Department of health at a glance by TCRC CTA TAWS

DEPARTMENT OF HEALTH AT A GLANCE

Central Tibetan Administration, Tibetan Voluntary Health Association Dharamsala, India

Contents Introduction

Health Human Resourses

Organizational Structure of DoH (TVHA)

Location of Hospitals,PHC & Clinics in India & Nepal

Health Information System (HIS)

Tibetan Medicare System (TMS)

The Health Education Program

Telemedicine

Ngoenga School for Tibetan Children with Special Needs

Program for People with Special Needs

Medical Care for Poor People

Mother and Child Health Program (MCH)

Tuberculosis (TB) Control Program

HIV/AIDS Prevention and Care Program

Mental Health Program

Tibetan Torture Survivorâ&#x20AC;&#x2122;s Program

Tashi Yangzom

Treatment

Published by:

Substance Abuse and Rehabilitation Program

Water and Sanitation Program

Oral Health

Advisor: Dr. Tsering Wangchuk (Health Kalon) Mr. Sonam Choephel Shosur (Health Secretary) Board of Editor: Tsegyal Dranyi Thutop Namgyal Trinley Palmo Tenzin Tseyang Compiled, Layout & Designed:

Integration on Traditional Tibetan and Allopathic Medicine

The Revised MBBS Bond

Hospitals

Primary Health Centres

Clinics

Tibetan Medical and Astrology Institute( TMAI)

Delek Hospital

Clinics in Nepal

How You Can Help Tibetan Health Department

Volunteer Information Corner

Financial Report 2013

Addresses of Hospitals, PHCs & Clinics

List of Health Programs and Projects

Tibetan Voluntary Health Association (TVHA), Department of Health, Central Tibetan Administration Contact: The Secretary Department of Health(TVHA) CTA, Gangchen Kyishong Dharamsala, Distt. Kangra HP 176215 Tel: 0091-1892-223408/ 223486 Fax:0091-1892-222718 Email:health@tibet.net Website:www.tibet.net/health

DEPARTMENT OF HEALTH Central Tibetan Administration “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” defines World Health Organization. The maintenance and promotion of health is achieved through different combination of physical, mental, and social well-being, together sometimes referred to as the “health triangle” “The WHO’s 1986 Ottawa Charter for Health Promotion further stated that health is not just a state, but also “a resource for everyday life, not the objective of living.

directly administered and funded by the Department of Health, including all recurring and nonrecurring expenses ranging from staff salaries to health care services and programs. As of now, the Department employs a total workforce of 181 staff members including 8 doctors, 38 nurses, 54 community health workers and other relevant staffs. Community health workers have been the backbone of the health service provided by Department of Health since last few decades. They have played an important role in filling the gap of shortage of medical staffs in the Tibetan refugee community. Each health staff working in Department of Health’s health centers perform multiple roles. Apart from acting as the health care provider to the local people, they also work as a social worker, counselor and health educator in their day to day routine, thus promoting the wellbeing of the entire Tibetan refugee community.

Introduction After the Chinese occupation of Tibet in 1959, His Holiness the Dalai Lama and the Tibetan people fled to India as refugees. While rehabilitating the refugees in the newly developing Tibetan settlement, some health care centers were set up by various non-governmental organizations. When these organizations handed over the administration of the health care projects to the respective settlements, there was a need to establish a department within the infrastructure of the Tibetan Administration to finance and manage these health care units as well as to plan a comprehensive health care system for the Tibetan in Exile. Health is a basic and elementary need for the general welfare and development of any community. Thus, recognizing the importance of maintaining the health status and well being of Tibetan refugee community, the Central Tibetan Administration formally established Department of Health in December 1981. Presently, the Department of Health is one of the seven departments of Central Tibetan Administration. It is registered in the name of Tibetan Voluntary Health Association (TVHA) under the Indian Society Registration Act XXI 1860 and working as a registered charitable organization to look after the basic health care needs of Tibetan refugees. Through a network of 7 hospitals, 5 primary health centers and 38 clinics across India and Nepal. The operation and management of these hospitals and health centers are

Aims & Objectives: an overview The main objectives of the Department of Health is to provide a comprehensive health care to the Tibetan refugee population settled in various parts of India and Nepal. These include: • To ensure adequate, preventive, promotive and curative health services based on both Modern allopathic and traditional Tibetan systems of medicine. • To allow people to gain greater access to primary health care by providing convenient health services to the masses. • To provide comprehensive maternal and child health care services, including social care and child protection services. • To provide affordable quality healthcare services to all people (which also include the local Indian or Nepalese people). • To make health care accessible to the poor and impoverished section of the society. • To boost the preventive and promotive aspects of the health care by disseminating Health information and education programs. • To provide hospital services at various levels. • To support collaborative community health promotion initiatives.

Health Human Resourse 1. Current Staff Position at DoH: S.No Designation 1 Secretary 2 Additional Secretary 3 Joint Secretary 4 Deputy Secretary 5 Under Secretary 6 Section Officer 7 Office Superintendent 8 Office Assistant 9 Senior Clerk 10 Junior Clerk 11 Hospital Staff 12 Contract 13 Driver 14 Peon 15 Plumber 16 Gardener Total:

No. of Staff 1 1 1 1 4 3 3 5 4 2 2 1 1 2 1 1 33

21 61

*Plumber,Watchman,Peon,Gardener,Sweeper Ngoenga Staff: S.No Designation 1 Administrative Staff 2 Medical Staff 3 Teaching Staff 4 Foster Parents Total:

No. of Staff 11 4 10 12 37

3. Staff under Tibetan Medical & Astrology Institute: S.No Designation No. of Staff 1 Amchi (Doctor) 131 2 Astrologer 16 3 Administrative Staff 265 4 Others(Wages) 109 Total: 521

2. Allopathic System-Medical Staff: S.No Designation

No. of Staff 1 Doctors (MBBS, MD) 8 2 Dentist 1 3 Nurses (GNM/B.Sc Nurse) 35 4 ANM 2 5 Nurse Aid 1 6 Community Health Worker 54 7 Laboratory/ X-ray Technician 9 8 Pharmacist 6 9 Ophthalmic Technician 2 10 Dental Therapist 4 Total: 120

Non-Medical Staffs: S.No Designation 1 Hospital Administrator 2 Accountant 3 Cashier/ Office Secretary 4 Driver 5 Cook

Others* Total:

Health Infrastructure: Health institute or centers Hospital under DoH Primary Health Center under DoH Clinic under DoH

No. of Staff 9 11 3 12 5

No. of Total staff H e a l t h members centers 7 7 5

Tibetan Medical College TMAI branch clinics*1

1 54

14 211

Clinics under (TCV)*2 Clinics under (THF)*3 Clinics under (CST)*4 Clinics under (STS)*5

10 3 6 5

10 15 6 11

*Self Supporting *1Tibetan Medical & Astrology Institute *2Tibetan Childrens Village School *2Tibetan Homes Foundation School *3Central School for Tibetans *4Sambhota Tibetans School

ORGANIZATIONAL STRUCTURE OF DEPARTMENT OF HEALTH (TIBETAN VOLUNTARY HEALTH ASSOCIATION), CTA, DHARAMSALA

KALON

SECRETARY

Kalon Dr. Tsering Wangchuk

ADMINISTRATIVE DIVISION

Secretary Sonam Choephel Shosur

PUBLIC HEALTH DIVISION

• Administration Section

• HIS Section (Health Information System)

• Tibetan Medicare System Section

• Disease Prevention and Health Promotion

• Ngoenga SchoolSection

• TTSP Section (Tibetan Torture Survivors Program

PROJECT AND ACCOUNT DIVISION

• Project Section • Account Section

Hospitals & Health Care Centers run by the Department of Health, CTA

Choglamsar(Leh) 1 PHC & Clinics

Changthang Areas (9 areas)

Srinagar Ladakh Dalhousie Bir & Chauntra Tashi Jong

Manali & 15 Mile Kullu & Pondoh Rewalsar Solan TIBET Dharamsala Satuan, Kamrao & Puruwala Tashiling Paljorling Dorpatan Dickyiling Manang Jampaling Tashi Pelkeil Walung Lo-Tserok Chailsa Ravangla Trushi Nepal Gangtok Shabru Pokhara Majnu-Tilla Kathmandu Bouda Jorpati

Poanta Sahib Manduwala Lakhanwala & Khera Clement Town

Tuting Tenzingang

Tezu

Sonada

Bhutan

Jawalakhel

Miao

Nagaland Manipur Tripura Mizoram Mainpat

Bandara Chandragiri

Mundgod

7 Hospitals 5 Primary Health Center 38 Health Clinics 2 Mobile Clinics 1 School for Special Needs Children

Bylakuppe Hunsur Kollegal

Health Information System (HIS)

principle of public-private partnership and scientific financial analysis, TMS program addresses In order to understand the overall health status of the deficiencies in the current Tibetan healthcare the Tibetans in exile, we need a strong and reli- system by making comprehensive healthcare serable system of data collection that can effectively vices accessible to all people. monitor the burden and distribution of diseases at As per this scheme, all registered memregular intervals. In collaboration with the John bers, whether families or individuals, are eligiHopkins School of Public Health, the Depart- ble to receive a maximum annual benefit of Rs. ment launched the current Health Information 100,000 and Rs. 50,000 on hospitalization costs System in 2011. This project is funded by PRM if they make an annual contribution of Rs. 3,565/grant (through Tibet Fund) and the Gere Founda- and Rs. 950/- respectively. The calculations have tion. taken into account only the pure risk factors and The Department provided HIS training to do not include the administrative costs of runits staff members that focused on evaluation and ning this scheme. This scheme therefore ensures monitoring tools. The computerized health inforits members the maximum benefits for the minimation system, which is currently operational in mum possible contribution as its operating cost is 18 health centers, collect and send monthly electronic data to the Department. About 24 other borne by the Health Department, CTA. smaller and remotely located health centers, including those in Nepal, submit the paper version The Health Education Program of HIS by post. The Department in turn feeds The Health Education Division has been playing these data into our main database. a crucial role in improving the overall health sta In order to assess the efficacy of HIS, the tus of Tibetans living in exile by creating awareDepartment recently carried out an evaluation exness about health issues since its inception in the ercise in all Tibetan health centers located across mid-eighties. Special focus is paid on increasing South India. The Department is currently planthe knowledge of general public regarding prening to upgrade the HIS system to produce better vention of communicable diseases like Tubercuquality data and to make it more user friendly. losis, Hepatitis B, and HIV/AIDS etc. It is mainly responsible for designing, publication and distribution of health education materials like posters, pamphlets, brochures and videos. It also reguThe Tibetan Medicare System (TMS) is essen- larly conducts various culturally relevant and tially a social health program initiative to serve evidence based awareness campaigns in different the healthcare needs of the entire Tibetan popu- Tibetan schools, settlements and monasteries. lace in India. It not only provides full coverage to Marking Important Health Days, the most impoverished sections of the society, but like the Worldâ&#x20AC;&#x2122;s TB Day, Hepatitis B, HIV/AIDS benefits even the wealthy people as well. It serves Day, in all Tibetan settlements is a major responas an additional safety net for medical emergency. sibility of this Division. It also provides funding Designed as a self-financing scheme based on the to all the health centers and schools to organize such events. It provides training and workshops to community health workers and general public regarding disease prevention and health promotion activities. As of March 2013, a series of brochures on reproductive cancers is being specifically designed for future women health training programs. This division thus plays a significant role in promoting health awareness among the Tibetan population living across Indian and Nepal. Tibetan Medicare System

TELEMEDICINE

services accessible to the people living in the most remote and isolated regions. Telemedicine is the use of telecommunication The Health Department therefore would and information technologies in order to provide like to extend its heartfelt gratitude to the Assoclinical health care at a distance. It helps elimi- ciazione Italia-Tibet, Camellia Foundation, and nate distance barriers and can improve access to others, who have made this project possible with medical services that would often not be consis- their generous support. tently available in distant rural communities. It is also used to save lives in critical care and emer- Ngoenga School for Tibetan Children with Special Needs gency situation. Telemedicine is a rapidly developing application of Clinical Medicine in which medical Ngoenga School for Tibetan Children with Speinformation is transferred through the internet. cial Needs in Dehradun was established with the

seed money bestowed by H.H. the Dalai Lama. The School was inaugurated by H.E. Sakya Trizin Rinpoche on the 8th March 2000 and started off with 26 students. This is the one and only school for Tibetan children with special needs living in exile under the administration of the Central Tibetan Administration. Today, the school accommodates fifty students aged between 6-18 years coming from Tibet, India, Nepal and Bhutan. All of them are with both mental and physical needs. The aim of establishing this school is to provide education with health care and social support to the children with special needs. Keeping in view the health of children with special needs the school has been feeding them organic meals with non vegetarian items and fruits. Please log on (www.ngoengaschool. org) for more information.

