Health Care in Tibet /Yushu

2021 in East Tibet.

“When can we visit Surmang?” again and again I was asked by our patrons in Beijing.

2021 was hardly the year in which I could give an optimistic answer. Everything in 2021 was shut down.

When 2021 dawned in China, it was a time of city-wide shut downs, of draconian prohibition of foreign travel in or out of China, of mandatory masks, and the required use of cell phone software that verified one’s location and the health status of all Chinese and all visitors to China. There were no exceptions.

As project managers, we were passing the disaster going the other way. Our goal was to drive the car of clinic project design forward in three directions:

• one, the main one was to keep it open to the people we serve.
• Another one one was  to raise the clinic itself to international standards of health care.
• the tbird being to begin converting part of the clinic to a lodge.

After 30 years at Surmang I could read the handwriting on the wall: Yushu was becoming China’s Bhutan. So 2021 was dedicated to two goals: —meeting international standards of clinical care: not only keeping the clinic open in the face of Covid shut downs, but moving ahead with the renovation of the clinic: a modern toilet, washing machine, shelves and scrubs, new meds storage, kitchen, tiled bathroom with hot water shower. — and guest quarters, the development of a lodge for visitors to Surmang.

The first 6 months of the year was a time when travel in Beijing was somewhat relaxed —meaning we could actually enter a huge Home Depot-type store, where we went ahead and bought: -a complete kitchen with oven and sink and copious counter space and shelves and -a large Panasonic refrigerator -a Japanese tea house, complete with tatami mats and shoji screens.

These were stores were places we were familiar with. In the pre-Covid days they were somewhat bustling, like American big-box stores. This year they were largely empty. With the kitchen interior measurements in hand, I was able to place the order and have the design department come up with the kitchen drawings. The store manager knew well our charity clinic and told me they would support our purchase. The ¥150,000 (US $24,000) kitchen could be ours for ¥100,000 (US $16,000). It was a severe price reduction that included all the design modifications and transportation.

While not an IKEA-style assembly, the parts had to be all coded to be able to fit together. Now I started to wonder about putting in a wall, shoji screens and tatami mats for the bedroom whose walls we’d removed to expand the upstairs.

When I went to visit the company that made such a room, such a tea house, it became clear to me that we should not just put up walls and screens, but tatami mats and shelves. The full monte.

The tea house company, like the big-box retailer, also promised a deep discount. And they made good on their promise. The whole tea house was sold to us for a little over $3500.

Installed. Delivered.

We would install a traditional Japanese tea house in a 100% ethnic Khampa Tibetan region! What made the idea even more ironic was the fact that my own late Buddhist teacher was not just an aficionado of Japanese culture, but a lineage holder in the Sogetsu School of Japanese flower arranging!

II. Surmang in September.

I was worried for a good deal of early 2021. First there were no flights out of Beijing. Then no flights to Xining, Qinghai. Then Yushu Prefecture wherein lies Surmang, was on lockdown. Then just Surmang. By the end of July I began to get indications that we could indeed go in September.

I went with Mikko Lan, a Director of Ogilvy, and with Boon from a UN Women’s foundation. We went for about 10 days. While we were there we assembled the beds, the shower, and the kitchen.

It was a transformation worthy of the most beautiful butterfly. 2022's plan is the addition of 3 bedrooms upstairs is to create a lodge so that when this scourge does end we can accommodate eco- and anthro- tourists (and our Beijing patrons!) to help make the Surmang Clinic sustainable! The icing on the cake will be meeting and clinical rooms downstairs

Now it is 2022. Let’s all plan on meeting at Surmang! Do you drink tea?

Lee

Links:

• Surmang website
• Blog about Surmang by Scott Kronick
• Interview with Lai Zhang

My daughter iana, was born about 3 months premature, 26 years ago. My wife, Wenjing, had placenta previa and fibroid mayomas , uterine tumors that, as if the prematurity weren’t enough, were threatening my wife’s and baby’s  life with fatal hemorrhaging. Thus began my journey with mother and child health.

It was something that neither of us could prepare for. Because of a very great Headmaster at Western Academy of Beijing, Ian Rysdale, Wenjing was air evacuated to the Queen Mary Hospital in Hong Kong, which with its 18 stories, had a one entire floor a pediatric neo-natal care unit. 1 ½ months later, a very tiny Iana Cybele Weingrad was born. And Wenjing was alive to talk about it. iana was named after Ian Rysdale.

Thus my journey with mother and child health began right then and there, with my own lifetime membership in the circle of life. 

I began to see these struggles in every small child and every mom, dad, grandpa and grandma in rural China. With our clinic in 4400 m-high rural Tibet, I became sensitized to not only how vulnerable women are there, but how dangerous it is, especially when you don’t live near an urban 18 storey Hospital. 

With no private automobile ownership, living on a funky dirt road, on the south side of a 16,000’ mountain pass,  5 or 8 hours away from any hospital,  I learned that this is not some freakish rural outlier. It is the norm, precisely the  challenge, what  every rural Tibetan woman faces, day in , day out, traditionally without midwives, or nearby hospitals. I even came up with a slogan: "if you want to save a culture, save a mother."

It is a very very bad case study of how threatened, un-empowered women, women who until our clinic came along, and how they lived with since time immemorial. It is one where they had to give birth by themselves in the fields with the animals or in the yak bier, and cut their umbilical cord by themselves, with the oldest, rustiest knife available. Unassisted.

It was a ritual that perfectly mirrored the very low status of Tibetan women.

After the birth of our baby,  iana, I vowed to do something about them. Now 25 years later, I can boast that we trained our two doctors with over 150 very great volunteers, doctors  from Beijing, San Francisco, Vancouver, Colorado, New York. With the help of the American Chamber of Commerce of China, Ogilvy, Siemens and Beijing United Family Hospital we received modern equipment like an autoclave, ultrasound and microscope. 

In an area that held among the highest maternal mortality in the world, at 1200 mortalities/100,000 live births, we were able to reduce the MM to zero by 2011.

But we still have a ways to go — our building was aging and not aging well. In the last 6 years we turned all that around fixing

            —our leaky roof,  

            —our clinic floor

            —a new ceiling

            —a hardwood oak floor

            —a modern sanitary shower and toilet

            —computers and a printer for the doctors’ offices.

Somehow all of this seemed like problem solving,  problem by problem. Then it occurred to me when our patrons in Beijing would ask over and over again, that Surmang was not just some cast-off funky part of Qinghai. No.  It is China’s own Bhutan and with the right environment our patrons could come to an exotically beautiful —and holy— part of China but support our work at the same time. 

That’s how the idea of a lodge at the clinic was formulated. So this year we installed a new kitchen and with the generosity of a big company here in Beijing, and coverted one of the bedrooms into a Japanese shoji and tatami room, a tea room. Oddly enough we found that the suppliers of these rooms were willing to discount their materials 40%, 50% because they were, like me, inspired to give back to the neediest people in China. Take a look at what donations have done to our clinic. Make mother and child health a sustainable project!

And join our cause! 

Links:

• Surmang Website
• Phuntsok the Movie
• Lai Zhang, Mother of Tibet