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Covid-19 Prevention at the Grassroots Level: Experiences, Perspectives, and Responses in Rural Kham, Eastern Tibet, China
Abstract
The sudden outbreak of the novel coronavirus disease (Covid-19) caused an unprecedented catastrophe worldwide. Different communities adopted a wide range of preventive measures to halt transmission of the disease. This article examines how rural Tibetan communities in China’s eastern Tibet (Kham) have addressed this pandemic, including their popular discourses and practices concerning the ethics, etiology, and prevention of Covid-19. Through analysing the experiences, views, and responses of local Tibetans to Covid-19, this article reveals their underlying beliefs and values, and highlights the integration of their religious and medical practices. Analysis of ethnographic data shows that local Tibetans in Kham have not only relied on religious rituals and traditional Tibetan medicinal practices but have also adopted various modern public health measures to ensure effective prevention of the virus. Therefore, this study demonstrates not only a syncretic practice of religion and medicine in the landscape of Tibetan medical culture but also the practicality and adaptability of local Tibetans during crises.
... These individuals typically engage in occupations such as farming, planting, fishing, and casual labor, and they are often associated with the broader concept of civil society (Hermans et al., 2016). Grassroots communities are often used as sound political sources (Wangmo, 2023). This categorization of grassroots communities emphasizes no correlation between technology as a source of religious information and the religious attitudes or behavior of grassroots communities. ...
This study aims to explain the tendency of religious discussions carried out by grassroots communities 'untouched by online media' in the southern region of East Java. This research employs a quantitative approach to measure the tendencies of grassroots communities in Southern East Java regarding beliefs, practices, experiences, knowledge, and expectations of reward consequences. The study focuses on the regions of Malang, Trenggalek, Lumajang, and Blitar. Data collection was conducted through semi-open interviews with 40 purposively selected respondents. Data analysis utilized descriptive statistics to explain the trends in religious communication within these communities. The findings indicate that the propensity to engage in discussions about religious beliefs is intricately connected to topics such as the Oneness of God, appeals for assistance, concepts of destiny, the nature of Allah, and the interplay between religion and government. The highest score for religious communication is associated with discussions on the Oneness of God, which reached 82.50%. Examining tendencies related to religious knowledge and practices includes topics such as prayer, zakat (obligatory charity), fasting, Hajj, and approaches to attaining closeness to Allah, with prayer services achieving a significant score of 77.50%. In the analysis of religious experiences encompassing Islamic teachings, virtuous behaviors, immoral conduct, and individual experiences, the highest recorded score is 72.50%. The results reveal that discourse surrounding cooperation in righteousness is the most prevalent form of religious communication within grassroots communities, attaining a score of 90.00%. The emphasis on the Oneness of God and the observance of prayer services also underscores the community's commitment to core religious beliefs and practices.
Focusing on pastoralism, this article reflects on five diverse cases across Africa, Asia and Europe and asks: how have COVID-19 disease control measures affected mobility and production practices, marketing opportunities, land control, labour relations, local community support and socio-political relations with the state and other settled agrarian or urban populations? In response to the lockdown measures, we explore what innovations have emerged to secure livelihoods, through new forms of social solidarity and 'moral economy'. The cases examine how impacts and responses have been differentiated by class, age, wealth and ethnicity, and explore the implications for socioeconomic processes and political change in pastoral settings.
The epidemic of COVID-19 caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been in the headlines since December 2019. This Think Piece presents ethnographic vignettes from a recent (February 2020) field visit to Dharamsala, where the Fourteenth Dalai Lama and a Tibetan exile community reside in the northwestern Indian Himalayas. At that time there were no COVID-19 cases in India except in Kerala, South India, which had three confirmed cases. There were no cases in Tibetan communities in India, but they were considered vulnerable because of the influx of Buddhist pilgrims from China. My ethnographic focus is on traditional Tibetan medical responses of prevention and conceptions of contagion prior to any outbreak. I explore what counts as prevention, protection, and contagion in a Tibetan medical public outreach context during pre-epidemic days, and how politics and fear of ‘the other’ merge with the preventive aspects of traditional medicinal products and public health announcements in Dharamsala. Taken together, these ethnographic vignettes illustrate how local epidemic imaginaries draw on complex webs of potency. These combine, for example, substances and their smells with mantras, protective oils, and facemasks in varied ways, all in an effort to reduce anxiety and prevent contagion.
