Newsletter jan june 2014

TIBETAN HEALTH January to June 2014

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

Delegations from BMZ, GIZ, MIA and German Embassy received a Special Audience with H.H The Dalai Lama Tibetan Medicare System The Tibetan Medicare System (TMS) was first introduced in 2012, and is one of important programs of the Department of Health, Central Tibetan Administration (CTA), Dharamsala.

Till date, 1342 Tibetan people have claimed the cost of medical expenses incurred as a result of sickness or injury from accident or by certainty. It is coverage against the risk of incurring medical expense among the Tibetan people living in India.

Although the TMS is solely for the benefit of general public and its longevity also depends on their active participation, yet many feel reluctant to join in the scheme. This has caused a huge financial burden to the Health Department; and as a result, it’s sustainability is being questioned. Over the years, the department, by reaching out to every nook and corner of Tibetan settlements, is striving hard to create awareness of this noble cause.

TMS Awareness Campaign & Enrolment : In January 2014, Health Kalon accompanied by Mr. Nyima Gyaltsen, TMS program coordinator had launched an awareness and enrollment campaign on TMS for the Tibetan sweater sellers in major Indian cities and the settlements viz; Delhi, Jaipur, Jodhpur, Sonepat, Noida, Gujarat, Udaipur, Anand, Baroda, Sonamling Ladakh Jhangthang areas, Odisha, Dholanji, Kamrao, Satuan, Puruwala, Paonta settlements.

CONTENTS TMS Awareness Campaign and Enrolment Administrative News Health Programs Training News Health Day Programs Profile of New Staff News from the field Health Centers Message of Health Kalon on World Health Days List of Donor Dept. and TVHA Staff Update How You Can Help Tibetan Health Department Volunteer Information Corner

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Administrative News

During the visits, Kalon urged Tibetans to participate in the TMS so that they can protect their families from unexpected health emergencies. The TMS reference materials were also distributed to the public. He added that only with support of people and best use of it, Tibetan Medicare will become one of the best and self sustaining program of the administration. He also emphasized that Tibetan Medicare is for, of and by the people.

Similarly the health administrators and settlement officers took the responsibility of creating TMS awareness campaign in their respective settlements and in nearby cities to approach Tibet-

an sweater sellers. As a result, there have been overwhelming response from the public as their queries and doubts were cleared during the campaign. This year enrolment, which took place from January to March, has generated 13,151

members as compared to 10,190 in the previous year.

In the month of April, May and June the health administrators of Tibetan settlements Bir, Bhandara, Bylakuppe, Hunsur, Kollegal, Mainpat, Miao, Mundgod, Odisha and Dekyiling had negotiated with the corporate hospitals most frequently used by our patients on giving concessions up to 30 percent on in-patient bills of the Tibetans.

TMS Meetings: â–ş On 15 January, Health Kalon met Prof. David Dror, the director of Micro Insurance Academy (MIA) and his team. They discussed on the smooth continuation of operations and enrolment to the TMS. â–ş On 20 January, he met Mr. Heiko Warmkin, the head of economic corporation of the Embassy of Federal republic of Germany, India.

They had an hour-long discussion to update the status of TMS.

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He added that TMS is a holistic and tertiary health care programme meant for all Tibetan refugees. It is an integrated medical insurance scheme provided by the Department to provide financial security to the Tibetan public when faced with serious health problems. It is a nonprofit and charitable program that aims to improve public health and well-being of the Tibetan community. All Tibetan refugees residing in India under the direct care of TVHA are eligible for the Health Kalon Launched Campaign on Tibetan TMS. Health Kalon also announced that those Medicare System (TMS) in Dharamsala who have enrolled in the TMS scheme would get 10% discount on medicines at Men Tsee khang Health Kalon launched an awareness campaign clinics from 1 April 2014. on TMS in Dharamsala on 12 February 2014. It was attended by the local settlement officer, repHealth Kalon Inaugurated New Private OPD of resentatives of various Tibetan organizations and Delek hospital members of the public.

Kalon gave a brief introduction about the Kalon Dr. Tsering Department of Health and its various health care Wangchuk inauguprograms to improve the overall health of the Tirated the new private betan community. “Health Department is one of OPD (Out Patient Dethe three departments besides Home and Educapartment) of Delek tion department that is directly related to the pubhospital. The inaulic. We provide curative and preventative health guration was also atcare services by managing and financing health tended by Health Seccare centers, as well as by planning comprehenretary Shosur Sonam sive health care system for the Tibetan refugees”, Choephel. He talked he said. about the importance

“The department tries to improve public of healthy lifestyle health through various programs covering both and urged the Tibetan traditional Tibetan medicines and mainstream public to fully utilize the healthcare services promodern medicine. We also provide health incenvided by Delek hospital. tives and benefits to old people, former Tibetan Department’s other major program is the political prisoners and poverty stricken families. mother & child health program. Delek hospital The major programs’ include Mother & Child provides the necessary Pre and Post natal care, Health program, disease control program partic- ultrasound check ups, immunization of chilularly TB. For Tibetans residing in Dharamsala dren below 5 years etc for Tibetans residing in and nearby areas, these programs are being con- Dharamsala and nearby areas. Therefore, Delek ducted by Delek hospital which is an autonomous Hospital’s contribution towards public health is hospital under the health department”, he said. immensely significant. He also urged Tibetan el-

► On 9 March, Health Kalon and Mr. Nyima Gyaltsen, TMS coordinator, met with Mr. Christof Ruhmich, Head of Asia Team, Malteser International, and Prof. David Dror, the chairman and MD, MIA along with their team at the Bureau of His Holiness Dalai Lama, New Delhi whereby they discussed about progress and status of TMS. Health Kalon outlined the major challenges of the TMS.

ders, poor families, former Tibetan political prisoners and retired and current Tibetan civil servants to avail the health benefits provided by the department for them.

Public Health Assessment of Hepatitis B in Ladakh

A team consisting of three CTA Health Department staff members, three health clinic staff, and two public health researchers conducted group Tibetan Health-TVHA

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chronic Hepatitis B infected individuals in the Tibetan community.

This project is being implemented in collaboration primarily with University of Rochester Medical School and secondarily with University of Hawaii, USA. HIS 3 Software Upgraded in various Health Centers

and individual interviews in Sonamling Tibetan camps in Leh and the Jhangtang areas of Sumdo and Samey including TCV School and Men Tsee Khang branch clinic from May 5 to 21, 2014.

The goal of the project was to provide formative information to identify and better understand attitudes, practices, and public health challenges facing Tibetan refugee populations residing in Tibetan settlements (especially issues facing women and children), and importantly, to help design a pilot project to address public health improvement, with a particular focus upon Hepatitis B reduction.

