Mr. Weingrad says he saw past the romance of saffron-robed monks spinning prayer wheels and the wild scenery to the consequences of the dire poverty that afflicts most nomadic Tibetans, many of whom live on a few cents a day.
He found that maternal and infant mortality rates in Surmang County were among the highest in the world, according to an assessment carried out by the international health experts he consulted. Twenty percent of babies were not surviving until their first birthdays, the survey reported. And 3 percent of mothers were dying in childbirth, 300 times the rate in the United States.
In response, he created the Surmang Foundation, which in 2005 began to train 40 local women like Puder as community health workers with simple, birth-related skills.
“There are so many problems in these ultrapoor areas,” says Weingrad. “We just picked out one niche where we think we can make a difference.”
It does not take much to make a difference between life and death here.
Sometimes it might just be the slim package that the clinic’s two doctors give to expectant mothers who visit for an ultrasound exam. It contains a disposable sheet onto which the baby can be delivered cleanly and a sterile razor blade – safer than the rusty knives often used to cut umbilical cords. Sometimes it can be the presence of a woman like Puder at a difficult birth. The clinic cannot perform emergency cesareans, but she says she did once stop a woman’s bleeding with massage and Tibetan medicine. “She would have been lucky to survive had she been on her own,” Puder believes.