Cultural differences hinder AIDS prevention efforts in Tibetan-populated regions

By Yin Lu Source:Global Times Published: 2016/12/2 5:03:41

AIDS-prevention volunteer Jampa Chupal Sangpo (left) and his wife  Photo: Courtesy of Jampa Chupal Sangpo

AIDS-prevention volunteer Jampa Chupal Sangpo (left) and his wife Photo: Courtesy of Jampa Chupal Sangpo



Jampa Chupal Sangpo, 38, is dedicated to protecting Tibetan-populated regions in China from AIDS.

It all started in 2008, when he learnt during a conversation with friends that in his hometown of Luhuo county in Sichuan Province, which has a population of only 46,000, there were a large number of people infected with HIV. What's worse, many of the cattle ranchers from his village had no idea they were HIV positive and continued to have unprotected casual sex.

"They were talking as if it were a joke," he said. "This lack of knowledge shocked me. I felt I had an obligation to educate the public."

This prompted him to set up the Engo Health Consulting Service Center in Chengdu, Sichuan Province, with "Engo" meaning "AIDS prevention" in Tibetan. With the help of the local government, his work includes educating the public, volunteer training, psychological care and translation for HIV positive patients who don't speak Putonghua.

Choosing to work in Tibetan-populated regions, including Tibet and part of Sichuan, Yunnan and Qinghai provinces, Sangpo said he is faced with many challenges due to the region's comparatively poor economic conditions and especially the polygamous tradition of the community.

Lack of support

Every year, he travels around the region to give seminars. Over the last year, he has given 58 speeches to over 20,000 people and distributed condoms.

During this time, he realized that the supporting medical facilities and personnel in many places were of a very low standard.

Both parents and the four children of one family he met were HIV positive and were unaware that they could have tried antiretroviral therapy.

Sangpo often thinks about the people he was unable to help. "Last year, we had a young man, very good-looking, only 37 years old," he said. The man was in very poor health and died soon.

Due to a lack of resources on the plateau, many people came to Chengdu, Sichuan to get tested or the medicine they need.

"About 80 to 90 percent of the people who come to us for help are very poor," he said. "With their immune system in terrible condition, they can't afford to go back to their local CDC (centers for disease control) to wait for antiretroviral medicine to be issued to them."

As a result, he is calling for the government to put more manpower and money into the area, as well as more cooperation between the health authorities and volunteer groups.

Jampa Chupal Sangpo gives a lecture to Tibetan residents about AIDS prevention. Photo: Courtesy of Jampa Chupal Sangpo

Jampa Chupal Sangpo gives a lecture to Tibetan residents about AIDS prevention. Photo: Courtesy of Jampa Chupal Sangpo



Major challenges

Some of the major challenges facing anyone trying to manage the prevalence of AIDS in Tibetan-populated areas stem from cultural differences, according to Sangpo.

One problem facing the region is the relatively backward transportation and communication network. He has also seen a lot of cases of people sharing needles, making it easier to get infected. But the biggest challenge comes from the different lifestyle.

Tibetan culture is very open to polygamous relationships, and condoms are also not well accepted in Tibetan society.

Between the ages of 9 and 15, Sangpo lived on a ranch. "I have lived a lifestyle that many children of today couldn't imagine, including tent sex. So I know how weak people's health knowledge is, and what their sexual lifestyle is like."

"This needs to change," he said. "Fortunately, a lot of young people have left the ranches for better education, and are less willing to go from tent to tent to meet women."

But at the same time, there are more sex workers in the region nowadays, he added. "People here have little or no health knowledge and have unprotected sex with them."

He added that even during the picking season for Caterpillar Fungus (an expensive herb for traditional Chinese medicine that grows on the Tibetan Plateau), customers are offered sex twice in exchange for one fungus, and can have unprotected sex for more funguses.

Different measures

According to an academic report published in the Chinese Journal of AIDS and STD in August 2015, since 2004 when the first local HIV case was reported, HIV has become more prevalent in Tibet, with 253 reported cases between 2004 and 2013. The number of herders who are infected is growing significantly.

The situation continues to become more difficult for Sangpo.

"Back in 2008, I often jokingly said that the problem in Tibetan-populated areas was that people didn't know what AIDS was. Was it food or some kind of clothing? They had no idea," he said. "But now, everybody is talking about it. There are now many rumors flooding the Internet."

Sangpo said that some of these rumors include the belief that at a high altitude with good air and a diet of good yak meat, HIV won't affect the community. Others believe that as there are many Lamas born here, the land will be protected from AIDS by Buddhism. Some say washing private parts with cola will prevent them from contracting the virus, while there are even rumors that if you have AIDS, you will be jailed, or even buried alive.

These rumors have resulted in people not wanting to get tested or receive antiretroviral treatment.

As a result, he has to tailor-make his methods of educating the people and preventing AIDS in the region.

The most effective method is inviting monks to participate in the push, due to the great influence of Buddhism in the region, he said. 

With the help of several eminent monks, he was able to raise about 4 million yuan ($580,000), which was used to distribute 2 million copies of AIDS-related materials. They also made about 1 million CDs in three Tibetan dialects. Currently, they have trained 448 volunteers to work across the region.

Social media has also helped him reach more people. His WeChat public account now has 160,000 followers and the number is growing at a rate of about 200 people per day.

"Now we are faced with 100 problems, and if we continue with our work, there will be 1,000. But as long as we never stop, there will be no AIDS at all in the future."


Newspaper headline: Tibetan AIDS fighter


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