Newsletter aug december 2013

TIBETAN HEALTH August to December 2013

About Us Tibetan Health is the official Newsletter of the Central Tibetan Administration’s Department of Health (Tibetan Voluntary Health Association).

DOH (TVHA) is responsible for overall public health promotion and medical care service of over 120,000 Tibetan refugees in India, Nepal and Bhutan.

The health department manages and finances 50 health centers in India and Nepal including Ngoenga School for Tibetan refugee children with special needs (www.ngoengaschool.org) apart from different health programs, projects, and activities.

Tibetan Health Newsletter is published two to four times a year to inform and update about our health promoting initiatives to our friends, donors and supporters. This newsletter also gives you an overview of health programs, projects, activities and needs of the department. Most importantly, it covers success stories and outstanding contributions of all our field health staffs including hospital administrators, doctors, nurses and community health workers etc. This newsletter is dedicated to them, for their selfless dedication and hardwork, which are the backbone of this successful and unique refugee healthcare system.

Tibetan Health is distributed free to all who are interested in the works of the Tibetan Department of Health.

Advisor: Dr. Tsering Wangchuk (Health Kalon) Mr. Sonam Choephel Shosur (Health Secretary) Edited by: Mr. Tsegyal Dranyi Mr. Thutop Namgyal Mrs. Trinley Palmo Ms. Tenzin Tseyang Compiled, Layout and Designed by: Ms. Tashi Yangzom You can also contact: Department of Health (Tibetan Voluntary Health Association) Central Tibetan Administration, Dharamsala, Distt Kangra (HP) INDIA 176215 Tel: 0091-1892-223408 / 223486 Fax: 0091-1892-222718 Email: health@tibet.net Website-www.tibet.net/health

H.H. The Dalai Lama blessed Medical Officers of Department of Health, CTA The Department of Health currently has four Tibetan doctors serving in department affiliated hospitals and health centers in Tibetan refugee settlements. Their selfless contribution is highly appreciated by the Department of Health, CTA and the Tibetan community in general.

It was a great honour and a pleasure for the four medical officers to receive a special audience with His Holiness the Dalai Lama at his residence in November 2013. The doctors are Dr. Lodoe Phuntsok, Dekyiling Hospital, Dr. Tsering Rinzin Choedon, Tso Jhe Khangsar Hospital Bylakuppe, Dr. Tenzin Norsang, DTR Hospital Mundgod, and Dr. Tenzin Dechen, Primary Health Center Bir. His Holiness emphasized on their dedication to serve Tibetan community in the field of medical care in the settlements and suggested to keep up their hardwork for the betterment of people who are in need.

Department urgently need Tibetan Doctors in hospitals and health centers in the settlements particularly at Odisha, Miao, Mainpat and Hunsur etc. Department urges all Tibetan MBBS graduates who have not yet served MBBS Bond, to submit their service to the department for the Tibetan community.

CONTENTS H.H Dalai Lama Blessed Medical Officers of Department of Health, CTA Administrative News Health Program Training News News from the field Health Centers Profile of New Staff Statement of Health Kalon on World AIDS Day Volunteer Information Corner List of Donor TVHA Staff Update How You Can Help Tibetan Health Department Water and Sanitation Project TMS Updates

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Visit to Italy and Germany, December:

Administrative News Health Kalon’s official Visit to Poland:

Health Kalon Dr. Tsering Wangchuk visited Poland on 20 October 2013. He gave a talk on the three key guiding principles of the present Kashag and introduction of the Central Tibetan Administration (CTA) to the Poland Tibetan community.

Kalon escorted H.H the Dalai Lama on his visit to the International Summit for World Peace and the 13th Summit of Noble Laureate Assembly. He gave a talk to the college students of Warsaw regarding Tibet issue and the CTA.

He met with the Helsinki Foundation of Human Rights based in Warsaw Beata Bublewicz and Adam Kozil of Tibet Desk, Poland where he spoke about Tibet issue and requested for assistance on projects of health department. He visited Dr. Tenzin Jangchup’s clinic, the Tibetan Herbal Healing Clinic co. Ltd. The visit concluded with an interview at the Warsaw radio station, Poland.

Before leaving for Poland, he stopped at Samyeling Tibetan settlement, Delhi on 19 October and had a special meeting with the local committee members, settlement officers, Men-TseeKhang doctors, schoolteachers and health staff on the dengue epidemic and health situation in the area. Since March 2013, 160 settlers have been infected and one person has died after getting infected with dengue. Health Kalon spoke on health related precautions and the medical facilities provided by the Department. He conducted a field inspection of the staff rented house construction at Samyeling settlement and also visited Tibetan Youth Hostel.

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Health Kalon attended a seminar in south Ty­ rol (an autonomous province in northern Italy) along with other Kalons on 2 December 2013 which was followed by an official meeting with head of South Tyrol Mr. Luis Durnwalder, Head of Trento Mr. Ugo Rossi, President of Provin­ cial Council Dr. Martha Stocker and Mr. Bruno Doringatton. He also met with the members of Italy Tibet Association, Kiwanis Club, Tibetan community in Trento and Bulzano, Italy.

In Rome, Kalon met with Tibetan community members and Mr. Franco, President of Yeshi Norbu Associa­tion Italy

He visited St. Rafaella Hospital in Milan and met with the executive heads and Dr. Rafa­ ella Chionna. He also met President and Project Manager of AISPO to talk about future projects of the department and expressed his gratitude towards the support for Tibetan TB control program of the department and Delek hospital.

He addressed the three key guiding prin­ ciples of the present Kashag to the Tibetan com­ munity in Rome, Munich, Hamburg and Frank­ furt. He celebrated Nobel Peace Prize Day with the Tibetan community in Munich, where close to 60 people had gathered for the function.

At Munich, he met Mrs. Wager, Former President of German Aid to Tibetans and conveyed his gratitude for her long support to the Tibetan people.

At Hamburg, he met President, Mrs. Heidi Meyer, and other Board members of German Aid to Tibetans and presented some of the most prioritized projects of the depart­ment of health. He concluded his visit after meeting with Tibetan community members and visit to Tibet House in Frankfurt.

in Nelamangala from 9-14 December, which were attended by a total of about 400 students.

