Projects in India
Responsible Sustainable Development uplifts people living in poverty in a way that empowers them rather than doling out handouts and charity. It is best to give back power to vulnerable people so they can make choices about their lives rather than to be caught in a constant struggle of survival.
Tibetan Refugee Hepatitis B Project
India is home to over 100,000 Tibetan people who sought refuge there after their country was invaded in the late 1950’s. The Indian government has graciously welcomed the Dalai Lama and his people and has done their best to integrate them into Indian society. The Tibetan community lives throughout the country often in refugee camps. Leh, Ladakh is home to about 4,000 Tibetans.
The Tibetan people have a disproportionately high prevalence rate of Hepatitis B as compared with the general population. Transmission is from mother to child during childbirth and it appears the virus has been passed from generation to generation this way. Hepatitis B is caused by a virus that affects the liver which over time can lead to cirrhosis and liver cancer usually affecting people at the prime of their lives between the ages of 20-50 years old. Hepatitis B cannot be cured, but transmission can be prevented with an effective vaccine currently on the market. For those who are already infected, a number of new medications have been formulized to slow the replication of the virus and, therefore, prolong life.
The Tibetan people face many challenges being face-to-face with a potentially lethal virus. In accordance with the foundation of responsible sustainable development—to help people help themselves and others—I joined hands with the Autonomous Tibetan Provisional Government in India and set up a screening, vaccinating and treatment program for Hepatitis B. Our goal was to insure that all Tibetan people without the virus are vaccinated and that all people with active Hepatitis B have access to life-prolonging medication. The medication currently on the market is prohibitively expensive.
Hundreds of people with active Hepatitis B in the early stage were treated with traditional Tibetan herbal preparations found to slow the progression or the virus. Dozens of other people with more active and advanced disease were treated with western medicine until their virus went into remission. With the success of the project in Leh, the Tibetan Provisional Government adopted the program and now is providing Hepatitis B care for all of its citizens countrywide.
Hepatitis B Screening
A community in unity
A young woman stands inside the kitchen of her small mud-brick home in a Tibetan refugee camp in Ladakh, India.
“She scared,” the nurse translates to Dr. Cary Rasof, who has just diagnosed the woman’s mother with Hepatitis B.
“But your mother is old,” Rasof replies, trying to calm her down.
The woman relaxes slightly. Indeed, her mother has lived with hepatitis B, a potentially chronic condition that gradually damages the liver, in old age. Like, she will too. Either way, she’s still fearful after getting the diagnosis – for herself and her child.
Rasof found himself in this refugee camp by chance. Not tied to an organization or funding, Rasof is an independent volunteer who has committed his life serving others based on the principles of seva – an Indian term for selfless service. Rasof relies on 17 years of volunteer experience ans the connections he’s made to get from project to project, an d to help fund the testing and treatment for Tibetans with hepatitis B.
While in Ladakh working on a project to create better healthcare access for a remote village, he learned of the disproportionately high rate of hepatitis B among Tibetan refugees, and put together a public awareness program encouraging Tibetans to get tested. After giving 10 presentations, nearly all of the 2,000 in attendance agree to under testing. Of those, approximately 10 percent have been diagnosed with the virus, most unaware they were infected.
Rasof and Sidol, a Tibetan nurse from the nearby city of Leh, walk past a generator sitting at the entrance of the ramshackle clinic. Inside, the nurse-doctor duo pull up chairs around a small table. A medicine cabinet with semi-stocked shelves stands in the corner of the mostly empty room. Next door, a team of nurse assistants hunch over a table with vials of blood laid out on it.
“Out of 800 [patients], 80 have tested positive so far,” Sidol informs the doctor, looking down at her files. He nods, knowing the consequences and the importance of getting treatment.
Hepatitis B is a worldwide disease. According to the World Health Organization, the virus has infected approximately two billion people and 350 million suffer chronically, causing an estimated 600,000 deaths per year. The disease is most prevalent in Asia and the Pacific islands, accounting for 78 percent of those chronically infected in the world. The highly infectious virus spreads through childbirth, blood transfusions and sexual transmission.