In total, 326 Tibetan refugees residing within the Sonamling Tibetan settlements in Ladakh, including 295 community members participated in group interviews (including those who disclosed positive hepatitis B status and were subsequently interviewed individually as well) and 31 additional community members (including hepatitis B positive and negative participants) were interviewed individually. Population, community, neighborhood, and individual consent were obtained prior to conducting interviews, which were led by department staffs working with local health clinic providers. The team was also able to provide health education sessions around Hepatitis B along with distribution of Hepatitis B educational materials in both Tibetan and English following the group interviews and individual counselings were given as requested.

Analysis of the data from the interviews is underway and will culminate in recommendations to the Department of Health, CTA regarding development of an approach to Hepatitis B which is a complex disease, mostly asymptomatic, and can cause life threatening conditions like liver cancer and liver cirrhosis if left untreated in the long run. High cost of Hepatitis B medications continue to pose huge economic burden to the

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With the completion of (HIS) Health Information System 3 software upgrade, the department successfully rolled out its new updated version of Health Data Base in 13 health centers viz; Bylakuppe, Hunsur, Mundgod, Kollegal, Mainpat, Odisha, Bir, Dekyiling, Delhi, Poanta, Dharamsala, Tezu and Miao. The new software data base system consist better quality with wider information collection of health status, new list of diseases diagnoses, changes and modifications in the health indicators, a separate collection of reproductive health data and provision for reporting of a list of notifiable diseases. Moreover, this new program is designed for easier use, better understanding of the system and faster data import process for analysis.

In the month of May, Department HIS program coordinator Tenzin Tseyang visited TPHC Dekyiling and Poanta Clinic situated in Doon valley to assess the data quality of the new HIS software upgraded system and provide onthe-job training to the health workers at the clinic/hospital. HIS data monitoring and evaluation has been successfully carried out in these health center.

German Embassy Members visits Dharamsala A team of 13 delegations led by Mr. Wolfgang Hruschka, an acting head of Federal ministry for economic cooperation and development (BMZ),

met Health Kalon and TMS staff in Dharamsala on May 27, 2014. Mr. Nyima Gyaltsen gave a 15 minutes presentation on TMS scheme followed

by Health Kalon’s explanation on further improvement of the scheme. Mr. Hruschka agreed to extend his support for the TMS program. Mr. Heiko Warmkin, head Economic Cooperation and Development, Embassy of the Federal Republic of Germany, India spoke about importance of the scheme and encouraged more effective awareness programs in order to increase the number of enrollees. Prof. David, MD MIA, said he looks forward to a continual partnership with the Health Department, and would help in solving the problem on the Management of Information System of TMS.

derway.

The Shenphen Aid funded delivery equipments such as hydraulic labor table with SS sink, baby warmer with cradle, focus light, oxygen cylinder with trolley, pediatric suction machine, fetal doppler, sterilizer heater, bed side locker, two revolving stools, steel cabinet, neonatal ambubag and two water purifiers. In addition, an electricity generator was also donated for safe deliveries at night.

As of now, the number of mothers delivering in health center is comparatively higher thereby bringing down referral cases and health care costs of the patients.

USAID Delegation visit Dharamsala

The Shenphen Tibet Aid funded Maternity Equipment & Generator to Miao Health Center

On June 12, a three day visit of Ms. Nancy Godfrey, Health Office Director of USAID India and Mr. Ashok Jha visited the Department of Health to look for ways for any possible help they could extend to TMS and other health programs of DoH. The department had an extensive discusTibetan women in Miao will benefit from im- sion with them on further improvement of TMS proved health facilities after Shenphen Tibet Aid, and they advised/suggested reviewing the TMS through the Department of health, funded child packages. delivery equipment and an electricity generator Health Programs valued at Rs 669,271 for safe delivery.

Since the settlement is known for highest birth rates, a separate maternity unit was con- Gynecologist Visit Program structed. Moreover, the health center has three midwives in which two are trained in safe deliv- This program was successfully carried out in folery practice, and the training for third nurse is un- lowing settlements i.e Bir, Dekyiling, Ladakh,

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Miao, Hunsur, Kollegal, Mainpat, Odisha, Bandhara, whereby women in the area were given free health check up by a visiting Gynecologist every month and a few visits were also carried out in Clementown, Rajpur, Dharamsala (through Delek hospital) and in Paonta Tibetan settlement.

Through this program, women were screened for common Gynecological and Obstetrical diseases and when diagnosed, were referred to health centers and hospitals for early treatment and management. This program helped in strengthening our Mother and Child Health Programs. Pregnant women received monthly antenatal care and check up when the gynecologist visited the settlements.

This program has been received with much appreciation by the general public and women, in particular. This program is funded by NCA.

Mobile Health Campaign in Northern Tibetan Settlements Department of Health covered mobile health education in Tibetan settlements situated in Northern India viz: Rewalsar, Pandoh, TCV Vocational Training Center Patlikul, Bhuntar Tibetan College and Monasteries from 3 to 7 June, 2014. The program aimed to improve the overall health of Tibetan people in exile through preventive methods of various diseases through a public health approach, the mobile health campaign. Health Education dealing staff, Kapsang and Bir Tibetan Primary Health center Staff Nurse, Karma Dolma acted as the resource persons.

Cervical Cancer Screening and Vaccination Program Cervical cancer screening program was carried out in Tezu settlement where a total of 82 women underwent Pap smear test in the month of March.

Similar programs are being carried out for women in Ravangla and Tenzingang (both remote regions), and Dekyilling which will be completed by end of July. This program is funded by PRM. In Kollegal, a remote Tibetan settlement in southern India, a similar program is being carried out funded by SOIR-IM.

In these remote settlements, women living there do not have proper access to gynecology and obstetrical care services and this puts them under vulnerable and high-risk groups.

Such programs integrated with health education made women aware of cervical cancer, the need for regular checkups, and those with suspected malignancy were informed about their condition so that they can refer to other specialized centers.

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The topic covered were Hypertension, Tuberculosis, Hepatitis B, Diabetes, Cervical Cancer, Jaundice, Stomach Cancer and HIV/AIDS as per suggestions provided by various settlements, monasteries and schools. About 570 people participated including settlers, students and monks.

Health education pamphlets were also distributed for more understanding and education. The health event was successfully concluded with positive feedbacks received from the participants for the initiative tasks from the Department of Health.

Bir Mobile Health Education Program: Department’s Public Health Division Head, Mrs. Trinley Palmo and Volunteer Nurse Tenzin Yangchen conducted mobile health education program in Tibetan settlements, schools and monasteries in Bir from 19 to 22 June. A total of about 1500 people benefitted from the program. The topics of the mobile health education program included: infectious diseases like TB, HIV AIDS and Hepatitis B along with some common chronic conditions like hypertension, stroke, heart attack and diabetes. On the whole, this mobile health education was a great success. Distributed additional health education brochures (based on their needs).

