Front row: Rila, Pam Logan, Director Wang. Back row: Tashi Wangmo, Zezhen Lhamo
The program has evolved a bit since we started it in 2001. We have lengthened the period of internship from three weeks to a total of seven. We have honed our selection process to ensure that the women who are chosen for training are the ones most likely to master the material and remain in their communities.
Most importantly we have strengthened our cooperation with the county Health Bureaus. We originally envisioned that our midwives would serve as stand-alone medical providers in remote villages, however our survey in2004 revealed that the midwives are more effective when incorporated into existing rural clinics. Then they can learn from the doctors, but they still provide much-needed services, for doctors in rural areas rarely have the time ? or training - to make house-calls to pregnant women in out-lying areas. Our midwives, on the other hand, can and do ride or walk to houses and encampments many hours distant from the clinic to check on the progress of pregnant women ? women who don?t realize the importance of regular checks and would never come in on their own.
Now, therefore, nearly all of our newly-trained midwives are assigned to clinics. A few, however, still wind up on their own in remote areas. For these midwives, more training is needed, for their communities need general medical services, not just OB/GYN. Because of some restructuring we did for the program, we had some extra money to devote to broader training for a few select midwives. In March we sent three to attend a nine-month course in general rural medicine.
[Note: the term ?barefoot doctor? is not much used in China anymore, but it is pithy way to describe medical care providers who enroll in a crash-course in rural medicine, studying the basics of hygiene, first aid, and general medical care for no more than a year before being sent back to their rural communities to practice.]
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A few weeks ago, I went to visit our three trainees, who were in the middle of their course. The program is provided by the Taiwan Tibetan Friends Foundation and is offered in Litang each year to about 30 students., for the last seven years Most of the students are selected by the program organizers and are from the counties of south Kham. They had a few extra spaces this year and so were able to admit our three women, who are from north Kham, by special arrangement with Kham Aid. Our cost was 9000 yuan (about $1,100) per student, including tuition, lodging, and food..
Director Wang praised our three midwives, Tashi Wangmo from Baiyu, Rila from Serthar, and Zezhen Lhamo, also from Serthar., saying ?your girls are hardworking and serious. Their education level is quite good, so they keep up very well.? Both our three and their fellow students in the program are all herders, a population that generally has a low level of educational achievement. That?s one reason why doctors are so much needed in nomad areas.
Our three budding doctors gave us written reports for us on what they are learning in Litang. Some excerpts follow.
Tashi Wangmo:
"I was informed by the Women?s Union on March of 2005 to come to Lithong county for a further study in medical care. During my staying here, I have the intention to develop my career in medical field, hoping to help those who are suffering from pains and illness. ?In order to master all basic knowledge of various subjects, I have paid extra attention in classes. After class, I ask teachers about any class content that I don?t understand. I hope I can apply what I have learned in class to my residence in a clinic or hospital [note: the Litang program includes a period of residence in local health care facilities].. Besides, I will contribute as a village doctor in my hometown for spreading some basic medical knowledge to my people." Jul 28, 2005
Rila:
"I was sent by the Ganzi State Women?s Union to Lithong on Feb 2005 for a further study in medical care. It has been 5 months since I am here. ?Currently I have learned some foundation courses (like anatomy, pathology, fields of medicine, pharmacy, diagnostic and Tibetan medicine) on basic principle of medicine. I have got a 90/100 grade for all my subjects in examination. Now I am practicing as a resident in various divisions. Besides these medical training, I also learned much on human relations: how to respect people, the importance of mutual help and support, and medical ethics. In the next two months, I must work hard to finish my study so as not to disappoint all my supporters for their love and care. After finishing my training, I will do my best to contribute as a village doctor to help herdsmen of my town. I am looking for another training opportunity in the future so that I can continue to improve my knowledge in order to help my people. Again, I have to thank you for teachers of Litang Health department, the Taiwan Tibetan Friends Foundation for their care, and finally Kham Aid Foundation and the Ganzi Women?s Federation for their support." Jul 28, 2005
Zezhen Lhamo::
"I was sent by Ganzi State Women?s Union to come to Lithong for a further study in medical care on Feb 28, 2005. During these five months, teachers gave us a lot of training on medical care and I have acquired some basic medical knowledge as well as practical experience. I am glad that I have gained a very satisfactory result in the examination. ? During our spare time, we visited a home for the elderly. I saw some old people ignoring their personal hygiene, having formed many poor habits that are bad for their health. After seeing them, I got the idea that I must not only focus on treating sick people in the future, but spend more efforts on prevention. I hope I will be given more opportunity to learn." Jul 28, 2005.