Gobi Women’s Song DVD on Amazon [PDF]

Set against the background of barren expanses, Gobi Women’s Song immerses the viewer in a different world. It is a world in a transitional moment, one that has occurred in all cultures, which decides the future lives, environment and lifestyle of its people. Five 21st century nomadic women share their lives. They hum with the song of the soul passed down from their grandmothers and at the same time deal with the pressing issues of today’s world. Their colorful and harsh life is about connection—with the environment, community, family, and ultimately, with us.

In English and Mongolian with English subtitles. 73 minutes. Revisited 11 minutes.

http://www.amazon.com/Gobi-Womens-Song-Revisiting-Women/dp/B00807I2FA/

Shriner’s Hospital in Boston is donating surgery and all care for her. American Airlines Miles for Kids is giving free flights for Naraa and Orkhon, from Beijing to Boston. Eznis is giving free flights from Dalanzadgad, South Gobi to Ulaanbaatar. Hospitality Homes of Boston is a wonderful organization which has host families to take in patients and their families who need medical care in Boston. Because there were four of us–Munkhjin, Orkhon, Naraa and me (Sas) this organization has given us a lovely apartment for a very low cost. We are very close to Shriners.

Naraa’s surgery was to be this past Monday but she had pneumonia, so it is being rescheduled for next Wednesday, the day of the New Moon, New Year’s Holiday in Mongolia. She has a little cough still so we are hoping she will respond to the medication she is on. All good wishes, prayers, blessings, thoughts are welcome for this.

Thank you everyone who has helped get Naraa here! We will let you know as her treatment proceeds.

Examination

I am really optimistic about their potential for success. They seem to have an extremely organized set up, with clear missions and feasible ways of achieving such goals. We mostly discussed their work on improving primary health care because that is most relevant to Nomadicare’s work. Their basic strategy to classify sum hospitals into three classes—A, B and C—based on features such as the population of the sum, their remoteness from a bigger hospital, and other unique factors such as the present of illegal miners. Illegal miners are people who dig their own shallow mines hoping to find valuable raw materials and flock to certain rich in resources. These illegal miners put a huge strain on local health care systems because they are not accounted for and the actual size of the population that a health care center is serving is much larger than the reported population. The managed met with at Third Health Sector Development gave us the example of a sum with a normal population of 2,000 but 10,000 illegal miners. Further, illegal mining is a very dangerous activity and results in a lot of accidents.

The general theme of the Third Health Sector Development project, at least in terms of primary health, is to greatly improve the efficiency of hospitals by having staff that can take on a wide range of diagnoses and treatment. They plan to have more specialized doctors in the aimag center hospitals and sum doctors will refer complex cases to the aimag center. The current plan is being implemented in 5 pilot aimags. The project is also developing training and retraining materials in a wide range of topics to improve the knowledge of the existing personnel. Overall it sounds like a really great project and the classification of hospitals seems like a good idea. The only issue that we find slightly unfortunate is that laboratories are only being emphasized in B and C level hospitals, not the A level small sum health centers. We think that a well-equipped laboratory is important to help the doctors decide whether or not to refer a patient to a larger hospital.

In addition to having our last meetings before returning to the US we have also been having some fun. Today we went to the black market called Narantuul which sells everything and anything in a huge open air market. Not only was it the coldest weather in which Sas and I have been to Naruntuul, but it was also the coldest day of the winter this far. Mongolian’s classify winter as having 81 days broken into 9 sets of 9 days. The “third 9,” as they call it, began last week and is supposed to always be the coldest days of winter. So far we haven’t been disappointed. But tomorrow is supposed to be even colder, brrrr. Even though it is so cold I am looking forward to taking advantage of my last days in Mongolia and I’m trying to cherish everything, even the weather.

Vansemberuu developed a medical kit that contains 10 types of traditional Mongolia medicines, a thermometer, antiseptic, bandages, Band-Aids, and most importantly a healthy living guidebook. The representative we spoke to assured us that the guide was written in simple Mongolian to accommodate people who may not have received much education, big font, and as simple as possible. It also contained quick reference guides for each medicine including clear pictures of the ailment for which they should be taken (runny nose, coughing, etc.), directions and restrictions for usage. I basically understood the general idea of the pamphlets even though I don’t speak Mongolian so that’s pretty promising. The also explained that only a small part of the thick guide was dedicated to the traditional medicine treatments, and over 75% of the book was dedicated to more general aspects of herder life. Vansemberuu also runs trainings for doctors and local families in traditional medicine and health living so they have a deeper understanding of the tools provided in the medical kit.

The family medicine kit created and distributed by Vansemberuu. The colorful boxes to the right are the traditional medicines (packaged in plastic inside the cardboard boxes for the first time ever) and the easy to read guide.

While the kit itself is already really great on its own, the distribution model Vansemberuu I think is the most notable and unique aspect of the project. The local doctor, who receives a stipend from Vansemberuu to promote the project in addition to his or her existing responsibilities, distributes the medical kits to rural herder families at no cost. The doctor decides which families in the county should receive the kit based on need, desire, and whether they will pay for the medicines the use. A few times per year the doctor visits the families who have the kits to do check ups, and also replace the medicine in the kit that the family has used since his/her last visit at a small fee. The representative called it a “use now, pay later” system which I think is really creative and fits the needs of the herders. It provides them with free knowledge about traditional medicine and living healthier lifestyles through the training and guidebook, and spend money only when necessary, to replace the medicine they finished using. The doctors also purposely visit families during the two times a year when have money from selling their goods—the spring because from cashmere, the beginning of winter from selling meat. Further, the “pay later” aspect of the model serves both to increase the sustainability of the program by reducing costs, but also so that the herders learn to value health care.