Dental Screening Program

Women Health Education Program in Nunneries

Nutritional Supplement Support Program

In June 2014, nuns in Shugseb nunnery were educated on breast cancer and breast self examination and were taught about diet and hygiene’s role in improving health from the perspective of both allopathic and Tibetan traditional medicine. This program funded by PRM aims to improve the overall health of nuns through primary prevention by empowering them through health education. Earlier, similar sessions were carried out in Dolmaling nunnery and nunneries at Tilopur. Remaining 4 nunneries in Himachal and Uttarkhand will be completed by end of July.

Under this program, nutritional supplement support in the form of monetary support is given to crèches in Miao, Gankyi (Dharamsala), Hunsur, Kollegal and Odisha where the toddlers and children receive nutritional supplement along with their mid day meal. The fund is used to buy eggs, milk and occasional fruits so that they can get extra vitamins and minerals and protein which helps them in growth and development. This program is funded by PRM.

A dental screening and teaching program was carried out in Miao, Tezu and Tenzingang located in remote north eastern region of India in the month of March by Dr. Joanne (Australian Dentist) and Mr Rinchen lak (Bir Dental Therapist).

A total of 752 people including school children were screened and educated on oral health and those in need, received treatments that ranged from simple scaling to extraction and fillings. The program was funded by PRM, but the Australian dentist Dr. Joanne volunteered for the program without any fee.

Training News Basic Healthcare Workshop to Newly arrived Tibetan Women Department organized a basic healthcare workshop to 32 recently arrived Tibetan women from Tibet, aged between 17 to 25 years who are currently studying at Sherab Gatsel Lobling School, Dharamsala. The duration of this workshop was three days from 29 to 31 January 2014. Resource persons include Head of Public Health Division, Tibetan Health-TVHA

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Mrs. Trinley Palmo, Health Education coordinator, Mr. Kabsang and two staff nurses and a volunteer mental health nurse from Department of Health and a doctor from Men-Tsee-Khang.

The training mainly focused on women health issues such as sexually transmitted diseases, cancers, diet and nutrition, general health and hygiene and mental health. Talks were also given on Tuberculosis, HIV AIDS and Hepatitis-B with power point presentations from respective resource persons. In addition, this workshop involved presentation from traditional Tibetan Medicine’s perspectives on women’s health.

On the last day, as requested by the administration of Sherab Gatsel Lobling School, half an hour presentation on general information about sexual transmitted diseases, especially AIDS, was provided to about 40 male students as well. This workshop was aimed to create greater awareness about basic health issues particularly relevant to women’s health among these newly arrived Tibetan women and to empower them to practice positive health seeking behaviors in their daily life.

Basic Healthcare Workshop to newly arrived Tibetan Women at TCV Suja: On 15 May, a two day women’s health education program was organized at TCV Suja which aimed to improve the overall health of newly arrived Tibetan women through primary prevention by empowering them with basic healthcare education. Resource persons were Dr. Tenzin Dechen, TPHC

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Bir, Dr. Jayang Dolma, Men Tsee Khang, Kabsang, Department Health Education staff, Tenzin Dolkar, Department staff and Tenzin Yangchen and Tsering Yangkyi, volunteers at Department of Health.

They educated on Urinary Tract Infection (UTI), Cervical Cancer, Hepatitis B, HIV/AIDS, Mental Health, Pulmonary Tuberculosis, MDR and provided basic health information from the perspective of both allopathic and Tibetan traditional medicine.

Workshop on “Access to Services”- HIV/AIDS” HIV support group meeting-cum-workshop was organized at Aasha Kirana Hospital, Mysore from 12 to 14 March 2014 with the title theme “ACCESS TO SERVICES - HIV/AIDS”. 6 HIV patients, 4 staff nurses and Mr. Kapsang from Health Department participated. The topics of the meeting included basic information on HIV, special reference to care, presentation of life stories

by HIV patients, and they also visited ART centre at JSS hospital, Mysore which gave the participants an opportunity to explore the laboratory facilities and technologies. A doctor from Tibetan Medical Astrology Institute branch at Mysore was also invited to speak on the nature of human body and other relevant information. The participants also had group meeting on social stigma, societal problems and finding solutions.

HIS Data Management skill Training A week long data management training was held at Lhakpa Tsering hall and DOH Office from 23 to 27 June, 2014. The main aim for holding this training was to build capacity of department of health staffs to work on health data and their analyses. The training was given by resource person Dr. Lobsang Tsering. The topics of the training included Microsoft excel, access, EpiInfo and general data management. Staffs particularly involved in handling data were chosen to receive the training. This included program coordinators/ managers of TB, HIV, MCH, HIS and TMS. Participants were made to exercise on live data samples in order to analyze them and get practice. A second phase/part of this same data management training will be held in the first week of September. This data management training was funded

by PRM, USA.

Delivery Training Program Under this program, 4 nurses from Odisha hospital, Mundgod hospital, Kollegal hospital, Bylakuppe hospital were sent to Behrampur Christian hospital in Odisha for a month long delivery care training from 15 May to 15 June 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 in their remote settlements. A batch of 3 nurses from north eastern Tibetan health center were sent to Odisha earlier in the month of January.

Health Day Programs Health Department held “Run for TB marathon” awareness campaign on TB Day

lize and encourage the TB patients to come forward to avail the subsidized and free TB services provided by the department so that every TB patient have equitable access to TB care in our community and that none of the TB case is missed.

A Run for TB marathon was organized by Department in collaboration with Delek Hospital and Tibetan National Sports Association (TNSA) at Mcleod Ganj to commemorate 2014 World TB day and to create widespread awareness about TB within the Tibetan community.

A total of 118 runners participated in this marathon including students from Upper TCV, Lower TCV, TCV Gopalpur and Sherab Gatsel lobling along with general public. The event was inaugurated by Health Kalon Dr. Tsering Wangchuk. Speaking on this occasion, he explained the various TB related preventive and treatment incentives provided to the Tibetan community by the TB Control Program of the Department of Health through its network health centers and hospitals. He also stressed the need for greater awareness about TB especially among the Tibetan youth studying in various schools and colleges along with members of the monastic community. The TB day event at Dharamsala was funded by PRM, USA and TNSA.

World TB Day was marked in Dharamsala on 23 March 2014 at TCV day school, Mcleod Ganj.

This year’s TB day theme “Reach the 3 million”, as designated by WHO, emphasized the need for greater global effort to reach the 3 million TB infected people who currently don’t have access to TB screening, treatment and care. The TB day events organized by Department of Health, CTA Exile Tibetans remember brethren on Internathrough its various health centers aimed to mobi- tional Day against Torture

Tibetans in exile on Sunday remembered their brethren suffering repression under the Chinese rule while observing the international day in support of victims of torture scheduled on 26 June, jointly organized by the Department and GuChu-Sum, an ex-political Tibetan prisoners association, at TCV Day school, Dharamsala on 22 June 2014. Hundreds of Tibetans including Golog Jigme, a Tibetan monk who recently escaped to India from the Chinese captivity in Tibet, joined Tibetan Health-TVHA

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On 26 June, Department observed the International Day against Drug Abuse and Illicit Trafficking at Sherab Gatseling Lobling and Mewoen Tsuglak Petoen School in Dharamsala. Public Health Division Head, Trinley Palmo raised awareness on drug abuse and its problem to the students.