Objective
Since December 2019, an outbreak of corona virus disease 2019 (COVID-19) occurred in Wuhan, and rapidly spread to almost all parts of China. This was followed by prevention programs recommending Chinese medicine (CM) for the prevention. In order to provide evidence for CM recommendations, we reviewed ancient classics and human studies.
Methods
Historical records on prevention and treatment of infections in CM classics, clinical evidence of CM on the prevention of severe acute respiratory syndrome (SARS) and H1N1 influenza, and CM prevention programs issued by health authorities in China since the COVID-19 outbreak were retrieved from different databases and websites till 12 February, 2020. Research evidence included data from clinical trials, cohort or other population studies using CM for preventing contagious respiratory virus diseases.
Results
The use of CM to prevent epidemics of infectious diseases was traced back to ancient Chinese practice cited in Huangdi’s Internal Classic (Huang Di Nei Jing) where preventive effects were recorded. There were 3 studies using CM for prevention of SARS and 4 studies for H1N1 influenza. None of the participants who took CM contracted SARS in the 3 studies. The infection rate of H1N1 influenza in the CM group was significantly lower than the non-CM group (relative risk 0.36, 95% confidence interval 0.24–0.52; n=4). For prevention of COVID-19, 23 provinces in China issued CM programs. The main principles of CM use were to tonify qi to protect from external pathogens, disperse wind and discharge heat, and resolve dampness. The most frequently used herbs included Radix astragali (Huangqi), Radix glycyrrhizae (Gancao), Radix saposhnikoviae (Fangfeng), Rhizoma Atractylodis Macrocephalae (Baizhu), Lonicerae Japonicae Flos (Jinyinhua), and Fructus forsythia (Lianqiao).
Conclusions
Based on historical records and human evidence of SARS and H1N1 influenza prevention, Chinese herbal formula could be an alternative approach for prevention of COVID-19 in high-risk population. Prospective, rigorous population studies are warranted to confirm the potential preventive effect of CM.
Background:
The initial cases of novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP.
Methods:
We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number.
Results:
Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9).
Conclusions:
On the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.).
Ophiocordyceps sinensis is a well-known insect fungus, naturally distributed in the Tibetan Plateau of Asia. It has been long known by its synonym Cordyceps sinensis both in scientific and non-scientific communities but was recently transferred to Ophiocordyceps. Over the last 300 years, the morphological characters of this taxon have been studied by different professionals and experts, such as religious persons, travelers, entomologists, pharmacologists and mycologists. Morphological descriptions of mature O. sinensis stroma based on recent studies are compared in this study with those of the type specimens of Berkeley (Lond J Bot. 2:205–211;1843). A literature review indicates that the specimens of Berkeley (1843) are immature. New names have been proposed for O. sinensis-like species from alpine regions, such as O. gansuënsis, O. crassispora, O. kangdingensis, O. multiaxialis and O. nepalensis, and it is not obvious how these differ from O. sinensis. Epitypification and revision of O. sinensis is, therefore, essential to resolve the taxonomic ambiguity of O. sinensis and related species.
Shelter-in-place ordinances were the first wide-spread policy measures aimed to mitigate the spread of COVID-19. Compliance with shelter-in-place directives is individually costly and requires behavioral changes across diverse sub-populations. Leveraging county-day measures on population movement derived from cellphone location data and the staggered introduction of local mandates, we find that economic factors have played an important role in determining the level of compliance with local shelter-in-place ordinances in the US. Specifically, residents of low income areas complied with shelter-in-place ordinances less than their counterparts in areas with stronger economic endowments, even after accounting for potential confounding factors including partisanship, population density, exposure to recent trade disputes, unemployment, and other factors. Novel results on the local impact of the 2020 CARES Act suggest stimulus transfers that addressed economic dislocation caused by the COVID-19 pandemic significantly increased social distancing.
The substitution of materia medica in Tibetan medicine was an important issue in the past, and still is today. This article will offer a brief survey of references found in Tibetan written sources, and discuss the only three Tibetan treatises that deal exclusively with the subject. It will explore the underlying modes of substitution, and provide insights into the criteria that are used to determine suitable substitutes. Ultimately it will be demonstrated that one can distinguish seven criteria—namely the taste, healing potential, type, substance, name, shape, and smell—that are used to determine an appropriate substitute for rare or expensive materia medica in the Tibetan medical tradition.