Telemedicine is the ability to provide interactive health care utilizing modern technology and telecommunications. Telemedicine services save expenses that the patients spend on travel and accommodation. It is most beneficial for people living in remote, isolated regions, which is why we have introduced this as a pilot project. As of March 2013, there is only one pilot telemedicine clinic in Mainpat, with plans to expand to more locations next year. The installation of these clinics however depends on a reliable, constant supply of electricity and internet connectivity, in addition to the technical skills to operate the system. With technological support from the Tele-radiology Solution Pvt. Ltd. of Bangalore, the installation of telemedicine at Mainpat was completed in Aug. 2012. Technicians from Bangalore trained our medical staff on how to operate the system and handle the patients. The clinic as such has been fully operational since 27 Aug. 2012. Regarding the telemedicine clinic in Odisha, the project has been temporarily halted because of the ongoing road widening works. Telemedicine makes quality health care

Program for People with Special Needs In addition to the children with special needs currently admitted in the Ngoenga school, people with special needs can also be found in various

Tibetan settlements. They include children who are currently on the waiting list for admission in special school. There are others whose parents want to keep them at home with their family. In these cases, the Department provides them a monthly stipend through the settlement officer located across India, Nepal and Bhutan. The Department also provides aids and appliances like wheel chairs, crutches, hearing aids, etc., to all those who cannot afford them. Furthermore, the Department also provides assistance in the form of prosthetic medical allowances to all needy disabled people.

Moreover, all pregnant women receive free supply of micronutrients (Iron, Folic Acid/Calcium) for one year, along with two free ultrasonographic tests during pregnancy. Micronutrients based on tradition system of medicine are also provided to mothers and children. To facilitate greater access to better medical care during childbirth, the program provides financial support to all those who are admitted in outside hospitals for delivery. In addition to frequent reproductive health awareness campaigns, the program also undertakes special projects like cervical cancer screening project for all married women and gynaecological training to community health workers, etc.

Medical Care for Poor People Tuberculosis (TB) Control Program As per the guidelines of the Kashag (the highest executive body of the exile Tibetan polity), following an extensive poverty survey across the exile Tibetan Community, all people living below the poverty threshold were grouped in three categories for intervention by three Departments of the CTA. According to this arrangement, the medical expenses of all people, who have been screened and approved as eligible by the Central Poverty Alleviation Committee, are reimbursed by the Department.

The Departmentâ&#x20AC;&#x2122;s TB Control Program strives to reduce the incidence of TB morbidity and mortality in the exile Tibetan community. The program emphasizes early detection and treatment of new TB cases. It also ensures greater treatment compliance by existing patients to prevent multi drug resistant form of TB. It promotes community wide advocacy and social mobilization on TB. The program implements the WHO-recommended tuberculosis control strategy known as DOTS (Directly Observed Therapy, Short Course). All the major hospitals are equipped with trained health personnel and basic diagnostic and treatment facilities. The Department provides financial assistance to all those who could not afford to pay for the TB medication and treatment. The quantum of such assistance varies from person to person depending on the severity of their economic hardships. TB patients are generally treated in the outpatient setting. Severely ill or infectious TB patients, particularly those of MDR TB, are however hospitalized and quarantined in isolation wards to prevent them from infecting others. Similarly, the Department also undertakes TB detection initiatives in congregated settings like schools and monasteries in order to prevent and control the prevalence of TB. Public awareness about TB is promoted by disseminating health education materials like videos, posters, pamphlets, etc., through the network of hospitals and health centers. The Department keeps its health workers and staff members

Mother and Child Health Program Since the launch of the MCH and Reproductive Health Program of the Department, there has been a significant improvement in the overall status of maternal and child health in the exile Tibetan community. Mothers today are far better aware about the importance of immunization for preventing diseases and the proper growth of their children. There is as such universal immunization coverage in all Tibetan settlements. Under this program, all pregnant women receive free vaccine and medical tests related with hemoglobin, blood group, blood sugar, Hep-B, HIV/ AIDS, VDRL, Malaria, urine microscopic, glucose, etc. Similarly, all children under five are provided free MMR, Hep B and Hib vaccination, in addition to the universal immunization program that includes BCG, DPT, Measles and oral polio drop. Babies born to mothers infected with Hepatitis B are provided Free Hep B Immunoglobin vaccination.

well-informed about the latest developments in the TB prevention and control measures. Health staff members also receive regular in-service training in premier TB institutes in India, including National Tuberculosis Institute in Bangalore, Tuberculosis Research Center in Chennai, LRS Institute for TB & Respiratory disease in Delhi, etc. Staff members from the central TB unit of the Department regularly inspect the ongoing treatment programs in hospitals and health centers located in areas of high TB incidence.

Mental Health Program The Mental Health program was introduced in 1991 in response to a growing need for better care of torture survivors and mental health patients. Moving beyond the conventional religious and medical treatment, the program strives to provide a holistic support system for mental health patients. In order to provide psycho social support and mental health services, field workers are appointed in various Tibetan settlements across India. Every year all mental health field workers receive intensive training on various aspects of mental health services.

HIV/AIDS Prevention and Care Program The Department carries out HIV/AIDS awareness campaign in various Tibetan communities through its network of hospitals and health centers. As the awareness campaign about HIV/ AIDS (and substance abuse) is primarily focused on the young people, special funding assistance are provided to schools for initiating activities like drawing and essay competitions themed on those topics. The Department also publishes educational materials in Tibetan and English and distribute them free in both Tibetan and local Indian communities. Counselling training based on both modern and traditional system of medical care are provided to health staff so as to make them more competent in dealing with HIV/AIDS patients. These training include stages and process of counselling, building up of values and attitude as a counsellor, counselling on prevention of disease transmission, as well as pre- and post-test counselling, etc. Under this program, the Department not only provides free medication to all HIV/AIDS patients. It also provides financial support for various other medical expenses like conveyance, room rent, daily allowance, expenses of a helper, etc., incurred on visiting the Integrated Counselling and Testing Center and Antiretroviral Treatment Center located in the nearest city or town hospital.

Tibetan Torture Survivors Program Many of the new refugees from Tibet are political prisoners who have been subjected to brutal inhuman torture in Chinese prisons. They suffer from mental health problems like post-traumatic stress disorders. Thus, the Department in 1991 began Tibetan Torture Survivors Program in order to take care of the growing number of tortured Tibetan prisoners of conscience. The programâ&#x20AC;&#x2122;s main objective is to rehabilitate Tibetan torture victims by making them physically, mentally and economically self-reliant. The program therefore provides medical and social benefits, in addition to counselling services. Since its inception, the program has provided social and medical benefits to over 648 victims. As of March 2013, the program is supporting 95 torture victims. Integration of Modern and Traditional Tibetan System of Medicine The Department aims to build a comprehensive system of medical care based on both the modern allopathic and traditional Tibetan system of medicine. The Departmentâ&#x20AC;&#x2122;s hospitals operate in close coordination with branch clinics of Tibetan Medical and Astrological Institute (TMAI). The Department also hosts meetings between doctors of Delek Hospital and TMAI to discuss the modalities of enhancing better understanding and integration of the two different systems of medicine.

Substance Abuse and Rehabilitation Program

Water and Sanitation Program

Substance abuse is not only a problem arising out of the availability of psychoactive drugs but it has great deal to do with social conditions which create the demand for consumption of such substances. Therefore, the approach is to recognize drug abuse as a psycho-social medical problem which can be best handled through community based interventions. The Department of Health on its part gives maximum emphasis on educating the people on prevention about its ill effects and rehabilitates the current user at different de-addiction centers. Schools in our community hold the priority list and we have initiated our action by constituting special committee comprising of both staff and students to control substance abuse in schools. We organize annual substance abuse workshop cum review meeting for school heads, teachers, counselors and students to discuss the issues related to substance abuse. We also organize various activities such as inter-school drawing competitions and awareness lectures during which rehabilitated persons share their experiences.

The Water and Sanitation Program is one of the main programs undertaken by the Department. Through this program, the Department ensures adequate supply of safe and clean drinking water in the Tibetan settlements, schools, monasteries, nunneries, etc. Provision of safe and clean drinking water, in addition to clean and hygienic sanitation facilities, constitutes a major factor in the promotion of public health in the exile community. Provision of safe drinking water and clean sanitation facilities commonly includes the following: construction of water tanks; drilling of bore wells; water management training; laying of water pipeline; construction and renovation of toilets, bathrooms, drainage, septic tanks and garbage disposal; provision of water filtration tanks and treatment plants like Reverse Osmosis plant (RO), etc. Essential Drugs and Universal Precaution Under this program, the Department ensures its hospitals and health centers an adequate supply of essential drugs and other necessities for the practice of universal precaution. This program ensures that even the small health centers and clinics, including those located in the remote regions, are well equipped to deal with common health problems at the local level without having to refer every case to the outside hospitals, which are quite often located far away from the settlement.

Treatment and Rehabilitation Program Under this program, the Department provides counseling and funding assistance for the treatment of substance abuse and addiction at a rehabilitation center located in the nearest city or town. The greatest challenge that the Department faces in this program is with regard to persuading and motivating the drug addicts to willingly seek treatment at a rehabilitation center. Special in-service counseling training and workshops are thus provided to the Departmentâ&#x20AC;&#x2122;s health staff members posted in Tibetan settlements across India.

Oral Health Oral health is of major concern for the Tibetan children. This program particularly targets Tibetan settlements located in the remote, far-flung regions. Through this program, the Department hosts oral health talks, distributes free toothpastes and toothbrushes and organizes dental camps- where dental screening and treatment are conducted.