The main objective of these talks are to provide knowledge about HIV AIDS to these young people so that they can be informed and take responsible decisions to reduce the spread of HIV AIDS in our community.

From 16-20 December, an HIV AIDS Counseling training was organized at Christian Medical College (CMC) in Vellore, Tamil Nadu.

The training was aimed at providing HIV AIDS Health Department conducted a month long program in December, 2014 to pre- counseling to people living with HIV (PLHIV) as per the national policy of NACO (National AIDS vent AIDS in the Tibetan community Control organisation) and to equip the health staff The department has dedicated the entire month with necessary skills so that they can provide efof December for various AIDS awareness cam- fective counseling to people living with HIV in paigns in settlements, colleges, schools, and has our community. The topics covered during the conducted a counseling training for health depart- training include pre and post test counseling, ment staff at Christian Medical College, Vellore. developing micro skills for counseling, dealing These programs were funded by NCA (Norwe- with psychological problems of PLHIV, counseling for prevention of mother to child transmisgian Church Aid).

To mark the World AIDS Day on 1 De- sion (PMTCT), behavioral change counseling cember, the department organized a series of and counseling injection drug users. About 10 awareness talks, quizzes, essays, drawing and staff members of department of health and one poster contests in about 25 Tibetan schools, in- staff from Kunphen Center for Substance Abuse cluding Sherab Gatsel Lobling School and Pe- Prevention have participated in the training. toen School in Dharamsala. Community-wide HIV awareness programs organized in various The Tibetan MBBS Student Signed Tibetan settlements to mark the world AIDS day Revised Bond include a theater play by Tso-Jhe Khangsar hospital staff members for residents of Bylakyppe Tibetan settlements to emphasize the vital messages of HIV prevention and stigma reduction.

The focus of this year’s HIV AIDS awareness programme was Tibetan college students since youth are at a greater risk for contracting HIV AIDS. Awareness talks on HIV AIDS were scheduled at the Tibetan Youth Hostel, the Dalai Lama Institute for Higher Studies in Bangalore and the Institute for Small Trade Learning Tibetan MBBS student Mr. Tenzin Wangchuk from Dhondenling Tibetan settlement, Kollegal, studying at Sardar Patel Medical College, Bikaner, Rajasthan signed the revised MBBS bond on 3 September 2013. The bond was signed between the Tibetan Voluntary Health Association (CTADOH); Tibetan Chil­dren’s Educational and Welfare Fund (CTA-DOE), and the selected student, who in exchange for the reserved MBBS seat Tibetan Health-TVHA

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granted through CTA agrees to provide 3 years service in Tibetan settlements under the di­rection of the department of health after comple­tion of their MBBS degree.

So far, all Tibetan medical students and interns who are studying at Sardar Patel Medical College- Bikaner, IGMC-Shimla, and Dr. RPGMC Kangra-Tanda, had signed MBBS bond of Central Tibetan Administration and promised to come back to provide 3 years service at hospitals and health centers in Tibetan settlements under the di­rection of the department of health after in TPHC, Bir. There is no x-ray facility in and comple­tion of their MBBS degree. around the settlement and patients have to go to SOIR-IM and USAIDs Official visited the nearest diagnostic center, which is over 15 kms away. In medical emergency, patients face Department lots of inconvenience and often fail to get timely medical care. Furthermore, with the fact that tuberculosis is a major health problem in the Tibetan community and tuberculosis program being integrated with the primary health care system, x-ray becomes inevitably crucial for successful implementation of the tuberculosis program.

The new machine will benefit more than 25,000 people of Tibetan settlement, 8 monasteries, 4 schools, 2 Elderly People Homes besides the local Indian population. The new X-ray machine Health Kalon and the department heads with was financed by PRM, US. the former IM General Secretary, Mr. Bo Paulsson and current IM General Secretary, Mrs. Ann Health Programs Siensen during their visit to Department in NoNew Programs Launched by DoH to vember 2013.

Improve the Health Status of Tibetan Women

1.Monthly Gynaecologist Visit Program in Tibetan Settlements: This program is suc-

cessfully being carried out in 10 Tibetan settlements of Bir, Dekyiling, Ladakh, Miao, Hunsur, Kollegal, Mainpat, Odisha, Bhandara and Dharamsala where women in the area are given free health check up by a visiting Gynecologist Health Kalon with Dr. Nancy, Health Director of USAID, India and her colleagues. Their visit aimed to review the progress of USAID’s support for Tibetan Torture Survivor Program (TTSP).

A New X-ray machine installed in Tibetan Primary Health Center, Bir

A new 300 MA X-ray machine has been installed

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every month. Through this program, women are screened for common Gynecological and Obstetrical diseases and when diagnosed, they are referred to specialized health centers and hospitals for early treatment and management. Women have received this program with much appreciation. The program is funded by Norwegian Church Aid (NCA).

2.Women Health Education Program Launched in Nunneries: This program,

funded by Population Refugee and Migration Bureau of US State Department, aims to improve the overall health of nuns through primary prevention by empowering them with education.

This program would cover ten nunneries in Himachal Pradesh and Uttaranchal in North India.

In November 2013, around 300 nuns in Dolmaling nunnery were educated on breast cancer, hepatitis B, diet and the role of hygiene in improving health, from the perspective of both allopathic and Tibetan traditional medicine. In December, Karma Drupgyu nunnery was covered under the program where other than these health topics, the nuns also learned about menstrual cycle and how to use sanitary pad. Toothbrushes for younger nuns and sanitary pads for the adult nuns were distributed.

3. Cervical Cancer Screening and Vaccination Program

Cervical cancer screening program was carried out in Miao Tibetan settlement where a total 287 women underwent Pap Smear test in October 2013. A total of 29 women received HPV vaccination with the first dose in October and the second dose in November. The final dose is scheduled to be given in April 2014.

