Cause of Women and Children's Health Care Developing
Women and children account for 66 percent of the Tibetan population. Whether they are healthy or not directly concerns the procreation and development of the whole ethnic Tibetan nationality.
In old Tibet, disease was prevalent and went untreated. A serious lack of doctors and medicine ensured slow population growth. In 1951 the population of Tibet had reached about 1 million, and the average life-span of a Tibetan was 36 years, the health of women and children couldn't be guaranteed. It was regarded as ''filthy act'' for women to produce children, 'they were only permitted to give birth in cattle pens or sheepfolds. Even on snow or rainstorms, women were not allowed into houses or tents to have their babies. When the infants were born, the lying-in women cut the umbilical cords, using unsterilized scissors, and then bound the umbilical cords, with woolen strings.
This primitive style of delivery raised the infant mortality rate to 153 per thousand. Many lying-in women died from complications resulting from retained placenta, bleeding after delivering and postpartum fever. If the mothers went through a difficult labor they and their infants would usually die. Almost nobody could escape death. Because of the adverse living conditions and primitive customs, the death rate of the infants was as high as 299 per thousand.
Since the peaceful liberation, the state invested 640 million yuan to Tibet for the construction of hospitals, improvement of medical and health conditions, the training of doctors and nurses, and the development of sanitation and antiepidemic work. The state also instituted a system of free medical care that exists only in Tibet. In other places, only our state's cadres and staff enjoy free medical care. Infectious diseases bubonic plague and smallpox were rapidly brought under control, and other diseases were treated and cured. The average life span of Tibetans has increased from 36 to 64.
There are many women working as doctors in the region who enjoy the love and respect of their people. Tshe-ring, who graduated from Beijing No. 2 Medical College, is among this and the head of first generation of women doctors. Today she is studying internal medicine at the Second People's Hospital in Tibet Autonomous Region. In 1971 she traveled to the countryside in Lhunze County to develop medical work, where she trained a group of health-care workers and solved the problems created by a lack of doctors and medicine. She remembers staying awake for three days and nights to save the life of a girl who had contracted poisonous dysentery.
Tshe-ring gave a medical catheter checkup for dexiocardia to five patients who had chronic mountain caress, along with a professor at the National Chestward orbital in Great Britain, which produced the results they ended for their research work of chronic mountain sickness, Since 1983 Tshe-ring has been the council member of the Chinese Medical Association.
Yeshe Yangzom is also a Tibetan doctor who graduated from a medical university in Beijing. She went to work in Tibet after her graduation. She had worked for ten years in Nagqu, scaled 4,500 meters above sea level on the high, cold plateau. In 1977 the Nagqu Prefecture launched an investigation titled ''Reviewing the Death of Tumor Patients from the Past three Years.'' She led two doctors and several village doctors and investigated more than 1,000 people in six villages, they cured the tibetan people as she was making the investigation. Once, when a lying-in woman was in shock because of the bleeding caused by a retained placenta, Yeshe Yangzom traveled for three hours on foot to save the woman's life.
Since 1970 medical health networks at three levels have been built in Tibet Autonomous Region and midwives have been trained to use new ways to deliver children. Up until 1977, there were 4,379 rural and pastoral medical workers and 1,556 midwives who had adopted these new skills. In 1980 in the prefectures and cities where these methods were being used, the rate of midwifery rose to 40 percent and increased to 52.2 percent in 1985, with the likelihood of a future increase.
The hospital delivery rate in 1984 increased by 40.5 percent more than that of 1980. The rate of illness by eclampsia before delivery in 1984 decreased by 33 percent from 1980, and this was basically controlled by 1985. In 1985 the infant modality rate in the Tibet Autonomous Region had decreased to 69.07 per thousand.
The departments of obstetrics and gynecology at each hospital were now equipped to check and cure cervicitis, vaginitis, uteritis and other diseases which endangered women's overall health. The dissemination of information about labor protection during pregnancy, postpartum period, lactation and monthly period had been enhanced.
The development of medical and health care and the improvement of the health of the population have decreased the infant and child mortality rates, and the birth rate and natural population growth rate are increasing yearly. In 1959, the birth rate was 14,35 per thousand and natural population growth rate was 8. 1 per thousand; the population was million; the average birth rate from 1970 to 1974 was 25 per thousand and the natural growth rate was 15.46 per thousand and the population was 1.66 million; the average birth rate from 1975 to 1985 was 24 per thousand. In 1983 the birth rate was 27 per thousand and natural population growth rate was 18.36 per thousand, which was the highest among all the provinces in China. The average birth rate was 23 per thousand from 1986 to 1988 and natural population growth rate was 15 per thousand. By the fourth national census in 1990, Tibet had a population of 2.2 million.
The improved quality of the birthing process for Tibetan women is a major factor influencing the increase of the population. According to the data of the fourth national census in 1990, we can see that sterility rate of women from age 60 to 64 was 17 percent, which means that 17 women among one hundred aged 60-64 had not given birth to children or had children that did not survive; this figure was 9 times 2 percent which is the normal rate of the sterility all life. And this phenomenon was rare in the subject of population. The vigorous fertility of this large group of women appeared before the Tibetan Democratic Reform in 1959, which proved the low quality of birth at that time. The low marriage rate and poor health were the main reasons for sterility for those Tibetan women.
Since Democratic Reform was carried out in Tibet, Tibetan life has improved and women's health standards have improved.
