A Volunteer Reflects: Dr Robbie Chase in Tibet

By Robbie Chase

In August 2001 I had the good fortune to accompany Zasep Rinpoche to his homeland of Zadoh, formerly in Kham of eastern Tibet. This is where in 1999 he had organized a local committee to oversee construction of Jamseng Health Centre to provide traditional Tibetan medical care in the rural area along the banks of the Zachu , the Mekong, where he was born and spent his nomadic childhood. These are some of my memories and impressions.

The setting was stunning, set next to the Mekong river which, at 14,000 feet is a fast running torrent. The valley is a lush green, with glades of juniper and small trees on the mountainsides. Across the tension cable bridge on the other river bank were huge, centuries old piles of carved mani stones surmounted with prayers flags, what remains of a destroyed temple and legendary Riwoche monastery. Nearby was a large circular depression, remains of a compound erected in the 1960s for holding Tibetans being taken away to labour camp prisons at the time of the Cultural Revolution.

The situation was generally more peaceable now, the Tibetan majority population in this region of Chinghai province have representation in the local government and can practice their religion and pursue cultural activities. But there were pressures at work against the nomadic lifestyle, thousands had lost herds in bad winters and had moved into towns and cities seeking work and a different life.

The 2001 trip was the occasion to officially open Jamseng Health Centre which serves the local inhabitants, mostly nomadic families living in black yak hair tents in high pasturelands with their animals during the summer, coming down to adobe huts with walled compounds for the winter months. While the sun was warm and intense at the height of summer and strong, nights were cold with amazing stars and life on the land was rugged.

The mainstay of Jamseng’s clinic services was Tibetan traditional medicine provided by Dr. Leydar and Jamar a lama monk, for on average 20 people a week. For the opening and Rinpoche’s return, hundreds came from many miles away for days of festivities. We had brought a large container of medicines from US and Canada appropriate for primary care among other donations. Michelle Davidson also came, she was instrumental in organizing Seva’s eye care team from Nepal to come perform dozens of cataract operations the following year.

Over several days at Jamseng and in the hospital compound in Zadoh town, people with health troubles were invited to ‘see the doctor’, with Rinpoche translating, the line ups were long, they weren’t used to this kind of service! …diagnosis, management advice, western pharmaceuticals and blessing pills.

Common health complaints were pain in the joints, back and limbs ‐ nomadic life is strenuous and living in tents in damp conditions without chairs is particularly hard on the knees and backs. Many had old injuries from falling off horses or motorcycles, locked elbows from overuse using slingshots shepherding yaks and sheep. Elevated blood pressure, often very high, was common, several with previous strokes and cardiac symptoms; when we gave them a simple diuretic pill, we requested they return to follow up check, often they’re complaint of headache and blurred vision had been relieved. Gall bladder complaints were very common, likely from the meat and dairy based diet from their own animals; this not readily treated with the medications we had; many young adults in their early 20s already had surgery. Another prevalent liver problem was echinococcus with liver cysts from tapeworms hosted by dogs, sheep, goats and humans in pastoral populations. Older people in their 60s and 70s who had suffered long imprisonment and hard labour had heart pain, as chronic depression and post trauma was described in translation.

I have strong memories of the people: patient in the line up, dignified, and handsome. Many of the women wore traditional dress, with headpieces of coral, amber and turquoise braided in their hair. Although it was August, the warmest month, most wore lined undergarments and layers of clothing which presented a challenge. They were quick to smile and laugh- their teeth strong and white from lots of calcium and little sugar.

Altogether it was a wonderful experience, challenging and unforgettable in many ways: to experience Rinpoche’s homeland and people, to appreciate nomadic culture, the monasteries of the Tibetan spiritual tradition and the changes and pressures brought upon by the history within the past generation.

When I returned in the summer of 2004 with Rinpoche, the trip to Yushu took 7 hours this time on the brand new highway across the plateau from Xining instead of 30 hours; there was talk of an airport. Around Zadoh much of the open land for grazing had been fenced to disrupt the seasonal migration of nomadic families with their herds; the hydroelectric dam on the Mekong River was near completion.

Dr. Candace Cole came this time, and with Dolma’s help to translate in place of Rinpoche, more attention could be paid to women’s health concerns, which included involuntary sterilization and depo-provera injections. Where we travelled by Jeep or horseback we set up medical clinics to diagnose health problems, dispense donated medications, promote health and sanitation with advice, personnel training and project coordination.

The project work was a powerful lesson in skilful means and compassion – to develop and sustain the effort and the eventual decision to wind up the project as the reality of challenges facing the work on several levels became clear.

Robbie volunteered for two Gaden Relief missions to Tibet, in 2001 and 2004. He is an Assistant Professor in the Department of Community Health Services at the University of Manitoba. He teaches graduate and undergraduate students, based on his international humanitarian project work in Iraq, Sri Lanka, Afghanistan, Tibet, Uganda and elsewhere. His research focus is on the Life Story Board, an visual interview and information system he developed for research and humanitarian mental health work for children affected by armed conflict. In 2009 he founded Vidaview Information Systems Ltd to manufacture Life Story Board toolkits and to further develop the tool for research and clinical use.