Core Project and Government Partnership.
This year our clinic at Surmang saw over 12,000 patient visits for free, including meds. This year the clinic played a central role in the roll-out of our partnership with the Yushu Prefecture Public Health Bureau. The purpose of this partnership is to bring the Surmang model into the public health system as a sustainable prototype. Our clinic became user-friendly jumping off point for volunteer doctors, doing training at the 4 partner hospitals.
The awesome challenges of this project
It’s hard enough to create and run a private one-off project in remote Yushu Prefecture. But to leverage the qualities of that project and our good relationship with official China, to put it in the public health system, is something else again. No one else is doing that.
The challenges boil down to the fact that at our own clinic we control all the elements of HR, management and central supply, and zero of those in the 4 partner hospitals in the public health system. How we present our model depends on how we engage docs in the PH system. We have been selective in the sense of only training those who are focused on personal and medical excellence. Our job is to convince them that our foundation is the ticket to help them achieve just that.
Doctor Volunteers in 2013
This year we were lucky to have three volunteer doctors apply for our program. For reasons beyond us, one was denied a Chinese visa. Our two remaining volunteer doctors were Elizabeth Van Dyne and Rebekah Sands. Dr. Van Dyne had the excellent translation services of Mathilde Paturaux, and worked for us for about a month in June. Dr. Van Dyne came to us from the US and Mlle Paturaux from Brittany, France. They were able to travel to Surmang and all 4 of our partner township hospitals: Mauzhuang, Xialaxu, Xiewu and Longbao.
Here is an excerpt from her report:
On the last night I drew a smashed, congealed Snickers bar out of my bag, and broke it into 4 lopsided, jagged pieces. We laughed as we chewed, seeing each other’s faces through the light of a battery-operated lamp. “This is very, very good,” one of the Tibetan physicians said. It was one of her few lines of English she said to me, and she said it to emphasize how really good the chocolate bar was. From the medical education, patient interactions, majestic scenery, to the Snickers bar, as I boarded the plane to take me back to Beijing and S. California, I had to agree, yes this was all very, very good indeed.
In September we hosted volunteer Dr. Rebekah Sands from New Zealand. Rebekah is a product of the international school of Tianjin and speaks flawless Mandarin. Her self-sufficiency was a first for our foundation –it’s not every day that we come across a person who has native-level Mandarin, to have a medical volunteer who does not need an interpreter. She spent more time on her own, a quality that bespeaks her true Kiwi grit and self-sufficiency. Drs. Sands and Van Dyne were great addition to our previous vintage of great volunteers.
Training Village Health Workers
As we know, Tibetan culture is under enormous pressures – cultural, political, and economic. Among those, probably the most unsung are those created by maternal and infant mortality. The death of a mother in rural Tibet often means financial ruin or the cratering of the family unit. This accounts for the high number of orphanages in ethnic Tibetan areas. That’s why we say, “if you want to save a culture, save a mother.”
Remoteness and geographic challenges are as serious as any other cultural challenges – keeping women and children far away from services and in the cross-hairs of maternal and infant mortality. There is no doubt that to cure maternal mortality, hospital delivery is the key. However with poor dirt roads, no village cell phone service, no public transportation and no private ownership of cars, infrastructure is the primary obstacle to realizing that goal.
Since it’s beyond our capacity to build roads or an ambulance service connecting the villages to the township hospitals, we must provide assisted delivery in the remote villages as we’ve done at Surmang through the Community Health Worker project.
This year we trained over 50 Village and Community Health Workers, under the direction of Janis Tseyong-jee, MPH. What made this year’s training unique was that the trainers were all Khampa Tibetan women: Janis, Dr. So Drogha, and Pema tso, one of our Community Health Workers. We have moved a step into training other trainers –TOT.
While there are government paid Village Health Workers, they are an under-utilizied, and largely untrained resource.
But, as we’ve shown over 20 years, these health challenges are amenable to change. In fact, compared with other challenges, especially political and economic, we can make a real difference. We are on the cutting edge of what people can do in such challenging conditions, and have instilled confidence among rural women that there is something they can do about their own situation. Our unique contribution is that we are not extra-system.
We want to transplant this model inside the public health system. In late July, we met with the government – they support our work, just as we support putting our model in the public health system. At our summer meeting with the Director of the Yushu Public Health Bureau we received a standing ovation when I said, “if you want to save a culture, save a mother.” Please join this cause.
Surmang Foundation has become legally registered in Qinghai Province as the, The Qinghai Nomadic Health Promotion Assn. Registration was done with the active help of the Qinghai Government, and our two most pro-active supporters, Mr. Deng Haiping and Dr. Xiao Jiugha. Dr. Xiao is a Khampa Tibetan and retired head, Yushu Prefecture Public Health Bureau.