Planning your elective: Tibet

Mark Wilson gives you the lowdown on planning your elective in Tibet.

This month's elective report is truly fascinating, and I take my hat off to Kieren for being the first person I know who has been able to do an elective in a Tibetan monastery hospital. This does of course make it rather difficult to give advice on planning an elective in Tibet. Before Tibet opened up, I studied Tibetan medicine at Men-Tsee-Khang in Dharamsala, north India--the home of the Dalai Lama and the Tibetan government in exile. It was an amazing experience, and an elective studying Tibetan medicine would be a fantastic way to experience Tibetan culture.

The region

Tibet is in the Himalayas, bordered by India, Nepal, and Bhutan to the south. It sits on the highest plateau in the world, averaging a height of 3700 m. This remoteness kept Tibet separate from the rest of the world. People lived peaceful lives and the Tibetans developed their own sciences and systems, such as Tibetan medicine. In 1949, however, this all changed. China decided to invade Tibet claiming that it was "liberating" the people. The Dalai Lama fled in 1959. The atrocities the Chinese did, the knocking down of Tibetan monasteries, and the destruction of Tibetan culture turned Tibetans and the rest of the world against China. China continues to oppress the Tibetans--for example, by imprisoning the Panchen Lama (a small boy, second to the Dalai Lama) and nominating their own leader. These problems have meant that any foreign visitor to Tibet, until recently, has had to be escorted on a Chinese run tour. Be wary while doing research if planning an elective in Tibet. The Chinese put out information on the state of health care that many organisations say is wildly inaccurate.

Tibetan medicine

Tibetan medicine cannot be summarised in one paragraph. Its origins date back more than 2000 years and were influenced during its development by conferences with doctors from India, China, and Iran. The foundations are based in four tantras. These are commonly painted as trees--the trees of physiology, pathology, diagnosis, and cure. Like ayurvedic medicine (Indian) the five elements of bodily energy (earth, water, fire, air, and space) are central to the tantras. Any self respecting Western medic would dismiss all this as nonsense--indeed, it has similarities to medieval medicine in Britain. Evidence now shows, however, that some Tibetan drugs and treatments, such as branding and cupping, may actually have scientific merit. Remember this has developed over thousands of years, and Tibetans and many others believe in it wholeheartedly. Do not just dismiss it because it does not make sense to our teachings. A more detailed introduction to Tibetan medicine can be found at www.tibetan-medicine.org

Hospitals in Tibet

As explained, access to hospitals in Tibet itself is extremely limited. It is important to decide whether you want to do modern Western medicine or Tibetan medicine. The latter is practised mainly by monks in monasteries. Information on Western style hospitals is easier to come by.

The TAR People's Hospital (Xizang Zizhiqu Renmin Yiyuan) (tel +86 891 633 2462; fax: +86 891 633 3478) is a huge hospital on the Linkuo Beilu in Lhasa. The jijiu zhongxin (emergency treatment centre) is next door. These are Western style hospitals.

Lhasa City People's Hospital (Lhasa Renmin Yiyuan) sits on the eastern side of the junction where the Beijing Donglu meets the Linlang Donglu. It is a modern medicine hospital.

Tibetan Medical and Astrological Institute (Mentsikhang) is opposite the Barkhor Square. The Mentsikhang is a Tibetan medicine hospital. You must bear in mind that this is now under Chinese control. Many of the doctors who were originally here fled Tibet and set up Men-Tsee-Khang in Dharamsala.

Yanwangshan School of Traditional Tibetan Medicine, 6 Bai Ta Road, Lhasa 850 003, is China's replacement for the Tibetan medical school that used to be here.

Tibetan hospitals outside Tibet

Dharamsala is the seat of the Tibetan government in exile and home to the Dalai Lama.

Tibetan Medical and Astrological Institute of HH the Dalai Lama (Men-Tsee-Khang), Gangchen Kyishong, Dharamsala 176 215, District Kangra, Himachal Pradesh (www.men-tsee-khang.org) is the institute for the preservation and further investigation into Tibetan medicine. The hospital has a number of clinics all over India (and now throughout the world) that continue to practise Tibetan medicine. It has a clinic on-site and also one just up the road in Macleod Gange. The hospital has no beds here, but the Delek Hospital (for Western medicine) is right opposite.

Tibetan Delek Hospital, Gangchen Kyi-shong, Dharamsala 176 215, Dist. Kangra, Himachal Pradesh (www.tibet.net/eng/delekhospital) is run by the Tibetan community but serves the needs of the Tibetans, Indians, and Westerners living in the area. Although the hospital is run by Tibetans, the doctors are mainly unpaid Western volunteers. There is a long stay tuberculosis ward, and much of the outreach work is also focused on treatment for tuberculosis. There are about 20 inpatient beds for adults and children and daily or twice daily outpatient clinics, including a weekly antenatal clinic. The medicine practised here is Western style. There is also a torture victims unit on site (for new refugees from Tibet).

Visas and vaccinations

You need a visa to enter China. Previously, special arrangements have had to be made to enter Tibet. Contact the embassy for up to date advice (Embassy of the People's Republic of China, 31 Portland Place, London W1N 3AG; tel 0891 990 909; 020 7631 1430).

Cover for hepatitis A, polio, and typhoid is recommended, but you should have most of these already. Malaria is not a problem in Tibet, but take prophylaxis if passing though an affected area to get there.