Drugs related brochures were also distributed to the public at Mcleodganj main square in collaboration with Kunphen staff (NGO).

Profiles of New Staff the programme.

A minute’s silence was observed as a mark of respect for all those Tibetans who sacrificed their lives and suffered immensely for the cause of Tibet under the Chinese rule.

Health Kalon Dr. Tsering Wangchuk addressed that the day is being observed to express support and solidarity with all those people who are suffering torture, described by human rights organizations as “cruel violation of human rights”. He said the objective of this year’s International Day in Support of Victims of Torture is to fight against impunity with which torture is committed. He underlined that the international community and individuals have the responsibility to provide legal remedies and awareness to alleviate those suffering from torture in different parts of the world including Tibet. He said the Tibetan administration and NGOs should make collective efforts to provide medical and livelihood support to those Tibetans who escaped to exile from the Chinese persecution.

Tibetan political prisoner Golog Jigme spoke about how he was tortured in the prison by the Chinese authorities. In addition, banners and posters were printed out for general public knowledge, and T-shirts printed with this year’s theme were distributed to the public.

Health Department Appoints New Medical Officers at Kollegal and Bylakuppe

The Department formally appointed Dr. Sonam Dhondup and Dr. (Ms) Jigme Kalsang as New Medical Officers of Tso-Jhe Khangsar Hospital, Bylakuppe and DVT Hospital, Oderyarpalya, Kollegal on 5 May and 11 March 2014 respectively.

Dr. Sonam Dhondup, a returnee of Tibetan Scholarship Program-USA this year, is a MPH graduate from Stony Brook University, USA. He had already worked as Medical officer of DTR Hospital, Mundgod and Tibetan Primary Health Center, Bir earlier.

Dr. Jigme Kalsang is an MBBS graduate of Maulana Azad Medical College, New Delhi.

The International Day against Drug Abuse and She worked with Medical officers of Tso-Jhe Khangsar Hospital at Bylakuppe initially to gain Illicit Trafficking

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and share clinical experience and joined DVT Hospital from 1 June 2014.

The appointments came as a result of Health Department’s intensive outreach to Tibetan MBBS doctors with full support from the Kashag for strict implementation of CTA’s MBBS bond, that require selected Tibetan MBBS doctors to work under CTA health service for three years in return for reserved MBBS seats in India.

The Department still urgently needs at least seven more Tibetan allopathic doctors in hospitals and health centers in the various settlements, particularly one each at Miao, Odisha, Mainpat, Hunsur, Ladakh, Bhandara, and Mundgod.

Appointment of Staff Nurses at Bandara Primary Health Center and Jangthang Ladakh

she did nine months experience work in Dehradun Indiresh Hospital (Private) i.e. from 12 August 2013 to 6 April 2014. It was while she was working in Dehradun that she came to know about the vacancy of staff nurse post at Ladakh Changthang.

She left her job at Dehradun and joined as a staff nurse at Ladakh Jangthang clinic.

Nurse Kunsang Dolma: Born in the year 1987 at Jangthang chummur, Leh-Ladakh, at the age of 10, she enrolled in TCV Primary school at Chummur village. Up to 10th standard, she studied in TCV School at Choglamsar, LehLadakh after which she completed her schooling from TCV Gopalpur. She did her degree in Nursing from AINS (Alva’s Institute of Nursing Science) from Mangalore and after finishing her nursing course, she worked for over one year at Delhi in SHHI (Saroj Hospital and Heart Institute). She left her job in Delhi and returned to Ladakh to work as computer instructor in New Millennium school at Ladakh for a few months. On 5 May 2014 she joined as the staff nurse of Mobile Medical Unit at Jangthang nomadic areas in Leh, Ladakh under Department of Health (CTA).

Nurse Tenzin Youdon: She was appointed as staff nurse at Bandara Tibetan Primary Health Center on 4 June 2014. She was born in Kollegal Tibetan settlement situated in southern India Karnataka state. After completing her school, she joined St. Martha’s College of Bangalore for further studies. She has oneyear experience of working in healthcare; working 6 months in CTVS ICU at News from field Health Centers Apollo Hospital at Delhi and a further 6 months DTR Hospital, Mundgod: On 7 April, World in Vikram Hospital Medical ward at Bangalore.

Health Day was organized at Mundgod settlement Nurse Kalsang Dolma: She was born in Ladakh in 1990. She did her primary as well as secondary education in TCV School, Ladakh and higher secondary education in TCV Gopalpur. After completing her school, she had started the General Nursing & Midwifery course for the duration of three years and also acted as the female head role for one year in Alva’s Institute of Nursing Science in the year 2012-2013. After getting six months of internship experience in Mangalore, Tibetan Health-TVHA

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with the participation of about 350 settlers including school children. The event was attended by 7 Medical officers of Tibetan and Indian health centers including monastery treasurer and camp leaders. Hospital executive secretary addressed the day and talked about the importance of keeping pollution free environment followed by a message from the settlement officer. “It is an individual responsibility to be aware of health related information”, said Mr. Guru Gyaltsen, Regional Freedom Movement staff. Moreover, Men Tsee Khang Dr. Kyizom gave a talk on viral diseases like Chikungunya; causes, symptoms and its prevention. In addition, Dr. Tenzin Norsang spoke briefly about dengue fever disease. He educated the community to keep surroundings clean and cover up the open water reservoirs. Hospital also released a notice to clean up all the surroundings of the respective monasteries and health centers.

World Environment Day was observed on 5 June to raise awareness to take positive environmental action to protect nature. Settlement Officer, Executive Secretary, Head of Regional Committee, Dr. Tenzin Norsang, Environment Desk, Dickyi Chodon attended the event. They addressed the importance of maintaining clean environment and preserving our earth with our daily actions in order to maintain dirt free environment. The top three most neat and clean camps were given awards in recognition of their efforts

and to encourage them further still in continuing with the efforts to keep environment clean. The event ended with free distribution of 100 mango tree seeds to the 18 camps and monasteries with the message of making the settlements cleaner, greener, and brighter.

health education with the participation of various local committee members, settlement officer, health staff and school children. Men-TseeKhang Dr. Lobsang Dhargye and Nurse Tashi Youdon acted as the resource persons. They gave talks on health education from both allopathic and Tibetan Traditional medicine’s perspectives.

260 people attended the day.

On 9th May, Phende Hospital conducted a monthly gynecologist visit camp at Tibetan settlement Hunsur by inviting medical team from Apollo BGS Mysore. Total 20 women examined and out of which 10 did pap-smear to detect cervical cancer. Settlement women have received this camp with much appreciation.

