Visiting medics help Tibetans live the high life

Free programs are paying dividends for local people. Wang Xiaoyu reports from Nyingchi, Tibet autonomous region.

Editor's note: This is the ninth story in a series about the Tibet autonomous region, focusing on the area's history, poverty alleviation measures, healthcare, and the cultural and business sectors.

Last month, a surprisingly late spring snowfall dusted the home of Sherab Dorje in Kongpo'gyada county, Tibet autonomous region. However, that was the least of his family's worries as the 4-year-old, whose cheeks were flushed after days with a high fever, suddenly collapsed and began convulsing on the floor.

He was rushed to the local hospital, where he received medication to reduce the fever; a quick fix to relieve his potentially life-threatening breathing difficulties.

However, the treatment could not prevent the problem from recurring. While it was the third time that month that the Tibetan boy had experienced seizures, he has had convulsions since he was less than 12 months old.

Eventually, the affliction is likely to be tackled at the roots, because Sherab Dorje recently saw a doctor from Beijing who was visiting the county for two days to provide residents with free consultations and treatment.

Communities across Tibet have benefited from wide-ranging medical assistance programs that have been introduced in the past few decades.

The most notable is a project initiated in 2015 by several government bodies, including the National Health and Family Planning Commission, the predecessor of the National Health Commission.

It has sent four groups totaling 660 medical professionals to eight health institutions with the aim of improving the healthcare infrastructure and establishing well-trained medical teams.

By the start of last month, people in Tibet had access to more than 1,000 treatments that were previously unavailable in the region, and nearly 850 advanced treatment methods or medical technologies had been introduced, according to Wang Yunting, deputy director of the regional health commission.

Moreover, six large cities are now home to at least one top-tier hospital each, he added.

Medical assistance has also been provided in smaller towns and villages tucked away on the massive Qinghai-Tibet Plateau, as volunteer programs launched by social institutions have joined the efforts to improve people's well-being and foster greater health awareness.

Free treatment

Yuan Shuihua, president of the Beijing Junyi Traditional Chinese Medical Hospital, was one of 16 doctors who volunteered to provide services in Kongpo'gyada.

He led Sherab Dorje's uncle from the bustling consulting room, and speaking in a measured tone intended to help the man - who has limited understanding of Mandarin - better understand, he explained the possible causes of the boy's seizures and suggested suitable therapies.

"The key is to identify the cause of the convulsions, rather than handing out pills to curb acute symptoms," Yuan told Sherab Dorje's uncle. "The root could be as simple as a nutritional deficiency, such as a lack of vitamin B, which can easily be cured by taking supplements.

"However, in the case of a genetic flaw or issues associated with brain development, he will require a more-holistic treatment plan," Yuan added as Sherab Dorje's uncle nodded wistfully.

In the consulting room, another doctor took Sherab Dorje's pulse and blood pressure, then he handed the boy a pamphlet that listed health tips based on his condition.

Like Sherab Dorje, most of the patients at the hospital were given free medication, and the visiting medics read the results of their scans and tests. The doctors also discussed the patients' illnesses with them to provide deeper understanding of the problem and the treatments available.

"After decades of channeling medical resources from the more-developed regions into Tibet, it's becoming increasingly important to reshape community norms that equate falling ill with feeling pain," Yuan said.

Medical workers setting out for the county share a unanimous observation: to further improve the well-being of people in Tibet, it is vital to foster health awareness, rather than simply giving out medication to provide a onetime alleviation of discomfort.

Rising life expectancy

According to the most recent data from the National Health Commission, the average life expectancy of people in Tibet is 70.6 years, a giant leap from the 35.5 years recorded in the 1960s.

Wang Yunting, deputy director of the regional health commission, said the influx of medical professionals has greatly eased the strain on resources in the region, where a shortage of doctors and nurses, limited provision of medication, and outdated treatment methods have driven down standards.

For example, Kongpo'gyada has just one county-level hospital, a three-story, lime-shaded building covering 22,000 square meters, located at its center.

For many years, the hospital was so poorly equipped that operations could not be performed on-site. However, in 2017, a group of experienced doctors arrived from Zhongshan, Guangdong province, about 3,300 kilometers away in South China.