Mobile Health Education Program in Northeastern Tibetan Settlements

The department organized a mobile health education program in Tibetan settlements, schools and monasteries located in the states of Sikkim and West Bengal from 2-9 December 2013.

Trinley Palmo, Head of Public Health division and Ngawang Tenzin, Mother and Child health coordinator visited five Tibetan settlements respectively at Ravangla, Gangtok, Kalimpong, Darjeeling and Sonada to create awareness about health conditions like hypertension, tuberculosis, hepatitis B, HIV AIDS and cancer.

Additionally, health talks were provided in three major Tibetan schools namely CST Kalimpong, CST Darjeeling and CST Sonada along with four main monasteries in these region. The health talk in schools and monasteries focused on personal hygiene and oral health. Many informative educational materials were distributed to the local participants.

The program, funded by SOIR IM, aimed to generate greater awareness and outreach regarding preventive health among the Tibetan population based in Northeast India. About 1684 people benefited from this mobile health education series in northeast regions of India. Previously in September, Ngawang Tenzin, mother and child health coordinator and Nurse Yangkyi, Dekyiling PHC completed the first series of mobile health education program in Shillong, Miao

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and Tezu Tibetan settlements which covered surance Academy (MIA). about 1000 people.

The workshop focused on upcoming budget structure of TMS with MIA team and presenDental Screening Program tations by each 11 co-partners of MIA regarding their social health schemes including TMS. A dental screening and oral health education pro- The workshop concluded with a question gram was carried out in 12 Tibetan schools locat- and answer session among 40 participants of the ed in Northern India namely; Dekyiling, Clem- co-partners of MIA. The participants came to reentown, Herbertpur, Paonta, Dholanji, Mussoorie alize that TMS is a unique social scheme that has (CST/THF), Shimla, Rajpur and Puruwala in the provided huge amount of benefit to the members month of November by Dr. Joanne, an Australian inspite of its financial down swing.

Dentist and Mr. Rinchen Dorjee, Bir dental therapist. Dr. Joanne is a member of Australian den- Health Financing Workshop (TMS) tal team and has been working with the Tibetan community since 2006.

Two-day health financing workshop was orga About 2912 students were screened and nized at Hotel Tibet, Dharamsala on 31 October educated regarding oral health. The main aim 2013. The workshop covered general introducof the screening was to survey dental health of tion of health insurance, overall financial proceTibetan students and to educate them regarding dure of TMS and its claim experiences. dental health. We are very grateful for the dedica- Deputy Director of Project Implementation of Dr. Joanne in improving our Tibetan oral tion, Mr. Denny John and Medical Advisor, Dr. health.

B. Dinesh Baliga of MIA gave presentations.

In addition, Mr. Norbu Lodoe, Dental

The participants include the field medical officers of Tibetan Settlements and TMS dealing staff from Department of health. Overall, it was an informative workshop and the participants could understand certain level of practical proposition that they have been experiencing. The workshop was a good exposure and helpful for making decisions in the future. The workshop was funded by Training News Maltester International and organized by Micro Insurance Academy (MIA) and the Department Tibetan Medicare System Experience of health.

Therapist from Odisha carried out a dental screening program for the general public and children in Central India namely; Bhandara and Mainpat Tibetan settlements from 22-30 November 2013.

288 people were screened and filling and extraction were done for more than 100 people.

Sharing Workshop

Review Meeting cum Workshop on TMS

On 30 July 2013, Tibetan Medicare System Program Manager, Mr. Tsegyal Dranyi and TMS Communication Officer, Mr. Nyima Gyaltsen The Department conducted a three-day workshop attended one and half day experience-sharing on Tibetan Medicare System (TMS) at the Library workshop at New Delhi organized by Micro In- of Tibetan Works and Archives. Health Kalon Dr.

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Tsering Wangchuk inaugurated the workshop and talked about the Tibetan Medicare system as a sustainable financing source designed to serve the health care needs of the entire Tibetan exile community.

He discussed about the prevention of diseases being more important than cure and talked about creating more awareness about health and hygiene to stop the root causes of most diseases.

He said that a greater emphasis should be paid on Tibetan settlements located in remote areas where there is a lack of access to basic health amenities.

Health Secretary Sonam Choephel Shosur, in his speech, talked about the over all health issues faced by the Tibetan community in exile.

Mr. Tsegyal Dranyi, Additional Secretary, talked about the aims and objectives of introducing the Tibetan Medicare System.

The topics for discussion during the workshop included ‘How to enrol for Tibetan Medicare System’, ‘Claim Procedures and Documentation’, ‘Management of Information System (MIS)’ and ‘Strategic Communication’. The three-day workshop was concluded on 28 November 2013. It was financed by Maltester International. 29 participants include Tibetan health workers, representatives of Tibetan settlement offices and staff from the department of health.

Health Workshop Health Problems

to

Tackle

Mental

The Department conducted the second mental health workshop at Vidya Sagar Institute of Mental Health and Neurosciences, New Delhi from 19-23 August 2013. This training was particularly organized for the community health workers of Nepal. 18 health staff members attended the training including 9 from Nepal Tibetan settlements of Chailsa, Shaybru, Paljorling, Dorpatan, Boudha and Tashi Palkhiel.

The training focused on child and adolescent mental health, posttraumatic stress disorders, basic counseling skills, trauma counseling, psychotherapy, addiction and substance abuse prevention. Clinical Psychologists, Dr. Pallav Bonerjee, Deepali Rao, Chandrashekhar, Rachna Giri and Art Therapist, Ms. Sonia Bhandari from VIMHANS were the resource persons.

It was aimed to upgrade the skills of various health staff in the prevention and clinical management of mental health problems in their respective health centers. The training was funded by USAID.

Training for Accountants of the Hospitals

The Department organized a nine-day workshop in Dharamsala on “Accounting, tallying, income tax and budgeting” from 20-28 August 2013.

About 11 accountants from hospitals and health centers including Ngoenga School for Tibetan children with special needs participated.