World No Tobacco Day was observed at Pende Hospital on 31 May to highlight the health risks associated with tobacco use and effective

ways to reduce tobacco consumption.

World Environment Day was commemorated at Rabyeling Tibetan settlement jointly organized by Phende hospital and Regional Tibetan Women’s Association on 5th June 2014 with a huge gathering of nearly 300 participants. Resource persons were Mrs. Tsering Youdon, MemPhende Hospital, Hunsur: World Health Day ber of Parliament in exile, Mr. Phurbu Choedak, was observed on 7th April to raise awareness on settlement officer, Dr. Lobsang Dhargyal, Men

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Tsee Khang and Mr. Pemba Labrang, Executive secretary. Three villages were rewarded for maintaining the cleanest surroundings throughout the year. TMS guidelines kits and identity card were distributed to TMS members of the settlement.

Moreover, hospital staff members did planted silver trees and different flowers in the hospital premises as to enhance the environment.

Menlha Hospital, Odisha: On World Health Day, Menlha hospital conducted a health talk to spread awareness on Malaria with the theme “Vector Borne Disease: Small Bite, Big Threat”. Nurse Tsering Dhondup talked about Malaria and its preventive methods. 78 settlers attended the talk.

TPHCC Dekyiling, Dehradun: Tibetan Primary Health Care Center, Dekyiling celebrated World Immunization Week from April 24-30 with the aim to promote one of the world’s most powerful tool of disease prevention. Staff Nurse Dekyi Kari visited each camp to raise awareness on the importance of immunization and successfully reached out to 352 settlers.

In addition, World No Tobacco Day was observed on 31 May to protect the present and future generations not only from the devastating health consequences due to tobacco, but also from the social, environmental and economic scourges of tobacco use and exposure to tobacco smoke.

Dr. Tenzin Dadul (Dentist) gave valuable talk to draw attention to the settlers regarding the use of tobacco and the negative health effects. 150 people attended the talk.

mosquitoes. The event raised awareness about the threat posed by vectors and vector-borne diseases and to educate the communities to take action to protect themselves by cleaning up surroundings and taking the related precautions. Men Tsee Khang Doctor talked on basic health education and Nurse Tenzin Dickey talked on the year’s theme. 120 settlers attended the event.

TPHC Mainpat: World Cancer Day was marked at Mainpat settlement on February 4 to raise awareness of cancer and to encourage its prevention, detection, and treatment. Staff Nurse Tenzin Nordon gave an awareness talk keeping in mind the year’s theme “Debunk the Myths”. 122 settlers attended the event.

Tibetan Primary Healthcare Center observed World Health Day on 7 April 2014. The talk was organized in each camp on year’s theme to encourage people’s involvement in the program. The talk mainly focused on the causes, signs and symptoms, mode of transmission, its prevention and treatment of diseases. Men Tsee Khang Dr. Pema also talked on the basics of Traditional Tibetan Medicine. 90 settlers participated and cleaned their own respective surroundings.

Tibetan Primary Health care Center Mainpat has organized World No Tobacco Day on 31 May 2014. The health talk was arranged campwise to optimize people’s involvement in the program and to promote better understanding. Staff

PHC Norgyeling, Bhandara: World Health Day was organized at Bhandara Tibetan settlement with the theme of “vector-borne disease: small bite, big threat” on 7 April, 2014. Hospital Executive Secretary mentioned that Bhandara settlement is well-known for its high temperature and Tibetan Health-TVHA

13

Nurse Chunkyi marked World No Tobacco Day, highlighting the health risks associated with tobacco use and advocating for effective policies to reduce tobacco consumption. 85 settlers attended the event.

TPHC Bir: Tibetan primary health center Bir organized a talk on Osteoarthritis on 15th January 2014 at Bir settlement. Volunteer Mrs. Orla, an experienced nurse in the field of osteoarthritis for last six years gave health education and taught various exercises to treat arthritis which were really helpful as per the feedbacks received from health center to promote awareness on gastric problem, the most common disease in our comthe settlers. 25 adult attended the event.

Health center also marked the World Can- munity. Dr. Tenzin Dechen and Mr. Sonam Gonpo Hara carried the event and about 30 elder people attended the talk.

TPHC Bir in collaboration with Vivekanand Medical Institute (VMI), Palampur organized a free knee check up camp for community on 27 May 2014. Dr. R.K Jha, senior orthopedic surgeon carried the event accompanied by health center staff members. The event aimed to detect and treat the common ailment like arthritis and ligament injuries. A total of 39 people with knee problem benefitted from this camp.

On 7 April, World Health Day event was cer Day on 4 February to raise awareness about organized and graced by settlement officers of Bir cancer, its prevention and diet. Executive Sec- Tibetan Society and Chauntra. Dr. Tenzin Dechen retary Mr. Sonam Gonpo Hara carried the event gave a health education talk on the vector borne and 38 people participated in the event. The com- disease, its mode of transmission, etiology, prevmunity took great interest in listening to the talk. alence in the community and prevention. 41 set In addition, on 19 March 2014, the health tlers attended the talk and positive feedback were center also arranged a talk on health education received from the participants. and covered topics on Basic First Aid for Burns, Cuts, Severe Bleeding, Spine Injury and basic TPHC Miao: Tibetan Primary Health Center orCPR. Volunteer registered nurse Bruce Mencias ganized the World Health Day on 7 April to proand Sara Rita Da Costa were the speakers and mote the basic health information about vector topics were discussed with visual aids, demon- borne diseases to the settlement people. Resource persons were Nurse Dolkar Palmo and Dr. Bhastration and a translator.

In February, a health talk was hosted by tacharya who provided talk regarding the causes

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and the prevention of Malaria and Dengue.

In the settlement, the main causes of these diseases were highlighted to be due to negligence, untidiness around home and disarray disposure of wastages. “It is the duty of each and every individual to keep their surroundings dry and clean in order to stop breeding mosquito”, he added. 320 settlers attended the talk. They also talked about the growing drug addiction problem among the younger generation.

Poanta Clinic: World Cancer Day was organized on 4th February 2014 to promote awareness on cancer, its causes and ways to reduce the burden in our community. Dr. Lobsang Yeshi, Men-TseKhang and Pema Tsering, Community health worker were the resource persons. 32 settlers attended the event.

In addition, World Health Day event was

better understanding and knowledge.

Satuan Clinic: On 7 April, World Health Day was organized at Satuan Tibetan settlement to raise awareness on diabetes to the settlement people.

Community health worker, Passang carried the event to educated the people on Diabetes mainly on its causes and symptoms. The event also included cleaning the environment which is essential for human health and well-being. 40 settlers attended the event.

