Project Manager: Dagmotar (Kaylee)
This project is invite five doctors to Gasar Village to train villagers about how to take care of their health in their daily lives. The gynecologists will particularly focus on women’s health about how women should take care themselves, so whole villagers health knowledge will improve.
Asia Foundation Funded this project
Dagmotar is from Zuo Gai Township, Hezuo City, Gannan Prefecture, Gansu Province, China. She got an Associate’s degree in English at the English Training Program at Qinghai Normal University’s Nationalities Department in 2009. She is currently working in Tad primary school in Zuo gai Mema Township, Hezuo city, Gannan prefecture and Gansu Province.
What? This was health training for Gasar village in Hezuo city, Gannan prefecture, in Gansu province. Especially focused on women health issues in this area as well as many women illness exist in this village.
Who? All Gasar village women are able to come to join this training. (It includes students, new bride, elders and kids) total has 132 people participated in this training.
Photos of the project implementation
The village women were the participants of the heath training.
Doctor Danba ,kuoluo, Jimxitsho ang dagmo explain the basic knowledge of cleaning, and how to prevent women from diseases and how to take care after got the diseases.
Each village woman got very basic cleaning tools (a basin, a towel, soap, and napkin) for each participant.
Doctor Danba was asking village women some health problem that they have and answer the questions that women have been asked
Project summary
Project title: Health training project for women in Gasar village
Project goals: The immediate goal of this project is to invite four doctors for Gasar village. One hundred thirteen households include the training; they will learn how to take care of health in their daily life and how to prevent from flu. Particular gynecologists focus on women’s health and teach women how to take care self as being women. In addition, introduce how their health affects their life and the next generations. The long-term goal of this project is to improve the women’s health condition through the training and the lectures help to relieve the women from their pain. The health information can plant seeds of health care in their mind. This knowledge can be passing down from mothers to their daughters; they will pay attention on daily foods and cleaning
Project location: Gasar (Xinsi in Chinese) is a large village contrast to the neighbor villages in place Zuogai Duoma Township. This village located in Zuogai Duoma and it is 28 kilometers away from Hezuo city the capital city of Gannan prefecture, Gansu province in China.
Total beneficiaries: one hundred thirteen households got benefit from this project and one hundred women participants in this training. Those people include (elder’s kids, students, new bride)
Implementation organization: Dagmotar( project manager), project committee ( Toja Tsering , Sonam Tsering , Tugar) village leaders) Female Doctor (kuoluo, Jimxitsho ang dagmo) Male Doctor ( Danpa) and Shem Women’s group.
Contact group: Shem Women’s group
Funds receive: Dagmotar received 7, 600rmb from Shem Women’s group on January 27th 2009
Detailed Project activities
| Date | Doctor | Content |
| 17/ 01/09 | Three doctors (Danba, kuoluo, Jimxitsho) came from Lechuk County Tibetan Hospital and arrived Hezuo city. | Preparation for training |
| 18/01/09 | Doctor Dagmo and the other three doctors went to Gasar village with the cleaning tools | Arranged doctors and the villager leader and gave announcement to each household. |
| 19/01/09 | Doctor DanbaDoctor Dagmotar | First, in the morning the village leader opened Gasar village meeting hall and prepared for the training. Doctor Dagmo whose home is in gasar village introduced the detail purpose of the training toward village women and mentioned some rules during the training time. Then briefly introduced each doctors. She told about daily cleaning and explain how important to do cleaning in our life. Second the doctor Danba start to talk with women period and how to take care when women have menstrual period. Briefly introduced the women organs such womb by drawing pictures to the village women. |
| 20/01/09 | Doctor KuoluoDoctor Jimxitsho | Second day doctor kuoluo start talk about the pregnancy and the nutrition during women pregnancy. Especially how to take care pregnant women after gave birth and during the pregnancy. She suggests local women what kind of clothing and under pants will help to prevent get illness. What kind of medicine would helpful to cure common women illness?Then later Doctor jimxitsho talked about how to prevent pregnancy. She particularly focused on young women in the village alarm them how diseases effect by sexual relationship. Told them what kind of prevent pregnancy tools should use and what kind of medicine can take to avoid pregnancy. |
| 21/01/09 | Four Doctors | Teach how to use those washing tools. Especially before go to bed and after went to bathroom. Take comments from the village women in order to further this kind of project happened in the future. |
| 22/01/09 | Four doctors | Finished the training with a small ending ceremony. |
What did you learn from this training?
