Written by Laurence Brahm - Published by Hongkong Culture on 10/08/2006

Ba Kuo was a Tibetan doctor from Aba region of Sichuan. Concerned over lack of medical treatment available to Tibetan nomads, he quit his established practice at a hospital to spend months traveling alone in nomad highlands treating his people. Often disappearing into regions so remote, his own family lost news of his whereabouts for months at a time. Burdened by carrying his own medical gear and overexposure to harsh conditions, Ba Kuo himself became seriously ill and passed away.

I heard Ba Kuo’s story from his daughter living in Lhasa. She fell into a six month depression following her father’s death. If Ba Kuo only had a jeep at his disposal, he might still be alive, well, and treating Tibetan nomads. Having traveled and filmed throughout the highlands, I knew only tough jeeps can access these regions. Ba Kuo’s tragic story of commitment inspired an idea how to bring medical care to nomads.

In early summer 2006, within just a few months of Ba Kuo’s passing, Shambhala launched its first mobile medical clinic to treat highland nomads in Qinghai Province. The clinic unit consists of two jeeps outfitted as ambulances operated by monks and nuns of Tharjay Monastery trained as paramedics by French Doctors with support of Shambhala’s sister charitable organisation, Tharjay Charitable Trust.

Actually, in remote regions of Tibet, a little concern and support can go a long way. Funding for the first nomad mobile medical clinic of RMB 204,000.00 was donated by Swiss Reinsurance to fund and outfit two medical vehicles administering care to isolated nomadic communities, residing in Droshok, Nangchen County, Yushu Prefecture Southern Qinghai Province.

Two four-wheel vehicles were purchased in Lhasa. United Nations Ambassador to China Khalid Malik and one of Tibet’s highest ranking lamas His Eminence Beru Khyentse Rinpoche, inaugurated launch ceremony of the vehicles in Lhasa.

The two vehicles left Lhasa on July 15th, 2006 and traveled for six days to reach their destination in Droshok, Yushu Prefecture.

Yushu Prefecture lies on the Tibetan plateau, closely bordering central Tibet. It has one of the lowest income levels in China. The prefecture comprises 258 villages and towns encompassing a population of approximately 270,000 people. Many in the prefecture are semi-nomadic or have recently settled into a stationary existence in response to government initiatives aimed at settling Tibetan nomads.

Current Chinese government policy calls for resettlement of nomads in faceless cement townships. While arguably they might receive government funded medical support – which is now commercialized and often beyond their financial reach – the nomads resettled will have abandoned their traditional lifestyle and livelihood, creating a new set of social problems by stranding nomads in urban oasis. This is a matter in conflict with their own tradition and sustainability of a lifestyle built around yak breeding and herding.

Shambhala takes a different view, supporting a more sensitive and evolutionary approach. Nomad herding, yak and sheep grazing patterns are an essential ingredient of environmental eco-system cycles of the Tibetan plateau. If they stop grazing then a delicate ecosystem may be affected. Han Chinese attempts to abruptly break this pattern can shatter millennium old seasonal integration between melting glacier snows, grasslands and life supported by the two.

The position of Shambhala is not to resettle the nomads and break their lifestyle and ethnic diversity but rather to bring the medical clinic services to them instead. If nomad lifestyles eventually settle, this should be a natural evolution determined themselves and not forced by distant government policymakers who understand virtually nothing about either ethnic lifestyle values or the environment. If nomads choose to continue pursuing lifestyle patterns as old as human memory then we should support their effort as an expression of free choice. With a little sensitivity and effort, medical care and education can be brought to the nomads even in the most remote regions. This is the most sensitive and direct way of sustaining their traditional lifestyle and culture while supporting its evolution through beneficial social services.

With SwissRe donated funds, two medical jeeps, a radio communication system, an ultra-sound machine, medicines and medical equipment were purchased to comprise the mobile clinic operating from an already established stationary clinic at Tharjay monastery staffed by two full-time medical practitioners specialized in traditional Tibetan medicine with some training in western medical treatment. The Tharjay Charitable Foundation supports French volunteer doctors who train monks and nuns at Tarjay monastery clinic every summer.

The mobile clinic spends up to 2 weeks in any one highland area. They operate by one larger ambulance jeep remaining stationary in a nomad camp, while the other jeep sweeps a wider area, serving still more remote nomads, bringing back critical cases while treating others on site. An independent survey of the mobile clinic found that five to six people were being treated and saved each day, underscoring how a little support can go a long way toward changing and even saving lives.

There is a serious shortage of trained medical doctors able to access patients in remote parts of Qinghai where basic health care is almost non-existent. Most communities rely on traditional Tibetan medicine, which is effective for treating many long-term ailments but has shortcomings on serious and sudden health threats.

The maternal mortality rate for Yushu prefecture as a whole is 400 per 10,000. Infant mortality is 38.1 per thousand and under-5 mortality 52.21 per thousand. These figures are significantly higher than the officially quoted national rates, and several times higher than in east coast cities.

At government clinics treatment for acute respiratory infections, one of the most common ailments on the plateau, costs around RMB 100-200 (USD 12-25). A broken bone will cost upwards of RMB 3,000 (USD 350) to set. Such costs are prohibitive for most nomads. Moreover, nomads live easily two or three days' horse-ride from the road, too far to come to a government established township clinic or hospital, even if they could afford it.

The Shambhala Mobile Clinic serves as an example of how a little sensitive concern and effort can go a long way towards helping others while sustaining their culture. Through the clinic, nomads receive medical care in their own living environment, are treated by trained monks and nuns keeping treatment within a cultural paradigm (traditional Tibetan women will not allow a male doctor to touch them, nomads are encouraged to continue their nomadic lifestyle while benefiting from better health care.

The nomad mobile medical clinic is dedicated to sustaining the livelihood of nomads.

One day the story of Ba Kuo’s own vision of helping his people to sustain their culture may inspire more than mobile medical clinics. It could serve as inspiration for many other efforts such as rural outreach education bringing social support systems these to the nomads so they can remain nomads rather than breaking their lifestyle and culture to try and make them into something which they are not.

Laurence Brahm is a global activist, international mediator, political columnist and author. He is the leading advocate of a fresh development paradigm - The Himalayan Consensus - an innovative approach to development.

Back to Top