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"On my part, I remain committed to the process of dialogue. It is my firm belief that dialogue and a willingness to look with honesty and clarity at the reality of Tibet can lead us to a viable solution."

Tibet’s forgotten children

December 14, 2007

By Dr Cesar Chelala
Gulf Times, Doha, Qatar
Thursday,13 December, 2007

NEW YORK: Recent studies on children’s health in Tibet reveal that
almost half of them suffer from malnutrition. As a result, they have
stunted growth and potentially defective intellectual development. In
spite of the Chinese government insistence on the region’s economic and
social progress, Tibet continues to be one of the poorest regions in the
world, with a per capita income of less than $100. New public health and
social policies are needed to ensure that children won’t continue to be
victims of a situation that places them, and their culture, at
considerable risk.

In 1996, the Western Consortium for Public Health, a private US-based
organisation, had concluded that the height of Tibetan children was a
matter of grave concern, and indicated that 60% of the children studied
fell drastically below accepted international growth reference values.
Their data indicated that children’s shortness was a result of
nutritional deficiencies –chronic malnutrition during the first three
years of life- rather than the consequence of genetics or altitude, as
had been previously suggested.

Chronic malnutrition makes children more vulnerable to diseases common
to children in the developing world such as intestinal and respiratory
infections, which are frequently fatal. In addition, chronic
malnutrition affects children’s neurological and physical development.
Although the Chinese authorities proudly claim that they have
significantly reduced Tibetan infant mortality rates, those rates are
still much higher than the ones for infants in China in its entirety.

The essential findings of the Western Consortium for Public Health were
later confirmed by a study carried out by Dr Nancy Harris –an expert on
Tibet’s health issues- and researchers from the Public Health Institute
in Santa Cruz, California, the University of California at Berkeley, and
the Tibet Medical Research Institute in Lhasa.

For over a decade, Dr Harris has spent six months each year in Tibet.
She and her partners are bringing basic medical care to more than 8,500
Tibetan children and families, who often live in settlements lacking
electricity and basic sanitation.

According to the study conducted on 2,078 Tibetan children up to seven
years of age, stunting was linked to malnutrition and was often
accompanied by bone and skin disorders, lack of hair’s pigmentation, and
other diseases of malnutrition. 67% of the children studied also had
rickets, a bone disease most frequently caused by vitamin D deficiency.
The study was carried out in children from 11 counties containing more
than 50 diverse urban and non-urban communities in the Tibet Autonomous
Region (TAR) of China. The children’s health situation is further
complicated by poverty and a poorly developed health infrastructure.

In 1993, Dr Harris launched the Tibet Child Nutrition and Collaborative
Health Project. Although initially it got financed by Dr Harris herself,
since 1994 it has received external funding. Dr Harris and her team are
implementing programmes aimed at lowering infant and maternal mortality
levels through a health care training and midwifery programme.

Many who were sceptical of the team’s approach to solving health
problems now praise its innovative approach to the health emergency
situation in Tibet. Dr Harris believes that most of what is needed to
improve Tibet’s children health situation already exists in Tibet’s vast
array of medicinal plants. In that regard, the collaboration of Tibet’s
traditional practitioners has proven to be essential for her program.
They, along with the spiritual leaders, are the ones who can lead a
community to change their health practices.

To further improve Tibet’s children health and nutritional status,
guidelines already successfully used by Dr Harris on a limited
children’s population should be followed on a wider scale: a rickets
education and prevention programme, encouragement of the use of an
indigenous high-protein root called droma, support for traditional
Tibetan medicine complemented with allopathic drugs when indicated, and
a health care training and delivery programme.

These measures should be complemented by strengthening the
infrastructure and access to health services, as well as by policies
aimed at reducing poverty and illiteracy. The children of Tibet, for too
long the victims of inadequate care and attention, deserve no less.

* Dr César Chelala, an international medical consultant based in New
York, writes extensively on health and human rights issues. He is the
author of Children’s Health in the Americas, a publication of the Pan
American Health Organisation.
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