1) See doctor on early time
The village women in Gasar village said this kind of training is really helpful in their life. They were bothered by the women illness but they don’t have confidence to tell the doctors and their own family members so they hide their illness for longer time. At the end their health became worse and worse. From his training they understood that they shouldn’t act like this again. This stupid act leads toward serious result.
2) Take care self in special time
Women in Gasar village not much alert the importance of hygiene during the menstrual period. Mothers usually don’t have much idea about to teach their daughters how to take care it. Most of women in Gasar village they said they never take a rest and add more cloth during on period. They spend their time as usual, doing heavy works. After the doctors told them that they should take little rest and do little work in this special time. They will delay their work for a while. If you don’t have good rest, might cause some illness and panic after you get old. Doctor also says they should drink more hot water during this time. Those small useful health ideas are alert local women in effective way.
3) How to prevent early pregnancy
China birth plan is very active in the local areas so many young women use different way to avoid be pregnancies. But they don’t know specific and health way to do this. Doctor told them how it works if they follow the doctor’s comments to prevent pregnancy. They learnt what kind of medicine and tools very bad for the health and will create a negative result for their health.
4) What is the good way to have a health baby?
The local women generally have several children in the remote areas. Tibetan women usually are different from the other ethnic group. They don’t have much time take rest after gave birth because they need to work. Doctor told them is very important to have good food and good rest after gave birth. Let them aware that nutrition is important for mother and baby.
5) What is really a legal marriage?
The people here costumed to get married in their early age and some of them get married with people who own relatives. They don’t know the genetic problem. Many young people got marry under their eighteen. It against the law but they are not aware it. The doctors told what a legal married is and advised them do not married near relatives that will lead a negative causation toward next generations.
Project finances
| Receipt | Item | Donor contribution in rmb |
Local contri bution in rmb |
Proposed cost in rmb |
Actual cost in rmb |
Difference in rmb |
| #1 | Training fee | 3,200 | 0 | 4,000 | 3,200 | +800 |
| #2 | Hygiene materials (clean tools) |
2,180 | 0 | 1,600 | 2,180 | -580 |
| #3 | Transportation | 160 | 200 | 160 | +40 | |
| #4 | Small advertise cards |
450 | 0 | 300 | 450 | -150 |
| #5 | Meal fee(both doctors and participants) | 1,086 | 0 | 1,350 | 1,086 | +264 |
| #6 | Meeting house (including fuel fee) and instrument fee (microphone, speakers, and electric city.) | 330 | 450 | 330 | +120 | |
| living room fee(30rmb/per doctor/each day) | 600 | 750 | 600 | +150 | ||
| Project management expenses (phone call, photos, bus fare from Xining to the village) |
150 | 150 | 170 | -20 | ||
| #7 | Miscellaneous fee | 174 | 0 | 174 | – 174 | |
| Total | 7,556 | 600 | 9,300 | 8,176 | *+450 |
Note: *450rmb was left from the project, among 540rmb 150rmb was from the local contribution, and 300rmb is from the donor contribution. The 150rmb was given back to the local people because this was their contribution and now 300rmb is left in total from the donor contribution.
#1 originally we planned to invite five doctors but the training is Tibetan Losar time (New Year) I only had four doctors. We could not invite the other doctor because she said that her husbands’ granny passed away and she had no time for the training. Therefore there left 800rmb from the original training fee.
#2 the training materials fee much higher than the original one because more people came to join the training and added the doctor’s training fee on the material’s fee that who did not come to the training, so that made enough cleaning tools for participants.
#3 Doctors bought bus fee by themselves and not the taxi fee so the transportation fee cheaper than the original one.
#4 more advertise cards are given to the participants than the originally planned because more participants joined the training than we expected and also the price of the cards little became little higher than the original budget.
Notes# 5 the meal fee was much cheaper than the original budget because some villagers went their homes to have meals during the training. So we spent less money for the meal than we originally planned.
