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 15/day, in remote Qinghai Province, China. With few roads, cars or electricity, creating access to services is a high priority. Creating access to quality care is our aim. Our goal is to create greater access to free quality health care and earlier intervention, focused on mother and child health.The main problem is to empower women and girls. Our primary goal is to overcome world-record high maternal and infant mortality/morbidity. The downstream effects of healthy moms and babies impact Tibetan culture, more strongly than re-introducing wolves has resto...
Oct 27, 2015

report: Health Care in Tibet /Yushu (#5500)

 

 

 

2015 is 23rd year of our providing medical services in Tibet. It’s been an interesting year. But then again we are working in Tibet and at 4000m, (13,000’ +) it’s bound to be interesting.  

 

In terms of patient visits it was another over-the-top year for our clinic. About 1400 patient visits per month. This means that each patient returns about once. To give a reality check about our work and compare it with the much larger PHS county hospitals:

 

 

Number of doctors

Monthly patient visits

Surmang Clinic

2

1400

Township Hospitals

12

100

 

This means for an all-in budget of $150,000/year, our per-patient visit cost is about $9. This includes births and well-baby visits. I think that’s something.

 

The statistics above show what kind of model, what quantifiable outputs we want to contribute to the rural government hospitals. Actually the phrase “rural Tibetans” is a kind of joke, since most Tibetans live in far-flung farming or nomadic regions. Tibet is 1/5 of the Chinese landmass with .5 of her people. Before 1959 there were no roads, since the Tibetans didn’t use the wheel and thus no carriage or car (wheel is a sacred object), and there were no cities, except for Lhasa.

 

We continued our training of our two Surmang Clinic docs, Phuntsok and Drogha, as well as the training of docs in Yushu PHS hospitals in accordance with our government partnership.  We had a very great collection of 4 volunteer doctors, each doing a one-month rotation. 3 from Canada, 1 from Australia. Great people. Unbelievable what luck we had to get them and also for the people we serve great luck. One of my enduring observations is that from nomads to farmers, monks to businessmen, all Tibetans know quality and all Tibetans know when someone is there to help them out, without expecting anything in return.

 

The challenges we face are management, financial and legal.  By management, I mean that the project design is not from a school of public health, nor from a medical school, nor from a big foundation or foreign government. Our expertise is on-the-job training, which ensures that, if we pay close enough attention, it will be possible to learn lessons from our patients, doctors, and other stakeholders. I think that sense of pure vision is not lost to our Chinese government counterparts, because we have the blessing of being virtually the only international foundation in Tibet.

 

Financially we have always operated on a shoestring and always lived hand-to-mouth. I believe that there is strength in this approach, even though it is difficult. Our weakness is our strength and our strength is realizing that you don’t have to be big to get big results. This is the story of David and Goliath, and according to Malcolm Gladwell, about 40% of all military victories are where the winning side was smaller or less well equipped than their adversaries. When you win that way, the victory is sweeter because it’s come out of your playbook, your experience, not out of a tradition or a textbook. This is definitely our story and what contributes to what Dr. Ray Yip, recently retired Director of Gates Fnd China described as our pre-eminence as experts in the field of Tibetan health care.

 

Now we enter the cold weather in Tibet and the season when our patient visits and births will spike. I ask you to continue supporting our work as you’ve done in the past.

 

We still have a ways to go

 

·      Our priorities are home delivery with Community Health Worker assistance. But we need to maximize the clinical visits by pregnant women. For the ones that seem more difficult, we need to have clinical delivery or in the worst case, be taken to the prefecture hospital for delivery. We can do this.

·      We need to install a water system. We have the pumps. We need to raise the funds to do this. A water system will bring our clinic to the next level

·      We need to re-boot our sat dish so that we can effectively do remote consultation and diagnosis using blood diagnosis and ultrasound

·      We need to build a training center so that the PH service doctors we train will have a proper venue.

Jul 6, 2015

Semi-annual report 1/1/15 - 5/30/15

Surmang Patients with Dr. Phuntsok
Surmang Patients with Dr. Phuntsok

Surmang Clinic:  Semi-annual Report 1/1/15 to 5/30/15

Bi-lingual Report

By Dr. Phuntsok Dongdrup, Clinic Director

1

201420151318053168B420.193

1)    Case Record Data: During the period there were 13,180 patients come to the clinic, which including 53 baby deliveries, visit 168 patients at home, 420 B-Ultrasounds. Transferred 19 car accident patients to other hospitals. 3 patients dead from hypertension and dystocia.

2

 

2)    Treatment: Per the doctor’s record,most of the patients came to the clinic because of flu, hypertension, cerebral hemorrhage, arthritis, bone hyperplasia, appendicitis, cholecystitis, gastric ulcer, gynaecopathia, traumata, dystocia, dysentery, phthisis and hepatitis. After got treated in the clinic, most of them got well, only few patients were transferred to other hospitals since heavily cerebral hemorrhage or/and acute appendicitis.

3

9001200200600150

3)    Working time: Our regular daily working time is from 9am to 12pm and then 2pm to 6pm. But if have patients other than the working time, we will also have them treated, sometimes we even go visit patient who leaving dozens of miles away from our clinic at mid-night. And if any poor patient with serious sick and need to be transferred, we’ll drive and take them to the township hospital which 150km away from our clinic without any cost.