The Revised MBBS Bond The bond signed between the Central Tibetan Administration - Department of Health (CTA-DOH) alias Tibetan Voluntary Health Association (TVHA), Tibetan Childrenâ&#x20AC;&#x2122;s Educational and Welfare Fund (CTA-DOE) and selected Tibetan students, who in exchange for the reserved MBBS seat granted through the CTA agree to provide 3 years of medical service under the CTA-DOH. The following are the main terms and conditions of the Revised MBBS Bond: 1. The awardee will serve in the Tibetan Community under the direction of TVHA (CTA-DOH) for a minimum period of 3 years after the completion of his/her study (MBBS degree) in Tibetan settlements under the direction of the department of health. 2. Upon failure to fulfil the previous condition of 3 year service after completion of MBBS degree course under the department of health, the awardee has to pay a total amount of 20 lak rupees to TVHA (CTA-DOH), Dharamsala. If the concerned person fails to reimburse the amount, then the mentioned guardians/ parents are bound to reimburse the said amount. 3. Upon completion of the MBBS degree course, the awardee has to report to TVHA (CTA-DOH) with original MBBS Degree certificate for assignment of service in Tibetan settlement. 4. In case of any dispute and difference areas, the Justice Commissioners of the Tibetan Supreme Justice Commission, Gangchen Kyishong, Dharamsala shall be the sole arbitrators.

List of the Tibetan Medical Students, Interns and Doctors who had signed the Revised MBBS Bond, 2012-2013. S.No Name Ms. Rinzin 1

Choedon

Ms. Rinchen Sangmo

Ms. Tenzin Yeshi

Ms. Tenzin Tsomo Tenga

Ms. Kalsang Choedon

Mr. Ugen Gyatso

Parents Name/Address

College

Dr. Rajindra Mr. Tashi Namgyal/Mrs Pema Lhamo, Tibet- Government an Colony Dekyiling, Distt. Dehradun, UK cal College, Dharamsala

Student Prasad MediTanda,

Mr. Ke Tsering/Mrs. Kanzey, V-Village, H Sardar Patel Medical no-28, Dhondenling Tibetan Settlement, Kol- College, Bikaner, Rajlegal Taluk, Chamrajnagar Distt. K.S asthan Mr. Sonam Dorjee (Late)/Mrs. Tsering Dolma, TRS Sonamling, Camp-6, House no-60, P.O Agling, Ladakh, Distt. Leh, J&k Mr. Karma Lodoe/Mrs. Tsering Lhamo, House no-113, Dege Division, Tibetan colony, P.O Chauntra, Distt. Mandi, H.P Mr. Norbu Tsering/Mrs. Dolma Tsering, Camp-1, H no-24, P.O Tibetan Colony, Mundgod, Distt. Karwar,581411 Mr. Lobsang/Mrs. Tenzin Chozom, B-10, Dekyiling Tibetan Colony, S.D Road, Distt. Dehradun, UK

Indra Gandhi Medical College, Shimla Sardar Patel Medical College, Bikaner, Rajasthan Sardar Patel Medical College, Bikaner, Rajasthan Indra Gandhi Medical College, Shimla

S.No Name

Parents Name/Address

College

Student

Mr. Tashi Gonpo/ Mrs Sonam Dekyi, TCV Indra Gandhi Medical Handicarft Center, Samten Takla House, College, Shimla Distt. Kangra, H.P

Mr. Tenzin

Mr. Tashi Namgyal

Mr. Tenzin Tsewang

Mr. Tenzin Dasel

Mr. Gyurme Lodoe/Mrs. Tenzin Chodon, Sardar Patel Medical Mr. Ngawang House no-19, I-Village, Kollegal Taluk, College, Bikaner, RajTsetan Chamrajnagar Distt., KS asthan

Ms. Tsering Lhamo

Mr. Dhondup Tashi/Mrs. Pema Dolma, D- Sardar Patel Medical Village, House no-1, P.o Kollegal Taluk, College, Bikaner, RajChamrajnagar Distt., KS asthan

Ms. Tenzin Namdon

Dr. Rajindra Mr. Ngodup Dorjee/Mrs. Tenzin Tsomo, DeGovernment partment of Security, CTA, Gangchen Kyiscal College, hong, Dharamsala, Distt. Kangra, H.P Dharamsala

Mr. Tenzin Choenyi

Mr. Tenzin Lhakyap/Mrs. Karma Tsomo, Sardar Patel Medical Old camp-3, House no-13, Bylakuppe, Distt. College, Bikaner, RajMysore, KS asthan

Ms. Kunga Tselha

Mr. Phurbu Tsering (Late)/Mrs. Dawa Ph- Institute of Post Gratuenthok c/o Settlement officer Sakya Tibetan ate Medical Education Society, Distt. Sirmour, H.P and Research, Kolkata

Mr. Tenzin Wangdak

Mr. Tenzin Lekshey/Mrs Sichoe Dolma, House no 123, Palrabling Tibetan Settlement, P.O Dobhi, Via Katrain, Distt Kullu H.P 175129

Mr. Tenzin Norsang

Mr. Norbu Gyaltsho/Mrs. Dorjee Dolma, Tibetan Colony Dekyiling, P.O Manali, Distt. Kullu, H.P 175131

Mr. Tashi Sangpo

Mr. Lobsang (Late)/Mrs. Kunsang Tsomo, TRS Camp-6, House-4, P.O Bylakuppe, Distt. Mysore, K.S

Mr. Tenzin Choedhen

Mr. Sonam Tsering/Mrs. Ngawang Chodon, Indra Gandhi Medical TCV School Health Center, Dharamsala, College, Shimla Distt. Kangra, H.P

Mr. Tenzin Wangchuk

Mr. Tashi Norbu/Mrs. Tsering Kyima, Vil- Sardar Patel Medical lage-T, House no-5, Dhondenling Tibetan College, Bikaner, RajSettlement, Kollegal, K.S asthan

Mr. Gyurmey (Late)/Mrs. Keychok Dolma, Indra Gandhi Medical Tibetan Refugee Self Help Center, Gandhi College, Shimla Road, Darjeeling, W.B Dr. Rajindra Prasad Mr. Tsewang Dargyal/Mrs. Phurbu DolGovernment Medima, House no 630, Block-B, Bhagsu Road, cal College, Tanda, Dharamsala Dharamsala Mr. Jigmet Tashi/Mrs. Tsering Dolkar, House Dr. Rajindra Prasad no-10, Camp-9, Sonamling Tibetan Refugee Government MediSettlement, P.O Choglamsar, Leh Ladakh, cal College, Tanda, J&K Dharamsala

Dr. Rajindra Government cal College, Dharamsala Dr. Rajindra Government cal College, Dharamsala Dr. Rajindra Government cal College, Dharamsala

Prasad MediTanda,

Prasad MediTanda, Prasad MediTanda, Prasad MediTanda,

Voluntary Health Association staff Rules and Regulation guidelines. These hospitals are administered through an autonomous board of management. The daily management of hospitals is supervised by the hospital administrator, while Hospitals the medical division of the hospital is headed by a chief medical officer. It goes without saying that The Department of Health runs seven hospitals the construction of hospital buildings, as well as in Tibetan settlements spread across India. These the daily functioning of the hospital, are carried hospitals provide health services to a popula- out in strict conformance to the relevant Indian tion ranging from 5,000 to 16,000. They treat state laws and regulations on private medical eson an average 50-100 patients daily and are well tablishments. equipped with all basic diagnostic and treatment facilities like eye clinic, (minor) operation the- Kollegal Dhondenling Van Thiel Charitable Trust atre, laboratory unit, x-ray machine, dental unit, Hospital maternity ward, TB isolation ward, inpatient wards for male and female, pharmacy, physio- Dhondenling Tibetan settlement is the third largtherapy scanning, 24 hours ambulance services, est Tibetan settlement in India. With a current free immunization, etc. population of about 5,500, the settlement is lo Health conditions commonly treated in cated in the south Indian state of Karnataka, at a these hospitals are upper and lower respiratory remote location with extremely poor transportatract infection, Tuberculosis, gastroenteritis, tion and communication links. blood pressure, diabetics, waterborne diseases, The Dhondenling Van Thiel (DVT) Chareye-related problems, hypertension, arthritis, itable Trust Hospital was founded in 1974 by a viral fever, joint pain, skin allergies diseases, non-profit organization MYRADA (Mysore ReDental problem, Gastritis, Back pain, Abdominal habilitation and Development Agency). Since the pain, Typhoid, Diarrhea, Anemia, ear infection Department took full charge of the hospital in and delivery cases etc. 1986, it has over the years grown to be one of the The medical services provided by the largest Tibetan hospitals in India. hospitals also include a wide range of other pro- Fully equipped with basic diagnostic and grams: MCH (Mother and Child Health) and RH treatment facilities, the hospital provides quality (Reproductive Health) Program, HIV Program, services to both the Tibetan settlers and the loMental Health Program, Destitute Medical Pro- cal Indian population. The hospital treats daily gram, TB Program, Program for (People with) about 60 to 100 patients. It has 18 medical and Disabilities, Tibetan Medicare System Program non-medical staff members, including 1 Doctor (TMS), etc. (MBBS), 1 hospital administrator, 2 staff nurses, The hospital premises and buildings usu- 4 community health workers, 1 lab/x-ray technially consist of two blocks: administrative and cian, 1 ophthalmic nurse, 1 pharmacist, 1 Dental medical. The administrative block includes the Therapist, 1 accountant, 1 cashier/office secreoffice of hospital administrator, conference hall, tary, 1 peon, 1 driver, 1 sweeper and 1 watchhealth information section, health education sec- man. tion, patientâ&#x20AC;&#x2122;s record room, generator room, garage, staff quarters, staff kitchen, etc. The medical block includes outpatient department (OPD), emergency room, dressingcum-injection room, pharmacy, laboratory, x-ray room, nurses room, Minor OT, dental section, eye section, general inpatient ward, counselling room, examination room, TB ward, maternity and computerised billing counter. The staff members of the hospitals are appointed by the Department as per the Tibetan

Information regarding our Hospitals, Primary Health Centers (PHC) and Clinics:-

Doeguling Tibetan Resettlement Hospital Association (DTR), Mundgod

was founded in 1982. Initially, it had 15 staff members. After constructing new hospital buildings with funding assistance from Italy, the hospital was formally inaugurated by His Holiness the Dalai Lama in August 1995. His Holiness conferred the name Tso-jhe Khangsar to the hospital. In order to cater to the growing health needs of the two settlements in Bylakuppe and in addition to a significant local Indian population, the hospital today has a combined total of 22 medical and non-medical staff members, including 1 Doctor, 1 hospital administrator, 1 dental therapist, 1 accountant, 3 staff Nurses, 5 community health workers, 2 lab technician/ x-ray, 1 opthalmic technician, 1 pharmacist, 1 office secretary/cashier, 1 driver, 1 cook, 1 watchman and 2 sweepers. The institution also runs or governs the health care center at Chawkur, one of the farest camps.