Kullu Clinic: World Health Day was observed at Kullu Tibetan settlement to raise awareness on health education. Men Tsee Khang Doctor and community health worker, Tenzin Passang carried a talk on health and provided basic health information to the settlers. 50 setters attended the talk.

organized on 7th April 2014 with the theme of vector bone disease. Community Health Worker, Pema Tsering and Karma Yeshi gave health talk on malaria and dengue where as Men Tsee Khang’s Dr. Shakya Gyaltsen addressed public on general health awareness followed by question and answer session. Poster and pamphlet were distributed to the participants for better understanding.

About 130 settlers attended the event and the day ended up by cleaning the environment and using insecticide spray in every muddy and dirty area of the settlement and its school.

World No Tobacco Day was conducted at Paonta settlement with the participation of youth players of Gyalyum Chemo Memorial Gold Cup Football Tournament on 31th May, 2014. Around 40 players attended the health talk by Community Health Worker, Pema Tsering. The talk mainly focused on its prevention and health consequences of Tobacco use. Pamphlets are distributed for

Puruwala Clinic: The International Day against Drug Abuse and Illicit Trafficking was organized in collaboration with settlement office on 26 June 2014. About 60 community members attended the event. Community Health Worker Tenzin Topden raised awareness of the major problem that illicit drugs represent to society, in particular young people. Moreover, “Keyma” movie was shown to the settlers for better understanding which create awareness on substance abuse.

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Message of Health Kalon on World Cancer Day 4 February World Cancer Day, an initiative of the Union for International Cancer Control (UICC), is a global event during which the entire community of the world unites to fight against the global cancer epidemic. The main purpose of commemorating this day is to raise global awareness and provide education to prevent cancer. The day is also marked for making concerted efforts to act to prevent cancer, both at individual and at governmental level.

These tumors can either be benign, which are not cancerous and generally pose no threat to life, or malignant, which have the ability to spread and destroy neighboring normal tissues thereby causing metastatic cancer. There are many factors that contribute to the development of cancer namely: alcohol, carcinogens, use of tobacco, genetic predisposition, weakened immune system, radiations, increasing age and infections. The signs and symptoms of cancer are also varied. However, some common signs and symptoms are presence of lumps, changes in bowel habits, unexplained bleeding, unexplained weight loss, coughing and breathlessness, and fatigue.

In the Tibetan community in India and Nepal, there is a lack of strong evidence based data on cancer epidemiology. But generally, certain cancers like stomach cancer, esophageal cancer and liver cancer have been seen to be common causes of morbidity as well as mortality in the Tibetan exile population of India and Nepal.

There are many myths and misconceptions about cancer in society that may hamper the efforts to reduce of the disease burden globally. The UICC theme of this World Cancer day for 2014 focuses on reduction of cancer stigma and removal of myths about cancer, under the tagline “Debunk the Myths”. Four general myths about cancer have been highlighted, which are: 1. We don’t need to talk about cancer.

2. There are no signs and symptoms of cancer.

3. There is nothing I can do about cancer.

4. I don’t have the right to cancer care.

To honor World Cancer Day, I encourage everyone to take active steps in our personal lives to discuss and prevent cancer. First, open discussions about cancer with partners, family members, friends and colleagues can help to alleviate feelings of fear, anxiety and sadness that are associated with cancer. Providing proper support for persons living with cancer can help them cope and improve their quality of life. Secondly, for many cancers, there are warning signs and symptoms. Awareness is the first step to early detection and improving cancer outcomes. We must remember that more than a third of all cancers are preventable by reducing exposure to risk factors like alcohol, tobacco, obesity and physical inactivity. Early detection of cancer can play a crucial role in treatment and reducing the burden. It is very important to recognize the early signs and symptoms of cancer and take prompt action to seek medical attention.

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Message of Health Kalon on World TB Day March 24 commemorates the day in 1882 when Dr Robert Koch discovered the cause of Tuberculosis (TB), the tuberculosis bacillus. Since then, 24th March is observed every year as World TB Day worldwide. Tuberculosis is a preventable disease which can be prevented and cured easily by prompt and proper diagnosis and treatment.

The theme of World Tuberculosis Day, 2014 is “Reach the three million: A TB test, treatment and cure for all”. It has been highlighted in WHO 2013 Global TB Report that diagnosis of TB is missed for at least three million people suffering from TB. Even though TB is very much curable, our current efforts to identify, treat and cure people with TB are not sufficient. Most of these three million “missed” people live in the developing countries in some of the poorest communities, and they also include refugees. In 2013, we have seen one of the highest numbers of refugees and internally displaced people amounting to 45.2 million worldwide according to UNHCR. There has long been a significant connection between refugees and TB disease, and as many as half of the refugees of the world may be infected with TB. The difficult living conditions for Tibetan refugees cause many to be at risk for TB. The prevalence of TB was around 30% in the Tibetan refugee population in the early years of exile in the 1960s. Although social conditions have greatly improved over the years, TB continues to be a high public health threat in the Tibetan refugee population, particularly drug resistant TB. The Department of Health (DOH) has a TB control program which treats and gives care to Tibetans suffering from TB disease across various settlements in India through its wide network of health care centers.

The program practice its assignments in conformity with the treatment guidelines laid down by the WHO and that of the host nation, India. The primary health centers serve as first referral centers for patients within the settlements and the hospitals provide basic diagnostic and treatment facilities. The DOH is fully committed and has continued to raise awareness and mobilize support from all aspects in this fight against TB in our community. The clinics and hospitals provide either free or subsidized TB drugs for both standard and multi-drug resistant TB regimens and nutritional supplement for the TB patients. TB diagnostic tests like culture and GeneXpert are done free of cost. Regular TB screening is done in the schools and the monasteries through active case finding for early detection and treatment. Over the years, the department’s TB Control Program has continued to make remarkable achievements in provision of TB treatment in our community.

This World Tuberculosis Day is a time to be positive in the fight against TB in the Tibetan community as well as the world at large. It is important for every Tibetan to be ‘TB aware’. We must take action to understand the disease and call for interventions to reach out and give treatment to the people who may have TB but who have not been diagnosed. The department, with its active TB screening programs, aims to screen and identify potential patients who are unaware of their TB status. Researches done in the past have made us more aware of the distribution and determinants of TB disease in our community. It is now the time to act to reduce the disease burden so that we can have a TB free community in the near future.

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Message of Health Kalon on World Health Day 7th of April, every year, is commemorated as World Health Day. The theme of this World Health day is ‘vector-borne diseases: Small bite, big threat’. This year, the day focuses on vector-borne diseases and protecting ourselves from these diseases.

Vector-borne diseases are diseases which are transmitted through small organisms such as mosquitoes, bugs, ticks, flies, bugs, and freshwater snails from person to person and place to place. These small organisms are called vectors. They can put our health at risk, at home and when we travel. Some of the common vector-borne diseases in India are malaria, dengue fever, kala-azar, filariasis, chikungunya and Japanese encephalitis.

