This year's delegation consists of 10 people: Ralph Allen, architect (Ralph is the designer of the largest pediatric hospital in Asia, the Shanghai Children's Medical Center); Gary Swenson structural engineer specializing in earthquake construction; Sara Saad el-Dein, MPH and designer of our Community Health Worker project; Sara's husband Jon Hall, EMT; Ms. Gao Yu from the Institute of Population Studies, Peking University; Janis Tse Yong-jee, interpreter (her 6th year!); Christie Huang and myself from the Surmang Foundation.
Our purpose is to assess the situation at 5 township clinics, with an eye to rebuilding at least 2 based on the Surmang model. This 'community-based medicine,' depending on deep community buy-in through a corps of Community Health Workers and a couple of motivated local primary care providers. Like Surmang, the design of the projects will closely managed, and CHWs and doctors will be highly incentivized in terms of pay and housing perks, not to mention residential training, not only on-site, but also in Beijing. Our two Surmang docs, Phuntsok and Drogha are local heros and have the status of Rinpoches in the region due to their work and kindness. We need to grow that.
There will also be Surmang-like IT components consisting of satellite dishes, meds inventory management and distance referral and consultation.
The latter is being developed in partnership with Chindex/United Family Healthcare. UFH operates the first and largest of the international-standards hospitals in China. The idea is to be able to send digital images of X-rays, wounds, or ultra-sound, to a dedicated computer terminal at UFH in Beijing. There specialists --radiologists for example-- could help diagnose and advise these rural doctors.
The choice of which clinics to rebuild depends on how closely they follow the qualities of the Surmang Clinic: in a geographical and cultural center. One of the things we will probably ignore is "the catchment size," meaning how many people are served by the clinic. What we learned with Surmang is basically following Lama Kevin Costner's proclamation in "Field of Dreams": "build a field and they will come." The Surmang clinic went from a summertime drop-in clinic to a local institution that attracts patients from within a 200 km. radius, attracting over 10,000 patients a year.
(By contrast the government township clinic sees 500 hundred patients a year with a staff of 9).
When we told the head of the Yushu Public Health Bureau that we wanted to rebuild 5 clinics, he said, "Why 5? if you rebuild one run like your Surmang Clinic, all you need is to rebuild one."
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