The DTR hospital started with a single room clinic in 1967. At that time, the clinic had two beds with only a handful of staff members. The present day DTR hospital building was inaugurated on 1 January 1970. At that time, it operated under the Mysore Rehabilitation and Development Agency (MYRADA), a non-profit organization. The Department took charge of the hospital in 1993. Located in the South Indian state of Karnataka, the Doeguling Tibetan Settlement is the second largest in India. As of 2008, the settlement has a population of over 16,994 out of which 9,020 were monks. The DTR Hospital is equipped with all basic diagnostic and treatment equipment. It treats a daily average of about 30 patients. The hospital has a combined total of 26 medical and non-medical staff members, which includes 1 Doctor (MBBS), 1 Dentist, 1 hospital administrator, 4 staff nurse, 1 Nurse Aid, 6 community Phende Hospital, Hunsur health workers, 1 Lab. technician, 1 x-ray technician, 1 pharmacist, 1 accountant, 2 Sweeper, 1 The Hunsur Tibetan settlement was established in 1972 with an initial population of 3,200. The peon, 2 watchman, 1 driver/plumber, 2 cooks. settlementâ&#x20AC;&#x2122;s Phende hospital was established in 1974 with funding assistance from the Board of Tso-Jhe Khangsar Charity Hospital, Bylakuppe Located in the south Indian state of Karnataka, Lugsung Samdupling and Dekyi Larsoe settlements in Bylakuppe together constitute the largest Tibetan settlement in India. While Lugsung Samdupling was founded in 1962 with an initial population of 11,500, Dekyi Larsoe started in 1970 with 3,500 people. As of 2012, the combined population of Bylakuppe was 22,000. The Tso-Jhe Khangsar Charity Hospital

Trustees of Common Project of European Refugee Campaign. Its foundation stone was laid down by then state Chief Minister Shri Devaraj Urs. The hospital was managed by the Mysore Rehabilitation and Development Agency until 1976. It was later handed over to the settlementâ&#x20AC;&#x2122;s cooperative society. The Department took complete charge of the hospital in the late 1980â&#x20AC;&#x2122;s.The hospital at present has 13 staff members both the medical and non-medical including 1 hospital administrator, 1 accountant, 2 staff nurse, 1 pharmacist, 1 lab. technician, 3 community health workers, 1 driver, 1 cook/laundry, 1 sweeper and 1 watchman. In addition to quality medical services, the hospital also carries out a wide range of programs like organizing health awareness events, installation of medical camps for early detection and treatment of diseases, etc. Menlha Hospital, Odisha The Phuntsokling Tibetan settlement is located in the eastern Indian state of Odisha. What is today the Menlha Hospital was only a small clinic when His Holiness the Dalai Lama first inaugurated in February 1979. The population of the settlement has decreased from the initial 3,000 to about 2,500 in 2012. The hospital today has total 12 medical and non-medical staff members, including 1 hospital administrator, 1 x-ray/lab. technician, 1 accountant, 2 staff Nurses, 1 cashier/ office secretary, 1 dental therapist, 2 community health workers, 1 watchman, 1 driver and 1 sweeper. In addition to providing medical comprehensive services to the Tibetan settlers and the local Indian population, the hospital also carries

a whole host of health programs ranging from free immunization and MCH to health awareness talks and outreach events. In case of serious patients who require intensive in-patient treatment, the hospital refers them to the nearest city hospital of Bahrampur. Dekyiling Hospital Dekyiling Tibetan settlement was initially built to rehabilitate the Tibetan refugees who have migrated from Bhutan. The Tibetan refugees from Bhutan are in Dekyiling with scattered Tibetan of Mussoorie, Rajpur and Hardwar. The Dekyiling settlement people initially earned their livelihood by weaving carpet at the handicraft center of settlement. With funding assistance from the Health Department and various foreign donors, a primary health center was established in 1986. At that time, the settlement had a population of nearly 2,000. The health center at the Dekyiling settlement is one of the largest and serves as the central referral point for various other health centers located around the city of Dehradun, at Rajpur, Khera, Lakhanwala, Clementown and Manduwala. The settlementâ&#x20AC;&#x2122;s health center has a combined total of 14 medical and non-medical staff members, including 2 Doctors, 1 hospital administrator, 1 lab./x-ray technician, 4 staff nurses, 1 auxiliary nurse, 1 community health worker, 1 accountant, 1 driver, 1 sweeper and 1 cook. The health center not only provides basic medical services, but also undertakes various preventive and promotive aspects of public health programs.

Mainpat Hospital The Mainpat hospital was founded in 1986 in order to provide basic health care services to Tibetans as well as the local Indian populace. Before the inception of this health center, the settlement people (initially numbering 1,700) suffered major health problems. Since the settlement was located in a remote region, access to proper health care facilities was particularly difficult. This is the main reason why the settlement population has diminished significantly over the years. Fully equipped with basic treatment facilities, the center today has total 9 medical and non-medical staff, including 1 accountant, 2 staff nurse, 2 community health worker, 1 pharmacist, 1 ophthalmic technician, 1 sweeper and 1 driver.

Alongside the curative aspect of the medical services, these centers also undertakes a wide range of preventive and promotive health programs, including MCH and RH program, Tibetan Medicare System, health education, Hep/ HIV counselling programs, Tuberculosis DOT, etc. The daily administration of centers are supervised by the settlement officers. All medical and non-medical staff of hospitals and Primary health centers are recruited by the Health Department in strict adherence to the relevant rules and regulations of the Central Tibetan Administration. Primary Health Center, Miao

Choephelling Tibetan settlement was first established in the remote area of Changlang in Arunachal Pradesh with an initial population of about 1,600 in 1972. Later, in 1976, the settlement was shifted to Miao, which had relatively better transportation and communication links with the rest of the country. The town of Miao is located in the Changlang District of north-east Indian state of Arunachal Pradesh. The primary health center at Miao started as a small dispensary with a single nurse. The center was rebuilt at the present location in 1978. Further renovation works in 1996 extended the Primary Health Centers (PHC):in-patient ward of the health center. With four The Department runs a network of four primary resident nurses, fully equipped with basic diaghealth care centers in Tibetan settlements with nostic and treatment facilities, the health center population ranging variously from 1,000 to 7,500. today serves the medical needs of the settlement These health centers are fully equipped with basic population of 2,907 (as of 2012). medical equipment and treatment facilities. Many of these centers treat as many as 50 patients every day. Three of these centers have resident doctors, while the remaining have a visiting doctor once every week or two weeks. They provide a wide range of treatment facilities including OPD consultation, dressing room, pharmacy, laboratory, delivery room (equipped with oxygen and incubator), immunization, in-patient ward, nebulizer, ECG, x-ray, dental ward, physiotherapy, 24 hours emergency services, etc. These centers also provide ambulance services and provide home visits to the elderly or bed-ridden patients.

Primary Health Center, Bir and Chauntra

April 2013, the settlement has a population of 1198. In 1973, the settlement had a small disThe health center was established in 1967. At that time, it was a tent clinic with two paramedi- pensary run by a nurse appointed by the settlecal workers and an Indian visiting doctor. It was ment office. In 1981, the Department renamed managed by the Tibetan Industrial Rehabilita- the clinic as Norgyeling Health Center. The Detion Society (T.I.R.S). It provided health care partment took full charge of the health center in services to three settlements, viz. Bir Dege Divi- April 2001. Prior to that, the settlement office sion, Nagchen Division and Bir Tibetan Society, raised the entire administrative costs of running which were established in 1966 with an initial the health center. Even after taking the full charge population of 2,000. These settlements today of the health center by the Department, the sethave a combined population of 7,552 that include tlement office continues to assist in electing the health committee members and its chairman as 5 monasteries and 4 schools. In 1981, the center was upgraded into per the established rules and guidelines. a primary health care center with 12 rooms, a kitchen and a bathroom. The construction of ‘Fosco Maraini’ Tibetan Primary Health Center, new health center was sponsored by a group of Choglamsar Ladakh Tibetans residing in Switzerland and the Swiss Zonta club. The land for the PHC was donated The Sonamling Tibetan settlement in Choglamby His Eminence DZongsar Khentse Rinpoche sar, Ladakh was established in late 1960’s. The of Dege Division, Bir. Inpatient room and testing settlement consists of two different groups, viz. laboratory were added in 1992. In 2005, further Choglamsar and Jangthang. As of April 2013, out extension was made with donation from Vener- of a total population of 7,434, nearly two-third, able Ogyen Topyal Rinpochen of Bir Nangchen 5,154, are settled in Choglamsar. The remaining, Division. In 2008, the health center further con- 2,280, are based in the nomadic area of Jangthstructed residence quarters for a Doctor, hospital ang. administrator, staff nurse and the lab/x-ray tech- Child’s right organization, Save the Chilnician. A hall with a seating capacity of 100 was also constructed for organizing health education activities. Moreover, health center also provides comprehensive basic care to the Chauntra Tibetan settlement population of 868. Primary Health Center, Bhandara The Norgyeling Tibetan settlement was established in 1972 to accommodate 5,000 people. However, extreme climatic conditions and unsuitable environment, many have lost their lives and many others migrated to other places. As of 16

dren Fund set up four small health care centers in Choglamsar. These health centers provided basic health care services until they were closed down in 1992. The Department took charge of these health centers in the same year. The health centers resumed providing basic health care services to the settlement people. These health centers located in Choglamsar operate as the main center, while the other three located in Menlha, Choglam and Angling serve as sub-centers. With the growing public need and demand for a mobile clinic facility in the nomadic area of Jangthang, the department closed down one of the existing health centers and started operating a mobile ambulance clinic. The mobile clinic covered the nomadic areas of Sumdho, Sameth, Kharnak, Nyoma, Chummur, Hanley, Goyul, hanle and Kakshung. The sole remaining nomadic area of Jangthang Chushul has a separate health sub-center functioning with one health worker. From April 2014, branch clinic at Sumdho Jangthang area is going to have 2 resident staff nurse and 1 driver. This branch clinic will function direct under the main health center at Choglamsar. They will do monthy visit to 9 areas of Jangthang. In 2012, the Primary Health care center was constructed through the support by Fondo Samaritano Radici of Bergamo (Italy) and Africa Tremila, NGO and Italy Tibet Association. It was inaugurated by Health Minister, Dr Tsering Wangchuk on 31 August 2012. In the same year, a new Mazda ambulance was replaced by La Casa del Tibet and Roadway of Tibet. Under the aegis of the Department, the administration of the health center is handled by the 11-member local health committee. The daily works of the health center and its sub-centers are supervised by the hospital administrator. The health centers operate with 14 staff: 1 hospital administrator, 1 accountant, 1 staff nurse, 8 community health workers and 1 pharmacist and 2 drivers. Primary Health Center, Delhi The primary health center in Majnu-Ka-Tilla, Delhi was built in 1993 with generous funding assistance from Mr. Fabien Quaki through Medicines Du Monde. At that time, the health center operated with one staff nurse and a dental thera-

pist. Today, the center has 3 staff nurses with a visiting doctor twice a week. The clinic provides comprehensive basic health care services to the settlement population of over 2,500. The health center functions under the overall supervision of the settlement officer.

Clinics:The Department runs a network of fourty three clinics in the scattered Tibetan Settlements across India and Nepal. Since there are no permanent resident doctor in these clinics, they provide only outpatient services to not only Tibetans, but a significant local Indian and Nepalese population as well. All these clinics, except a few, are staffed by a community health worker with a visiting doctor once every week or two weeks. The health center is well equipped with all the basic diagnostic and treatment facilities, including OPD, BP machine, thermo meter, ear checkup, sugar testing machine, pregnancy test and weighing machine. The center also implements health services like free immunization to the children under the age of five, free medication to the people officially attested as the poorest of poor, etc. Health programs carried out by these health centers also include MCH (Mother Child Health) and RH (Reproductive Health) program, DOT (Direct observed Therapy) program and to avail information regarding both communicable and chronic diseases and their prevention. And health related events are organised as per direction of Department. The clinic is administered by the settlement officer and a community health worker works under. The clinics located in the areas of Nepal are administered by the (SLF) Snow Lion Foundation under the guidance of Department of Health, CTA.

Dholanji Clinic

Kullu Manali Clinic The Kullu dispensary was established in 1981. It is located inside the premises of a school near River Beas. At that time the population of the settlement was around 250 (now reduced to 200). The clinic was initially administered by the Education Department of CTA. The Health Department later took full charge of the clinic. The local settlement officer supervises the daily functioning of the clinic. Health staff visits once in a week to 15 Mile, Manali and Patlikul to provide health neeeds in these settlements.

Dholanji Tibetan settlement is located in the north Indian state of Himachal Pradesh. The settlement has a total population of 652, which also includes a significant number of monks and nuns. The settlement’s health centre was established in 1987. Operating with one community health worker, the health centre is fully equipped to provide basic medical services to the settlement people. Patients who require hospital care or consultation of specialists are promptly referred the hospital located in the nearest town of Solan.

Rewalsar and Pondoh Clinic

Dalhousie Clinic

The Rewalsar Primary Health Care Center was established in September 1987 by the Health Department in order to provide health care services to the Tibetan people in Rewalsar and Pondoh. As of April 2013, the town has a population of 300 and 240 in Pondoh settlement. The health worker also visits twice a week to Pondoh settlement. The clinic operates with one community health worker, under the close supervision of the concerned settlement office. The clinic is well equipped to provide basic diagnostic and treatment services.

The health center in Dalhousie was first set up by the local Tibetan people in the early 1970’s. At that time, the local Tibetan population in this town of north Indian state of Himachal Pradesh numbered more than a thousand. Located within the Tibetan Handicraft Center at Middle Bakrota, Dalhousie, the health center’s management was eventually handed over to the Department in 1983. The health center operates with one health worker under the close supervision of the local settlement office.

took over the responsibility and manages the primary health care center through the settlement office. It has every basic facility to cure the minor illness and refers the patient to the bigger hospital in need. It also provides health awareness talk, gives health education regarding the communicable diseases. Dhondupling and Lingtsang Clinic

Khampagar Clinic, Tashijong The primary health center at khampagar was established in October 1973 by H.E the late 8th Khamtrul Rincpoche. It was intended to provide basic medical care to the monks and the lay people of Khampagar. The department also arranged an additional staff nurse as felt and appealed by the Khampagar society. The health center is functioned with two-health workers, a laboratory and a visiting doctor who visits the center twice a week. The institute also observes health awareness program in the community. The Tibetan craft community and the department administer it. There are 661 resident in the settlement including monks and nuns at Dhongyu Gyatseling Nunnery.

The Tibetan Settlement at Clementown was founded by the late Gungthang Tsultrim in 1964 and was initially known as Tibetan Nehru Memorial Foundation (TNMF). Presently, it is called Dhondupling Tibetan Settlement as conferred by His Holiness the Dalai Lama in 1966. During the foundation of this settlement, primary health care center was initiated under the administration of TNMF settlement office. It has a prime purpose

Paonta Sahib Clinic Tibetan Industrial Rehabilitation Society Poanta has started the Primary health center at Tibetan settlement in 1969. It is situated near Paonta Sahib at a distance of 4km away from the city and 48 km away from Dehradun. Single community health worker serves the settlement populace of 576 approximately. Since 1984, the department

to provide health care services to 3000 Tibetan inhabitants as per 2013. Mrs. Khando Chagzolshang, the general secretary of Tibetan Homes Foundation, Mussoorie has shouldered the responsibility of all the medical expenses and the salary of two staff nurses for three years until 1989. Eventually, the department took charge and appointed one community health worker at the health center. The health care center building is under the registration of settlement office and it is functioning under the direct supervision of community health worker and the settlement office. Besides providing health care facilities, it also organizes health talk on various diseases to educate the common masses for a healthy community and visits Lingtsang Tibetan settlement thrice a week, today has a population of 505.

remote location in the north Indian state of Himachal Pradesh. The settlement was initially established with a population of 500 Tibetans refugees. The nearest town of Paonta Sahib is located at a distance of 20 kms. The settlement today has a population of 215. The primary health center was first established by the Tibetan industrial Rehabilitation Society. The health center was run by one community health worker and a visiting doctor every week. After the Department eventually took charge of the health center, Doctors from the Dharamshala-based Delek Hospital visited the health center at least four times a year. With fundKhera and Lakhanwala Clinic ing assistance from the Italian Association for The Khera Tibetan settlement was established Solidarity among Peoples, the Department built a in 1969 by the rehabilitation center, headquarter new health center with staff quarters. The Rajpur Est no. 22, Government of India to felicitate the chapter of Swedish Organization for Individual ex-soldiers of Special Frontier Force for their un- Relief assisted the health center in procuring adeprecedented service to the Indian Military. The quate supply of essential drugs. The health center settlement is located near Lakhanwala, Uttara- today operates with one health worker under the close supervision of the local settlement office. khand state. A staff nurse at the center works under the supervision of settlement office and the de- Puruwala Clinic partment. All the expenses of the health center is borne by the department of health, CTA. It pro- The health center is located in the settlement of vides basic health care services and visits twice Sakya Tibetan Society Puruwala, which was esin week to Lakhanwala settlement, population of tablished in 1969 with the guidance and bless468. ings of His Eminence Sakya Trinzin Rinpoche. It has three sections including a dispensa- The health care center was set up in 1983 and ry room, a dressing room and two-bedded patient provides basic health care services to a popularoom. Health center also initiates health education of 725 today. The clinic basically has two tion program in the community as per the direc- rooms: main clinic and dressing room. The clinic tion of the Department. at present has one community health worker who works under the direct supervision of the local Sataun Clinic settlement office as per the established rules and regulations set by the Health Department. The Satuan Tibetan settlement is situated at a

health centre was established by the local Tibetan Women Centre in 1970. Since the Department took full charge of the health centre in 1992, it has been working under the close supervision of the Dekyling hospital. The health centre has one community health worker and is fully equipped to provide basic medical services to the settlement people, numbering 387 in 2013. Tenzingang Clinic Kamrao Clinic The Kamrao Tibetan settlement is located at an extremely remote location in the north Indians state of Himachal Pradesh. The nearest town of Paonta Sahib is located at a distance of about 40 kms. The Tibetan settlement at Kamrao was initially established with a population of about 500. The settlement’s health care center was first established by the Tibetan Industrial Rehabilitation Society. The health center functioned with one community health worker. The Department eventually took over the management of the health center. Doctors from the Dharamshala-based Delek Hospital visits the health center at least four times a year. The Department upgraded the health center by renovating the old building and constructing a new staff quarter in 1998. The settlement had a population of 212 in 2012. The health center today functions with one community health worker under the close supervision of the local settlement office. Rajpur Clinic The Tibetan settlement at Rajpur is located on the outskirts of Dehradun. The settlement initially had a population of 500. The settlement’s

The Tenzingang Settlement in the northeastern Indian border state of Arunachal Pradesh was established in the year 1972 with an initial population of 34 families. The population in and around Bomdilla has grown over the years to about 900 people today. The settlement initially had a small clinic with two temporary staff working under

the supervision of the local settlement office. The clinic was upgraded in the early 1990’s by constructing a double-storey building with multiple rooms serving as inpatient ward, dressing room, doctor’s cabin, pharmacy and medicine store room. The clinic basically had all the basic amenities that one could find in a hospital. The construction of building and provision of new medical equipment for the clinic was funded by Mrs Daniel Mitterand Foundation, France. As the donation came through the tireless efforts of the Dewatsang family, the clinic was named after their late father Mr. Kunga Samten. The clinic today is known as K.S. Memorial Clinic. The clinic today operates with two medical staff who work under the direct supervision of the local settlement office.

Tung and Dilaram. The area had a combined total population of around 30,000 in 2013. The centre has been operating under the supervision of the settlement office. The centre has one community health worker (appointed by the Health Department) and one staff nurse (appointed by the settlement office with funding assistance from Shenpen Tibet Aid in Norway). In addition, the centre also has a visiting doctor once every week. A doctor of traditional Tibetan medicine, based in the nearest hill town of DarjeelTezu Clinic ing, also visits the centre once every two weeks. All emergency cases are referred to the nearest The Dhargyeling Tibetan Settlement in Tezu was hospital in Darjeeling or Siliguri. In addition to established in 1962 with an initial population of medical services, the centre also undertakes nunearly 900. Tezu is located in the northeastern merous public health initiatives. Indian state of Arunachal Pradesh. The present health center in the settlement was established by Ravangla and Gangtok Clinic the Department in 1980. The health center today operates with one staff nurse, two health work- The Ravangla Tibetan settlement is situated in the ers and one driver. As of April 2013, the post of north-eastern Indian state of Sikkim. The settlestaff nurse was vacant and the Department was in ment initially sheltered 810 people. Its population the process of appointing a new nurse. The health today is 1,275. Since the settlement health centre center operates under the close supervision of the was established in 1989, it has been operating local settlement office. Given the remote location with one community health worker. The cenof the settlement, the ambulance service provided tre also has a dental section. Every year dentists by the center has been extremely beneficial to the from France visit the centre to offer free check local populace. up to the settlement people. In addition to day-today common medical services, the health centre Tashiling Clinic, Sonada in collaboration with the local Tibetan settlement office, undertakes a wide range of public health The Tashiling Tibetan settlement in Sonada is lo- programs and events. cated in the eastern Indian state of West Bengal. In addition, health staff also visits twice The settlementâ&#x20AC;&#x2122;s health centre was established in a month to Gangtok scattered Tibetan settlers to the 1980â&#x20AC;&#x2122;s in order to provide basic health care provide medical services and availing Doctor services to the Tibetan settlers, as well as the during her visit. local Indian population in and around Sonada,

Two Autonomous Health and Medical Institution under CTA, Health Department Tibetan Medical & Astrology Institute of H.H the Dalai Lama (TMAI) Historically, Men-Tsee-Khang or Tibetan Medical and Astrology Institute (TMAI) was first established in 1916 by the 13th Dalai Lama in Lhasa, Tibet. After the Chinese occupation of Tibet, His Holiness the 14th Dalai Lama, followed Srinagar Clinic by some 80,000 Tibetans, took shelter in India. In order to preserve the rich Tibetan religious Upon request from the local Tibetan Muslim and cultural heritage, His Holiness re-established community in Srinagar, the capital of northern traditional Tibetan institutes of scholarship and Indian state of Jammu and Kashmir, the com- learning in exile. munity health centre was established to provide basic health services to an initial population of a few hundreds. The population today has grown to over a thousand people. The health centre operates with one health worker and is well-equipped to provide basic health services. Tuting Clinic The first ever Tibetan settlement officer was appointed on 15 April 2013. Prior to this it was under the administration of Tezu settlement office. Tuting is situated in a very remote area and some villagers are settled around the India Tibet border of northeastern state of Arunachal Pradesh. The region combined 17 small villages scattered over and population of nearly 1081 initially. The present health center in the settlement was established by the Department in 1995 with the contribution fund from settlement people. The health center today operates with one staff nurse and one community health worker. The health center operates under the close supervision of the local settlement office.

