Taiwan's effort to provide medical aid to Tibetans in Nepal at the end of last year was hampered by obstacles arising both from the Tibetan government-in-exile's longstanding distrust and Taiwan's inexperience with humanitarian aid in an international setting.
Taiwan's medical team comprised 16 medical professionals, organizers and officials, and was funded by the Mongolian and Tibetan Affairs Commission (MTAC) and Ministry of Foreign Affairs.
PHOTO: LIU SHAO-HUA, TAIPEI TIMES
It was to target the Tibetan community in Nepal and it arrived in Kathmandu on Dec. 26, the day that violence and strikes broke out and curfews were imposed following the publicizing of a derogatory comment about Nepal allegedly made by an Indian actor.
PHOTO: LIU SHAO-HUA, TAIPEI TIMES
Due both to their failure to notify the Nepalese authorities of their mission and its voluntary nature the medical team did not receive advance notice of the imposition of curfews in the capital. The absence of either official or semi-official Taiwanese representation in the country was also a contributing factor, the mission said.
As a result the team had to fend for itself in a turbulent situation and was forced to shorten its mission from five days to three.
Adding insult to injury, two statements were made by Tibetans condemning the MTAC.
Politics and history
"Taiwan's MTAC is going to destroy the unity of the Tibetan community," read copies of a an unsigned statement in Tibetan dated Dec. 23 and pasted on walls near the site of the medical team's operations in the Boudha district, one of the three Tibetan settlements built in Kathmandu since 1959. The statement appealed to Tibetans not to visit the medical team, saying that it was an "MTAC trick."
Another statement titled, "Tibetans condemn misguided Taiwanese activities," signed "the Tibetan community" and dated Dec. 27 was delivered to the medical team's hotel in Kathmandu.
The statement, in English, said that following the story on the medical team published in the Taipei Times on Dec. 19, 2000, "the Tibetan community totally rejects such an initiative and strongly opposes such activities directly or indirectly spearheaded by the Mongolian and Tibetan Affairs Commission of Taiwan."
"We [the Tibetan government] have never recognized the MTAC," said Samdup Lhatse, representative of the Office of Tibet in Nepal. "We are not against doctors. We simply reject any MTAC participation in the medical team."
Samdup Lhatse said the two statements were drafted by individual Tibetans to express "the feelings of [the Tibetan] people in Nepal."
But the local coordinator for the medical team, Tashi Shalu, said the statement had been released by the Tibetan office in Nepal. He said that the statements had caused rumors to spread among the Tibetan community and complained, "we are providing a social service. This has nothing to do with politics."
Tashi Shalu is the head of a non-governmental organization, the Himalayan Cultural and Educational Center, that was established by and has been funded by the MTAC since 1992. Because of their conflicting positions, the center and the Tibetan office have had no contact ever since.
The four decades of chilly ties between Taiwan and the Tibetan government-in-exile reflect this distrust, which some say results from the Taiwan government's failure to recognize the legitimacy of the Tibetan government-in-exile and its referring to it as "an organization in exile." Taiwan's position that Tibet was a part of the ROC offended the Tibetan government-in-exile.
Only when former president Lee Teng-hui (
The Tibetan government's growing friendship with Taiwan, however, never extended to the MTAC. They still consider the existence of MTAC an insult to Tibetans and complain that MTAC's policies have threatened Tibetan solidarity. "If help from Taiwan comes through the Tibetan government's channels, not through the MTAC, we will be happy to accept," Samdup Lhatse said.
Fearful and cold
On Dec 27, the medical team found itself stranded in the curfew imposed to control spreading protests and riots in the capital. No vehicle was allowed on the street to take them back to the hotel, a 30-minute car ride.
At sunset, a group of around 30 people -- including Taiwanese members of the medical team, Nepalese nurses and Tibetan helpers -- was forced to leave the area by foot. After the Nepalese police refused to escort them back to their hotel, the group sought refuge in the Hotel Tibet International in Boudha.
The hotel is run by the Tibetan government and refused to provide accommodation for the group. To make matters worse, the hotel staff duped the group, falsely telling them that taxis had come to collect them and locking the doors behind them as they stepped out of the hotel.
The group was left standing in near-freezing weather and in fear of the rioters.
"How can they do that to the medical team?" asked the organizer of the mission, Ho Tung-hao (
Ho said that his organization could not afford to foot the total bill for the aid mission and so requested funds from the government.