Health Kalon Dr. Tsering Wangchuk inaugurated the workshop and spoke to the participants regarding the importance of upgrading their accounting skills in their daily work. Additional Secretary, Mr. Tsegyal Dranyi stressed on the need to effectively manage and handle accountTibetan Health-TVHA

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and Additional Secretary, Tsegyal Dranyi attended the inaugural session of the workshop.

Workshop on School Health and Substance Abuse

ing tasks in their respective hospitals as per the annual budgetary rules and regulations.

Mr. Rinzin Choephel, Additional Secretary of the Office of the Auditor General, CTA was the main resource person along with Mr. Tenzin Legdup and Mr. Namgyal Samdup, officials from Finance Department. The workshop was aimed to build the capacity of the accountants. It was jointly funded by Africa Tremila and SOIR, IM.

The Department organized a three-day ‘School Health Workshop cum Substance Abuse Review Meeting’ at Dharamsala from 1-3 October 2013.

27 participants including school nurses, counselors and two school rectors from Tibetan schools participated. The three-day program covered topics like ‘Holistic Development among Children’, ‘Mental Health’, ‘Tibetan Healthcare (Sowa Rigpa)’, ‘Sexual Health’, ‘Alcohol and Drug Abuse’ and ‘Prevention of HIV/AIDS, TB and other Communicable Diseases’.

The aim of this workshop was to promote health of Tibetan children through better awareness about school health related issues. The stu-

Workshop on Health Information System (HIS-3)

Department organized a two-day workshop on Health Information System (HIS-3) at Hotel Tibet in Mcleod Ganj from 7-8 October 2013. 23 HIS dealing staff including Healthcare Workers and Nurses from different Tibetan settlements participated. Resource persons were Dr. Nigel Griffiths from Australia and Dr. Lobsang Tsering from Dekyiling Hospital.

Health Kalon Dr. Tsering Wangchuk talked about the health information system being a very important aspect of conducting health surveillance in the Tibetan community and that a successful health information system can improve the overall health of our community. The health information system identifies areas where health improvement is needed and can help in preventing diseases through a well-planned strategy. Health Secretary, Sonam Choephel Shosur

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dents would not be able to focus on their education without a proper physical and mental health.

Well-informed personnel can counsel children effectively and can help improve the general health of our children. The establishment of health clubs and committees in schools were recommended and a conducive environment for open discussions on sexual health education were encouraged.

Health Kalon emphasized the urgent need to prevent the use of abusive substances and tobacco by children in schools. Children need to be advised about the ill effects of these substances.

He talked about the importance of nutritious diet for children and raised issues about bullying in schools which can have an adverse effect on a child’s mental health. Therefore, he urged the school authorities to take extra attention towards such practices in schools.

Health Kalon launched ‘Rewa’, an adolescent health booklet to promote healthy life-

About 12 participants from each area participated. Expert Consultants from Feroz Engineering Works and Drillers were the resource personnels who provided the training on hand pump. The participants received wonderful experience and also repaired one damaged hand pump by pulling out all its rod and pumps during this training.

Delivery Training Program

style among Tibetan youths and to emphasize the importance of positive outlook towards life.

Speakers included Dr. Tseten Sadhutsang, personal physician of His Holiness the Dalai Lama, Geshe Lhakdor, director of Tibetan Works and Archives, and Dr. Tsewang Tamdin, traditional Tibetan medicine personal physician of H.H. The program also included a talk by Tenzin Choegyal, a former drug addict who shared his personal experience of dealing with drug addiction.

Under this program, the first batch of 3 nurses from North eastern Tibetan health center were Hand Pump Repair and Maintenance sent to Odisha Christian hospital for a one month Training delivery training program from 5 December 2013 - 5 January 2014. This program was funded by PRM and has been one of the pivotal capacity building training which has enabled our nurses to handle deliveries succesfully in their remote Tibetan health centers.

Three months Clinical Training in Taiwan

The training was conducted at Ladakh Sonamling Tibetan Settlement on 17 October 2012.

The Department funded in carrying out the two days training and purchased two hand pump tool kit, each for Ladakh Sonamling and Jangthang.

Nurse Namkhang Lhamo and Nurse Karma Dolma attended a three-month Taiwan International Healthcare Training from 1 October - 31 December 2013. In the first week of October, they got posted in the Emergency room and got introductory lessons which included triage process, pediatrics, medical and surgical rescue, observation & negative pressure isolation room.

They mentioned that they witnessed many injury cases like head injury and fracture of extremities including hemothorax with rib fracture for which ICD procedure was done. They observed and learned the usage of emergency equipments and instruments like laryngoscope, ET tube, mouth gag, monitor, EEG machine, infusion pump, defibrillator and SPO2 machines & oxygen line and emergency injections. They received training on CPR and did individual demTibetan Health-TVHA

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ment, the dieticians explained to them about various diets that must be given for different diseases to the patients and how to teach clients about healthy eating and maintenance of optimum body weight through proper diet.

In the home care ward which was introduced in Taiwan in 1993 where patients in need of long term care with diseases like stroke, CVA and dementia are admitted, they observed the nurses doing NG change every 2 weekly & also witnessed catheter care and provision of vaccines onstrations on dummy.

In medical ward, they observed proce- against influenza.

Both the nurses expressed their experidures like ultrasound guided abdominal tapping, aseptic dressing of surgical wounds in the surgi- ence as a very educative one where they gained cal ward and removal ICD tubes and also wit- lots of knowledge and learned many things that nessed amputation of ankle done for diabetic foot they plan to incorporate in their respective health patient. They also learned the responsibilities of centers in India. nurses in the hospital wards, which include recording of patients charts recording vital signs, News from the field Health Centers administering injections and giving oral medicaTso Jhe Khangsar, Bylakuppe: On 28 tion.

During a week posting at intensive care unit (ICU), they learned about handling of bedside ventilators, monitors, O2 machine, dialysis machines and other nursing care like catheter care, suctioning, rhyles tube feeding and preventive care measures to prevent pressure sore. They also learned about the mechanism of ventilator machines and infusion pump.