Thus, in March 1961, His Holiness the Dalai Lama re-established Men-Tsee-Khang (TMAI) at Dharamsala. The primary objective is to preserve, promote and protect the traditional Tibetan system of medicine (Sowa-Rigpa) and astrology, which has been practiced down the ages for centuries. The institute initially started with a doctor, an astrologer and ten students, enrolled in two schools: Chopra House and Gleenmore Cottage. In 1967, the two schools were merged into what we now know as Men-Tsee-Khang or Tibetan Medical & Astro. Institute. At that time, it was located in Mcleod Ganj. The institute was later shifted to the present location in 1982. The TMAI aims to preserve, promote and practise Sowa Rigpa, the traditional Tibetan system of medicine, astronomy and astrology. The mission statement of TMAI also includes education and higher studies in the fields of Tibetan 23

medicine and astrology, research and collaboration with scholars and institutes in India and abroad between different healing systems, and to produce Tibetan medicines in an environmentally sensitive manner. The TMAI headquarters at Dharamsala consist of numerous academic and administrative departments. The institute is run by a governing body of ten members, which includes Health Kalon as a chairman (served by the officiating officer from the Central Tibetan Administration) and a secretary (served by the director of the TMAI). The institute today employs 521 staff members which includes Administrative, Medical, Astrologer and temporary workers. The institute at present runs a wide network of 54 branch medical clinics across India. Out of which, 36 are based in Tibetan settlements and 18 in cities and rural areas.

Delek Hospital Delek Hospital has been providing health care services in Dharamsala for more than four decades. The visionary behind Delek Hospital was Mr. Tsewang Rinchen Rishing (Former Bon Chithue/ MP) who proposed the founding of an allopathic dispensary to cope with the many health problems in Tibetan refugee community. With His Holiness the XIV Dalai Lamaâ&#x20AC;&#x2122;s blessings, Tibetan Welfare Delek Hospital was officially inaugurated on October 4th, 1971. A new extension block of the hospital was constructed in 2010 by the Italian Government through their NGO, AISPO.

Although distinctly autonomous in its administration and funding at present, the hospital falls under the auspices of the Department of Health of the Central Tibetan Administration. The hospital has a nine member governing Board of Directors with Health Kalon as a Chairman and the day-to-day administrative work is overseen by an Administrator (CEO) who is supported by the Chief Medical Officer and the Hospital Secretary. Hospital has 49 staff members of both medical and non medical. Delek Hospital has an In-patient capacity of 45 beds of which the majority are occupied by TB patients. Round-the-clock care is provided by a total of 10 nurses including two Matrons. Other facilities include an operating theater (for minor surgery), recovery room, emergency room, delivery room, E.C.G., Heart Monitoring and a wide range of laboratory services. Additionally, Delek Hospital has a full fledged Out-patients (OPD) unit, Laboratory, Pharmacy unit, dental clinic, eye clinic, TB control clinic and a public health unit. It also runs an outpatient branch clinic at Mcleod Ganj. Delek Hospital has played a very important role in the prevention and treatment of TB in the Tibetan community. Besides TB, it provides treatment of all major infectious and non infectious diseases to both Tibetans and other people in the locality. It also provides maternity services and conducts normal deliveries. Under the National Immunization Programme, all children are provided with the following vaccines: BCG, Polio (OPV), DPT, Hepatitis B, Measles, MMR and Hib. Community Health Workers (CHW) Training has been conducted at the Delek hospital since 1981. To date, Delek has trained 265 CHWs and given 17 Refresher courses to 204 Health workers. Hospital also serves as elective centre for medical students from around the world and for Men-Tsee-Khang interns. Additionally, it creates public health awareness to the general public on important health days like World TB day, World Health day, HIV AIDS etc.

Clinics in Nepal

Tashiling Clinic, Pokhara

With funding from the Department, the health centre at the Tashiling Tibetan refugee settlement was built to provide basic health care services to The primary health centre at the Tibetan settlea population of 511. The health centre functions ment in Boudha was established in the early with a one health community with close involve1970â&#x20AC;&#x2122;s by the Snow Lion Foundation in order to ment of the members of the local health commitprovide basic health services to the local settletee. The health centre is well-equipped with basic ment populace, which has diminished from the diagnostic and treatment facilities. initial 500 to 137 (as of 2012). The health centre today operates with one community health work- Tashi Palkhiel Clinic er under the close supervision of the Snow Lion Foundation. The health centre is well-equipped with basic diagnostic and treatment facilities. Boudha Clinic, Kathmandu

Jorpati Clinic, Kathmandu The primary health care centre at the Tibetan settlement in Jorpati was established in August 1993. The population of the Tibetan settlement in Jorpati has increased marginally from initial 204 to 224 (as of 2012). Under the close supervision of the local settlement office and the Snow Lion Foundation, the health centre operates with one community health worker and a visiting doctor every Wednesday.

Tashi Palkhiel Tibetan Refugee settlement was established on 1962 on the total area of 120 rupani of land. The main sources of livelihood for the settlers are carpet weaving and small business. This settlement is located at Kaski Distt. of Nepal. The settlement consist of only village with 182 families and the present population of 976. The settlement avail with one modern allopathic dispensary and one staff nurse to provide basic medical treatment services.

Dorpatan Clinic, Pokhara

erating cost. The management and funding of the health centre was taken over by the Department in The Primary health centre was established in 1991. The health centre is well-equipped to pro1989 in order to provide basic health services to vide basic diagnostic and treatment services. The a population of over 200. The clinic today has centre today has one community health worker been operating successfully with one community (appointed by the Department) who works under health worker under the close supervision of the the close supervision of the local settlement oflocal settlement office and the Snow Lion Foun- fice. dation. The operating cost of the health centre is covered by donations from various foreign do- Walung Clinic nors. Manang Clinic The clinic in Manang settlement was established to provide basic primary health care services to the local populace. Given the extremely remote location of the settlement, the daily maintenance of the clinic suffered considerable difficulties. The community health worker of the clinic was therefore moved to another clinic in the same place, which was run by the Rotary Club of Germany. The health centre since then has been operating successfully with one community health worker under the close supervision of the local settlement office and the Snow Lion Foundation. The operating cost of the health centre is provided by donations of various foreign donors. Chialsa Clinic The primary health centre at the Delekling settlement in Chialsa was established and managed by the Swiss Red Cross Society in 1963. From 1966, the local settlement office took charge of the management of the health centre, while the Carpet Trading Centre provided funds for its op-

The primary health centre at the Sampheling settlement in Walung was established in 1972. The management and funding for the health centre was undertaken by the Snow Lion Foundation. The Department took full charge of the health centre in 1991. The health centre today operates with one community health worker under the close supervision of the Snow Lion Foundation. Shaybru Clinic The primary health centre at the Gegyeling settlement in Shaybru was first established in 1991. The Department has been managing this health

centre through the Snow Lion Foundation. The health centre procures essential drugs with funding assistance from Mrs Esther of Tibet Forever, Switzerland. The health centre has been operating successfully with one community health worker under the close supervision of the local settlement office.

Jampaling Clinic, Pokhara

Since 1984, Jampaling health care center has been providing basic health care services to 665 Tibetan residents. A single community health worker runs the health center with the assistance of settlement office and the department. Health center works much more efficiently after the administration charge has been taken over by the Lo Tserok Clinic Snow Lion Foundation. It has the basic amenities to cure common diseases and also promote health Lo Tserok Namgyaling Tibetan refugee settle- awareness program among theTibetans and local ment was first established in 1972 with and initial people. Moreover, the Tibetan residents are ofpopulation of 300. It is located at Marpha village fered 25% discount on the medicines. in Mustang, about 250 kms away from the Kathmandu, the capital of Nepal. The primary occupa- Paljorling Clinic, Pokhara tion of the settlers are farming. As of 2013, the Paljorling health center was established in 1990 settlement shelters 250 people. The settlement with a purpose to provide health care facilities health centre was first established in 1996. The to the Tibetan People living in and around the health centre with one community health worker settlement. It is very helpful to the community is fully equipped to provide basic medical treat- in terms of consultation or treatment for minor ment services. The centre has been operating un- illness. Moreover people can avail of 25% disder the close supervision of the Snow Lion Foun- count on medicines. Health center works efficiently under the supervision of SLF. Community dation and the local settlement office. health worker also arrange health awareness talks among the people.

HOW YOU CAN HELP TIBETAN HEALTH DEPARTMENT

Central Tibetan Administration’s Department of Health or Tibetan Voluntary Health Association works to improve the health of Tibetan refuges in India, Nepal and Bhutan. These are the Health Programs and Projects run by Department of Health or Tibetan Voluntary Health Association that urgently need your help. 1) Urgent Need of Support for Tibetan Medicare System (TMS): The Department started the TMS - a social health program- in the year 2012 exclusively designed to offer secondary and tertiary healthcare services to the exile Tibetan community in India. Likewise, it works in line with achieving the Health Department’s main objective: the ongoing prevention programs. The TMS program is a self-financing welfare scheme based on the principle of public-private partnership. The families and individuals will be eligible to receive the maximum annual benefit of Rs. 100,000 and Rs. 50,000 respectively on hospitalization costs for an annual contribution of Rs. 3,565 and Rs. 950 respectively. With TMS program, it has been possible for many people to have cured their illness such as gastroenteritis, hypertension, liver disease, cataract, cholecystectomy, upper respiratory infection, diabetes etc. Apparently, from phase 1, phase 2 and phase 3, the combine contributions received from 19960 members is Rs. 15,466,851/- in which the benefits paid to 1017 members is Rs. 22,574,581/- . The Department has incurred deficit of Rs 7,107,730/-, an equivalent to U.S. $ 118,462, up till 15 March 2014. In order to sustain this noble act, we are requesting grants/ donations from generous donors to create a financial safety net to back up the TMS program. TMS program not only saves life, but also act as an emergency financial security to a family and society. 2) Adopt Tibetan Health Centers: The Department of Health is one of the seven Departments of Central Tibetan Administration. Established in December 1981, its objective is to provide a comprehensive (preventive, promotive and curative) health care to the Tibetan population in exile through a network of 7 hospitals and 4 primary health centers and 43 clinics spread across India and Nepal. Ngoenga School, the first ever CTA owned school of Tibetan children with special need, is a home of 50 multiple disabled children from India, Nepal, Bhutan and Tibet. As of now, the Department employs a total workforce of 229 staff members, which includes doctors, executive secretaries, nurses, paramedic and other health personnel. The operation and management of these hospitals and health centers are directly administrated and funded by the Department of Health, including all recurring and non-recurring expenses ranging from staff salaries to health care services and programs. Over the years, the Health Department, being non-profit organization, has been facing severe financial difficulties in continuing its help and support to these health centers. Therefore, the Health Department is requesting individuals, corporate and associations to extend their help in the following ways: • Donations to run and manage the health centers, • Corpus Fund to sustain the Health Department and its units, • Adopt one of the Hospitals, Primary Health Centers, Clinics or Ngoenga school

3) Hepatitis B awareness, Testing, Vaccination and Treatment Project: The Department and John Hopkins School of Public Health jointly conducted a cross sectional study among a sample of 3000 people in Bylakuppe Tibetan settlement, South India in 2013 to estimate the prevalence of Hepatitis B. As per the preliminary findings of this study, the overall prevalence was found to be higher than 7% which is WHO’s high endemic categorization value. In our community, Liver cancer is most common along with Stomach and esophageal cancer, which is due to chronic Hep. B infection and Tibetan people eventually suffer and die from liver cancer. Majority of the Tibetans are unable to afford quality medications for clinical management of Hepatitis B because of huge cost of treatment. Such scenarios not only lead to high incidence of liver cancer in future but also cause rapid spread of current infection within the entire community. Therefore, the Department has been providing free Hepatitis B vaccination to all children under 5 years old since 2002. This project aims to reduce the incidence of Hepatitis B in the Tibetan community in India through Awareness, Screening, Vaccination and Treatment against /for Hepatitis B among of Tibetan children between the age group of 6-19 years, studying in all Tibetan schools in India and Nepal.