In 2013, the health information system (HIS) of the department of health (DOH), CTA reported 118 confirmed malarial cases from our Tibetan settlement in Odisha alone. Other Tibetan settlements that have reported significant malarial cases in 2013 are Bhandara, Mainpat, Miao, Tezu and Tuting. We have also seen individual cases of malaria in Bylakupee, Kollegal, Bir and Dekyiling, thereby comprising a total of 248 malaria-related cases in our health centers.

In addition, dengue outbreaks in Delhi last year have led to increase in dengue cases in Samyeling Tibetan settlement of Delhi due to the effects of ongoing continuous public mobility and travel through Delhi. We had 156 cases of dengue fever in Samyeling Delhi alone in 2013. Delek Hospital reported 30 cases of dengue whereas 29 dengue cases were reported each from the hospitals of Bylakupee and Mundgod settlement in 2013.

In recent years, the department of health, CTA has made renewed commitments in combating these diseases through widespread public awareness, education and other control measures. With funding support from Norwegian Church Aid (NCA) in 2013, the department initiated a malaria awareness and prevention campaign in five Tibetan settlements of Mainpat, Bhandara, Miao, Tezu and Tuting, which are located in malaria endemic regions of India, and distributed around free and highly subsidized insecticide-treated bed nets to people as one of the most effective way to reduce contact with mosquitoes. This year, we are determined to distribute free and highly subsidized insecticide-treated bed nets to Tibetan people of Phuntsokling Tibetan settlement in Odisha state under the budget year of 2014-2015.

Both malaria and dengue fever are preventable as well as treatable. We can take the following steps in order to prevent and protect one from these diseases: 1. Know about these diseases and particularly, know about how you can protect yourself and your family from these deadly diseases.

2. Take personal precaution to avoid bites from mosquitoes, particularly at night, by using mosquito repellent creams, wearing long sleeved clothes, using anti-malarial insecticides and spray. Always sleep inside the insecticides treated bed nets if you live and travel to an endemic region of diseases like malaria.

3. Make all efforts to reduce mosquito breeding sites around your house like standing water through regular cleaning of your surroundings, and by screening of windows and door of house with wire mesh to reduce entry of mosquitoes and other insects inside the house.

4. Get diagnosed early and get complete treatment when you have any signs and symptoms of these diseases. The first symptoms of malaria are usually very similar to ‘flu – aches and pains, fever, headache and so on. After a few days, chills, followed firstly by a high fever for a few hours, and then by profuse sweating occur. For dengue, symptoms usually begin 4-6 days after infection, lasting up to 10 days and include sudden high fever, severe headache, pain behind the eyes, severe joint and muscle pain, nausea, vomiting, skin rash and mild bleeding.

Prevention and control of vector borne diseases are, and must be, the responsibility of every one!

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List of Donor from January to June, 2014 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.

Donor

Country

1

Johns Hopkins University

USA

2

Ida Van Gulik

3

Vimala Associazione

Italy

4

Associazione Villaggio Terra Ong

Italy

5

Shenpen Tibet Aid

Norway

271,050.00 Health Project in Sonada

13.1.2014

6

Lhakar Tsochung

Australia

63,756.88 Tibetan Medicare Project

16.1.2014

65,829.00 Tibetan Medicare Project

21.1.2014

10,883.00 Tibetan Medicare Project

10.2.2014

500,000.00 Tibetan Medicare Project

28.4.2014

1,100,000.00 Tibetan Medicare Project

25.5.2014

7

8

BMZ & Malteser International via MIA

Tibetan Friendship Group

Belgium

Germany

Australia

Amount (Rs)

Purpose of Donation

Received On

S.No

The Epidemiology of Chronic Hepatitis B Sponsorship of Ngoenga 58,000.00 School

108,936.00

1,270,153.00 Tso Jhe Maternity & TB Ward 82,640.00

Substance Abuse Rehabilitation Project

5,235.00 Torture Survivors program 20,940.70 Eye Health Program Sponsorship of Ngoenga School Sponsorship of Ngoenga 175,525.82 School Sponsorship of Ngoenga 334,182.00 School

186,537.00 9

10

The Tibet Fund

Tibet House Trust

11

PRM Via SARD

12

Lhakpa Sigrist

USA

UK USA Switzerland

NCA Via SARD

Norway

4.1.2014 6.1.2014 13.1.2014

27.1.2014 27.1.2014 28.2.2014 30.4.2014 6.3.2014

2,900,603.00 Torture Survivors program

9.4.2014

5,648,546.00 Basic Health Care & HIS

19.3.2014

Sponsorship of Ngoenga School

20.3.2014

30,000.00

154,092.00 Malaria Control Programme

31.3.2014

290,000.00 Water & Sanitation Project

31.3.2014

388,000.00 Gynaecology Health Care

31.3.2014 31.3.2014

1,180,236.00 Renovation of PHC,Miao 13

3.1.2014

570,400.00 HIV/Aids Project

31.3.2014

250,000.00 Water Project,Kollegal

23.5.2014

Haematology Analyser, Kollegal

23.5.2014

650,000.00

708,970.00 Medicine Purchased, DTR

23.5.2014

39,662.00 Medicine Purchased, DTR

3.6.2014

Tibetan Health-TVHA

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14

Tsamchoe Dolma

USA

15

Shenpen Tibet Aid

Norway

16

Sharon D.Parr

USA

17

German Aid to Tibetans

Germany

18

University of Rochester School

USA

19

Mr. Chung Chih

20

SOIR-IM, Swiss Via Rajpur

Sweden

21

Mrs. Catherine Gobonya

Switzerland

22

AET Via CTRC

23

Yeshe Norbu Appello

Italy

24

Dekyi Yangchen & Friends

USA

25

PRM Via SARD

USA

26

NED (National Endorment for Democracy)

USA

27

Tenzin Jampa Samdo

USA

Taiwan

10,000.00 Leprosy Patients 386,360.00 Health Project in Sonada

17.4.2014

Sponsorship of Ngoenga School

17.4.2014

2,084,163.00 Tibetan Medicare Project

25.4.2014

239,012.00

335,538.00

213,753.98 Hepatitis B Project 69,300.00 Tibetan Medicare Project The Adolescent Health Booklet Publication Sponsorship of Ngoenga 340,181.00 School Drinking Water Project, 1,275,624.00 Mundgod 131,560.00

733,425.00 Tuting Health Center 94,717.90

Tibet Relief Fund

UK

57,228.00 HIS 552,392.00 HIV/Aids Project 24,717.00

Africa Tremila

Italy

30

Tseten Gawa

Nepal

Total

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Tibetan Health-TVHA

Sponsorship of Ngoenga School

5.6.2014 29.4.2014 1.5.2014 3.5.2014 10.6.2014 3.5.2014 14.5.2014 15.5.2014 23.5.2014 3.6.2014 3.6.2014 3.6.2014 5.6.2014

