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)    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)    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)    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)    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.



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.



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.




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.



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


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


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.


Jan 15, 2015

2014 Report

Dear Friends of Surmang,

It’s very meaningful to enter this year-end report, since it gives us the opportunity to reflect on 2014 and the years before.

2014 was a year that brought several things to fruition that had been cooking on the stove for the past 20 years. I often say that Surmang Foundation is like a rock and roll band that played small clubs in central California for 15 years and then one day became an overnight success.

Connecting to Tibetans

Maybe there’s a kind of inner Steve Jobs in me. When we were asked in the mid-90’s how we knew that the Tibetans would want a clinic, I responded in effect, “they don’t know they want it yet.”

Tibet is one of the most remote places in the world and Surmang sits at the center of that.

One of the marks of that success is risk taking connected with openness and communication with the Tibetan people of Surmang. Unlike the fans of the mythical rock and roll band, the Tibetans are not Californians. They lead traditional herding and farming lives are not into experimentation. So they are slow. There are few if any people wearing watches in Kham. In 1996 Tai Situ Rinpoche told me that going there would be like going back 500 years in time. He said, “For every 10 discursive thoughts an American has, a Tibetan has 1.”

So these are not people who are experimenting in lifestyle. The ideas that we had as a group came out of our admiration for these people as survivors, as people who are very warm, as people who are very genuine. I think that when you connect to people on that level, you can connect with your own warmth and genuineness.

When we opened full time in 2000, there was a question about how to charge for services, since these people make about US 12¢/day. It was clear that we couldn’t judge people based on their appearance since nomads who have 500 horses dress exactly like those who have 5. Also they didn’t seem to know they were poor. Was I going to be the guy who told them that?

 So we provided the services for free. And that’s the way it’s always been. It was only 10 years later that we found out –thanks to the Peking University assessment—that our cost of providing services per patient visit was about 1/7 that of the public health hospitals. In doing this, we stumbled across what is perhaps their #1 cultural value: jinpa, which in Tibetan means “generosity.” In about 2008 one of the high Tibetan lamas wrote a memorial, which declared our clinic a Medicine Buddha center.

 Another element of connecting directly to our beneficiaries is the lack of orthodoxy: neither medical, public health nor development. This means we, in essence, learned to cook from scratch, meaning we weren’t taking anyone’s word for it. In some ways this open view put our direct experience with Surmang on the front burner and as a result it became actually easier to take on appropriate public health, medical or development advice. It wasn’t always so natural or easy for me, like back in 2006 when Mauritz Van pelt told me that our foundation is about “empowering women.” I’ll never forget that. It was a defining moment; that advice would become our victory banner 9 years later, reducing maternal mortality in a place where it is the #1 killer and in writing a proposal about empowering women and girls in Tibet.

 It made it possible to hear the sage advice of Dr. Ray Yip, regarding Chinese PH policy during his many trips to Surmang. It made it possible to see that clinical delivery was the most advanced form of the assisted delivery our Community Health Workers were giving. But whatever we learned was based on the foundation of our own openness and experience.



We had 4 very great medical volunteers: Board member Dr. Julie Carpenter, back for her third rotation. Drs. Laura Kimbro, Trudy Singzon and Sisi Zhao. Dr. Kimbro is an OBGYN who has done many such international rotations as is Dr. Singzon. Dr. S is also a teacher of an international OBGYN protocol, A.L.S.O.

 2014 was the year we became –with the help of the Chinese Government, Yushu Public Health Bureau—a registered charity in China. It was the year we began the journey with supporters and donors from inside China. Why not? We are a Chinese organization. It was the year of our engagement with the Danish Chamber of Commerce China, resulting in the construction of a birthing center on our Surmang campus and the installation of birthing centers at 4 partner township hospitals.

 So it seemed natural, after our 4th Annual Fundraiser in Beijing, that we figure out how to use that birthing center to maximum advantage. The answer was articulated in a proposal written by Suzanne Smith and myself over a two-month period. The guts of the proposal lie in empowering women and girls in Tibet. And the means to achieving that goal is to reduce maternal and infant mortality. Dying in the process of creating life is the greatest challenge Tibetan women face. We proposed doing this through incentivizing mothers, community health workers and our doctors in pre-natal exams, birthing, post-natal and well-baby exams.

 And why not? Already our salaries to community health workers are 1/3 of their family income. Since the government has stopped the collection of cordyceps sinesis (“worm grass”) due to possible extinction, it makes sense that increasing income would make clinical delivery more attractive.

Through the help of Director Chris Devonshire Ellis, 2014 was the year that we partnered with Dezan Shira to get the benefit of their expertise in financial reporting. Not only that, they did 3 articles for us in their 40,000 member "Asia Briefing." 2014 was the year that our website, www.surmang.org, was redone largely with the help of the marketing firm, Shanghai Jungle. In our last reported week our requests for pages went from an average of 3500/week, pre-re-do, to 15,000 a week, post.

In addition  Did I mention that 2014 is the year when our Surmang Clinic achieved status as a government clinic? That means that we are the beneficiaries of meds, supplies and can register births (and deaths).

 Part 2 of the proposal is the creation of an income stream –a weaving co-op so we can re-introduce traditional yak cashmere blankets and shawls, a skill lost during the cultural revolution. Usually in the NGO business success is monitored according to measurable outputs and indicators. But for this project –as well as mothers and babies not dying in birth—the non-measurable outputs are really the strongest. These are: how a woman feels about having a baby. Joyful or life threatening? And how a traditional sacred craft like weaving reassures Tibetans of their place in this world. In a book on Balinese weaving, someone said, “the patterns in this cloth are the lens which brings the power invisible world into the visible.” I hope that the cloth of our foundation could as a whole could have a similar wholesome impact, as we enter 2015.

I welcome you to join us.

Lee Weingrad



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