4) Construction of staff quarters for medical doctors and staff members at Kollegal, Miao, Hunsur: The present staff quarters were constructed 35 years ago in 1974 and currently in a very poor condition. So far numerous minor repairs and maintenance work has done to the staff quarter to create better living conditions for the staff members, but no significant development was brought to the building. The staff members and their families are still struggling with agonizing conditions such as leakages, wall cracks, moldy and broken windows and doors, dampness from ceiling and ground. The roof of the building has broken and cracked from many side. During monsoon season, leakages are a common problem, and it creates an unhygienic and difficult living condition for the residents. The staff members residing in the building confronted various life threatening incidents such as poisonous snakes entering into their rooms through the wall cracks. Likewise, the material that made up the roof-, asbestos, is said to be hazardous to human health with its carcinogenic effects. To boosts the work spirit of the staff members, it is necessary to ensure safety and comfortable staff quarters. 5) Eye Camps in Tibetan Settlements in India and Nepal: The CTA demographic survey report 2009 reported 1853 cases of vision disability in the Tibetan population in exile. Age related vision problems, Vitamin-A deficiency during childhood, farmers over exposure to sun & dust and sweater sellers over exposure to sun and dust sitting on the footpath are believed to be common reasons for the vision impairment in the exile Tibetan community. In order to prevent avoidable blindness and to reach out to those who cannot reach us; the Health Department, with the kind help of donors, has been striving hard to organize free eye care services in all the Tibetan settlements in India and Nepal. The activities of the Eye Camp are as follows: • Free screening & consultation by ophthalmologist. • Detection of refractory errors in the eye. • Cataract Surgery and other surgeries such as Pterygium, Dekrocyctitis, glucoma etc. • Free medicines and Ocular Lenses to the patient. • Free food, medicines, accommodation and transportation for the patients.

6) Cervical Cancer Awareness, Screening and Vaccination Project: Cervical Cancer is the second most common cancer in women with around 500,000 new cases and 25,000 deaths each year out of which around 80% of cases occur in low income countries. (WHO statistics) A survey conducted on Tibetan womenâ&#x20AC;&#x2122;s status by Social and Resource Development (SARD) desk of Central Tibetan Administration (CTA) in 2012 reported that Urinary tract infection, Cervical and breast cancer are among the common diseases (other than Hypertension and gastritis) affecting Tibetan women, with lack of accessibility to health services, lack of knowledge, and poverty as among the causes cited for these rising problems affecting their health. The good news is that, it is preventable and also, the easiest female cancer, preventable through screening. Till date, we have been able to carry out cervical screening and HPV vaccination program in Miao and Hunsur Tibetan settlement successfully and we have plans to cover other Tibetan settlements under similar programs, especially in larger settlements like Ladakh, Mundgod, Dekyiling etc where large number of Tibetan women continue to resides and many young women from these region who are vulnerable to the HPV infections can thus protect themselves from the disease by getting HPV vaccinations which is unfortunately too expensive for many of them to afford. This program can not only reduce mortality and morbidity related to cervical cancer, but can also improve overall health status of women who plays an equal and important role in changing a society. 7) Urgent need of Ambulance at Tuting Health Centers: The public transport facilities are extremely poor in many Tibetan settlements in India and Nepal. The patients often face obstacles to access timely medical treatment from the distant hospitals. However, the health department is striving hard to facilitate ambulance services that provide medical stand-by 24 hours a day in all the Tibetan settlements especially in remote locations. The main objective of this project is to ensure that patients get a proper medical attention in the occurrence of a medical emergency at Tuting settlement in northeast India. 8) Renovation of DTR Hospital Mundgod, & Clinics at Ladakh Jangthang & Tuting: The present hospital and clinics were built four decades ago and in a dilapidated state. During monsoon season, the water leakage from the roof top results in moisture and dampness at top floor, causing an unhygienic environment. One can witness the buildings having numerous cracks causing threat to the patients and staff members. Most of the doors and windows are in bad condition, and in urgent need of replacement. The lack of proper facilities leads to unhygienic condition. Therefore, it is very urgent to renovate the hospital buildings and clinics to create a patient-friendly environment; where patients and employees enjoy comfort and safety. Our main objective is to facilitate family-centered care to patients, and to emphasize on human resource development for better employee efficiency.

Volunteer Information Corner Ways to Give, Volunteer Opportunities

The department runs 7 hospitals and 4 primary health centers and 38 clinics spread across India and Nepal and 1 Ngoenga School, the first ever CTA run school for Tibetan children with special needs from India, Nepal, Bhutan and Tibet. More information: (www.ngoengaschool.org). The hospitals offer opportunities for everyone to share their time, talents and interests to support our mission in the community. Doctors, nurses and other medical volunteers are most welcome to serve our hospital and health centers to provide medical care, health education and humanitarian assistance to Tibetan refugees in need. We will do our best to help you in whatever way we can during your stay. If you are interested in volunteering in one of the CTA DOH’s hospital, you can send e-mail to: health@tibet.net and we will send you additional information. Information for the Medical Students and Interns

The hospitals will give you information that may be of interest to you as a medical student. The more you know and understand about our hospitals before you decide to come, the better it will be for all. As a medical student you are allowed to observe patients only under supervision of doctors. You are expected to be present during normal working hours each day. Board and lodging are to be arranged by you. You are required to send your CV and a reference letter from your present University. You are also required to send a monthly fee of US $50 by cheque or via Western Union in the name of any CTA DOH’s hospital. The cheque, or wire, should be in Indian Rupees as our bank here does not accept foreign currency cheques in small amounts. Cancellation of your visit should be notified to the hospital’s elective co-ordinator at least two months in advance. However, the monthly fee is non-refundable. NB: The above information gives priority to registered medical students already on courses. Pre-registration medical students will only be allowed if space permits. Tibetan pre-medical or medical students living in India, Nepal and Bhutan will be offered placements without making an advance booking, but the student will be subject to completion of hospital formalities by sending us his/her CV and reference before their arrival. They are exempted to pay elective fee. Failing to meet these requirements may hamper their placement with us. Do you want more information?

If you are genuinely interested in working at CTA DOH hospitals as a medical student, you can send an e-mail: health@tibet.net and we will send you additional information.

Tibetan Voluntary Health Association, CTA, Dharamsala (H.P) Consolidated Balance Sheet as at 31 March 2013 Liabilities General Fund Other Fund Earmarked Fund Current Liabilities Total Rupees

SCH I II III IV

Amount 23,539,923.64 922,799.54 7,220,266.28 38,059,314.25 69,742,303.71

Assets Fixed Assets Current Assets Cash and Bank Total Rupees

SCH V VI VII

Amount 922,799.54 3,961,103.76 64,858,400.41 69,742,303.71

Schedule to and Forming Part of Consolidated Balance Sheet as at 31 March 2013 Particular General Fund Foreign Contribution Account Local Contribution Account Other Fund Foreign Contribution Account Local Contribution Account Earmark Fund Foreign Contribution Account Local Contribution Account Current Liabilities Foreign Contribution Account Local Contribution Account Fixed Assets Foreign Contribution Account Local Contribution Account Current Assets Foreign Contribution Account Local Contribution Account Cash and Bank Foreign Contribution Account Local Contribution Account

SCH

Amount

Total

10,052,772.01 13,487,151.63

23,539,923.64

698,213.29 224,586.25

922,799.54

III

252,070.58 7,472,336.86

7,220,266.28

7,286,038.72 30,773,275.53

38,059,314.25

698,213.29 224,586.25

922,799.54

809,800.00 3,151,303.76

3,961,103.76

VII

16,276,940.15 48,581,460.26

64,858,400.41

Consolidated Income and Expenditure Account for the Year Ended 31 March 2013 Expenditure

SCH

To Salary and Benefits

To Administrative Expenses To Clinic Expenses To Financial & Legal Expenses To Repair & Maintenance To Social Service To Vehicle Expenses To Fixed Asset Purchased To Excess of Income/Expd. Total Rupees

B C D E F G H

SCH Income Amount By Clinic Recurring 6,603,753.52 I 7,089,734.75 Received 621,855.80 By Interest Income J 10,094,949.84 13,432,234.94 By Other Income K 5,780,698.00 497.00 15,677.00 911,275.00 246,228.00 43,600.00 1,090,261.33 22,965,382.59 Total Rupees 22,965,382.59

Amount

Consolidated Income and Expenditure Account for the Year Ended 31 March 2013 Expenditure Salary and Benefits: Foreign Contribution Account Local Contribution Account

SCH

Amount

Total

2,440,678.54 4,163,074.98

6,603,753.52

354,287.80 267,568.00

621,855.80

9,306,008.94 4,126,226.00

13,432,234.94

497.00

15,677.00

Administrative Expenses: Foreign Contribution Account Local Contribution Account Clinic Expenses: Foreign Contribution Account Local Contribution Account Financial and Legal Expenses: Foreign Contribution Account Local Contribution Account Repair and Maintenance: Foreign Contribution Account Local Contribution Account

Social Service: Foreign Contribution Account Local Contribution Account Vehicle Expenses: Foreign Contribution Account Local Contribution Account Fixed Asset Purchased: Foreign Contribution Account Local Contribution Account

Income Clinic Recurring Received Dispensary Recurring Interest Income Foreign Contribution Account Local Contribution Account Other Income Foreign Contribution Account Local Contribution Account

768,081.00 143,257.00

911,275.00

65,877.00 180,351.00

246,228.00

43,600.00

SCH

Amount

Total

7,089,734.75

2,789,906.00 7,305,043.84

10,094,949.84

5,150,898.00 629,800.00

5,780,698.00

Country wise Receipt of Foreign Contribution S.No 1 2 3 4 5 6 7 8 9 10 11 12 13 14

Country Name Australia Belgium Canada France Germany India Italy Nepal Norway Poland Sweden Switzerland Taiwan United States of America Total

Amount (In Rupees) 70277 44000 192410 741153 3865943 3514147 11349172 40000 4218988 2700 325959 82080 364467 44040780 68852077

Declaration I hereby declare that the above particulars furnished by me are true and correct. I also affirm that the foreign contribution has been utilised for the purpose(s) for which the association has been registered/prior permission obtained, to the best of my knowledge. I have not concealed or suppressed any fact.

