MB Civic

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.