#6 and #7 Training house fee originally included in local contribution but the villagers changed the old village leader cause of some problem, so the new leader required small amount of money for the house fee that was much cheaper than the actual price.
Difficulties during the implementing project and what I learn from doing this project
Ø Firstly, I really should say thanks for this chance. I really learn many things by implementing this project. I feel helpless on the first day of the training. The villagers were not cooperative and hard to convince them to join this training. Particularly young women who are in my age. In front of them my role is changed not a school girl but an educated Tibetan woman to advice and tell how is important to join this training.
Ø Second, I understood have a plan on a paper doesn’t mean that everything going fine, sometimes the things happened opposite of our plan. Like the situation in my project goods price and time arrangement. So we must think carefully before the implementing the project and have full of preparation.
Ø Third, through this small-scale project I learn no matter how difficult it is, there is always a way to solve it, when you see the people you helped or did something for people who need it my feeling is hard to explain. This is a kind of happiness when you helped someone who needs help.
Interviews
1)Karmo
Karmo is one of new brides who joined this training; she came to Gasar village three years ago. She was born in a farmer family but she married with a nomadic boy in Gasar village. Since she got marry her lifestyle is different from before. She said before she attended the training she has never realized that what is women health care and no idea about how to take care of her in daily life. In fact what Karmo said is true; according to a Tibetan new bride except her mother no to tell her the importance of women health and danger of unhealthy sexual relationship. Even their mothers knew but they are often not able to meet. She also said that this was a great chance to learn something from the doctors because all the doctors are Tibetan and it is very easy to communicate each other in Tibetan.
2)Tsering Dorma
She is in her forty, last year she had operation in the county hospital cause of the women illness, doctors said that her illness lead toward serious condition and asked her why she did not see a doctor in early year. She joined this training and after the training we asked her about her idea on this kind of project. She said that she is very lucky to have a successful operation and she is scolded on herself no dare to see a doctor in earlier time. She said in her village they hardly to hear those kind of information, even though there are televisions but don’t understand the Chinese. She thanks for the doctors giving many instructions. She has a daughter who is in her twenty, Tesring Dorma said her daughter is not at home in current but she really wants to tell daughter what she learnt from the training.
Thanks Letter
Translation of the thanks letter
Receipts
#1
The total cost of heath training fee is 3,200rmb (each doctor was 800rmb and there are four doctors)
#2
Total amount of money paid for cleaning material fee is 2,180rmb.
#3
Total amount of money that paid for transportation fee is 160rmb (including bus fee and transport material (foods and hygiene material fee)
#4
The copy cards for advertise and the total cost was 450rmb (copy fee, scanning fee, printing fee)
#5
Total cost for the meal fee is 1,086rmb (meat, milk, vegetables, tea, fruits fast foods)
#6
House fee for training and the training instrumental fee total cost 330rmb
#7
It is the tax fee for getting formal receipt and it was 174RMB
Original Proposal
Project Location
Gasar (Xinsi in Chinese) is a large village compared to its neighboring villages in Zuogai Duoma Township. This village is located in Zuogai Duoma Township and is 28 km from Hezuo City, the capital city of Gannan Tibetan Autonomous Prefecture, Gansu Province, China.
Population
Gasar Village has approximately 113 households. There are 909 people in this village, and most of them are Tibetan but there are a few Han Chinese. The Gasar Village population is made up of 374 women, 439 men and 96 children under eighteen.
Education
The education level in Gasar Village is low. This is based on low school attendance and college attendance rates (there are currently 30 middle school students and 6 university graduates). The low rate of school attendance is caused by many factors including, but not limited to: i)low income ii) lack of trust in the school system, and iii) difference in expectations for boys and girls.
In the past many families could not afford to pay school tuition, so the school-aged children were kept at home to help with household labor. In 2006 the government policy “Free Tuition for Primary Schools” was enacted. Some middle schools also offered free tuition. Many poor income families are unable to afford tuition for high school and middle school. Some families borrow money to afford tuition.