Reacting to the problems which the medical team faced, Samdup Lhatse said: "We feel very sorry for those doctors," adding that it must have been out of fear of becoming a target for rioters that the hotel staff had failed to take the Taiwanese in.
The members of the medical team, however, thought that the attitude of the Tibetan office was the main cause of the rudeness of the hotel staff.
Plight of Tibetan refugees
"We cannot accept MTAC's statement that the circumstances of Tibetan refugees are poor," said Samdup Lhatse. "Tibetan refugees and settlements have been receiving assistance from the UN and the Nepalese government in cooperation with our government."
The United Nations High Commissioner for Refugees (UNHCR) has been sponsoring the Tibetan Refugee Transit Reception Center and set up a clinic staffed with three resident nurses and one visiting doctor.
According to the Tibetan office, there are approximately 20,000 Tibetan refugees in Nepal, 13,000 of whom live in the capital. Eleven settlements have been established nationwide, three of which are in Kathmandu.
"We are well looked after by the UN. Why did MTAC officials say in a press conference in Taiwan that they planned to provide medical aid to Tibetan refugees?" Samdup Lhatse said.
The existing refugee reception center was built by the EU in 1998, and currently accommodates around 400 Tibetans who have recently crossed the Himalayas to Nepal.
Many young children travel in groups and on foot over the high mountains for around a month to flee from China. "We sleep during the daytime and move at night," said a 16-year-old girl named Dolma who had arrived from Lhasa only two weeks earlier.
Dolma said Tibetans were discriminated against in Tibet and that genuine Tibetan culture and education were only otherwise available in Nepal or India.
In another one of the five dormitories at the reception center, a pair of brothers aged 10 and 12 sat shoulder to shoulder, their noses runny and their cheeks red. They had fled with a group of 13 people. Their parents remained in Tibet but had sent them to see the Dalai Lama and receive a Tibetan education in India.
Many Tibetans leave China primarily to see their religious leader, the Dalai Lama, who has been exiled from Tibet and has based the Tibetan government-in-exile at Dharamsala in north India since 1959.
"All the refugees will go to Dharamsala to see the Dalai Lama about one month after their arrival in Nepal," said Samdup Lhatse. "Later on they can choose where to stay and what to do."
Misplaced goodwill
Since the Dalai Lama's first visit to Taiwan in 1997, which aroused more widespread interest in Tibetan Buddhism and greater concern for Tibet among the Taiwanese public, plans have been made for medical aid to target Tibetans in exile.
"We have seen a lot of expressions of hope on the part of the Taiwanese government and the general public to be able to help Tibetans," said Samdup Lhatse, "but please come officially and respect our government."
"No involvement of the MTAC is our bottom-line," he added.
Some members of the medical team felt that the hostility had snubbed the gesture of goodwill by the medical service and ignored the need of many Tibetans for medical aid.
"Their public health is really in need of improvement," said nurse Lin Hui-ling (
But "such a transient medical service is hardly beneficial," admitted the team's leader Hung Kai-fong (
Limited time and resources
Some local NGOs and the Tibetan refugee center jointly said that any voluntary service should not last less than one month.
Despite the limited resources and time, the medical team did their best to serve both Tibetans and Nepalese. Over 800 patients came to see the doctors in three days.
A long line of patients of all ages waited in front of the temporary dental clinic. That and the satisfied smiles on their faces as they emerged after treatment made the team's dental achievements stand out.
General medicine and surgery were in great demand, but could not be satisfied with swift remedies. Many pandemics, such as hypertension and tuberculosis, in need of long-term treatment, were beyond the capability of the short-term medical service.
Poor public health and a highly polluted environment in Kathmandu have been responsible for many skin diseases, tuberculosis, gastrointestinal problems, hypertension, bronchitis, and malnutrition.
Lin said that the medical needs of their patients could have been better assessed before the team departed for Nepal. "We took many inappropriate medicines and lacked many necessary ones."
Many elderly people also suffer from joint pains because of having borne heavy burdens walking and climbing mountains for protracted periods. "An elderly Tibetan asked me whether he was ill because he would start panting when carrying loads of 25kg while climbing mountains of over 6,000m," Hung laughed, saying that the local Nepalese and Tibetans have an incredible tolerance for pain.
"Any medical service should be localized," said Chuang Shiow-shuh (
"Consider the case of remote Taiwanese Aboriginal villages. Have their medical conditions been improved by short-term medical teams from the cities over the years?" Chuang asked.
All said they had learned from the experience in Nepal and expect to be able to provide better services in the future.
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