Health is a basic and elementary need for the general welfare and development of any community, thus recognizing the importance of good health of the Tibetan Refugee Community, the Central Tibetan Administration established the Department of Health in December 1981 to provide curative and preventative healthcare services by managing and financing health care centres, as well as by planning comprehensive health care system for the Tibetan refugees in India, Nepal and Bhutan.
The Department is registered in the name of the Tibetan Voluntary Health Association (TVHA) under the Indian Society Registration Act XXI 1860. And it is working as a registered charitable organization catering basic health care needs of Tibetan refugees.
The main aim of the Department is to make Tibetan refugee settlements viable by improving the basic health status of Tibetan in exile. It includes providing adequate, equitable, and holistic primary health care services to all Tibetan refugees through its Primary Health Care centres and creating and expanding public health care programs in the community for disease prevention, promoting healthier lifestyles, and a cleaner environment. And with its primary goal of “Health for All”, the Department extends its healthcare services to both Tibetans and local Indian residents.
Currently, there are seven hospitals, five primary health centres, and 36 clinics across India and Nepal with a total number of staff is 247, which includes 163 medical staff and 84 administrative. Out of 163 medical staff, 6 are medical officers, 58 nurses and 32 community health workers.
Administration of Hospitals and Primary Health Centers
As said, there are presently 7 Hospitals, 5 Primary Health Centers (PHC) and 36 Clinics with one mobile clinic, one for remote nomadic areas in and Ngoenga School for children with special needs. There are a total of 247 staff (both medical and non-medical) working at these health centres; these staffs are appointed and administered directly by the Department of Health as per stipulated rules and regulations of the Central Tibetan Administration (CTA). Among the staff, the Department has appointed several Executive Secretaries to administer hospitals and primary health centres at the local level, whereas clinics are concerned, respective settlement officers under the Department of Home are local administrators. The Department is also responsible for the transfer of its staff.
The Department with financial assistance from its donors, bears the running expenses of these hospitals and PHCs, including salaries of the staff and other recurring and non-recurring expenses. On top of that, the Department also undertakes the implementation of special projects in the interest of primary health care services.
The Health Kalon and the Health Secretary, on an ex-officio basis, are the Chairman and Vice-Chairman of the Board of Directors (BoDs) of both the Tibetan Medical and Astro Institute (TMAI) and the Tibetan Delek Hospital, located in Dharamsala, Himachal Pradesh. And all the bills passed in the meeting of BoDs are thoroughly discussed and approved under the Chairmanship of the Health Kalon and the Health Secretary.
Men- Tsee -Khang, the Tibetan Medical and Astro Institute have 826 staff including 126 Traditional Tibetan Doctors and 15 Astrologist all over India and Nepal, whereas the Delek Hospital currently has 50 staff of which 9 are medical Medical officers and 31 nurses.
Implementation, Monitoring and Evaluation
Prioritizing the importance of community participation in all the health care programs or projects, the Dept. of Health has formulated a health committee in each settlement to work out and assess the healthcare activities at their locality. The committee meets at least thrice a year, where they discuss various possibilities to improve community health care services. The committee comprises of settlement officers who are the chairperson on ex-officio bases and the executive secretaries or local health workers are the secretaries of the committee. Besides, local group leaders are the members of the committee who are responsible for implementing as well as reporting on every healthcare activity carried out by the Health Department at the respective settlements.
Whereas the Department of Health as an overall administrator, monitors and evaluates the health care services through feedback and updates from local health centres in the form of periodic reports as well as during field visits. However, Department always prioritises the individual responsibility approach, which has helped establish “health” as the New Morality.
Training of Health Personnel There are numerous projects and programs undertaken by the Department of Health and training of personnel is one of the priorities. Lack of proper knowledge of the technical staff limps the programs/projects. However, if the problem is further analysed it would land on a shortage of think tanks and human resources in the department. At present, the majority of the CTA staff are only clerical and not professional, working with their limited knowledge and therefore, it is utmost necessary to provide them with short-term courses, training and workshops to improve their efficacy. In short, Department continues to organise various capacity-building workshops and training with the help of its generous sponsors.
Although the Department has made considerable progress in the past for many years, there is still a shortage of key medical and health personnel at healthcare centres and hospitals. Therefore, the training is not only given to the staff of the head office, but the program also focuses equally on giving training/workshops/refresher courses to the new health staff to improve the skills of all the existing health personnel in the field. Community Health Workers are critical in the Tibetan healthcare infrastructure and training to this cadre is one of the most important components of the program.
Due to the scattered nature of the Tibetan refugee community in India and Nepal, where many health centres are located in remote areas, well-trained Community Health Workers are the most essential resource of the department besides providing primary health care services to the community.
The Department’s training unit provides training such as First Aid, HIV-AIDS, Lab., Dental, TB, RH-MCH, Refresher Courses, Mental Health and so on.