This is an issue the Nomadicare’s sum health project has run into as well. During the week-long hospital training Nomadicare provides the medical professionals who attend the traditional medicine trainings with enough medicine to treat 10 people with the new skills they’ve learned. While the medicine is a good start, it is not a sustainable method of making sure the sum hospital always has the medicine available. A more effective option would be to request a small payment from the patient. However, since the care is being given at the sum hospital and there the current health care laws states that services at sum hospitals must be free, a fee for the traditional medicine cannot be charged. Vansemberuu’s operations do not fit that rule because they occur outside the sum hospital.

Sas and Oyun, General Manager of Vensemberuu, share information about their projects.

Our meeting lasted almost two hours we were so interested in Vansemberuu’s activities and it was really great to finally hear about a program that is directly engaging, strengthening and promoting traditional Mongolian medicine—they have currently given medical kits to 21,000 families and operate in 35 sum (countries) in 8 aimags (provinces). The only concern we have is the project is being turned over to the Ministory of Health in February and I hope the transition goes smoothly! We also see ample opportunity for us to collaborate, especially with the trainings that Vansemberuu provides doctors.

Sas, Dandaasuren, Bayarjargal and Nara read Nomadicare newsletters, and admire the pictures of themselves.

The same day we met with the Principle Health Specialist Claude Bodart at the Asian Development Bank who shared interesting ideas with us about traditional medicine and the role of the ADB in Mongolia.

We met with the director of the Health Sector Partner Coordination Committee at the Ministry of Health which was slightly disorganized because the committee is just getting started but their project is very interesting. When it becomes more organized I think it will be a great asset to Mongolia’s health sector. The committee is trying to create a database of all the groups working on health care in Mongolia so that it will be easy for organizations to contact each other, initiate collaboration, and to prevent the overlapping of services. When the database is created and if it is updated, it will hopefully be useful because both governmental and non-governmental organizations could look through the database and identify which areas of the country are receiving aid and which areas are not.

Last but not least, we met with the country director of WHO Mongolia Dr. Govind. He gave us a lot of information about programs occurring in support of traditional medicine and it was the first time we heard about most of them, which is very surprising given the fact we have already spoken to so many people in the health sector. It was really assuring to hear that so many others are working extending the reach of traditional medicine. He gave us some great reading about WHO’s involvement with traditional health we can’t wait to take a look!

-Jessica

The outside was -30 degrees F but still Khongoroo in her wedding dress and Joost in his suit were driven by a decorated (wedding couple dolls and balloons) black Hummer to the Central Square. Outside. We all followed. It is traditional to have a photo in front of the Chinggis Khan statue at the Parliament Building. This is the only time my feet have gotten cold here so far. I can only imagine how cold Khongoroo and Joost were with no coats.

The reception was at the Chinggis Khan Hotel. Very ornate. The five floor staircase was decorated with white gauze and white roses. 150 guests in round tables with a round dance floor in the middle. Eight at a table except the bride and groom who sat alone behind a wedding cake, round pastries, and a fat skinned sheep that represents good fortune. The sheep head faced the couple. A program opened with a speech from the groom’s father. Next a vodka toast. Next traditional music–horse headed fiddle, long song and throat singing. What followed was dancing and singing and toasting, two meals–one right after the other. Chicken then beef. Cutting the wedding cake. Toast from the bride’s father. Dancing.

Near the end the two mothers poured milk into a cup tower, which flowed into one cup after another to the end where it split into two cups, one for the bride and one for the groom. This represented the mixing of breast milk, the first food the couple had. Now even that early time is connected.

I sang the first solo of my life–a Mongolian song I have been studying about the four seasons of the steppes. The Mongolians joined in. I was really nervous.

My favorite part of the wedding was the dancing, a time where all the cultures were leveled into one. Where Mongolian men in traditional deels danced with the Westerners from the Netherlands and no translations were needed.

Sas

Khongoroo and Joost with the Nomadicare team. Left to right: Munkhjin, board member, Nomin daughter of Narantsetseg who went with us for the South Gobi training last year, Jessica Appelson, Middlebury College intern for January, Sas, Khongoroo, assistant 2007-2010 and Joost, cameraman 2010, Narantsetseg, Nomadicare laboratory teacher, Ulziisaikhan's wife, Ulziisaikhan, Nomadicare's traditional medicine teacher, Narantungalag, Nomadicare's assistant.

The ornate window at the wedding palace.

-Sas

Sunset in UB

We have been in Mongolia for a couple days now, and while we’re stilladjusting to the time difference, cold and polluted air, we are ready to start meeting with government and non-governmental agencies to spread awareness about Nomadicare’s mission. We are waiting to hear about our meeting time with the Mongolian Ministry of Health, and are excited to touch base with our excellent teachers for the summer training program, Nara and Ulziisaikhan.

I know everyone is curious about the weather, and it is definitely extremely cold. I think the coldest it’s been since we got here is -26°F yesterday morning. It takes us a while just to bundle up enough to go outside. While Sas and I feel like it’s extremely hard to look good while dressing warmly enough for this weather, we are continually amazed by how beautiful many of the Mongolian women look with their shearling coats, and some still wear high-heeled boots! There isn’t too much snow but plenty of ice to slip on. Now that we’ve settled in, things are suddenly moving fast and I’ll be back with more updates soon!

Jessica Appelson is a Neuroscience major from Middlebury College and an intern for Nomadicare this January.