In the Tibetans’ case, it’s most often transmitted through birth. Some who contract the disease cannot completely fight it off, leading to an increased risk of liver damage, cirrhosis of the liver and liver cancer. Though for many, including most of the refugees, the disease lies dormant, allowing them to conduct relatively normal lives.
Signaling the end of the day, the refugee camp’s driver pulls up in his dust-caked jeep designed for the rough Ladakhi terrain. Rasof and the all-women medical team pile into the vehicle to get a lift back to the main clinic. The jeep drives past a large metal sign that says, “IMMUNIZE. Miss not a single child” before stopping at a slightly larger, better maintained clinic.
Rasof walks into the office of Karma Gendun, the Executive Secretary for the Tibetan Primary Health Centre, and pulls out his laptop. He types up a medical report form for their staff to use as a template, paying close attention to its proper formatting.
Rasof has to feel comfortable dealing with bureaucracy in order to be effective in his work. He will sometimes approach the regional medical authority to discuss his plans and register his project. To more effectively handle this small project, however, he chose to involve as few people as possible.
“I would recommend staying subtle and under the radar because once politicians are involved there is confusion,” Rasof says. “We are for the people and keep it that way.”
Gendun walks in and takes a seat behind his desk. The two discuss treatment options and costs. The conversation turns to specific cases as Gendun pulls out a sheet with the names of patients who have been treated with traditional Tibetan medicine. Though it’s too early to definitively prove how many have been cured, his figures show that 30 per cent no longer show signs of the disease. The results demonstrate that the treatment is a potentially effective and safe option without the side effects of conventional drugs.
The Tibetan treatment is a hopeful sign for the community. It’s a local solution to a global problem, and just the kind of solution Rasof likes to see. He got into this line of work to create seva opportunities for others. As more Tibetans get tested and seek treatment, more Tibetan doctors get to help their own people.
“Personal and global transformation comes from being of service to others,” Rasof says. “It is through this notion of loving and giving that we change and grow and improve ourselves and our world.”
Women’s Health Project
Cervical Cancer kills over 300,000 women every year around the world. Most of these women are from developing countries and succumb to a disease that is completely preventable. Ignorance, embarrassment, indifference and poverty are all to blame for this senseless loss of life.
Northern India has been an area of political turmoil since Indian independence in 1947. Borders have been contested since partition and danger continues to weigh heavily on local populations. The Balti people are one such group living in these conflicted and isolated areas.
Turtuk is a small village in Northern India approximately 8 hours by car from Leh. To access the area you must cross the Karakorum Pass, the highest pass in the world, elevation 5200 meters. Until recently, the area was closed to outsiders, but with improved security, the Indian government now grants visitation permits for up to seven days.
Being so remote, the area lacks amenities and basic infrastructure. Health care facilities are available, but currently there are only male medical professionals. For personal and religious reasons, women cannot be examined by men. As a result, women will not go to the facilities for gynecological problems which are left untreated. It is well known and documented that gynecological infections and cancers are numerous among this population and lead to premature death.
A number of respected women in the community were chosen by the people to provide preventive healthcare services on the female population. In this way, the females in the community could have preventive healthcare services.
The ministry of health has committed to training the elected women to perform pap smears on women in the neglected communities.
The Faces of Turtuk
Microloans for People with AIDS
Millions of people live with HIV/AIDS in India. While the middle class is admittedly growing in a robust economy that seems immune to the global economic crisis, ignorance and discrimination seem to be growing and immune as well. People living with HIV/AIDS in India face tremendous hardship. Discrimination, physical and emotional abuse and blackmail are daily occurrences that wear and tear at the lives of those infected.
Burdened with innumerable challenges, people living with HIV must have hope and reassurance that they are beautiful as they are. To restore dignity people must find ways to sustain themselves through small self-made businesses. With improved personal income people living with HIV/AIDS will be more self-reliant and be able to weather the abuses they face in their society.
Oftentimes people have good ideas, but without capital they cannot bring their ideas to fruition. Being poor precludes people from receiving bank loans so good ideas stay good ideas, nothing more. Microloans are small manageable loans given to people who would otherwise not be eligible for a loan from a lending institution. A microloan was given to a a group of HIV+ women who formed a collective to embroider saris to earn needed funds to care for themselves. The microloan enabled them to rent a working space, purchase an embroidery machine and market their products