Completed projects (Himalayan India)
The previous activities of LSTM / Nomad RSI in Ladakh were implemented in a number of phases, each informed by research projects and each building upon the last. In addition to the ongoing projects listed above (seminars, THAME etc), major past projects have included: the training of a new generation of 16 amchis; the establishment of 15 Amchi Clinics; and the running of awareness campaigns on amchi medicine for villagers in rural areas.
The Dusrapa diploma course in amchi medicine
The Dusrapa (Tib. sdus ra pa ba) School, which began in 1999, was a central component of the revitalization programme implemented by LSTM and Nomad RSI. It facilitated the training of a new generation of amchis in a formal and standardised manner. The 16 young amchis trained at the Dusrapa School today represent a significant proportion of the future amchis of Ladakh. They are also important members of the network of amchis working with LSTM on their ongoing projects.
The training was intended for young Ladakhis already receiving traditional medical instruction in their villages of origin and for those living in inaccessible areas either without an amchi, or with only ageing amchi present. The Dusrapa diploma requires four years of intensive study and represents the first level in formal training in Tibetan medicine, one stage below the Katchupa. The curriculum was designed by a committee of respected Ladakhi amchis, based upon well-known training curriculums from Tibet but adapted to current conditions and expanded to include extra subjects.
The initial idea of the Dusrapa course was to inscribe amchi medicine into Ladakhi modernity, to raise both the status and the standards of its practitioners. The programme was thus designed to confer upon the students a new order of institutional legitimacy, which could be combined in the eyes of the people with their traditional forms of legitimacy (such as hereditary amchi lineages). It also allowed students who had not attained the required level of schooling, or who did not have sufficient financial resources to enter official Katchupa institutional training programmes, to study Tibetan medicine to a high standard. The course of study lasted for four years and was divided into two ‘batches’, the first starting in 1999 and the second in 2000.
Student selection process:
- Villages from all over Ladakh and Zangskar were selected that were lacking amchi altogether, had only ageing amchi present, or were facing great difficulty accessing health services of any kind
- Extensive consultation with village leaders and community members led to the nomination of a number of candidates
- A selection committee, comprising three respected elder amchis, then conducted interviews and decided which of the candidates were best suited to the course, based upon their lineage, existing ability and knowledge, aptitude and temperament
- Particular attention was paid to selecting appropriate young females for the training, to encourage gender balance
- After the selections were made, agreement was reached with the families of the candidates to ensure their commitment to the course – documents were signed by the student and their families, stating their intention to complete the course and return to their villages after graduation. Financial contributions of Rs 1000 (approximately 20 Euros) were made by each family to demonstrate this commitment
1st batch – 12 students: 9 male (one monk) and 3 female- Training began in 1999
2nd batch – 9 students: 4 male and 5 female- Training began in 2000
The course of study
The course of study, entirely subsidised by LSTM, was divided into four main components:
- Residential theoretical training (three semesters of six months), held in Leh at a solar school / hostel
- Summer camp instruction: training in medicinal plant identification, appropriate collection methods, storage and medicine preparation.
- Home study during summer: for most of the six summer months students returned to their villages, where they continued to study medicine with local (or related) amchis, assisted their families in agriculture and other work, and generally maintained contacts with their communities
- Clinical apprenticeships: each student followed a year-long apprenticeship with a well respected expert amchi. The knowledge and skills gained through such placements are not included in the theoretical section of the training and can only be learned through observation, direct instruction and practice. Topics covered included: diagnosis (especially by pulse-reading); treatment using diet and behavioural advice; use of drugs and other treatments (moxibustion, hydro-therapy etc); medicinal plant collection; medicine preparation (pharmacy); clinic management and clinical practice skills.
Examination
Three exam sessions were held per year in all subjects, to check student progress. Final examinations were taken only after completion of the full four-year course. Subjects: Theoretical knowledge (text books), practical skills (e.g. pulse reading), bodyig (Tibetan script) writing test, medicinal material identification. Exams devised, administered and marked by the highest local amchi authorities (President of LAS, Tibetan medicine lecturer at CIBS, Research Officer at Sowa Rigpa Research Centre and other respected local amchis).
Graduation
Graduation took place on 25th October 2004 at a special seminar in which 40 amchis and many notable members of Ladakhi society were present to congratulate and offer support to the graduate amchis. Of 21 students who began the course, 16 graduated (8 female and 8 male).