In the gynecological and pediatric ward, they learned about phototherapy, neonatal care including checking baby’s weight, giving baby bath and umbilical cord care. They observed amniocentesis procedure on a pregnant mother who is 17 weeks in order to rule out any congenital September 2013, World Rabies Day event was abnormalities like Down syndrome. Due to lack organized at Cauvery Valley Project (CVP) and of deliveries during their posting, they did not get Kailashpura Tibetan School, Bylakuppe. Nurse Sangay Choezom explained children about rato conduct any deliveries.

In the education department of the hospi- bies, how it is transmitted and what to do when tal, they gained knowledge on how to educate di- a person is exposed to the virus. Around 60 chilabetic patients about self insulin administration, dren participated in the event.

On 29 September on World Heart Day, checking blood glucose. In the nutrition depart- Nurse Tashi Palkyi gave a talk on heart diseases and cervical cancer to the community. Basic information about women’s health were also provided. 70 people attended the talk.

The hospital also organized a Global Hand Washing Day at three different location carried by staff nurses and community health workers of Tso Jhe Hospital. They educated younger children through demonstration acts and taught them how to wash their hands properly. The event end-

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The talk was very informative and helpful as per the feedback received from participants.

Phende Hospital, Hunsur: Phende hospital

observed World Heart Day on 29 September 2013 with the aim to raise awareness of heart disease symptoms, risk factors and prevention. Heart disease educational brochures were distributed in monasteries and settlement camps to promote further knowledge.

Nurse Tashi Youdon and community health worker Tashi Choedon gave important ed with distribution of soaps and hand sanitizers guidelines on tuberculosis and its prevention in to the participants and schools.

September 2013 and about 85 students participat A weeklong Diabetes awareness and free ed in the event. World Hand Washing Day was sugar screening program was conducted on 12 observed on 15 October to create awareness in the November 2013 with “Diabetes Education and monasteries and baby room caretakers to teach Prevention” as the main theme. Awareness talks the importance of hand washing and prevention and screening program were done in 7 different locations in the Bylakuppe settlement and 902 people got screened out of which 30 new cases were found. The event successfully raised awareness of diabetes and its prevention.

DTR Hospital Mundgod: On 12 October,

DTR hospital arranged a talk on “Prevention of Dengue in Tibetan Community” as the main theme. Nurse Sonam and community health worker, Yangchen Dolkar spoke about signs and symptoms and preventive measures to control dengue disease.

Global Handwashing Day was observed at two different locations in Mundgod on 15 October 2013. Community health worker, Tsewang Sangmo and Dekyi Tsamchoe carried out the talk to motivate children to embrace and share proper hand washing practices and to prevent spread of health infection, particularly by washing their hands with soap after going to the toilet and before eating food. Posters and liquid hand washes are distributed. 165 schoolchildren participated.

of many diseases by simply washing hand with soap. Leaflets were distributed for further knowledge and understanding. 50 participants attended the talk.

The hospital also organized World Diabetes Day on 14 November. Six medical professionals including doctors, nurses and lab technicians of Mysore Apollo Hospital did free Glucose screening and other needful tests to 77 settlers.

112 settlers attended the day.

Tibetan Primary Health Center, Bir: On

7 August 2013, TPHC Bir organized Oral Health and Hygiene Talk at Tibetan Sambhota School.

Dental Therapist Mr. Rinchen Dorjee carried out the program and demonstrated how to practice proper tooth care with the help of colourful charts for better understanding.

Additionally, a talk was organized on Eye Diseases and Precaution on 23 August 2013. Executive Secretary, Mr. Sonam Gonpo Hara conducted the talk on basic eye diseases and stressed Tibetan Health-TVHA

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prespective of both Tibetan tradition medicine and allopathic medicine to prevent heart disease.

Staff nurse gave education on related disease like blood pressure and diabetes. 90 people attended the talk.

World Hand Washing Day was celebrated on 15 October to create awareness among schoolchildren regarding importance of hand washing with soap in order to prevent many diseases. Staff nurse Tsering Yangkyi taught 71 schoolchildren about the importance of handwashing. Pens and on several diseases which affect the eye, either soaps were distributed to the participants. directly or as part of a system-wide problem. On 25 August, free eye check up was arranged by Primary Health Center Mainpat: The inviting eye specialist from the nearest hospital. World Heart Day program was held in Mainpat Tibetan settlement on 29 September 2013. ExAround 130 settlers attended the event.

On World Heart Day, TPHC Bir Dr. Ten- ecutive secretary and nurses raised public awarezin Dechen highlighted what actions can be tak- ness of heart disease including their prevention. en through a person’s life to reduce their risk of They conveyed the message that heart diseases heart disease. The heart disease and stroke could are one of the most common cause of death globbe avoided if the main risk factors like tobacco, ally and the primary causes of heart diseases are unhealthy diet and physical inactivities are con- poor diet, lack of exercise and smoking. 121 settrolled. 29 community people attended the valu- tlers attended the talk and were distributed soaps and milk. able talk.

On 15 October, Mainpat Phende hospital

On 15 October, TPHC Bir conducted Global Handwashing Day and Nurse Nyima Pal- staff conducted a Global Hand Washing Day with zom gave a talk to highlight benefits of Hand- the participation by some 116 schoolchildren washing with soap through demonstration to 69 and monks. They were encouraged to wash their participants including schoolchildren and set- hands with soap after going to the toilet and before handling or eating food. The day ended with tlers. the distribution of pens to every participant.

Dekyiling Primary health Center: A series of health talks were conducted at Dekyiling Norgyeling Health Center, Bhandara: settlement on 9-11 September and around 250 The health center organized a World Hand Washsettlers participated. Nurse Dekyi Kari gave gen- ing Day on 15 October with a talk by staff nurse, eral information on Urinary Tract Infection (UTI) Tenzin Dickyi. 45 schoolchildren and teachers in order to promote better understanding and also attended the talk. Soap and handkerchiefs were provided individual counseling for specific prob- distributed to all participants.

World Heart Day event was also conductlems.

On 29 September, Dr. Sonam Lhamo of ed at Bhandara settlement on 24 October to proMen-Tse-Khang and Tsering Yangkyi, staff nurse, mote public awareness about heart disease and provided health talk on World Heart Day from the their prevention. Staff nurse Tenzin Dekyi B was the resource person and 70 community people attended the talk.