During this time, some lamas have resumed secular life on their own accord, They have married and reproduced so that the lifetime sterility rate of Tibetan women in 1990 aged 55-59 has dropped to 14.78 percent; the rate of those aged 50-54 is 12.19 percent; and the rate of those aged 45-49, which dropped 43 percent in a decade, stands at 10.04 percent, while other women in this age group still have the ability to give birth.
Many women aged 40-44 still haven't passed the child-bearing age but the rate of still births has dropped to 9.38 percent. This undoubtedly can be attributed to progress made in Tibetan population development and marks the promotion of medical and hygiene conditions.
Health care for Tibetan women and children started from the ground up. Through this work, a specialized maternal and child health care contingent has been established and has grown. In the wake of reform and opening up to the outside world, the push for better maternal and child hygiene in Tibet has enabled reformers to receive an allocation of funds from the Autonomous Region Government and financial aid from international health organizations, including the United Nations Children's Fund (UNICEF), the International Save the Children Foundation, and the Swiss Red Cross.
Since 1985 seven hospitals for women and children have been set up in Lhasa City and Shannan, Xigaze, Nagqu, Nyingchi and Ngari prefectures.
The well-appointed Shannan Prefecture Hospital, with its beautiful setting, has a medical staff of 48, 80 percent of whom are Tibetans and women, ''Before the establishment of the hospital in 1 985, the infant mortality rate was 1 42.3 per thousand and the pregnant and lying-in women's death rate was 78.8 per ten thousand in Nedong county''' said Dr, Kalsang Dolma, Vice-Director of the hospital. ''Following the new method of delivering a child, the infant mortality rate was 30.26 per thousand and the pregnant and lying-in women's death rate was 56,2 per ten thousand in 1989.The percentage continues to decrease''' she said.
This hospital is responsible for women and children's health are in 12 counties of the prefecture and it often organizes a mobile medical team to remote mountainous areas.
In 1991 Kalsang Dolma led a medical team to Sekong Village, located 4,800 meters above sea level in Renrong Dwnship, Qiongjie County. The team included eight members who were all women except for the driver. They performed operations on 102 women and treated 1,500 people in Sekong and in other nearby villages. More than a month later when they returned to Shannan,the villagers were reluctant to let them leave. Five months later when Kalsang Dolma led the medical Ham again to Sekong Village, they did follow-up examinations of the 102 women and found that every operation had proved to be a success. The villagers gave them highland barley wine and buttered tea, and regarded them as relatives.
In 1989, under the aid of the UNICEF, more than 20 counties set up health stations. The maternal and child health work developed rapidly in these counties. In Luoshang County of Qamdo Prefecture, the birth rate, using the new methods, rose from 30 percent in 1989 to 80 percent in 1992. In urban Lhasa the same rate reached 100 percent, an these Counties the pregnant and lying-in women's death rate cropped from 71.58 per ten thousand in 1989 to 42.74 per ten housing in 1992; the infant mortality rate dropped from 91.8 per thousand in 1989 to 61.96 per thousand.
The movement to improve sanitation and prevent epidemic in Tibet also has quickly developed. At the time of the peaceful liberation of Tibet, several contagious diseases such as smallpox and bubonic plague were prevalent in the area. In 1959, 348,700 people were vaccinated. Since the early 1960s, smallpox has not appeared in Tibet.
In 1961 the Tibet Sanitation and Antiepidemic Station was established. In 1989 the entire region had 82 antiepidemic stations which employed 618 sanitation and antiepidemic workers. More than 80 percent of the counties now have antiepidemic stations; most of the work is done by women.Since 1986 the Tibet Autonomous Region has been vaccinating children. Since that time the incidence of contagious diseases and mortality rate have dropped considerably. The incidence of measles dropped 99.86 percent in 1991, down from l 985. Incidence of diphtheria and the tetanus in newborn babies has not been reported in the past six years. With the goal to wipe out poliomyelitis in 1 995 and iodine Deficiency Disease in 2000, two rounds of comprehensive prevention work were launched in December 1993 and in January 1994 respectively. More than 5,000 medical workers participated in the vaccination drive in 1 ,000 inoculation stations.
In addition to strengthening children's immunity from poliomyelitis, BCG and measles, vaccinations were also administered to newly-wedded women of child-bearing age, lactating women and preschool children were asked to take iodine oil capsules.
More than 176,000 children are inoculated against pololomyelltis, with an inoculation rate of 97.61 percent; 461,000 people are inoculated against measles, with an inoculation rate of 95.98 percent; 587,000 people are injected with the SCG vaccine, with an inoculation rate of 94.50 percent; and 163,000 people are given iodine oil capsules.
In addition, more than 100,000 farmers and herdsmen received treatment for common and frequently occurring diseases free of charge. Tsering Dolkar, Vice-president of the autonomous Region People's Government, praised the large-sale prevention movement and praised the efforts of the Medical team.
Family planning is policy of China. In Tibet, the family planning policy of ''one family, one child,'' is only advocated among the Han nationality cadres and workers who only take up 4 percent of the Tibetan population. The policy of ''one family, two children'' is advocated among cadres, workers and townspeople of Tibetan and other ethnic groups. The government does not carry out the family 'planning policy among the farmers and herdsmen who account for 88 percent of the total population in Tibet, but spreads information to those families about the importance of rational and good childbearing skills.