When Wang Tao first went to Tibet's Nagqu, he couldn't believe how backwards its medical services and resources are.
Wang is a doctor at the Children's Cardiovascular Center of the West China Women and Children's Hospital and he went to Tibet for the first time this April to help with medical checkups.
There were seven people in his team and they brought their own medical equipment, such as ultrasound machines, because local hospitals aren't sufficiently equipped to meet all the population's medical needs.
Because Tibet's herdsmen live in scattered communities in remote regions, Wang and his peers used schools as checkup hubs and checked 4,000 children within two weeks, finding 40 cases of congenital heart disease. The children were then transferred to larger hospitals to be treated.
Cooperation between Tibetan hospitals and out-of-region hospitals to treat local children with heart problems has existed for several years. Because of the high altitude and climate, children in Tibet have always suffered from a relatively high rate of heart disease. At the same time, hospitals on the plateau generally aren't as advanced in terms of technology and resources as those in other regions.
There has been some grass-roots cooperation on heart disease since as early as 2008. In 2012, the central government decided to provide funds so all children in Tibet could be treated for free, as well as to provide a foundation for more mature cooperation between hospitals in Tibet and other provinces.
Parents line up outside the pediatrics department in Tibet People's Hospital in Lhasa in June. Photo: Li Hao/GT
Children in Tibet are especially prone to heart disease because of the environment and weather, said Shan Minna, director of the department of pediatrics at the Tibet People's Hospital in Lhasa
An official who was assigned to Tibet for a three-year stint previously told the Global Times that he gradually found himself facing lots of health issues. He couldn't get used to the high attitude and had to carry an oxygen tank with him at all times. When he was not inhaling oxygen from the tank, he found his heart would beat faster and sometimes felt discomfort.
It's not a rare issue. Many of his peers from other regions have found themselves developing all sorts of diseases, one even said his organs have become larger since he moved to Tibet.
It's the same for local Tibetans. They are also affected by the weather and environment, and have taken on the weather at the expense of their health. Data from 2015 shows that the average life span in Tibet is 68, while the national average is 75.
"In the field of congenital heart disease, data shows 0.4 to 0.8 percent of children are born with these conditions in low-lying areas, but in high-altitude plateaus, it's 1 to 1.3 percent, almost twice as high," Shan said.
But in these regions, medical techniques as well as resources are lacking, Hua said. Often he and his team had to give lectures to the local doctors and train them on the newest technologies developed outside Tibet.
Furthermore, people in these relatively underdeveloped regions also lack knowledge about health.
"Early congenital heart disease has very subtle symptoms, such as irregular breathing patterns, or immature growth, children with these conditions might appear smaller than others their age and not as strong," said Hua. "But in the Tibetan regions, many parents are not equipped with enough knowledge to recognize these signs."
If the signs are spotted early on and the children have operations right away, the disease can be cured. But if one misses these signs and lets the disease develop to its latter stages, there's little doctors can do, and it can even threaten children's lives. In fact, congenital heart disease is one of the top killers of children under 5 in China.
During checkups in the field, his team found that this problem is all too common. Often they come across children with severe heart disease of which the parents have no knowledge, and many are surprised to find out their children are ill.
Doctors check on a child suffering from heart disease. Photo: Li Hao/GT
Starting a couple years ago, hospitals in Tibet launched joint programs with out-of-province hospitals and doctors, both those organized by the government and grass-roots exchanges, in order to help improve the situation in the region. Starting in 2012, the central government provided funds for children in Tibet to be treated for free with outside help.
Cooperation between Tibet People's Hospital and West China Women and Children's Hospital started in 2012. As of today 217 children have been treated as part of this partnership.
Help came in the form of outside hospitals sending doctors and nurses to Tibet to conduct health checkups and perform surgeries, as well as bringing patients to Sichuan for surgery. Besides, there were exchanges of up-to-date techniques and research.
Hua's team has been coming to Tibet every year to help train local doctors and perform surgeries. This April was the first time their Tibetan partner hospital asked Hua's team to help with health checkups.
The operations they give children are usually simple, Shan said.
"It's a micro operation and once performed, the child can walk after 24 hours and can leave hospital care within three or four days," she said. "And it will cure the disease once and for all. In the future, they will develop like normal children."
Yet the partnership process had been difficult. Many outside doctors can't get used to the environment in Tibet and many suffer altitude sickness when they first arrive. But despite these difficulties, they still perform checkups and operations under these conditions.
At the same time, it isn't easy on the children who are asked to leave Tibet for treatment either. But the results are quite obvious.
Tsering Dolkar, a young boy from a village in Shannan prefecture, was cured in 2013 through a joint effort between the two hospitals.
Yungchen Drolma, his grandmother, said excitedly that "the hospital has given my grandson a second life." When the child was sick, the family had no way of helping him. They didn't have much money and couldn't afford to send the child to the hospital. Now their child was treated for free and he has fully recovered, indeed he could walk within two hours of the operation.
Besides in Sichuan, Tibetan hospitals have been holding a number of exchanges and cooperative trips with other parts of China in recent years, including Beijing. Media reports show staff and volunteers from multiple hospitals have gone to Tibet to perform health checkups and bring back patients to perform surgeries.
Every year, thousands of children receive help from hospitals outside Tibet. At the beginning of 2012, the Communist Party of China's Tibet committee announced a plan to provide free medical assistance to all children with congenital heart disease in the region within two years.
Hospitals in a variety of cities including Beijing and Shanghai have joined these efforts.
According to a May 2016 media report, a team of experts from a Shanghai specialist cardiovascular hospital were sent to the Ngari prefecture of Tibet for eight days to do health checkups and perform surgeries. Ngari has an average altitude of 4,500 meters and a particularly high heart disease rate. According to data from the Ngari Red Cross Society, about 40 children develop heart diseases every year in Ngari.
But Shan says she doesn't want to rely solely on friendly outside forces, because it comes down to self-sufficiency and improving the local medical level, she said.
Hua feels the same way. He said from the start, he wanted doctors in Tibet to be able to perform surgeries and have cooperation between departments on curing heart diseases at the same level as in more advanced provinces, because doctors from other hospitals can only do a limited amount and devote limited time traveling to Tibet.
While he was in Tibet, he started holding lectures and discussions for the doctors there. Local medical staff also observe the operations and learn first hand about new technologies and methods of treatment.
Furthermore, Tibet is included in a cooperation net that includes many cities in the country's west.
Starting last year, hospitals in 10 provincial-level regions, including Tibet, Sichuan, Guizhou and Yunnan agreed to set up a cooperation network to better improve exchanges between regions and communications on technical advancements.
"If we are to pay attention to children in the entire western region, Tibet shouldn't be quiet about it," Shan said. "Instead, we should also contribute with our own powers."