Primary Health Center, Ladakh: World

Heart Day was observed in Ladakh on 29 September in order to increase public awareness of cardiovascular diseases, including their prevention. Community health worker, Yungdrung Palkyi and Kalsang Yangdol gave talk on heart diseases which was attended by 68 people. Pam-

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phlets titled “Know the facts about Heart Disease” were distributed among the participants for better knowledge.

A three-day health program was conducted in Ladakh on 10 October 2013 to provide health education on mental health, promote eye sight and global hand washing. Staff nurse Thinley Palmo, Tashi Tsomo, Kalsang Yangdol and Sidol Dolma spoke about these topics including their causes, symptoms and prevention at different locations in Ladakh settlement. 425 settlers and schoolchildren attended the event.

causes and prevention. About 20 settlers attended the event.

Herbertpur Settlement: On 28 September,

Tibetan Primary Health Center, Miao:

World Rabies Day was observed at Herbertpur Tibetan settlement to focus on Rabies prevention and to raise awareness about both human and animal rabies. About 45 settlers took part in the awareness campaign and over 38 dogs in the settlement were vaccinated against the disease.

In addition, a health talk was organized

by Herbertpur settlement office on 29 September 2013 to create awareness among settlers on heart diseases. Community health worker Pema

The primary health center arranged a two-day health talk on 14 November to mark World Diabetes Day. The day aimed to increase awareness of the effects of diabetes and its complications in the general population and free diabetes screening was done. Executive secretary Tsering, staff nurse Lhakpa Dolma and Pema Lhazom were the resource persons. An open marathon was organized in collaboration with Tibetan service cooperative society and Regional Tibetan Women’s association. Total of 102 settlers participated in the event.

Tsering gave talk on heart diseases and specifically talked about high blood pressure and diabetes, which are the major problems of the Tibetan community. He also advised on healthy diet and exercise habit to stay healthy and strong.

Global Hand Washing Day was also celebrated at Herbertput settlement to educate specially young children regarding the importance of washing hand with soap to control many diseases.

Community health worker Pema Tsering demonstrated how to wash hands properly. 60 students and community people attended the event.

Tibetan Primary Health Care Center Chauntra: On 30 September 2013, World Heart

Day was conducted in Chauntra settlement. Dr. Tenzin Dechen gave a talk which mainly focused on heart diseases including their cause, symptoms and prevention. Dr. Dechen answered queries of the participants, which included 34 settlers.

Kullu Health Clinic: In collaboration with

Kullu Palrabling settlement, the World Heart Day program was organized on 29 September 2013.

Community health worker, Tenzin Passang raised awareness to promote basic information about

Tibetan Women’s Centre, Rajpur: World

Heart Day was observed at Rajpur Tibetan Women’s Centre on 29 September 2013. Dr. Kunsang Tibetan Health-TVHA

13

Dolma, Men-Tsee-Khang gave a talk on heart Profile of New Staff diseases according to the traditional Tibetan medicine. In addition, Community health worker Tashi Wangchuk highlighted the prevention and control of heart diseases through allopathic way.

SOIR-IM funded a whole body check-up including heart check-up of the community. The talk was very informative and helpful as per the feedback received from participants.

On 15 October, global Hang Washing Day was organized during which posters were distributed and around 250 students attended the talk.

Tibetan Women’s center also organized an awareness event on 14 November to mark World Diabetes Day to promote awareness on its cause, signs, symptoms and prevention.

Poanta Health Clinic: World Hand Washing

Day was observed at Sambhota Tibetan School Poanta on 15 October 2013 in order to motivate and mobilize people to wash their hands with soap. The campaign was dedicated to raising awareness of hand washing with soap as a key approach to disease prevention. Community health worker, Rinzin Choesang and school nurse Tenzin Namdol conducted the event and gave demonstrations on how to wash your hand properly.

The day successfully ended with the distribution of soaps and towels to every participants, foster parents and junior teachers.

Rewalsar and Pondoh Tashiling Health center: World Heart Day was conducted in both

the Tibetan settlement in collaboration with settlement office on 29 September 2013. Resource persons were Dr. Balbir Singh and community health worker, Tsekyi Lhamo and Pondoh office secretary gave a talk to sensitize the local population about heart disease. They answered queries of participants on heart disease and distributed pamphlets. 35 setters from Rewalsar and 15 people from Pondoh Tashiling attended the talk.

14

Tibetan Health-TVHA

Appointment of B.Sc Nurse at Tibetan Primary Health Center, Miao

B.Sc nurse Dolkar Palmo was appointed as a staff nurse at Primary Health Center, Miao on 2 December 2013. She was born and brought up in the Tibetan Refugee camp at Miao Choephelling Tibetan settlement. After completion of middle school from Darjeeling, she went to Mussoorie where she completed her higher secondary school.

Due to her keen interest in health care service, she opted to become a nurse and studied B.Sc Nursing from Venkateshwara College of Nursing, Kakinda in Andhra Pradesh. During her four years of education period, she worked in various hospitals to practice under different doctors and senior nurses who helped immensely in development of her practical skills to serve patients.

She said, “I feel fortunate enough to encounter medical staff vacancy in my settlement’s health center which is under the aegis of the Department of Health, CTA. Prior to this, I have been working as a volunteer nurse in this primary health center for two months and have made multiple contributions in the advancement of the community health in the settlement. During this period, all the staff at TPHC were very cooperative, energetic and easily approachable for any solution. I feel that there is no service greater than serving one’s own society. I hope I can serve at the best of my abilities. May the dark side of society lighten with joy and health. May all diseases disappear and every sentient being attain the Buddha hood.”

Statement of Health Kalon on World AIDS Day Tibetans, like everyone else, can contract HIV. Cases are still increasing. Our goal is ‘0’ new cases. Every year on 1 December World AIDS Day, we remember those who died with HIV AIDS, their families and friends, and we unite in the struggle to fight against this deadly virus. World AIDS Day is an important opportunity for you to learn the facts about HIV and to put your knowledge into action to prevent it. Understanding how HIV is transmitted, how it can be prevented and facts about people living with HIV will help you to take care of your own health and of others as well.

