Publications

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Racial Discrimination in Tibet (2000)

Discrimination in Healthcare

Extortionate Hospital Deposits

According to refugee testimonies, the greatest obstacle to Tibetans seeking healthcare is the fact that alongside expenses for a pass, treatment and medicine, patients are also required to pay a deposit before being admitted into hospital. This deposit is usually an exorbitant amount of money, and far beyond the means of both rural Tibetans who survive on subsistence farming and urban Tibetans who suffer from discriminatory wages. Once again, the lack of clear regulations governing the size and adjudicator of this deposit has resulted in widespread abuse and discriminatory access between counties and prefectures in Tibet, with Tibetans suffering the most. According to many refugees, the Chinese staff dominating the healthcare sector show considerable preference to Chinese patients, and in many cases either reduce the deposit required or even waive it altogether.

As one 17 year-old girl from Lhasa put it, "Everything the government announces on television about free healthcare is completely untrue. If you are seriously ill and do not have any money, you just have to prepare yourself to die. The hospital demands between 1500 and 2000 yuan as a deposit or they will turn you away, no matter how sick you are. I was once in the Mimang Menkhang hospital visiting my cousin, when an old Tibetan woman came in carried by her two sons. She was very, very ill, but the doctors said that without a deposit of 1800 yuan they would not admit her. The sons only had 300 yuan, and although I gave what I could, it was still not enough. Her sons pleaded with the doctor all afternoon to help them, but he refused. By evening the old lady had died. It was terrible. I knew three Tibetans who died like this after being denied admission, but I have never heard of a Chinese patient dying for the same reason. They are always seen first by the doctor and never turned away."

Tsering, a 13 year-old boy also from Lhasa told TCHRD the following story. "One night our neighbour's wife (Tibetan) became seriously ill and they had to call for an ambulance. Even before they reached the hospital, they were asked to pay 150 yuan for the ambulance. Arriving at Mimang Menkhang hospital, they were then asked for a further 5000 yuan for a deposit. Our neighbour was helpless, as he had no such amount of money and no means of getting it in time. He had to go back home with his wife, and she died the next day."

Dorchoe Kunchok Tendar escaped from Drayab County in Chamdo at the age of 61 and reached Nepal in April 1998. "In my county Tibetans had to pay at least 500 yuan, usually a lot more. Even if a person is dying they will not be admitted without this payment. Chinese and Tibetan Officials working for the government have much easier access however, and are always given priority."

Samten from Kyirong County reported in January 2000 that to be admitted into hospital a deposit of 2000 - 3000 yuan must be paid. "If you are not able to pay, they will not admit you, even if you are close to death. The Chinese patients pay no deposit however, and are generally treated better and with more respect. For minor illnesses some Chinese are even treated free of cost. It makes me so angry when Tibetans are dying at the hospital door."

Though refundable, the amounts demanded for these deposits are truly extortionate, given that in 1998 the per capita net income of farmers and herders in Tibet was only 1,158 yuan, with the per capita disposable income of urban residents 5,438 yuan. As a survey of the available health care in Tibet carried out by the Swiss Red Cross confirmed, "the time and labour costs as well as financial costs of going to health services do deter farmers from going to county hospitals". Furthermore, it appears from these and other testimonies from various regions in Tibet that the deposit is determined not by county policy, but rather by particular hospitals and often the individual doctors themselves, who apparently calculate an amount relative to the severity of the patient's illness. This makes it difficult to pin the discrimination down to an accountable source, and even more difficult for Tibetans to lodge official complaints.