Even though tuition is free in these cases, many families choose not to send their children to school because they do not trust the quality of the school system. Some families recognize they will not be able to afford high school and university tuition, so they believe that primary and middle school is a waste of time. Some families who can afford to send their children to high school and university choose not to because they believe the money spent will not guarantee an official government job for their child after graduating. These families believe it is more stable and realistic to let their children continue their way of living as herdsmen.
In addition, female children are especially disadvantaged because many parents prefer that their girls work in the house or marry at an early age. People think that women should learn how to run a household and take care of children.
Cash Income
There are three ways of generating income for Gasar villagers, and there is remarkable income inequality. There are 113 households but only 23 households can be called relatively rich. The rest of the households suffer from low income, labor scarcity, poverty-related health problems, and low education.
The first way of earning income is based on livestock. The richest family in Gasar Village owns four hundred sheep, around one hundred yaks and several pigs. Rich families can earn about 18,000 rmb from selling livestock. They can also sell yak hair (7 rmb per jin [1 jin = 0.5 kg]), cheese (18 rmb/jin), butter (15/jin) and sheep skins (30 rmb per skin) to increase their income.Besides this the women can sell yak dung to the local monks. Usually one basket of yak dung costs 2 rmb and if the small scale business is going well then women can earn 2,000 rmb/year. The yearly income of the richer families in Gasar Village is above 20,000 rmb. These families are able to save some money after all the expenses for family needs. However, if they have a university student or a sick person in the family, this amount of money is not quite enough.
The poor families own around ten yaks and around twenty sheep. Some of the poorest families do not have any livestock and rely on manual labor jobs for a living. The poor families hardly sell their livestock but they store cheese, butter and yak hair to earn about 1,400 rmb in a year. They might be able to sell one sheep that could help them earn around 2,000 rmb, which they could use to buy food and clothing.
The second way of the earning income is to dig caterpillar fungus (a kind of herb) in the spring and to pick mushrooms in the summer. Villagers can earn an average of 1,000 rmb/year from digging caterpillar fungus (one fungus can sell for 10 rmb depending on quality) and around 800 rmb/year for selling dried mushrooms.
The third way is to leave the village to work as manual laborers. The local villagers usually do not have any work skill, so they do physical tasks. Usually the women in the village can find local manual labor jobs. From this villagers can earn 1,000 rmb or more.
The richest families in Gasar can earn around 20,000 rmb per year. They spend 3,000 rmb on food for people and livestock. Another 3,000 rmb is spent on festivals. Families with university students must spend an additional 8,000 rmb for tuition. These families are able to save the left over amount.
The poor families in this village earn around 6,000 rmb per year. Around 1,200 rmb is spent on food for the family. Families with livestock must spend more money on food. If the family has one university student they must pay 8,000 rmb for tuition. Paying for clothes, medicine, and festival expenses costs at least 4,000 rmb total. These families must borrow money from the local bank or relatives.
Herding
Gasar Village is a nomadic village but some families do not have any livestock at all. Most Gasar villagers rely on livestock to live. However, there are fifteen families in Gasar Village who do not have any livestock, so they rely on digging herbs, picking mushrooms and manual labor to survive.
Agriculture
Gasar Village is in a cold climate area that does not support agriculture. Villagers plant grass for livestock, but do not plant crops. They must buy barley and vegetables from farming areas or in the market city of He Zuo.
Project goals
The immediate goal of this project is to invite five doctors to Gasar Village to teach the villagers how to take care of their health in their daily lives and how to prevent sickness. The gynecologists particularly focus on women’s health to teach how women should take care themselves as being women. In addition, the doctors introduce how health practices affect villagers’ lives and the lives of the next generations. The long-term goal of this project is to improve women’s health through the training and the lectures. The health information can plant seeds of health care in their minds. This knowledge will be passed down from mothers to their daughters.
Problems
1. Heavy work burden for women, increased importance of women’s health
Traditionally, women are responsible for the bulk of the labor tasks in a nomadic area. While men share in the herding responsibilities, women are almost entirely responsible for milking yaks, churning milk and storing dairy products. Women are also responsible for all of the household chores. In the local cultural context, women are integral to the functioning of a nomadic household. Thus, there is an increased need for a basic awareness of women’s health.
