Medical Issues for Travelers

BE AWARE: medical evacuation from Kham is a difficult and expensive business, and it can take days. We therefore recommend prevention:

4. Write down the telephone number of your country's embassy in China and keep it safe is your money belt or wherever you carry your most valuable papers.

Health care for travelers in Tibet is well covered in most of the popular guidebooks, so here we will only give information that is specific to Kham.

Altitude sickness

For detailed information about Altitude Sickness, its symptoms, prevention, and treatment, see the International Society for Mountain Medicine. What follows is Kham-specific information:

If you ascend by road to Kangding, and spend a few days acclimating there before moving deeper into Kham, you should have little trouble with altitude sickness. Shortness of breath, light headaches, and minor sleep disturbances are usually not cause for worry. However, symptoms that persist longer than a few days, difficulty in breathing and/or very bad headaches are a sign that it's time to turn around. At the very least you should descend to Kangding, or even Luding, and rest there for a few days before trying again.

The road from Chengdu to Danba requires crossing a very high pass on the first day, and is not recommended for people with little prior experience at high elevation.

Towns in the region that are lower in elevation and therefore make good "bolt-holes" for the sick are Nyachuk (Yajiang), Pelyul (Baiyu), Batang, Derong, Danba, and Jiulong.

If you are suffering from altitude sickness and are unable to descend far enough to get well, go to a hospital and ask them for oxygen ("yang-chee"). They can provide it to you inside the hospital or dispense to you an oxygen-filled "pillow" with a valved hose coming out of it that you can take away.

Most every county town in Kham has a hospital of some kind, but the standard of care cannot approach anything like that of the West. Doctors in Kham are good for cleaning and stitching up wounds (including dog-bite), injecting antibiotics, dispensing oxygen, vitamins, and many kinds of drugs, rehydrating you by means of an intravenous drip, and maybe pulling an aching tooth. Most hospitals have facilities to perform simple surgery such as appendectomy or caesarian section, but you would probably be wise to avoid having any kind of surgery in small town hospitals in Kham unless your situation is dire.

Note that many independent medical practicianers, including some hospital staff, employ Chinese or Tibetan medicine. If that's what you want, fine. But the rule is: buyer beware. Generally speaking, if a facility offers more than one kind of medicine, they will ask you what kind you want. A foreigners who can't communicate will probably be given Western medicine.

If you are suffering from an acute health emergency, you will probably opt for a county hospital. Our surveys have shown that better hospitals are found in KANGDING and DAWU. However, you should not expect even these facilities to cope well with heart attack, frostbite, severe burns, stroke, internal hemorrhage, compound fracture, herniated disk, or any condition requiring surgery or advanced electronic equipment for its treatment. If you are really sick, you must get out of Kham, and the sooner the better. Chengdu is the first place to go for better medical care, and there you should head for Huaxi University Hospital. But if your case is complicated, then you should fly to Beijing, Bangkok or Hong Kong.

In Chengdu the following clinic is designed to meet the needs of expats and travelers:

Global Doctor Chengdu Clinic

Ground floor, Tingtaoyuan,

Bangkok Garden

No. 21, Section 4

Renmin Nan Road

Chengdu, Sichuan 610016 Click here for map.

Tel: +86 28 8525 9928

Fax: +86 28 8525 8088

Emergency contact:+86 (139) 8225 6966

Email: chengdu@eglobaldoctor.com

Note: This not a hospital, and the services it can provide are limited. For example, it is not licensed for injections and intravenous treatments. They can, however, send one of their English-speaking staff with you to a Chinese hospital, in which case you will be billed by Global Doctor which will add their own service charges.

In an emergency, telephone the number 120 or go directly to Huaxi Hospital or some other facility with an emergency room.

Tibetan dogs pose a significant risk to travelers and residents alike. Do not be an easy target by hiking the countryside, walking city streets, or strolling around monasteries alone. Do not approach private homes without a local person to escort you past the guard dog. Chains have been known to break so never turn your back on a dog, even if it is chained up. Stray dogs rarely attack unprovoked but when they do, it's usually from behind, so watch your back at all times. Monastery dogs are often the most dangerous. A walking stick or umbrella make good defensive weapons; throw rocks if you have nothing else. Above all, if a dog threatens you, do NOT TURN TAIL AND RUN.

If you are bitten, then you should consider the possibility that you may contract rabies, a fatal illness. Not every dog that bites has rabies - in fact MOST biting dogs in Kham are NOT rabid. However, rabies is such a dangerous disease that it's not worth taking chances. You should immediately return to Chengdu (or some other large city) by the fastest means possible and undergo a course of rabies vaccine, a series of injections that must be administered over the course of one or two months.

Do not wait to seek care. If you wait until symptoms appear then the injections won't work and you will die a very painful and unpleasant death. Even if no rabies is present, dog bites are usually very dirty and must be treated by a doctor who can clean and disinfect your wound and prescribe appropriate antibiotics. The Global Doctor Chengdu Clinic (above) can treat you, as can most Chinese hospitals.

In addition to the above-mentioned dangers, Tibetan dogs in Sichuan have been reported to carry a disease called hydatidosis. You should not touch even friendly dogs and you should avoid any contact with dog feces. If you are traveling with children, take care that they do not fall or play on the ground where there may be traces of dog feces and many other nasty substances present.

If you have a special interest in Tibetan medicine, it is widely and actively practiced in Kham, and in fact because of Kham's rich flora it is a source of many herbal remedies that are exported to other parts of Tibet and abroad.. Hospitals that practice traditional Tibetan medicine may be found in many places and the list grows constantly. Here is an abridged list of places where large Tibetan medical facilities are present: Derge, Pelyul, Maisu (a town in Dege), Sershul, Rongbatsa (a town in Ganzi), Tagong (go to Heping/Tashi Nunnery about 15 km out of town). The hospital in Pelyul was founded by well-known doctor Pentsok Rabten. The one in Sershul operates a school where they teach the medical doctrines of Mipham. All of these facilities manufacture traditional medicines from local and imported materials.

Emergency evacuation

BY ROAD. From most places in Kham, the road trip back to Chengdu is no more than three days, so road evacuation will be the best and most cost-effective choice for most situations. Even if you have insurance, your insurance carrier cannot easily arrange and pay for a vehicle to get you out. If time is of the essence, then it will probably be better to hire a car yourself. It's a good idea to carry rmb7,000 or so for emergencies.

BY AIR. If the sick person is too fragile to be transported by road, then you need to get them to an airport or else summon an helicopter. Call your medi-evac insurance provider or your embassy. The Kangding airport is slated to open in 2008 and will be located on the high plateau about half way between Kangding town and Tagong. Other airports outside Ganzi Prefecture include: