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.
May 24, 2011

The 1st Year -- transplanting the Surmang Model into the Public Health System

CHW training
CHW training

Putting access to quality services in first place, with a focus on mother and child health 

This year in a nutshell.

2011 is the most important year for Surmang Foundation since the clinic at Surmang was completed in 1996. 

Since that clinic was opened, we have developed a unique model of rural health care that puts access to quality services in first place with a focus on mother and child health. In that region a pregnant woman has a 1 in 15 chance of dying before delivery, three times the risk a US soldier faces in Afghanistan. 160,000 ultra-poor nomadic and farming patients have used our free services; they are a living testimony to the success of our project. As one of our 40 community health workers said last year, the only criticism is that “we didn’t start 10 years earlier; if we did many people who died would be walking the earth now.”  Yushu has one of the highest maternal and infant mortality rates in the world.

Something as simple as clean birthing kits and oral rehydration salts can save hundreds of lives. But someone has to help women to use them.

No matter how great, the success of this model was challenged by the fact that it is in a private, one-off, foreign funded project.   All that changed last year due to the tragedy of the Yushu Earthquake.  As a result, the Chinese Government asked us to transplant our rural health care prototype to the public health system.  We accepted the challenge and last December, signed an agreement to transplant our model into 4 rural township clinics.  Thanks in large measure to the support of people like you through GlobalGiving, we have come this far, so as a donor, our success is your success. This year we begin that journey. 

  • to make it easier for women to survive the challenges of motherhood and childbirth through a corps of 250 Community Health Workers, training 50 a year for 5 years.
  • to drastically reduce maternal mortality and infant mortality in the region.
  • train doctors in the four clinics --Longbao (at the earthquake epicenter), Xiewu, Xialashu and Maozhuang— so they can bring best practices to their patients
  • reduce costs by using the management methods that make the Surmang experience 1/5 the per patient cost of a public clinic.
  • Finally, it means building a community of health, connecting the providers, inspiring themWe will do this with our First Annual Festival of Health, at the Surmang Clinic in September.  This Festival is modeled after Threads of Life’s Indonesian Weaver’s Festival.

 

Snapshot – Longbao Clinic. 

The Longbao township was nearly wiped off the map by the 2010 earthquake.   It occupies a couple of temporary buildings and the construction of a new 2000sq m facility, and, while a top government priority, its completion is still a couple of years in the distance.  At this point there is only one doctor on staff and we will support his work with residential training given by Drs. Tim Silbaugh and David Clauss this summer.  At the same time our team of 6 PH professionals will recruit about 15 CHWs and begin their training. The idea is to connect the dots, not only from the remote villages and nomadic camps to the CHWs, but from the CHWs to the docs at the township clinics and then from the township clinics to the Prefecture Hospital.  We want to make sure that the CHWs are the front line providers for these nomadic women and children; that the township clinic has the resources –hardware and training—to handle referrals and that patients that cannot be treated there can be evacuated to the Prefecture Hospital in Yushu. 

This year is a big opportunity -- to  succeed here will be big, historic.  There are no other competing models of rural health care delivery systems for this catchment. Then we can apply our model to the rest of the 40 million Chinese who earn less than US14¢/day. Please help us!

CHW training 2
CHW training 2
CHW training 3
CHW training 3
CHW training 4
CHW training 4
Xialashu Township docs
Xialashu Township docs
Longbao Clinic
Longbao Clinic
Longbao region
Longbao region
Evacuation of Pregnant Nomad
Evacuation of Pregnant Nomad
Surmang Clinic and Monastery
Surmang Clinic and Monastery
Xiewu Township Clinic Docs
Xiewu Township Clinic Docs

Links:

Mar 1, 2011

A Private Model Moves into Public Health

Mother and Child. (credit AFP; Frederic Brown)
Mother and Child. (credit AFP; Frederic Brown)

Dear Friends,

Surmang Foundation has worked in Yushu, east Tibet, since 1992.  In the past 10 years alone, our clinic treated over 150,000 ultra-poor patients, providing free medical care as well as free medicine.  We have brought health services to farmers and nomads, men, women and children who otherwise have no safety net.  Our doctors and 40 health workers deliver 60 babies a year.  Without them, at least 20 would perish.

As supporters of our work, it is clear to me that our accomplishment is your accomplishment.  You made this possible; you did this.

In 2009, Peking University concluded that our Surmang clinic is a unique, successful prototype, with lower operating and per-patient costs, but higher quality care than is available in the public health system.

Apparently the Chinese government agreed.

After last year’s devastating Yushu earthquake, the government called on us to apply that successful model to 4 devastated township clinics.  The government looked hard at Surmang Foundation, liked what it saw, and agreed to apply our model in the stricken earthquake epicenter. We are very proud because this partnership is built on success, the success you helped to build at Surmang. We are also proud because this is the only public-private partnership of its kind in ultra-poor China.