Chosang, 30, a surgeon at the hospital, beamed as he recalled the first operation performed in the county, an appendectomy. At the time, he was a resident at a clinic in a small village nestled deep in the mountains.

"News that the first six or seven operations at the county hospital had been successful spread quickly and pumped up the spirits of those of us who worked in grassroots healthcare," he said, adding that the surgeries boosted the local healthcare network.

Last year alone, more than 300 operations were performed at the county hospital, mostly appendectomies and removals of kidney and gallbladder stones, according to Chosang, who like many Tibetans only uses one name.

"There are two other surgeons at the hospital capable of performing these operations. It's a rather small team, but we have coped fine so far," he said.

Gong Xionghui, associate chief physician at Peking University's Shougang Hospital in Beijing, also joined the two-day medical assistance program at the hospital in Kongpo'gyada.

He said that given the poor equipment and low staffing levels at the county hospital, a sensible approach would be to allow easy-to-master surgical techniques to take root there, while more-complex cases are sent to larger hospitals in other prefectures.

"I believe that surgical departments at county-level hospitals in Tibet should first and foremost address acute and prevalent health issues. In Kongpo'gyada, they have clearly achieved this goal," Gong said.

Raising awareness

Calls to raise health awareness have grown stronger in recent years as the infrastructure has been built up and the capabilities of regional medical personnel have advanced rapidly.

Chosang was born and raised in Lhasa, the regional capital, which enjoys first-class healthcare services. Having traversed many mountain trails to treat patients in remote towns and villages, he believes that too little attention has been paid to overall health in ordinary households, despite steady improvements in medical services.

"For example, someone who frequently senses a flickering pain in his bladder - a sign of stones - usually ignores it, provided there is no sustained adverse reaction and it does not interfere with his daily life," he said.

Meanwhile, Gong met dozens of patients in the county who rejected his suggestion to undergo medical tests that are key to identifying the causes of their illnesses, mainly because they were unwilling to travel to other parts of the region.

"Limited access to up-to-date facilities certainly plays a role in their reluctance, because some tests, such as MRI scans and gastroscopy, are not available at the county hospital," he said.

"But it certainly does not hurt for them to be aware of these medical technologies and their significance in helping to sharpen diagnosis. So, when conditions allow, they might find it easier to follow another doctor's advice to spend money and time on crucial checkups."

Chosang said, "The most common illnesses in Tibet are chronic conditions, and to tackle them, healthy lifestyle choices are almost as important as treatment plans."

Tibet is renowned for its harsh living environment. The average altitude is 4,000 meters above sea level, resulting in low oxygen levels and mercurial weather that primarily disrupt heart and lung functions.

Even the mildest areas, including the southeastern city of Nyingchi where the rich foliage pumps out extra oxygen, have high rates of coronary heart disease and high blood pressure, according to the local government.

The lifestyle also complicates health issues. The diet, which features large amounts of yak butter and meat, causes cardiovascular problems, while stones in the kidneys and gallbladder are prevalent as a result of low water intake.

"We have already launched some educational events targeting common disorders to urge local residents to pay attention to small changes, such as eating more vegetables while cutting down on yak butter and salt," Chosang said.

Back to normal

Garab, a retired teacher, is one of a growing number of people who have benefited from taking those suggestions to heart.

"My life hung by a thread because of worsening coronary artery disease. Following heart bypass surgery at the hospital in Nyingchi in 2013, I began to eat more fruit and vegetables," the 67-year-old Kongpo'gyada native said.

"I am always mindful of the doctors' words, and I have cut my meat and butter consumption bit by bit. It was easier than I had imagined."

After the bypass, Garab was relieved to find that when she walked across the bridge that spans the Nyang River which winds through the county and ascended three flights of stairs at the hospital, her blood pressure stayed within the normal limits.

"It's a testament to my conscious efforts to stay fit and healthy," she said. "High blood pressure and heart disease are prevalent in my neighborhood. I am no doctor, but I want to share my experiences to help more people eradicate these illnesses."

Contact the writer at wangxiaoyu@chinadaily.com.cn

(China Daily Global 06/19/2019 page4)