|Villagers often take painkillers to treat their headaches. (Sinan Nima)|
By Sinan Nima (an active Tibetan villager in Foshan Township in Deqin, a programme site of PCD in Yunnan)
Thanks to economic development in recent years, people of Foshan, a township located in the mountainous area of Deqin County of Yunnan Province, now enjoy a more affluent life. However, during this period, the health of Foshan villagers has got worse. They often suffer from headaches, and many people have become accustomed to taking painkillers. Some take a high dose, while others take painkillers regularly even though it only alleviates the symptoms and does not cure their disease. With the support of PCD, Foshan villagers have conducted a community health survey as an initial attempt to explore this issue. One would probably need to look deeper into all kinds of factors to find out the true cause of the problem and a final solution. However, as an initial reflection, villagers question the change in their traditional lifestyle, which they think might be the cause of their ill health. They are therefore exploring traditional and holistic Tibetan medicine that integrates the body, the mind and the soul, an approach which they think might be the solution. Sinan Nima is a villager who has been active in the community health survey. He explains his observations, inference and thoughts below.
Foshan Township is located in a mountainous area where people live at an altitude of 2,200 to 3,500 metres above sea level. There are around 4,000 villagers in Foshan. In recent years, the villagers’ way of life has gradually changed with economic development. Luxury items such as meat and wine, which used to be consumed sparingly - once a week or only during festivals - are now consumed every day. People put a lot more yak butter in their tea than they used to, and imported junk foods, which didn’t even exist in the past, are now consumed on a daily basis.
Meanwhile, we have no idea why people in most communities get headaches. Many villagers now take painkillers all the time - some up to five or six tablets a day. Apart from painkillers, villagers often take IV drips (to inject liquids, normally saline water but also medicine such as antibiotics, into the body). When they feel a bit unwell, they immediately visit the village nursing assistants or doctors and ask to be put on drips. Some villagers take antibiotics even for a cold. The nursing assistants or the doctors usually comply with their requests because they can earn more money this way. Apart from these health issues, many villagers living at high altitude suffer from high blood pressure. Many die from it and some suffer from paraplegia or complete paralysis. Because of this, with the support of PCD, the village nursing assistants and doctors of Foshan conducted a community health survey to study the drug use pattern of the villagers and their economic lives. Traditional culture and traditional bartering practices were also studied to explore the issue on a deeper level. Survey questions included the population of the community, how many villagers have IV drips every year, how many villagers use painkillers frequently, the dosage and the type of painkillers they use, how many villagers suffer from high blood pressure and their percentage in the village population. There were also questions about their consumption pattern, such as expenses of each family every year, how much is spent on imported goods, how much on local products, income and expenses for festivals and weddings, how many imported goods are consumed, and how much of the food is made by the villagers themselves.
The survey found that those who live at higher altitude are more likely to suffer from high blood pressure. About 30% of Foshan’s population of 4,000 (i.e. 1,200 people) suffer from high blood pressure. About 70% of the villagers have IV drips every year. About 10% of the population (i.e. 400 people) live at higher altitude, among them, many have a habit of taking painkillers, mostly for headache but also for stomach ache. Sometimes they visit doctors who practice western medicine, and the doctors prescribe painkillers too. That is why villagers gradually buy painkillers on their own. Thirty percent of the population (about 120 people) take 3-5 painkiller tablets every day.
In terms of their economic lives, villagers normally spend 30% of their income on food, clothing and repairing their houses. Another 30% is spent on beer and other beverages, cigarettes, imported packaged food and junk food. The remaining 40% is saved up or used to buy agricultural machinery.
Every year during the Spring Festival, villagers spend 70% of their income on imported goods and only 20% on local goods. Less than 10% is used on food or things produced by the villagers themselves. Because of this, I think that even though the economic conditions and the lives of the villagers appear to be improving, the quality of their lives and their health have actually declined. For example, we used to consume our own crops or buy produce from our own village. The food tasted better, and less chemical fertilisers and pesticides were used on the crops, which was better for our health. Because of this, our village nursing assistants and doctors decided to invite experts of traditional Tibetan medicine and Tibetan doctors to provide us with training on traditional Tibetan healing and knowledge of traditional medicine and health. Sometimes Tibetan doctors provide training to villagers on traditional Tibetan medicine and traditional ideas on how to stay healthy. Traditional Tibetan doctors are not only concerned with the physical condition of the patients, but also observe their psychological condition, aspirations, personality, morals and behaviour, because these will affect one’s mental health. Tibetan doctors think that to cure a patient physically is a superficial way of healing. To be cured, one must address the root cause of one’s illness. That is why one must do good deeds, cultivate one’s virtues, be content and learn prajna (wisdom taught by the Buddha).
Elderly people, who visited Tibetan doctors when they were small, became very emotional and cried when they saw a Tibetan doctor. Some of them did not have any serious problems but had become dependent on painkillers. After meeting with the Tibetan doctors, who reasoned with them and gave them a prescription for Tibetan medicine, some stopped taking painkillers.
When we showed the data that we collected in the survey to experts at Kunming Medical University, they were shocked to learn that the villagers often take painkillers and that some have been taking painkillers for over 10 years while others take a few tablets a day. The experts pointed out that the lack of oxygen at high altitude could be a cause of frequent headaches. It could also be due to high blood pressure or other illnesses. Another cause might be drug addiction if the villagers had become addicted to painkillers. On the other hand, some villagers might have high blood pressure from taking too many painkillers. According to the experts, if a person takes painkillers to treat a headache every day but the headache does not get better, then the situation will instead get worse and this will definitely increase their susceptibility to other diseases. They also said that villagers who took painkillers all the time must monitor their livers and kidneys and see if their blood pressure is normal. We subsequently conducted more surveys and found that 80% of the villagers who take painkillers frequently suffer from high blood pressure. However we were unable to get any concrete data vis-à-vis the conditions of their livers and kidneys.
After we conducted the health survey, many village doctors and nursing assistants stopped casually giving patients IV drips with antibiotics. They understand that it is wrong to destroy the health of the villagers for financial gain. They now try their best to restrain from the use of IV drips and tell villagers who take painkillers all the time to stop their habit. They also organise educational activities on community health and well-being and talks about the hazards of junk food and antibiotics. In an initiative to explore the problem of pesticides, pilot ecological farmers are now conducting tests on pesticides in agricultural products.