Healthcare accessible high upon the plateau

Educational exchanges, tech upgrades helping region stay in good shape

Residents of the Tibet autonomous region can now enjoy comprehensive medical services at local hospitals accredited as top-class healthcare institutions in China.

Such institutions, which have more than 500 beds and competitive medical technology, equipment and management, include the Tibet Autonomous Region People's Hospital and city-level people's hospitals in Lhasa, Shigatse and Nyingchi.

The upgrading of healthcare in the region has been achieved thanks to years of hard work by doctors and officials from both near and far, including Shanghai, which began sending experts to the plateau in 2015.

The program delivers groups of medical teams every year from seven cities and provinces, including Beijing and Shanghai, as well as Anhui and Liaoning provinces, to help train local doctors.

The latest official statistics show a total of 519 medical staff have been dispatched to the region. Among them, 62 experts from 23 top-class hospitals in Shanghai have been assigned to Shigatse People's Hospital in three groups by the Shanghai Municipal Commission of Health and Family Planning. Most participants have yearlong stints, but four are on three-year contracts.

"The level of medical care in Tibet was obviously lower than the average at Shanghai's hospitals, mainly because of the lack of timely updating of medical science and technology," said Long Ziwen, a doctor at Fudan University's Shanghai Cancer Center.

"For example, doctors at Shigatse People's Hospital were still using open surgery in the urological department when I was there in 2016. But in Shanghai, we already have minimally invasive and endoscopic surgery equipment.

"It is therefore imperative that local doctors learn new medical technology and introduce it more widely in remote areas."

Shen Hui, former deputy secretary of the Communist Party Committee of Zhongshan Hospital affiliated with Fudan University, was a member of the first 12-doctor team dispatched to Shigatse People's Hospital in 2015.

Shigatse is the second-largest city in Tibet, with a population of 750,000, and located 4,000 meters above sea level.

"The hospital only had 250 ward beds, with rather outdated facilities and a serious medical staff inadequacy," Shen said.

More complicated cases had to be transferred to Lhasa, the region's capital, about a five-hour drive away, while those needing a a gastroscopic exam had to fly to Chengdu, capital of neighboring Sichuan province.

"Since then, we made up our minds to thoroughly upgrade local medical services," Shen said.

Yu Hongmeng, deputy director of a Fudan University-affiliated hospital, also set up a three-year work plan.

"All members pledge to introduce advanced medical technology, clinical practices and medical science to locals during the program as we are not always there to help them with all issues," Yu said. "The goal is that one day they no longer need us, and can work independently."

Clinical training is included in their daily work, according to Yu Jian, a neurosurgeon at Huashan Hospital.

Yu Jian said he would gather local doctors twice a week and ask them about patients' clinical status.

"If they could not answer, I asked them to review the data again before joining group discussions," he said. "We also discuss intractable cases every month and receive remote mentoring from experts in Shanghai hospitals. This acts as a great way to broaden the doctors' knowledge of diagnoses and treatments."

Lu Ziyun, a team member dispatched to Tibet in 2017, noticed that doctors had to write down information by hand on test tubes.

"It's a waste of time and labor. So we promoted an electronic information recording system in the inspection department at the hospital, which is safer and more accurate," Li said.

With the new technology, 100 routine blood examinations take no more than 90 minutes now versus six hours previously.

Additionally, 84 local doctors at Shigatse People's Hospital have taken medical courses at hospitals in Shanghai since 2015.

For hospitals affiliated with Fudan University, the educational exchanges began even earlier, in 1995, when Shigatse doctors were randomly dispatched. Since 2014, around two to four doctors regularly go to hospitals affiliated with Fudan University to study neurosurgery, gastroenterology, pathology and oncology for up to six months at a time each year.

Shigatse People's Hospital doctors Wangdu and Sogchu Ladrin went to Shanghai for further study at the Endoscopy Center of Zhongshan Hospital affiliated with Fudan University in 2014.

"The center receives more than 100,000 patients every year, which pushed us to get up before 7 am every morning to learn more about digestive endoscopy before crowds of patients began arriving," Wangdu said.

Their three-month intensive study sessions are paying off. Sogchu Ladrin, for the first time, managed to conduct an enteroscopy on a patient suffering from chronic diarrhea. Meanwhile, Wangdu completed his first colon polyp removal procedure in 2014.

With the help of the assistance program, eight Shanghai-Shigatse clinic centers have been established since last year.

Minimally invasive surgery has been applied to urological surgery, and video-assisted thoracoscopic surgery is increasingly being utilized. Tibet also received its first chest pain center.

Beginning this year, hospitals affiliated with Fudan University have been offering remote teaching and practice platforms for doctors in Shigatase.

Apart from clinical diagnosis and treatment, Long stressed the importance of medical research in Tibet.

He said doctors at Shigatse People's Hospital only published around 60 articles in Chinese publications in the three decades to 2015. However, since then, more than 70 articles have been published, including over 30 articles in key periodicals.

"The medical research data in Tibet is relatively scarce, yet extremely valuable. If we make full use of its research value, it will greatly benefit the region," Long said.

"Our project will continue to provide pragmatic medical solutions for locals, especially for common diseases on the plateau. Through academic training, we aim to inspire young doctors to cultivate their professional abilities and achieve greater results in clinical treatment."

Contact the writer at caochen@chinadaily.com.cn