We stand at the threshold of putting our private clinic model inside the public health system and making it sustainable.  This is a big step, unique in China, unique in the NGO world and we need your help to do this.

In the arc of this journey, we will do what we do best:  train doctors in best practices, apply successful and transparent management, give the families –especially women and children-- of remote farmers and nomads access to free quality health care.  With your continued support, will be able to say, after 5 years, that you helped to treat not just the projected 75,000 patients at Surmang, but also an additional 300,000 patients at Xiwu, Longbao, Xialaxu, and Maozhuang, patients who earn less than US 14¢/day.

Your contributions will help:

§  Wire and create a network for remote diagnosis and consultation through United Family Hospital

§  Sponsor a public health festival to begin residential training of physicians and health workers

§  Train doctors at the 4 township clinics

§  Train a corps of Community Health Workers at 4 township clinics

We know our plan will work because it already works, and everything we have done is scalable. Your donations have enabled us to create 40 full-time community health workers.

When I met with them last year at Rangdou last year, and asked what they would do to make our projects better, one wept and said, “I would have started ten years earlier. Hundreds of mothers and babies who died needlessly would be walking the earth today.”

We can’t regain that lost decade, but we can make sure that in the next decade, the maximum number of remote poor nomads and farmers receive the health care that every human deserves. But we need your ongoing help to continue the journey, our journey. 

Please become a donor in our Planned Giving Campaign.  Give to our PAG campaign or pledge to give.

family in tent city
family in tent city
old woman walking down ruined street
old woman walking down ruined street
children playing in the rubble
children playing in the rubble
cooking amidst the ruins
cooking amidst the ruins

Links:

Nov 29, 2010

The Promise of Health: Rolling out the Surmang Model

new housing replaces tents
new housing replaces tents

Major Agreement with the Chinese Government

The Chinese Government has invited Surmang Foundation to sign a major and historic partnership agreement at the end of November.   The agreement will be signed the week of Nov. 28 in Yushu.The agreement calls for Surmang to install its unique rural health delivery system in five earthquake-damaged township clinics in and to rebuild one of the most severely damaged -- the largest of these five.

   Surmang has operated a private clinic in Yushu County, Qinghai Province since 1992.The Surmang Clinic has provided free medical care, including free medicines to over 130,000 patients in the past 10 years.  The Yushu region has one of the highest infant and maternal mortality rates in China, with a maternal mortality rate of 3,000/100,000 (Beijing is 80/100,000) and an infant mortality rate of 1 in 5. In this region giving life is a life-threatening disease.
   In addition to the training of local doctors and the provision of free services and meds, the Surmang
prototype focuses on “community-based health care” via a corps of Community Health Workers (CHWs), whose focus is on mother and child health.  The additional 4 clinics will add another 140 CHWs to the 40 at Surmang.
   In addition the agreement elevates the Surmang Clinic to the status of a village clinic, meaning the
meds supply chain is within the inventory system of the Ministry of Health.
   The poor have no access to quality medical care and women and children are at the greatest risk. This is a major breakthrough – it gives us the opportunity to influence and impact the way public health is practiced in the poorest parts of rural China.  It creates the opportunity to give a much larger population access to quality health care.  We estimate, that at current levels we will be able to benefit nearly a half million patients in the next 10 years.

  As importantly, this breakthrough takes a private, stand-alone, stove-piped model and brings it inside the public health system.  This means that we have the ability to influence and improve the quality of 40 million ultra-poor to basic health services, and to give greater access to those at critical risk --the women and children.

 

Getting our Docs out of Relief Tents and into Quality Housing

In June, after Yushu, we went to Surmang to assess the damage at the Surmang clinic.  It seemed like everyone in Yushu County was living in blue government-issue relief tents.  No one dared to sleep in a permanent structure. According to engineer Gary Swenson our second building, our inpatient facility, had suffered irreparable damage and had to come down.  Both Phuntsok Dondrup’s and So Drogha’s families were living in tents. 

   Phuntsok’s family has three small children (counting their orphaned nephew) and Drogha one.  Because I couldn’t imagine asking their families to spend the winter in these tents, when we got back to Beijing we contracted with a company that makes very high quality temporary buildings, guaranteed for 25 years. The company manufactured the buildings according to the design of architect Ralph Allen and on October 7th 5 engineers brought the parts out from Jiangsu Province --SE China-- and assembled them at the clinic nearly 2000 miles away.   I am very happy to say that our two doctors, our local heros, will have good, warm housing this winter.

Tent City: how all of Yushu
Tent City: how all of Yushu's residents live

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