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FROM THE MEDICAL DIRECTOR'S DESK Dr. Colin Butler The Lancet, Jan 1, 1994: Newly appointed US Surgeon General Jocelyn Elders says, "It (comprehensive health education) should start in kindergarten. It should be taught every day, every year.." If this is true in the US, then how much more is a similar attitude needed in the developing countries, most of which have hardly any health education? Tibetan Bulletin, November--December 1993: "His Holiness the Dalai Lama reiterated his call to Tibetans, especially those residing in Dharamsala [site of the exiled Tibetan administration in the Indian Himalaya] to pay more attention to the local environment, by keeping their surroundings clean." The Guardian Weekly, November 21, 1993: "The UN warns world refugee crisis is out of control, with at least 43 million global refugees". The Lancet, Jan 8, 1994: The 30 kilometre exclusion zone around the Chernobyl nuclear power station in Ukraine needs to be expanded to limit the exposure to the radioactive element, Americium-241. This is seeping into underground water from a site in the Red Forest, where waste from the accident was dumped, outside the original underground barriers. Nature, December 16, 1993: As part of its review of Indian science, this journal showcases Indian entrepreneur M.R. Narayanan's Central Electronics Company's Delhi display of solar powered lights (suitable for conducting evening classes), solar powered television and solar radios, aimed at India's 500,000 villages. TB WATCH Despite the fact that US$480,000 has been spent on TB eradication since 1984, the incidence of TB among Tibetans in India has increased from .96 per cent in 1990 to 1.16 per cent in 1992, according to Health Secretary Mrs. Namgyal Taklha in the November-December, 1993, issue of Tibetan Bulletin. TB DRUGS TO TIBETANS BODHI has donated to the Tibetan Department of Health US$4500 (Australian $7000) of rifampicin, an anti-TB drug vital for short term treatment. We hope this will be used as "first line" treatment, and boost cure rates for Tibetans which are so often compromised by poor compliance. SOLAR HEATER AT DREPUNG BODHI hopes to fund a solar heater at Drepung Gomang in Mundgod, as requested by Losang Tsultrim. PROJECTS UPDATE HEALTH EDUCATION VIDEOS: Tenpa T.K. has requested that BODHI fund the translation of a health education video from Hindi to Tibetan. We are waiting for budget information. Also, we are researching production using Tibetan and Indian personnel. TB ERADICATION: In January, 1994, the Department of Health of the Tibetan government in exile requested that BODHI not conduct its planned TB trial in conjunction with traditional short-course chemotherapy. Both lack of sufficiently trained research assistants and the difficulty of obtaining the frequent sputum cultures necessary to adequately evaluate the therapy's effectiveness mean a properly conducted trial would be too difficult. Consequently, BODHI is now investigating potential interest from the Indian National Institute of Tuberculosis, the Christian Medical College at Vellore, South India, and also with Lanka Jatika Sarvodaya Shramadana Sangamaya (Inc.) in Sri Lanka. BOWSER: Progress has stalled temporarily, due to Tibetan inability to provide reliable manpower to undertake the actual work, even though BODHI has offered to fund their training, vaccinations et al. Instead, suggestions have been made that we should hire Indians to carry out all the work. This was not part of our original agreement with the Tibetan settlements; our first reaction is that, if we hire Indians, it should be to benefit Indians. While we recognize that the wages paid to the Indians (which under our original plan would be partly from the Tibetans) would be of use to them, we are concerned that the Tibetans' passive participation will not be sustainable. Who will pay the workers' salaries in future years? We also do not wish to reinforce a worrying tendency we see in the thinking of exiled Tibetan: that of disguised begging. Are we being too harsh? What do readers think? T.E.A.C.H. SCIENCE LAB UNDERWAY Thanks to the generosity of BODHI's donors, the Tibetan Educational and Children's Home (T.E.A.C.H.) has purchased two microscopes, one simple and one compound, and twenty-six books for the science laboratory. Thank you--keep it coming!