Addresses of the Hospitals Hospital Administrator Dhondenling Van Thiel Charitable Trust Hospital P.O. Tibetan Settlement â&#x20AC;&#x201C; 571457 Odeyarpalya, Kollegal Taluk Dist: Chamrajnagar, Karnataka State, India Phone: 08225-273225(O), Telefax: 08225-273225 Mobile: 8861080878, 9449202006, Email: dvthospital@tibet.net Hospital Administrator DTR Hospital P.O Tibetan Settlement Mundgod, Distt Karwar 541188 Karnatake State, India Phone: 0838-245760, 245638, Tele Fax: 0838-245738 Email:dtrhospital@tibet.net Hospital Administrator Tso-jhe Khangser Hospital Kailashpura P.O Bylakuppe 571104 Mysore Distt, Karnataka State Email:tsojhehospital@tibet.net Hospital Administrator Phende Hospital Rabgyaling Tibetan Settlement P.O Gurupura 571188, Hunsur Taluk Distt Mysore, Karnataka Email:phendehospital@tibet.net Hospital Administrator Dekyiling Tibetan Health Center P.O Kulhan 248001, S.D Road Distt Dehradun, Uttranchal Email:tphcdekyiling@tibet.net Hospital Administrator Menlha Hospital Phuntsokling Tibetan Settement Lobersingh P/o Mahendragada 761034 Distt Gajapati, Odisha Email:menlhahospital@tibet.net Hospital Administrator Primary Health Center Fendeyling Tibetan Settlement P.O Kamleshwarpur, Mainpat Distt Surguja, Chattisgarh 497127 Email:tphcmainpat@tibet.net Primary Health Centers Hospital Administrator Norgyeling Health Centre P.O.Pratapgarh-441702, Distt .Gondia Maharastra State Email:tphcnorgyeling@tibet.net

Hospital Administrator Primary Health Center Choephelling Tibetan Settlement P.O Miao 792122, Distt Changlang Arunachal Pradesh Email:phcmiao@tibet.net

Community Health Worker Tibetan Primary Health Center P.O Rewalsar 175023 Distt Mandi, H.P Email:tsomandi@tibet.net

Hospital Administrator Tibetan Primary Health Care, Bir P.O Bir-176077, Chowgan Distt Kangra, H.P Email:tphcbir@tibet.net

Community Health Worker Primary Health Center Tashiling Tibetan Center P.O Pondoh 175124 Distt Mandi, H.P Email:tsomandi@tibet.net

Hospital Administrator Tibetan Health Care Center Sonamling Tibetan Settlement P.O Choglamsar 194104 Leh-Ladakh, J/K Email:tphcladakh@tibet.net Nurse Head Samyeling Tibetan Camp New Aruna Nagar colony Majnu ka Tilla, Delhi 110054 Email:tsodelhi@tibet.net

Health Clinics Community Health Worker Dispensary C/o Tibetan Settlement Office 15th Mile Tibetan Camp P.O Manali 175131 Distt Kullu, H.P Email:palrablingso@tibet.net Community Health Worker Kullu Manali Clinic C/o Tibetan Settlement Office P.O Dalpur 275131 Distt. Kullu, H.P Email:palrablingso@tibet.net Community Health Worker Primary Health Center Tibetan Khampa Industrial Society Nangchen Division, P.O Chauntra Distt Mandi, H.P Email:tsochauntra@tibet.net Community Health Worker Primary Health Center Doegu Yugyalling Tibetan Settlement P.O Jassowala 248147, Lakhanwala Herbertpur, Distt Dehradun U.K Email:tsoherpur@tibet.net Community Health Worker Primary Health Center C/o Tibetan Welfare Office Below High Court, 31A-N.H. Way Gangtok 737101, Sikkim Email:tsogangtok@tibet.net

Community Health Worker Gampopa Clinic West Point, Dali Tenzin Norgye Road Darjeeling 734101 West Bengal Email:tsodarjeeling@tibet.net Community Nurse K.S Hospital Tenzin Gang Tibetan Settlement P.O Tenzin Gang 790002, Via Bomdila Distt West Kameng (A.P) Email:tsotendang@tibet.net Community Health Worker Primary Health Center Sakya Tibetan Society, Puruwala P.O Gorkhuwala 173025 Distt Sirmour, H.P Email:tsopuruwala@tibet.net Community Nurse Primary Health Center Dhargyeling Tibetan Settlement P.O Tindoling 792001, Tezu Distt Lohit, A.P Email:tsotezu@tibet.net Community Health Worker Primary Health Center Tibetan Colony, Badamwani Hawal Sangeen Danwaza Srinagar 190003 J/K Email:sarfarazshahkuli@yahoo.com Community Health Worker Primary Health Center Tibetan Refugee Handicraft Center Middle Bakroda P.O Dalhousie 176304 Distt. Chamba, H.P Email:tsodalhor@tibet.net Community Health Center Primary Health Center Kham Kathok Tibetan Settlement P.O Sataun â&#x20AC;&#x201C; 173029, District Sirmour, HP Email:tso_sataun2012@tibet.net

Community Health Worker Primary Health Center Kamrao Gapa Tibetan Settlement, P.O Sataun â&#x20AC;&#x201C; 173029, District Sirmour, HP Email:kamrao@tibet.net Community Health Worker Primary Health Center Doegu Yugyalling Tibetan Settlement P.O Jassowala, Khera Herbertpur, Distt Dehradun, U.K 248147 Email:tsoherpur@tibet.net Community Health Worker Primary Health Center Tibetan Cholsum Industrial Society P.O Bhuppur, Paonta Sahib Distt Sirmour, H.P 173025 Email:tsopoanta@tibet.net Community Health Worker Primary Health Center Lingtsang Tibetan Settlement P.O Menduwala, Via Prem Nagar Distt Dehradun (UK) India 248007 Email:urgenkl@yahoo.com Community Health Worker Primary Health Center Tibetan Craft Community TashiJong, P.O Taragarh Distt Kangra, H.P 176018 Email:tashijongoffice@yahoo.com Community Health Worker Tibetan Primary Health Center Clementown 248002 Distt Dehradun, U.K Email:tnmfoffice@yahoo.com Community Health Worker Health Care Center C/o Tibetan Bonpo Foundation Dolanji, P.O. Kotla Panjola - 173 223 Via Oachghat-Solan Distt. Sirmour, HP Email:bonshi2012@tibet.net Community Health Worker Health Care Center Kunphenling Tibetan Settlment P.O. Ravangla - 737 134 Distt Namchi, South Sikkim Email:kunphenling@tibet.net Community Health Worker C/O Tashiling Tibetan Settlement P.O. Sonada - 734 219 Distt Darjeeling, W.B Email:tsosonada@tibet.net

Community Health Worker Primary Health Center, Podung Basti P.O Tuting-792601 Upper Siang Distt Arunachal Pradesh Email:psschoephel@yahoo.com

Clinics in Nepal Community Health Worker Primary Health Center Gagayling Tibetan Refugee Settlement Shabru Besi, P.O Dunchen Rasuwa,Bagmati Anchal,Nepal Email:shawara3@yahoo.com Community Health Worker Primary Health Center, Manang C/O Office of Representative Gaden Khangsar, Lazimpat P.O Box no 310 Kathmandu, Nepal Email:tashilingpkr@fewanet.com.np Community Health Worker Primary Health Center Namgyaling Tibetan Refugee Settlement Chairok Goan, P.O Marpa Mustang, Nepal Community Health Worker Primary Health Center Norzinling Tibetan Refugee Settlement P.o Dhorpatan,Distt Baglung Dhaulagiri Anchal,P.O Box no 7, Via Pokhara,Nepal Email:tashilingpkr@fewanet.com.np Community Health Worker Primary Health Center Ward no 2, Jorpati Khampa Camp Kathmandu, Nepal Email:choejorkhangsar@gmail.com Community Health Worker Primary Health Center Tashiling Tibetan Settlement P.O Box no 24 Pokhara, Nepal Email:tashilingpkr@fewanet.com.np Community Health Worker Primary Health Center Jampaling Tibetan Refugee Settlement P.O Box 97 Pokhara, Nepal Email:lodriksettlements@yahoo.com

Community Health Worker Primary Health Center Delekling Tibetan Refugee Settlement P.O Box no 1, Chailsa, Salleri Sagarmath Anchal, Solu Khambu, Nepal Email:shawara3@yahoo.com Community Health Worker Primary Health Center Paljorling Tibetan Refugee Settlement P.O Box no 18 Pokhara Nepal Email:lodriksettlements@yahoo.com Community Health Center Health Care Centerâ&#x20AC;&#x2122; Samphelling Tibetan Settlement Foley Gaon, GA, VI, SA Laileep, P.O Gunsa Distt Taplezung, Nepal Community Health Worker Jawalakhel and Boudha c/o Snow Lion Foundation P.O Box no 1313 Kathmandu, Nepal Email:choejorkhangsar@gmail.com Community Health Worker Tashi Palkhiel Tibetan Refugee settlement Kaski Distt, Gandaki Anchal, P.O. Box. No. 7, Hyangja, Pokhara Nepal Email:tphc@hotmail.com Secretary Snow Lion Foundation P.o Box no 1313 Kathmandu, Nepal Email:slf@wlink.com.np

Two Autonomous Health and Medical Institution under CTA, Health Department Delek Hospital Gangchen Kyishong Dharamsala, Distt. Kangra Himachal Pradesh, 176215 Phone No: 0091-1892-22053/23381 Fax: 0091-1892-22406/24957 Email:delek@sancharnet.net Men-Tsee-Khang (Tibetan Medical & Astro. Institute of H.H. the Dalai Lama) Gangchen Kyisiong Dharamsala, Distt. Kangra H.P. 176 215 India Tel: 00-91-1892-223113/223222 Email: tmai@men-tsee-khang.org

HOW YOU CAN HELP Central Tibetan Administrationâ&#x20AC;&#x2122;s Department of Health or Tibetan Voluntary Health Association works to improve the health of Tibetan refugee in India, Nepal and Bhutan. List of Health Programs and Projects of Department of Health or Tibetan Voluntary Health Association on which you can help. 1. Health Information System 2. Water and Sanitation Program 3. Health Education Program 4. Health Resource Development Program 5. Tibetan Medicare System 6. Mother and Child Health Program 7. TB and MDR TB Prevention and Control Program 8. Integration of Tibetan Sowa Rigpa Medicine and Western Medicine Program 9. Ngoenga School for Tibetan Children with Special Needs 10. Health and Medical Training Program 11. Hepatitis B Prevention and Control Program 12. HIV/AIDS Prevention and Care Program 13. Substance Abuse Prevention and Rehabilitation Program 14. Oral Health and Hygiene Program 15. Eye health program including Cataract screening and Surgery 16. Medicare and Welfare of Tibetan Torture Survivors Program (TTSP) 17. Mental Health Program 18. Care of Tibetan People with Disability 19. Telemedicine Clinic Pilot Project 20. Cancer and Chronic Disease Prevention and Control Program 21. Essential Drugs and Ambulance Fund 22. Emergency Medical Fund for people below poverty line in India, Nepal and Bhutan 23. Adopt Tibetan Health centers project 24. School Health Program 25. Womenâ&#x20AC;&#x2122;s Health Program 26. Malaria Prevention and Control Program 27. Corpus Fund 28. General Donation Fund 29. Installation of fully equipped Dental chair and accessories at remote Tibetan health centers 30. Set up of fully equipped Eye Clinic at Tibetan health centers at Mundgod, Hunsur, Miao, and Odisha 31. Set up of X-ray room and X-ray machine at remote Tibetan health centers at Miao, Bhandara and Ladakh Please make donation by cheque/bank draft/IMO payable to Tibetan Voluntary Health Association towards any of the Projects above.

Bank Detail

A/c Holder - TVHA A/c Number - 11510100000519 UCO Bank, CTS Gangchen Kyishong Dharamsala -176215 Distt. Kangra (H.P), INDIA

SWIFT CODE - UCBAINBB212 PAN - AAATT1509K TAN - PTLT10935B IFSC - UCBA0002059 www.tibet.net/health health@tibet.net