Publications

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Racial Discrimination in Tibet (2000)

Discrimination in Healthcare

Introduction

Article 5 (e) (iv) of the ICERD guarantees the right of everyone, without distinction as to race, colour, national or ethnic origin, to enjoy:

"...the right to public health, medical care, social security and social services."

The International Covenant on Economic, Social and Cultural Rights (1966) also specifies that steps should be taken by State Parties to create

"...conditions which would assure to all medical service and medical attention in the event of sickness."

Although the PRC Constitution does not itself speak of the right to health, China has continued over the years to place healthcare at the forefront of its White Paper propaganda, and claimed substantial improvement in the Tibetan sector each year. A 1998 report from the Information Office of the State Council asserted that "the Central Government and Tibetan governments at all levels are greatly concerned about the health of the Tibetan people". Between the years 1992 and 1997 it claimed to have disbursed 964.61 million yuan in expenditures for public medical services in Tibet, allowing it to further assert in 1998 that "a basic medical and public health network now covers the whole of the Tibet Autonomous Region".

Statistically, the number of hospitals and clinics in Tibet has increased, but to a degree far less than the Chinese authorities would have us believe. For example, in 1991, there were 1,197 medical establishments in the "TAR", and 5,077 hospital beds. By 1998, these figures had only slightly increased to just over 1,300 and 6,700 respectively an increase hardly proportionate to the aforementioned investment or time period of seven years. Furthermore, these medical institutions are largely confined to the county capitals and larger towns, which are substantial distances from the 88% of Tibetans living in rural and pastoral areas. Refugees across the region unanimously testify to the dire lack of health facilities available at village and township levels, which renders the recent Chinese assertion that "nowadays, medical institutions can be found everywhere" somewhat unrealistic to say the least. Even a comprehensive outside appraisal commissioned by The Lhasa Health Bureau admitted that "hospital medicine is currently more emphasized than the first-line health service of village and township [township]."

As one 18 year-old man from Nye Shi village, Derge County in Kandze "TAP" reported after escaping in April 1998, "There were no Chinese people living in our area, so we had no electricity, no roads, no schools and no health services. The authorities have no interest in developing areas where they themselves have no benefit, and so if anyone in our village became sick, we had no one around to help us."

An Australian Human Rights Delegation to China in 1991 also confirmed that access to facilities such as healthcare depended on Chinese interests:

"Clinics, schools, electricity and other social services are all available in Chinese population centres, but are often far enough away from Tibetan towns as to make them marginally relevant to the lives of most Tibetans. Tibetans who happen to live near Chinese settlements are casual beneficiaries of government programs which would not exist in their present state but for the Chinese population."

Even when institutions are built with the express intention of being used by Tibetans, they become in practice little more than token gestures that actually lie far beyond the means of the population they were built to help. As one foreign tourist from New Zealand witnessed:

"In Labrang in Gansu Province the Chinese government built a modern hospital with the assistance of the World Bank "for Tibetans". However, the hospital fees are sky high- daily charges are in the region of 2000 yuan (US$250) per day, so the hospital is mainly used by super-rich Chinese businessmen and other foreign government dignitaries. The whole complex is nothing more than a showcase for the World Bank, and of no use whatsoever for Tibetans."

Statistics concerning existing medical establishments anyway become useless if the access to such facilities is restricted, and it is here that many Tibetan refugees have reported discrimination. One of the contributing factors seems to be the lack of a centralized policy concerning healthcare, and the different regulations adopted between counties and even sometimes townships. Although it insists that it has adopted a "preferential medical policy" in Tibet, the Chinese government itself has proved inconsistent in its statements concerning the healthcare system, particularly in terms of how it is funded.