs at Zatch

Links:


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