Diplomas were presented by Mohamed Abbas Abidi, Chief Executive Councillor for Health, and were signed by the Chief Amchi of the Health Department, the President of Ladakh Amchi Sabha and the President of LSTM.
Partners
Ladakh Amchi Sabha
Himalayan Amchi Association, Népal
Men Tsee Khang (Dharamsala)
Fondation Rolex, Suisse
Clinics for Dusrapa amchis
Between 2003 and 2005, LSTM and village councils supported the Dusrapa graduates in establishing small amchi clinics in their villages across Ladakh and Zanskar. These clinics provide vital opportunities for the new generation of young amchis to begin their practices, to continue to improve their skills and to embed themselves back in their communities.
They also serve to make amchi medicines easily available to the population in areas where it was previously absent or problematic. LSTM’s initial support included a wide range of medicines and raw materials, equipment and medical thangka (hanging paintings) representing Sangye Smanla, the ‘Buddha Master of Remedies’. The team also provided ongoing support and advice to the young amchis.
List of practicing Dusrapa graduates
In 2004
| Name of students | Villages | Sexe |
|---|---|---|
| Dorje Tashi | Igoo | M |
| Padma Lamo | Kulum | F |
| Tsewang Dolkar | Khema | F |
| Nyilza Angmo | Digger | F |
| Tsering Angdus | Lingshed | M |
| Sonam Tondup | Choglamsar | F |
| Tashi Phuntsog | Lingshed | M |
In 2005
| Name of students | Villages | Sexe |
|---|---|---|
| Rinchen Angmo | Domkhar | F |
| Sonam Dolma | Shara | F |
| Tashi Dolma | Karu | F |
| Padma Wangmo | Abran | F |
| Sonam Rinchen | Rangdum | M |
| Kunzang Dolma | Hamiling | F |
| Tsering Namgyal | Kharnak | M |
| Tsering Zangpo | Markha | M |
Partners
Ladakh Amchi Sabha
Niwano Peace Foundation
Fondation Yves Rocher (Prix Terre de Femmes- France)
The Funding Network (GB)
Fondation Rolex
Awareness campaigns on amchi medicine
While establishing the clinics for the Dusrapa amchis, LSTM conducted an awareness campaign in each of the concerned villages. These campaigns aimed to confer legitimacy upon the young amchis on their return to their villages. They also enabled the LSTM team to explain to the public the particular problems being faced by amchis and to encourage the people to remunerate the amchis for their services. The campaigns thus served a dual purpose – helping to establish the young amchis in their villages and raising awareness of the economic problems threatening the amchi medical system.
Partenaires
Ladakh Amchi Sabha
Fondation Yves Rocher (Prix Terre de Femmes- France)
The Funding Network (GB)
Drug banks
During 1998 and 1999, it became clear to the Nomad RSI team that many amchis were suffering from a lack of access to raw materials, limiting the range of medicines they were able to make and even discouraging them from practising. The Drug Bank project aimed to remedy this by providing some of the required materials and medicines to several amchis who were facing such difficulties.
The secondary aim of the project was to help the amchis establish cost-recovery systems in their villages, which would enable them to re-stock once the materials provided through the project ran out. Although successful in assisting the concerned amchis materially, the complexity of amchi-patient relations quickly became apparent, pushing the cost-recovery component beyond the means of the project and leading to its discontinuation. The project has been reframed as the amchi clinics and health centers projects.
Lingshed Amchi Health centre
One of the villages benefiting from the Drug Bank project was Lingshed, a very remote village in central Ladakh. Lingshed was selected as a pilot site for extension of the drug bank idea into a complete Amchi Health Centre. A clinic building was constructed in 2000, with funding from a number of partners, medicines and materials were supplied to the clinic and in 2001 the full health centre project was launched. Two existing amchis were employed at the centre, working alternately and keeping regular hours. A system to collect enough money from the patients to allow re-stocking of materials and to pay small salaries to the amchis was devised, in which each household pays a small annual contribution (Rs.100 at first) and in return would receive ‘free’ treatment. This was a bold experiment in initiating a new form of support for amchi medicine and a new way of working for rural amchis. Evaluations in 2002 and 2005 show that the centre continues to be well received by the villagers, to run well and to move closer to financial autonomy.