In terms of Sowa Rigpa – commonly referred to as ‘Tibetan medicine’ by Tibetans and locals – in Darjeeling there were two clinics: the Men-Tsee-Khang (MTK) clinic, staffed by Amchi Lobsang Thubten, as well as pharmacist and receptionist, and the Chagpori Tibetan Medical Institute (CTMI), set up by Trogawa Rinpoche (1931-2005) in 1992, and now run by Trogawa’s nephew, Amchi Teinlay. Both Trogawa Rinpoche and Amchi Teinlay had also travelled to Europe and practised at a clinic in the Netherlands. At both clinics, prices were low compared to biomedical and Ayurvedic clinics. For example, a consultation and 7-10 days’ herbal medicine at both the MTK and CTMI cost me approximately Rs.100-150 per visit, compared to Rs.300 for a similar service at an Ayurvedic clinic I visited in town.
Illustration 8: Amchi Lobsang Thubten at the Darjeeling MTK clinic The Darjeeling MTK clinic is one of the many branch clinics of the MTK system dotted around India, all administered and funded by the Tibetan Department of Health in Dharamsala. In the Darjeeling clinic, consultation fees were low (Rs.40), prescribed herbal medicines could be bought immediately from the onsite pharmacy and, as in other MTK clinics, monks, nuns and schoolchildren paid half price, with
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those over seventy receiving free medicines. In some MTK clinics both amchi and patients keep patients’ records (see for example Samuel 2001b, p. 253), but in Darjeeling, this was not the case, and instead it was customary for patients to bring along their previous prescriptions written by the amchi in a small record book which they kept themselves.
In the Darjeeling clinic, Amchi Lobsang saw a mixture of Tibetan and Nepali patients, as well as a few foreigners. Having grown up in another part of India, he had been learning Nepali since being stationed in Darjeeling approximately two years previously. However, like many Tibetans who had lived and studied in
Dharamsala, he had a high level of English and often communicated with patients in this. In Darjeeling the clinic was generally open Monday to Friday all day and every other Saturday morning. In addition, on alternate Saturday mornings Amchi Lobsang saw patients at the TRSHC, and once a fortnight he travelled to the Tibetan
settlement at Sonada and spent the day treating patients there. He was kind enough to let me observe his clinic one morning in Darjeeling, and to go with him on one of his day visits to the Sonada clinic. On the morning that I observed the Darjeeling MTK clinic, he saw ten patients – although he told me that this was often highly variable – and on the Sonada clinic visit he saw thirty-nine patients, which he said was typical of his visits there. At both clinics, he diagnosed patients through pulse diagnosis, questioning and the use of a sphygmomanometer (manual or electronic), and the most common complaints were hypertension, diabetes, gastric problems and joint problems such as arthritis.
The CTMI clinic, housed in an old building halfway down one of Darjeeling’s steep paths near to the main square, was also open all day Monday to Friday, and Saturday mornings. Student amchi studied at the Chagpori Medical College, situated at
Takdah, approximately 30km from Darjeeling. When I arrived in Darjeeling in June 2011, they had twelve students, with nine recently graduated and approximately ten new students expected to enrol in September 2011. The students study there for five
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years, and follow this with a one-year internship, before usually setting up their own private clinics.18
The CTMI clinic had one resident amchi, Amchi Lobsang Samten, who had been practising there since 2003, and a chief pharmacist, who was a monk. As the director of CTMI, Amchi Teinlay oversaw the running of the clinic (and the entire
organisation), and also saw patients who requested him – many of whom had known and been treated by his uncle. Amchi Lobsang saw approximately fifteen to twenty- five patients per day, and told me that they were ‘mostly local people’ –
predominantly Sherpa. He explained that many older Tibetans preferred the MTK clinic, where they received free medicines, whilst the CTMI clinic saw a higher proportion of younger Tibetan patients. Consultation fees were low (Rs.50-70), and free treatment was given to the very poor. He reported the main complaints to be gout, arthritis, back pain, breast cancer, breast cysts, gynaecological problems, kidney problems, high blood pressure and epilepsy. Amchi Lobsang Samten used pulse analysis for diagnosis – occasionally supplemented by urine analysis and/or a sphygmomanometer (manual or electronic) reading. Patients were predominantly treated via herbal medicine – mostly pills but also herbs for tea – but he reported sometimes also performing moxa, cupping using copper and china cups and/or golden needle therapy on the head or feet, and very occasionally bloodletting. Similarly to the MTK clinic, medicines prescribed by the amchi could be bought immediately from the onsite pharmacy.
Whilst some Tibetan informants in Darjeeling had a preference for one or the other of these clinics, a significant number reported that they had visited both and felt them to be equally good. At both clinics, sometimes amchi referred patients to other medical or healing specialists if they felt these would better treat their patients. For example, Amchi Lobsang Samten recommended consulting monastic practitioners for some conditions, either in combination with, or in place of medical treatment, and it is to these practitioners which I will turn next.
18 If necessary, students may also do two years’ preliminary language study of Classical Tibetan prior to commencing their study of Tibetan medicine.
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