Canadian Natural Health Coalition

Surmang Foundation is the first NGO in Qinghai Province, China, and has operated a primary care clinic there since 1992.  This pristine region, a place of traditional ethnic Tibetan culture, is part of the 30 million ultra-poor catchment of China.  The average income there is less than US14¢/day. In this region the chances of dying in pregnancy or childbirth is 1 in 15, nearly double the danger of being a US soldier in Iraq.  Infant mortality is 1 in 5.

In the past 11 years the Surmang Clinic has treated over 77,000 patients for free, including meds. The success of the project can also be measured in terms of community buy-in.  This is a function not only of free services, but also

• medical providers who are local Tibetans.

• quality medical care. Our two doctors, Phuntsok Drongdrup and So Drogha, have been well trained both in residence on-site by visiting doctors, but also in Beijing at the Tsinghua University Hospital.

• access to services via Community Health Workers.  CHW is community health worker.  They are the interlocutors between our clinic and projects and the beneficiaries who use those services. Their job is to teach public health including most importantly, well baby and safe pregnancy.  They treat patients within the scope of their knowledge, including assisting in births.

• Refer patients to the clinic who need to see a doctor, articulate the needs of the community to the foundation, the clinic, the doctors so that we can assess projects, and create further relevance of our services to the needs of the community.

Although it is possible to speak of weave of local culture, health outputs and activities, in reality the path to sustainability requires community participation and a sense of local ownership.  But that is not enough. We have to look beyond Surmang.
In reality what has been created at Surmang is a prototype for health care among all the ultra-poor of China.

As far as long-range sustainability goes, this health promotion project to be successful must be integrated into the national health care system and not just operate in our own stove-piped projects. And so the Surmang Prototype of amara: the rural china health alliance (http://www.amara.org.cn) has been created as the container for rolling out this prototype into a sustainable model network for the ultra-poor catchment. We are now in the process of engaging the Chinese health care system so that we can create a model network of 30 clinics and say after the next 10 years that we've brought free quality health care to over 2 million patients.