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

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Sep 1, 2010

Standing up for Yushu

Dr. Phuntsok, survivor
Dr. Phuntsok, survivor

On April 14, 2010 a 7.1 force earthquake devastated Yushu Prefecture, a nearly 100% ethnic Tibetan region of Western China. The city of Yushu (Jiegu, Tibetan) was in a matter of minutes wiped off the map and its 120,000 residents were instantly homeless. This included all residences, and all monasteries. In addition, as many as 4000 people died.

One of those directly affected was Phuntsok Dondrup, Medical Director of Surmang Foundation’s Surmang Charity Medical Center Clinic. He is one of two doctors who have treated over 130,000 ultra-poor patients in the past 10 years for free. At the time of the earthquake he asleep with his wife and two small children. After 4 hours, other family members dug them out. But his two sisters-in-law were not as lucky. Both perished, leaving the married one’s child an orphan. Phuntsok suffered a hairline fracture of his pelvis.

Among all the buildings damaged was our outpatient building at Surmang.

Immediately upon hearing of this tragedy, Surmang Foundation was offered temporary office space at Boston Consulting Group’s (BCG) offices in downtown Beijing. For a week we considered how best to serve the people of Yushu. In the face of the overwhelming first response and relief efforts by the Chinese Government and citizens, we decided that it would be better to provide what we do best: clinic delivery systems and our unique (amara) management model, both based on “community-based health care” with a special focus on mother and child health.

With BCG’s help we forged a plan to do just that. In June, we sent a team to Yushu to do an emergency assessment. The members of our party were personally devastated by the size of the refugee resettlement and the extent of the damage. The Yushu we’ve come to know and love over the past 18 years has ceased to exist.

We visited all 10 Yushu County clinics to see which ones would be best candidates for rebuilding and adding the amara model. It was perhaps the first time anyone had done such an assessment. We presented our results to the director of the Yushu Public Health Bureau. They agreed that we should rebuild a clinic at Haxiu town, create a regional health center at Surmang, and extend our community-based health care model to 3 other clinics.

Now, six months later, Surmang Foundation is about to take the first steps in this rebuilding process. We are the only foreign foundation in the region and we are moving forward with partnership with the Chinese Government. However grim, this tragedy has created an opportunity to extend a worthy model solution to China's rural health care crisis.

Phuntsok's extended family
Phuntsok's extended family
One of 20 refugee tent cities
One of 20 refugee tent cities
condemned apartment building
condemned apartment building
the remains of Surmang Foundation office
the remains of Surmang Foundation office
w/no monasteries -funeral rites are done in tents
w/no monasteries -funeral rites are done in tents
boy who lost his mother and father
boy who lost his mother and father

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