In our own Tibetan community in India, despite years of concerted efforts on awareness and education, HIV positive cases are seen to be a growing concern. While the surveillance health information system of the department of health covering selected settlements has recorded 13 HIV positive cases in 2012, the actual number of people who are HIV positive in our Tibetan community is believed to be much higher. Stigma, fear, discrimination and poor understanding of HIV are all factors that are associated with under-reporting and low uptake of testing for HIV. The understanding of the prevalence of HIV in our society remains a challenge.

With the help of modern medicine and effective anti-retroviral therapy, it is possible for people who have HIV/AIDS to live long productive lives. It is very important for everyone to know his or her HIV status by testing for HIV. Early diagnosis can enable timely treatment. Pregnant women who are HIV positive should talk to their doctors and be proactive about how to prevent the transmission of HIV to her baby with proper medical support.

It is claimed that more than 25 million people around the world have died of HIV AIDS virus during the last 30 years. Approximately 35 million people around the world including 2.1 million in India are living with HIV in 2012, according to the World Health Organization (WHO). The disease continues to pose a public health threat to all communities and societies globally. Even more concerning is the fact that HIV pandemic is still spreading the infection at a significant rate.

The department of health is dedicating the month of December for HIV awareness and is launching a mobile awareness campaign whereby our staff are going to various places to spread awareness on HIV AIDS to college students, school children, settlement residents and Tibetan sweater sellers across India. The department has put great focus on this and will continue to do so in various abilities; promoting HIV AIDS awareness and education, promotion of condom use and its importance on HIV prevention, organizing workshops on HIV counseling, conducting free HIV testing for all pregnant women and conducting support meetings for people living with HIV AIDS. The department also provides support in the form of stipends for Tibetans with HIV for convenient and timely access to treatment on ART from local Indian governmental hospitals.

I would like to urge every Tibetans to focus and act on the theme of this World AIDS Day of “Getting to Zero”, echoing the global vision of “zero new HIV infection, zero discrimination and zero AIDS related deaths. I would like to thank the donors of our department of health namely PRM, NCA, SOIR IM for their financial and moral support which greatly motivates us to charge toward HIV AIDS reduction in the Tibetan community in India.

Tibetan Health-TVHA

15

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. Preregistration 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.

16

Tibetan Health-TVHA

List of Donor from August to December, 2013 TVHA, Department of Health expresses our deep appreciation and thanks to all the Donors and Volunteers. We would like to request your continued support to achieve our goals.

S.No

Italy

25,728.00

2

Donor Yeshe Norbu Via Tenpa Ngodup Shenpen Tibet Aid

Norway

276,432.00

3

The Tibet Relief Fund

England

292,502.00

4

Associazione Villaggio TerItaly raong

117,941.00

5

Johns Hopkins University

USA

546,664.00

6

BMZ Germany Via Maltester International & MIA

Delhi

1,500,000.00

1

7 8 9

Country

Amount (Rs)

Shenpen Tibet Aid SOIR-IM Via Rajpur US AID via USA Embassy Yeshe Norbu Via Tenpa Ngodup

Norway 234,000.00 Swiss 150,000.00 New Delhi 1,589,520.00 Italy

82,560.00

11

The Tibet Fund

USA

550,000.00

12

Sharon D.Parr, California

USA

152,568.00

13

Tibet Charitable Trust Via Tibet House Trust

London

981,546.00

10

1,040,025.00 14

Vimala Associazione

Italy

998,424.00 1,664,042.00

15

SOIR-IM Via Rajpur

Swiss

547,995.00 263,288.00

16

The Tibet Fund

USA

6,195.00 588,525.00

17 18

German Aid to Tibetans The American Himalayan Foundation

Germany

416,035.00

USA

629,046.00

Purpose of Donation Sponsorship of Ngoenga Children Health Project in Sonada Ngoenga School/Tenzingang grant Rehabilitation of Substance Abuse The Epidemiology study of Chronic Hepatitis B at Bylakuppe TMS 1st Inst.grant Health Project in Sonada Salary of dealing staffs Torture Survivors program Sponsorship of Ngoenga Children Eye Camp at Odisha, Bhandara & Mainpat Sponsorship of Ngoenga Children Recurring expenses of Clinic in Northeast Ambulance for Miao PHC Vehicle Fund for Tso Jhe Khangsar Hospital, Bylakuppe Toilet Renovation at Ngoenga School Health Project 4th Quarter Sponsorship of Ngoenga School 2nd&3rd Qtr. General Donation Eye Camp at Mundgod settlement Eye Camp in Tibetan Settlement Special Diet for Ngoenga School

Tibetan Health-TVHA

17

19

PRM Via SARD

USA

20

AET Via CTRC

France

21

US AID via USA Embassy, New Delhi

USA

736,574.00 Torture Survivors program

22

Yeshe Norbu appello

Italy

861,473.00 Ambulance PHC Bhandara

23

Tibet Religious Foundation of H.H.The Dalai Lama

Taiwan

24

Staub/Kaiser Foundation

Switzerland

Total

23,645,508.00 Basic Health Care & HIS Sponsorship of Ngoenga Chil161,508.00 dren

General Donation for Tibetan Medicare Health expenses of Ngoenga 1,108,862.00 Children 40,107,664.00 940,703.00

Hospitals received Direct Donation from Donor w.e.f. August to December 2013

S.No Particular 1 Eye Surgery Camp Pharmacy for poor and 2 needy 3

Hospital equipment

Amount Donor Place 357,144.39 Initiative Oberland and Iwanitz451,926.00 DTR Hospital, ky, Germany Via Sakya MonasMundgod tery, Mundgod 142.575.77

Inkind Donation

S.No Assets

Donor

1

BP Apparatus Machine

2 3 4 5 6 7 8

Ambu Bag Needle and Syrings Cutter Fire Extinguisher 2 Kg MRF Wheels Digital Sony 5x camara Nebulizer Billing Printer

