Home » Great MindsSpring 2008

No Permit? No Training? No Problem.

by David Amsalem, class of 2009 No Comment

“Well, that’s great you want to volunteer, but what do you have to contribute?”

This painful, yet relevant question was posed over the phone by one of a group of Italian doctors who were running a hospital in a remote part of Tibet. I was reminded of volunteering in an HIV clinic in Kampala, Uganda, not a year earlier. Because I had no medical or counseling training, my contribution in Kampala was limited to hours of pill counting in the dispensary.

I countered the doctor with a bold proposition. He answered back, “Well, if you get your EMT certification, then we could really use you. Call us when you are certified, and we’ll be waiting for you at the hospital in Lithang.”

So I spent January–February 2007 obtaining my certification as an Emergency Medical Technician (EMT). I also added Wilderness EMT training to help me deal with emergencies in isolated settings with minimal equipment. 

Then, one week before I was scheduled to leave for Tibet, I received a devastating phone call. The hospital had been taken over by the Chinese government. The Tibetan staff had been kicked out, and no foreigners, including the Italian doctors who had funded and built the facility, were allowed.

There I was, newly certified with a leave of absence for the spring semester and no prospect of work. I began a frenzy of e-mails and phone calls to every contact I had, as well as to any nongovernmental organization (NGO) I could find in Tibet. Determinedly, I decided to travel to Beijing as planned; make my way to Lhasa, the capital of Tibet; and use my medical skills.

By the time I arrived in China, I had leads, but nothing definite. After five gray and dismal days in Beijing, I managed to sneak onto a train going to Lhasa. I say, “sneak,” because I didn’t apply for or purchase the permit required by the Chinese government to travel to Tibet. I didn’t want to be screened out by the authorities as an undesirable visitor.

And so I arrived in Lhasa, the Forbidden City, the highest capital in the world. This strange, medieval town would be my home for several months.

On Top of the World

I spent three frustrating weeks trying to volunteer for every NGO in Lhasa, to no avail. The government crackdown left none willing to let me work with them. As I searched, I became familiar with the town, its customs, and its incredibly warm and generous people. Giving up my hopes to volunteer medically, I explored what the culture had to offer and what it needed from me in return. 

“I have met people and experienced the topics we raise in public and global health courses, and this has motivated me more in the classroom.”

In my time in Lhasa, I taught English in three schools. My pupils ranged from 70 kindergarten students to 60 15–25 year-olds. Every afternoon I traveled outside of town to the famous Sera Monastery to study Tibetan language and Buddhism with Togme, a monk. I gave speeches and lectures to schools and youth organizations about first aid and emergency medicine. Thanks to the great work of the Hope Corner, a local youth program, I taught first aid to many of the tourist guides who drive Land Cruiser tours. Soon I could not walk half a block without running into people I knew or hearing a student yell, “Teacher, teacher!” from across the street. 

I spent many days simply walking the Kora (holy pilgrimage) clockwise around the Jokhang Temple, Tibet’s holiest. I sometimes played pool with young monks, wandered the area’s winding alleys, watched kung fu movies in small teahouses, drank yak butter milk tea, and wrote.

One of my most memorable experiences was camping in the snowy mountains with some new Argentinian and Israeli friends. Aside from a few yaks, we neither saw nor heard another living soul during our time there. Every morning we would select a peak in the distance, pack up dried yak meat and a bar of chocolate, and set out. Every night, we would heat some tea and watch the sunset from our 5,000-meter throne on top of the world.

Off to Katmandu

After three months, my visa was to expire. Still eager to get some medical experience, I decided to try Katmandu, Nepal, where regulations for foreign volunteers would be less strict. After I e-mailed a few leads, I was contacted by doctors at Patan Hospital. They were excited that I was an EMT and wanted to discuss a project. I hitchhiked to the border as quickly as I could. I managed to slip out of Tibet as unnoticed as I had slipped in by sticking with two English twin sisters who had all the necessary permits and forms.

After settling into my new lush, green and hot environment (I hadn’t seen a tree or shrub in three months), I met with the doctors.

Their still-theoretical project was to establish a central ambulance system for the Katmandu Valley, which had no emergency medical service. We would need to develop a free emergency number (like 911), create a dispatch and communication center,
get and equip ambulances, establish an EMT school, and convince people to use this system rather than take a taxi or bus or walk to the emergency room when they were in need of medical attention. Because I was trained to work on an ambulance in the United States, the doctors believed I was the most qualified person they had come across to handle the project. 

So I did. 

I planned, met with the directors of every hospital and emergency medical center in Katmandu, and inspected the existing makeshift ambulances (more like slow and expensive private taxi services). The few of us working on the project obtained a three digit number, convinced the Katmandu police to let us use their dispatch system and house our ambulances (the service now has three), and got the Nepalese army to make its retiring medics available as the first class of EMTs. 

Then I ran out of time. In August, I had to return to school.

The Return

The months I spent in Asia were the most incredible of my life. Not only did I see and do things I would have never imagined, but I gained life experiences that give me vivid and true insight into world issues. In classes for my major, medicine, health and society, I feel differently about most of the subjects we discuss because I’ve seen it firsthand. I have met people and experienced the topics we raise in public and global health courses, and this has motivated me more in the classroom. I’ve integrated all I learned traveling and working abroad into my studies at Vanderbilt. 

Today, I continue my work with my Nepali counterparts on what has become the National Ambulance Center–Nepal. I have also worked with several of my teachers on writing proposals and developing fundraising strategies for the National Ambulance Center. I registered our organization as a 501(c)(3), obtained training material for the EMTs, and have been fundraising until I return to Katmandu next summer. 

For I am returning. I have something to contribute. 

Senior David Amsalem is a medicine, health and society major from New York City. To add your own contribution to the National Ambulance Center—Nepal, visit www.hhnepal.org.

Photo by David Amsalem.

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