By Meredith Aikman
Tibet, the name evokes images of soaring snow covered mountains, large valleys filled with yaks and sheep, maroon robed monks at Buddhist monasteries, ruby-cheeked children in brightly colored clothing and the wind blowing prayer flags. It also brings to my mind that of hope: hope for the people, hope for a spiritual belief, hope for preserving a culture, hope for survival. I wondered how hope could persevere with so much pain and so much despair. I found hope when I heard children laughing and playing games, and while watching villagers perform a traditional spring dance at a monastery. I felt hope when I viewed a Skilled Birth Attendant as she held the baby that she helped deliver.

In January and February, I had the fortunate opportunity to travel to Amdo and visit Tibetan Healing Fund’s projects. At an average altitude of 10,000-12,000 feet and temperatures around zero, it was necessary for a girl from Dallas to wear 6 layers of clothing, which included 2 jackets in order to keep warm. I attended the teacher-training workshop and visited with the Skilled Birth Attendants in Guide County, nomad villages in Guinan County, Labrong Monastery, Repkong County, Dowi County, and Kumbum Monastery and Hospital.

While in Guide County, I visited 3 of the newly trained Skilled Birth Attendants (SBA). Each of the SBA live in their native village where they assist with women’s health education, safe motherhood and delivery. Each of the women were grateful to have attended the training course and to a have better understanding about women’s health issues and were appreciative that the training course was designed to be simple, hands-on and practical. They all expressed their concern of living in a remote area and the lack of health education, knowledge and access to health care.

After discussing the health situations with the SBA and other women in the villages, I realized the importance of how the cultural factors, social and government programs influence the health issues, beliefs and perceptions. Because the birthing process is considered unsanitary, many women give birth outside the home or in stables. In some cases it is considered taboo for an outsider to assist in the birthing process as the outsider could carry evil spirits. Some of the practices are very innovative due to lack of basics like blankets, diapers, clothing, etc (not necessarily sanitary). To keep the babies warm and dry, mothers place the baby in a bag that is filled with dung soot. The soot absorbs the urine and feces and keeps the child warm.

After leaving Guide County we drove 5 hours to Guinan County to visit the nomad villages. Because of the isolation and lack of outside communication, many of the Chinese prison camps are located in this area…it felt and looked like Siberia. Up until 5 years ago these nomadic villagers lived in tents and wandered around herding sheep and yak. Recently they built “winter homes” where they spend the winter months and in summer they roam the grassland living in tents. As we pulled into the village, I could not believe the poverty, isolation, harsh environment and the number of yaks wondering about. We were greeted with smiles, tea and lots of yak and mutton. There are many thoughts and images that come to mind when I reflect on my time in the nomadic village but the issue that weighs on my heart is the children who appeared malnourished.

Our next stop was Repkong. The ethnic mix and topography of Repkong is fascinating. The valleys that make up the basin vary from rolling grasslands, which support the nomadic camps through forested gorges to barley and wheat terraces. I felt like the area has an air of the Wild West. During the spring festival people from all over the county travel by bus, foot or animal to attend the festivities at the main monastery. This was also a time that the nomads in bright colored shaggy, sheepskin coats with the ruby cheeks would barter or trade for supplies.

While in Repkong I stayed with Tsering Kyi, her husband and their twin girls. Tsering, is a westerned trained OB-GYN and conducted the Skilled Birth Attend training. Tsering was pleased with the outcomes of the SBA training and the dedication and eagerness of the women wanting to learn. With the training completed for one small area, Tsering knows that there are many village women and children who do not have access to health care and knowledge about safe motherhood delivery and preventable health care. Tibetan Healing Fund is working with Tsering to develop a strategy to help increase access to safe motherhood and create a network of midwives.

I was overwhelmed when I saw the harsh surroundings and life that the Tibetans face daily. The lack of water, the terrible condition of the land and the poor health situations are only a few of the difficulties that they must try to overcome. But the ray of hope for the future of many Tibetans is the concern and care from groups like Tibetan Healing Fund who are actually collaborating with villagers, leaders, government and others to listen to their ideas and to help improve the situation.