Quantity Place

Ms. Kazal Ebora & Dawa Yarphel Ms. Kazal Ebora, Canada Ms. Oral Quin, Australia

2 1 1 2 4 1 1 1

Tibetan Primary Health Center, Bir

TVHA staff update from August to December 2013 New Appointment:

S.No 1 2 3 4 5

18

Name Tsering Tenzin Dechen Lhakpa Dolma Kunchok Dhondup Dolkar Palmo

Designation Exe. Secretary Accountant Staff Nurse Sweeper Staff Nurse

Tibetan Health-TVHA

Place TPHC Miao PHC Odisha TPHC Miao PHC Mainpat TPHC Miao

Appt. Date Remarks 01.08.2013 05.08.2013 07.10.2013 11.10.2013 Contract 02.12.2013

Resignation:

S.No 1 2 3 4 5 6

Name Dawa Dolma Tsultrim Dorjee Phuntsok Tsering Chime Dupa Rinzin Choesang Kalsang Dickyi

Designation CHW CHW Driver Driver CHW CHW

Place TPHC Miao TPHC, Miao DVT Hospital TPHC, Miao Health clinic, Poanta Sahib TPHC, Miao

Dated Remarks 10.10.2013 23.09.2013 30.09.2013 21.10.2013 Contract 08.11.2013 27.11.2013

Terminated:

S.No Name 1 Dr. Lobsang Tashi

Designation Medical Officer

Place DVT Hospital

Dated 24.07.2013

Contract Completed:

S.No Name 1 Tenzin Deden

Designation Place Nurse Aid Tso Jhe Hospital, Bylakuppe

From 07.12.2013

Transferred:

S.No Name 1 Tsekyi Dolma

Designation CHW

2

Kalsang Choedon CHW

3

Tashi Gyalpo

From To Dated Rewalsar Clinic Dalhousie Clinic 01.08.2013 Phende Hospital, PHC, Delhi 01.08.2013 Hunsur

Executive Secretary/Pharmacist

PHC Dekyiling

PHC, Bandara

06.12.2013

Retirement:

S.No 1 2 3 4

Name Choenam Passang Chokpa Janki Tashi Dolkar

Designation CHW CHW Sweeper CHW

Place Tso Jhe Hospital, Bylakuppe Tso Jhe Hospital, Bylakuppe D. T. R Hospital, Mundgod Health Clinic, Lingtsang

Dated 30.08.2013 30.09.2013 01.10.2013 01.10.2013

Retirement Extension:

S.No Name 1 Sonam G. Hara 2 Pema Norbu

Designation Executive Secreraty Driver

Place PHC Bir PHC Mainpat

From 15/08/2013 01/09/2013

To 14.08.2014 31.08.2014

Ngoenga School Resignation:

S.No Name 1 Tenzin Dolkar B

Designation Teacher

From 07.12.2013 Tibetan Health-TVHA

19

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

20

Tibetan Health-TVHA

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 and vaccination of Tibetan children. About 2000 Tibetan children between the age group of 6-18 years, studying in major Tibetan schools in north and northeast India, will be the target group.

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.

Tibetan Health-TVHA

21

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 women’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.

Please make donation by Cheque/bank draft/IMO payable to Tibetan Voluntary Health Association towards any of the Projects and programs mentioned above.

Bank Detail 22

A/c Holder - TVHA SWIFT CODE - UCBAINBB212 A/c Number - 11510100000519 PAN - AAATT1509K UCO Bank, CTS TAN - PTLT10935B Gangchen Kyishong IFSC - UCBA0002059 Dharamsala-176215 www.tibet.net/health Distt. Kangra (H.P), INDIA health@tibet.net

Tibetan Health-TVHA

Water and Sanitation Projects Completed from August to December 2013 Drilling & Installation of Water hand Pumps for Nomadic settlement in Jangthang, Ladakh

The universal Education of Trentino, Italy through Dr. Claudia and Italy Tibet Association had generously helped and supported the seven water hand pumps installation in five different locations in Jangthang Ladakh: two each in Samedh and Sumdo; one each in Chumur, Kagshung and Goyul. The project facilitates drinking water to a population of 1037 Tibetan nomads residing in these areas. ▼

100KL Overhead tank constructed at Dhondupling Tibetan Settlement, Clement-town, Uttarkhand. The project was collaboratively funded by Swedish Organization for Individual Relief(SOIR-IM) and Her Eminence Jetsun Khandro Rinpoche. ▼

1 submersible pump was installed at all camps and chain pull procured at Mainpat Tibetan settlement.

The project was funded by Swedish Organization for Individual Relief (SOIR-IM). ▼

Transformer and electrification work were completed at L,P & U village of Kollegal, to provide adequate water supply which is highly depending upon proper power supply to the water pump. ▼

Tibetan Health-TVHA

23

TMS updates as on 15 March 2014 Comparative result on TMS members’ contribution and reimbursement

Amount

13,000,000 11,700,000 10,400,000 91,00,000 78,00,000 65,00,000 52,00,000 39,00,000 26,00,000 1300000

TMS member contribution Reimbursed to TMS member

Phase one

Phase two

Phase three

6095343

1389030

7978913

6665752

1497133

12864614

Phase TMS Claim Updates of 3rd Phase as on 15 March 2014

a ao ling msal i y a k ar De Dh

Mi

in Ma

Settlement

495752 214482

501547 293495

pat

773308 501805

lhi

De

801193 470767

822698 320653

r l ppe ndgod ega Hunsu l u l k o la K Mu By

Reimbursed to TMS member

885171 226001

926370 458214

1228892 738300

1887506 916493

Amount

1056867

2391192

TMS member contribution

Bir

Top Ten Enrollment in Three Phases TMS member 2771

2663 2144

1330

1305 1015

pe

up lak

By

24

od

M

g und

al ing lleg ekyil o K D

Tibetan Health-TVHA

ao

Mi

ur

ns Hu

Settlement

848

a

ish

Od

780

777

pat msala ara Dh

in Ma

583

lhi

De