4

 

4)    Special cases in countryside: different from the patients in big cities, most of countryside patients are come to the clinic with fire burned, dystocia, acute appendicitis, cerebral hemorrhage and bromatoxism.

1

20142015

5)    Community health training: from year 2014 to year 2015, we took foreigner volunteers doctors Chao and Berg to Yushu Surmang clinic, Maozhuang clinic, Xiewu town and Longbao town for community health work training. Our first stop is the Modi village in Surmang Township, where the Surmang clinic located. The main contents for are mother-child health problem, sanitary conditions and doctor training. After the training we found: the high maternal and infant mortality are because the rare healthcare and poor sanitary conditions, as well as the poor knowledge on how to deliver babies. Training for the women who leave in the area is very hard because nomadic leaves scattered and the traffic condition is bad, but every single people in the group did their best to ensure the training completed successfully.

2)CHW

38

2014 502525

6)    Community Health Worker: 38 nomadic women from different villages are part of our community health network. During the training period, we taught the women how to help pregnant woman to deliver baby with better and healthier way, they learned very fast even more than our expectation. We believe they can definitely help other pregnant women on dystocia and other birthing related issues when they back to their own village.

 

3)

 

7)    When community health workers returned to their own village, they helped a lot for their own neighborhood, and the response from different regions are all positively. People expect more and more charity would come to their place with taking advanced knowledge to help local people live better and healthier.

4)

38

8)    Surmang Foundation covered all the meal related expenses during the Community Health Worker training, including all the doctors (local and foreign), interpreter and 38 women who got trained. And for getting heathier and better environment for pregnant women, a birthing center is under built.

 

 

 

Dr. Phuntsok Dongdrup

Medical Director,

Dharma Sagara Clinic

Surmang Foundation

2015611

11th June 2015

Prayer Flags
Prayer Flags
Our partners
Our partners
Patient exam
Patient exam
Dr. Berg & patient
Dr. Berg & patient
Drogha making a house call
Drogha making a house call
Waiting Room, Surmang Clinic
Waiting Room, Surmang Clinic

Links:

Apr 17, 2015

Into High Season at Surmang

Waiting Room, Surmang Clinic
Waiting Room, Surmang Clinic

This year we begin our 23rd year in Tibet.

We start the year with a new birthing center and with the challenge of installing birthing centers in 3 partner township hospitals in Yushu Prefecture, Qinghai Province. Sometimes people ask me what is the greatest difficulty of working in Tibet. The answer is always “everything.”

There are severe challenges in what a health promotion organization can do, since in this most-Tibetan, ultra-rural region, there is hepatitis, STDs, TB, infant stunting (no iodine in the salt) chronic cardiovascular disease (ever try walking around at 13,500’ for a few years?), and of course infant and maternal mortality and morbidity.

The question is not “what can we do to help?” but “what can we do that will achieve the greatest sustainable results?” In answer to this question, we chose mother and child health. Why? Because regardless of political, environmental, spiritual challenges, without healthy mothers and health babies, there is no Tibetan culture of any kind. Period.

If you want to save a culture, save a mother.

When we look even deeper, we have found that the lack or care for women and girls, women and babies, is a reflection of the low status that women and girls have in Tibet and for that matter nearly everywhere else in the world. Because we are a small foundation, we’ve had to focus and we found that focusing on safe deliveries, healthy babies, and strong girls, is an important contribution we can make to Tibet.

Why? For one thing, no one else is doing it. At least no one else is doing it quite the same way we are. We started out by basically getting the trust of our communities by offering free medical care and free medicine, with medical services given by people who are from their area, who speak their language. Doctors and patients who look at this help And it is.

Next we examined the reality of health care in the region through one of the only mass-data public health surveys (2005) and through an apples-to-apples comparison between our services and those of the Public Health Bureau. By the time the devastating 2010 Yushu earthquake came along, we had something to offer them, a model that we hoped to roll out as a sustainable prototype.

We moved out of our safe niche at Surmang into the bigger world of rural public health in partnership with the government.

That was the beginning of our partnership with the Yushu Public Health Bureau. I know many people will think  that “the government is not the solution to the problem, it is the problem.”  But in this case our government partners were and are all ethnic Khampa Tibetans who have an eye for innovation and an appreciation for grit.

We came up with training programs for not just our two docs, Phuntsok and Drogha, but for the docs we train in Maozhuang, Xialaxu, Xiewu and Longbao township hospitals. Our volunteer doctors were and are superstars –strong open people who are happy to make a palpable difference.

The reception our docs received was equally strong. Tibetans are naturally warm, genuine people and they are quick to recognize warmth and genuineness in others who come to help. The result of this synergy was the government offering to create an umbrella organization to guarantee the continuity of our work. After all, since 2008, there has been a steady attrition of international foundations in Tibet. Trace Foundation, Bridge Fund, One HEART Tibet, Doctors Without Borders, Tibet Poverty Alleviation Foundation. All gone. There are very few international foundations left in Tibet, as we are reminded by our government partners.

An officially chartered organization was started by the government in 2014, The Yushu Farmers and Nomadic Health Promotion Association. Through this organization our programs have the basis for continuing far into the future.

But there is a catch. The departure of all these big foundations is because of their funding from either the US Government or very big international foundations. We receive funds from neither. So we are dependent on you donors through Globalgiving.org. Please help!

Please continue your support and generosity.

Babies are our business.
Babies are our business.
examination
examination
patients
patients

Links:

 
   

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