96,000.00 Driver Salary, Tenzingang

5.6.2014

Ambulance Maintenance, Tenzingang

5.6.2014

8,282.00 Emergency Relief Fund Hep. B Awareness & Training Project Supplementary salary for 1,189,298.00 six Doctors Salary for visiting Doctor at 118,273.00 Fosco Maraini health center Ladakh Sponsorship of Ngoenga 40,000.00 School 1,080,279.00

29

Sponsorship of Ngoenga School

4,734,951.00 Basic Health Care

10,000.00 28

Dental Chair & Equipment, Miao

320,000.00 Health Project

France

10.4.2014

31,209,232.28

5.6.2014 11.6.2014 11.6.2014 25.6.2014 26.6.2014

Hospital received Inkind Donation from Donor w.e.f January to June 2014

S.No Particular Digital X-ray & Computer 1 & UPS, Cassettes 2 Induction Cooker 3

Quantity Amount(Rs) Donor

Infra red Thermometer

1

900,000.00

BU Gankar Rinpoche

1

3,200.00

Ajay Medico, Palampur Nurse Barbara from Belgium

1

Place TPHC, Bir ‘‘ ‘‘

Department staff update from January to June 2014 New Appointment:

S.No Name 1 Tenzin Sangmo 2 Tenzin Dolkar 3

Sonam Choedon

Designation Junior Clerk Office Assistant Office Superintendent

Place Date Remarks Department of Health 18.04.14 Newly appointed Department of Health 16.04.14 Newly appointed Transferred from Department of Health 03.06.14 Finance Dept.

Transferred:

S.No Name 1 Tsering Dolker 2

Designation Section Officer Office SuperinTenzin Choephel tendent

3

Tenzin Kunchok

Office Superintendent

4

Tenzin Choney

Junior Clerk

From To Dated Dept. of Health Settlement Office, Ladakh 15.03.14 Dept. of Health Settlement Office, Ravangla 10.04.14 Cabinet history documenDept. of Health tation & Interim place14.04.14 ment section Dept. of Health Kashag Office 23.06.14

TVHA staff update from January to June 2014 New Appointment:

S.No 1 2 3 4 5 6 7 8 9 10

Name Tenzin Phuntsok Arti Devi Jigme Kalsang Dolma Tsering Yangchen Lhamo Lama Kalsang Dolkar Lobsang Tashi Tsering Dhondup Tenzin Shedhen Passang

Designation Driver Sweeper Medical Officer CHW Registered Nurse CHW CHW B.Sc Nurse Peon/Sweeper Sweeper

Place TPHC Miao TPHC Bir DVT Hospital Lo- Tserok Clinic, Nepal Tashi Palkhiel Clinic, Nepal Tashijong clinic Khera/Lakhanwala Menlha Hospital, Odisha PHC, Ladakh Phende Hopsital, Hunsur

Dated 01.02.14 25.02.14 11.03.14 15.03.14 01.04.14 01.04.14 18.04.14 22.04.14 01.05.14 01.05.14

Remarks Contract

Temporary Temporary Contract Temporary Temporary

Tibetan Health-TVHA

21

11 12 13 14 15

Tsewang Gyurmey Kunsang Dolma Dr. Sonam Dhondup Kalsang Dolma Tenzin Youdon

Driver Staff Nurse Medical Officer Staff Nurse Staff Nurse

Changthang, Ladakh Changthang, Ladakh TsoJhe Hospital, Bylakuppe Changthang, Ladakh TPHC Bandara

Designation Pharmacist Office Sec./Cashier Sweeper Driver CHW

Place Menlha Hopsital, Odisha Phende Hospital, Hunsur TPHC Bir Changthang, Ladakh Kamrao clinic

05.05.14 05.05.14 05.05.14 01.06.14 04.06.14

Resignation:

S.No 1 2 3 4 5

Name Danadan Panda Tsering Tsomo Gamo Dorjee Tsering Tenzin Norphel

Dated 05.02.14 11.02.14 15.02.14 02.04.14 17.05.14

Remarks Contract Contract Contract

Transferred:

S.No 1 2 3

Name Nyima Tsering Tenzin Lhawang Pema Tsering

4

Karma Thinlay

5

Sonam Yougyal

6 7 8 9 10 11

Tenzin Dickyi Dechen Tsomo Tenzin Dickyi Tenzin Topden Tenzin Tsewang Dawa Choedon

Designation CHW Exe. Secretary CHW

From PHC Bandara PHC Mainpat Khear/Lakhanwala DTR Hospital, CHW Mundgod Ngoenga Di- Menlha Hospital, rector Odisha Staff Nurse PHC Bandara CHW Gangtok clinic Staff Nurse Dekyiling Hospital CHW Ngoenga School Dental Therapist Tso Jhe Hospital CHW PHC Mainpat

To Pondoh/Rewalsar Menlha Hopsital, Odisha Poanta clinic

Dated 23.01.14 27.01.14 01.02.14

PHC Mainpat

01.02.14

Ngoenga School

05.02.14

Dekyiling Hospital Ravangla clinic PHC Delhi Puruwala clinic DTR Mundgod PHC Bir

20.02.14 11.03.14 01.04.14 15.04.14 05.05.14 15.06.14

Retirement:

S.No 1 2 3

Name Dawa Tsamchoe Tashi Wangchuk Sonam Gonpo Hara

Designation Nurse Aid CHW Exe. Secretary

Place Tashijong clinic Rajpur clinic PHC Bir

Dated 13.03.14 17.04.14 05.05.14

Remarks Early Retirement Early Retirement

Ngoenga School Transferred:

S.No Name Designation 1 Tsering Yangzom Staff Nurse

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Tibetan Health-TVHA

From To Ngoenga School Lingtsang/Clementown

Dated 26.06.14

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. Following 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, liver disease, cataract, cholecystectomy, upper respiratory infection, 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 special school for 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

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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 8.9% 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 screening and vaccination of general public in remote locations.

4) Construction of new staff quarters for medical doctors and staff members at Kollegal and Miao: The present staff quarters are constructed 35 years ago in 1974 and now in a very poor condition. So far numerous minor repairs and maintenance work has been 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.

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Tibetan Health-TVHA

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, and 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

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

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Mobile Health talk at remote Jangthang area inLadakh.

World Environment Day at Ravangla settlement.

A run for TB marathon at Miao settlement.

World Drug Day awareness talk at ladakh.

World Hepatitis Day awareness talk at Poanta settlement.

World Drugs Day awareness talk on Canabies at Mandi settlement.

Dr. Dadul raised awareness on World TB Day at Dekyiling.

Women Basket ball match on World TB Day at Paonta.

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Tibetan Health-TVHA

Tibetan Medicare System awareness and enrolment campaign for the Tibetan sweater sellers and Tibetan Settlements.

DoH and Hospital administrators negotiated with cooperate hospitals to provide concession on inpatient bills of the Tibetans.

New Ambulance at PHC Bandhara and PHC Miao funded by Yeshi Norbu and Vimila Association, Italy

Tibetan Health-TVHA

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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.

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.