2. Culturally taboo for women to seek medical help for obstetrics/gynecology
Culturally, Tibetan women are shy to talk about sexual sickness in public, so many women are too shy to see a doctor when get pains or infections. Many women bare the pain until it becomes very serious. Some of the pregnant women also think that to see a doctor to check women’s illness is shameful.
3. Lack of basic information about hygiene and gynecology
Due to the above cultural taboo, there is a lack of information about basic women’s hygiene and gynecology.
4. Lack of information about obstetrics
Many villagers believe that pregnancy should not be treated as a special condition. People believe it is a small thing, one not to pay much attention to. When women in the village become pregnant they usually continue to do heavy work until the time of birth. They are usually expected to go back to work after seven days of giving birth. In many cases there is no mid-wife present. There are high risks for the mother and the child. Additionally, most men believe that giving birth is a women’s duty and her own problem to bare. For example, many men do not know that smoking affects the baby’s health.
5. Lack of information about safe sex
There is no open discussion about STDs or family planning, especially for younger people. Villagers are not aware of safe sex practices or the potential outcomes of not practicing safe sex.
6. No access to doctors and difficult transportation
Villagers need to herd their livestock in different pastures. They change their pastures three times in a year. They live for months at a time in remote valleys where there are no doctors. Some families who live in their summer pastures must ride a horse or take a long truck ride to see a doctor. Even when families are in the village it is very inconvenient to go to the clinic. Only one bus goes to the village and it can be difficult to hire a car in case of emergency. Because it is very inconvenient, women often would rather “tough it out” than go see a doctor.
Benefits
1. Basic health awareness (i.e., hygiene, nutrition, etc.) will benefit all people, especially women. After the training, there will be a good foundation of knowledge about women’s health.
2. Women will be able to talk about women’s illnesses in an open forum. They will see from the training that it is not shameful to talk about women’s illnesses. Also, they will be encouraged to see a doctor when they have health problems. If doctors tell them face to face about the causes of certain infections and STDs then they will at least be aware of the problems. As the training will also focus on preventative health measures, the villagers will know the causes of some basic health problems and will know what to do to prevent them.
3. Men and women will have a basic understanding of gynecology and hygiene.
4. Villagers will be more aware of complications related to pregnancy and child birth. Women will be encouraged to go to the hospital for pre-natal care and to go to the hospital to give birth.
5. Information about safe sex will prevent unwanted pregnancies and the spread of STDs.
6. Villagers who attend the training will be able to pass on their knowledge to neighbors and family members. So, even if access to a doctor is limited villagers still have access to information.
Beneficiaries
The project will directly benefit 250 women from Gasar Village in the Zuogai Duoma Township. The other 563 villagers will indirectly benefit. So in total 813 people in Gasar Village will benefit from the project.
Gender equality
This project promotes gender equality in the following ways. By bringing educated women doctors and professionals to give the trainings, the villagers of Gasar will interact face to face with empowered women. Also, as a female project manager I will show the villagers the importance and value of education for girls.
Government approval
On September 5th, 2008 I received permission from the local government to implement this project. The local government leader Sangji approved this project and they also said that their office will send an assistant if it is necessary during the training.
Project steps
1) Hold meeting with the village women and the leader with the doctor.
2) Collect information from locals villagers and talk with the person who has done this kind of project.(done)
3) Contact the hospital in Gannan, Baojianzhan. (done)
4) Ask three gynecologists, one medical school teacher and one nurse to train the local villagers. (done)
5) Figure out the price of the training fee and the other materials fee that will be needed in the training.(done)
6) Write a proposal.(done)
7) Receive the funds.
8) Purchase the materials with villagers.
9) Invite the doctors to Gasar Village.
10) Hold a meeting with the villagers and select five men to give announcement to each family. There will be between 160 or 200 women attending the training, but for men it is an optional training.
11) Hold 5 days training.
12) Take pictures of the process of project.
13) Write final report.
Time Frame
The implementation of the project will take 8 days.
1day: Invite the doctors to Gasar Village.
1day: Give the announcement about the training and the time when should villagers come. Manage the doctors living.
5days: Training the villagers. Take photos.
1day: Interview the village beneficiaries