Gaden Relief Projects Helping Tibetans preserve their unique culture. Trip Report

Zadoh Preliminary Trip Report – September 2001
Submitted September 11, 2001

By Dr. Robbie Chase

[Excerpted from an email message to Zasep Rinpoche.]

1. MEDICATIONS FOR LAMA RIGDEN AND OPUG'S WIFE

I started to write instructions in English for taking the medications for hypothyroidism and diabetes. Both are chronic conditions and the dosage will need adjusting based on symptoms and urine tests. This needs to be translated and given to them BEFORE they start taking them. Rinpoche, I was going to email this to you and then you could translate it and mail it to Jamdak?

First, I need to confirm the pills George ordered:
Metformin (for diabetes) was 500 mg, (how many? 1000?).
Thyroxine I don't know the pill size - 50 micrograms?

Can Sharon track down the exact strength and number? I will get this to you when I have the information to work with.

2. CAN-MAP

Today I sent a letter to Carole Jay at CANMAP with a signed prescription for the medications they supplied. According to her records the medicines CANMAP provided had a price of $210.35 CAN, with a value of $444.48. We used all the acetaminophen (tylenol), hydrochlorothiazide (by high blood pressure), metformin (diabetes), and cimetidine (stomach ulcer), which has the value of $222. The other mediations (amoxicillin, iron tablets, and penicillin) were donated to Dr. Urgyen inYushu.

Not included in this is the albendazole tablets (for hydatid cyst and intestinal parasite treatment) and the tobramycin drops (for eye infections) that John Rumball arranged - cost for this was $400?

3. OTHER MEDICATIONS COSTS

At least half of the bulk of the medications we brought was donations, a lot of them antibiotics, oral contraceptives, and topical treatments. Overall I would say they had greater value than the CANMAP donation $600, but we didn't distribute them as much, and what remained was given to Dr Urgyen's clinic. This includes a few knee, wrist and back braces, wound cleaning solutions and swabs, and elastoplast bandages.

Also, I purchased in Winnipeg 500cc wart remover ($35) - all used, and urinalysis test strips (500 for $225) and blood glucose test strips (200 strips for $165) - total bill $425 - paid by Gaden Relief. The total value then is $1870, out of which I would estimate that we distributed $300.

4. EQUIPMENT

On departure the following medical equipment was stored in the suitcase for future use:

1. hemoglobinometer- costs $375; works in 2x"C" size batteries available locally
2. 2 blood pressure kits - mercury filled
3. 1 blood pressure kit - rotary dial
4. 1 stethoscope
5. 1 Bayer 'Glucometer Elite' blood glucose meter. Uses a 'CR 2032' battery. Test strips and control testers expire within a year and will have to be re-purchased
6. 36 - 5cm x 4.5m rolls of elastoplast bandages

5. ZADOH HEALTH ACTIVITIES

I recorded 141 patients seen at the clinics and sessions we organized. I summarized this in a 6 page table listing age, sex, site, health complaint, blood pressure, hemoglobin level if taken, and treatment (TB sputum test, advice or which drug given). I will send a copy of this to Evan for his records. In summary, 78 were women, 63 men. Five were 13 years or younger (9%), 27 older than 60 years (19%), the rest between 17 and 59 (109 people, 72%). We saw 28 at our first clinic at the Zadoh hospital on August 11, 38 at the second clinic on Aug. 20, 19 elsewhere in Zadoh (Karno's house and elsewhere), 7 during household visits connected with the genogram interviews, 30 at Jamseng Health Centre, 10 at the nunnery, and 8 seen at Jhampa's house on the way to Chepu.

There were probably an additional 20 for whom I didn't write anything down, of which half would have received pain medication. Eighty-two (58%) received acetaminophen or another pain/arthritic reliever. Ten (7%) received blood pressure medication. A 25-day course of cimetidine for ulcer treatment was given to 6 individuals. Other less common medications included metformin to two diabetics, cough syrup to 4, amoxicillin courses to two children with perforated ear drums and chronic ear infections, topical cortisone and antibiotics for chronic skin conditions. Six had a morning sample of sputum collected, a slide prepared - I will hand these over to the HSC TB laboratory here [in Winnipeg] for staining and examination.

6 ACTIVITIES IN CANADA

Today I got four CD copies of most of my digital pictures. I saved them all as jpegs, but did not shrink their size or quality too much; most are still big files 200-400 KB and are not he best format for a website or email. I will keep one copy, send one to Evan, one to a Toronto friend of mine, so I have copy for you if you would like me to send it to you, let me know.

I went to Videovid in Vancouver and they recorded a half hour I did summarizing the trip and talking about the health issues. I hope that ends up being useful for Evan's CD project.

In the next month l will prepare a report summarizing our experience, and thoughts about future activities which I will share with you and others (Michele, Sharon, Evan and Conrad) for comments and changes. I still need to organize my notes and contacts about this.

I would be happy to help organize proposals for future plans, but I am not in a position to lead it. The idea of a meeting in Vancouver with people in the Zadoh committee, Rokpa, Seva and TRAS (including Isaac Sobel, Candace Cole and colleagues at UBC) sounds great, over a weekend at the end of November or early December was suggested, which would work for me. Let me know if this is likely to happen so I can plan.

Work starts up again with lots to do. The MSF project has moved ahead while I was away, with plans that Tajikistan will be the site for the first pilot program for children. I will be in Toronto Sept 21-24, and October 12- November 12 for that project, which involves developing the 'genogram' into a useful assessment tool to help with program evaluation. It was great to have an opportunity to use it in the households we visited in Zadoh.