This book explores medical thought in Tibet and reveals an otherwise unnoticed intersection of early modern sensibilities and religious values in traditional Tibetan medicine. It looks at how Buddhist concepts and values were adapted to medical concerns and highlights important ways in which Buddhism played a role in the development of Asian and global civilization. The book opens with a description of the achievements of Tibetan medical illustration, commentary, and institution building during the period of the Fifth Dalai Lama and his regent, Desi Sangyé Gyatso. It then looks back to the work of earlier thinkers, tracing a strategically astute dialectic between scriptural and empirical authorities on questions of history and the nature of human anatomy. It shows key differences between medicine and Buddhism in attitudes toward gender and sex and the moral character of the physician, who had to serve both the patient's and the practitioner's well-being. It ultimately finds that Tibetan medical scholars absorbed ethical and epistemological categories from Buddhism yet shied away from ideal systems and absolutes, instead embracing the imperfectability of the human condition.
This article will explore the relationship between Tibetan medicine and Tibetan Buddhism by analyzing early Tibetan medical treatises. It will investigate mantras, meditative visualizations, and rituals that were used to prevent and to cure diseases and will study their medical context. Some of the questions addressed will be: Are these techniques employed in the case of special diseases or at particular stages of medical treatment? If so, how firmly are they established in medical texts? Are they just accessary parts and not really “medical,” or do they form an integral part of medical expertise in premodern Tibet? This article will thus question our current understanding of Tibetan medicine from an emic textual perspective on healing practices.
The practice of using animals and their by-products has a long history in the Tibetan medical tradition. Such therapies also often include products deriving from insects, some of which will be discussed in the present paper. After a brief introduction addressing the importance of medicinal products deriving from animals and insects in the Chinese and Indian medical traditions, the systems used by Tibetan and Mongolian doctors to classify animals will be discussed. The medicinal use of eleven insects will be examined by textual analysis, with a particular focus on the traditional description of the animal and their healing potentials. This set of eleven insects includes flies, ants, two unidentified insects, butterflies, cicadas, and four kinds of beetles, such as diving beetles and blister beetles.
This article examines the interface between religious practices and the physical environment for contemporary pastoralists of the Minyag area in Kham. It details how Kham pastoralists practice their religious beliefs by incorporating entities of their physical environment, such as yaks, in ways that complicate a singular dichotomy between spiritual and physical. Explicating a vernacular understanding of “life”, this article proposes that everyday religious practices normally categorized into a distinct concept of “religion” is, for pastoralists of Kham, best understood as integrally connected with other domains of their world.
Precious pills represent a special kind of Tibetan drug that once was, and still is, highly sought after by Tibetan, Chinese, and Mongolian patients. Such pills are generally taken as a potent prophylactic remedy, and can be used to cure various diseases. The present study seeks to discuss the dispensation and efficacy of precious pills according to the presentations of historical Tibetan medical scholars. Several treatises dealing with these instructions will be analysed, thereby revealing their underlying concepts, and highlighting their points of both general consensus and disagreement. The analysis of these detailed instructions will reveal the fact that these precious pills were not merely given to a patient but, in order to ensure their full efficacy, involved an elaborate regimen concerning three chronological periods: (1) the time of preparation, (2) the time of dispensation, and (3) the time after dispensation. Thus the present study surveys not only the ritual empowerment of drugs in Tibetan medicine, but also the importance of social relationships between doctors and patients in Tibetan medical history.
This book explores the cultural history of embryology in Tibet, in culture, religion, art and literature, and what this reveals about its medicine and religion. Filling a significant gap in the literature this is the first in-depth exploration of Tibetan medical history in the English language. It reveals the prevalence of descriptions of the development of the human body - from conception to birth - found in all forms of Tibetan religious literature, as well as in medical texts and in art. By analysing stories of embryology, Frances Garrett explores questions of cultural transmission and adaptation: How did Tibetan writers adapt ideas inherited from India and China for their own purposes? What original views did they develop on the body, on gender, on creation, and on life itself? The transformations of embryological narratives over several centuries illuminate key turning points in Tibetan medical history, and its relationship with religious doctrine and practice. Embryology was a site for both religious and medical theorists to contemplate profound questions of being and becoming, where topics such as pharmacology and nosology were left to shape secular medicine. The author argues that, in terms of religion, stories of human development comment on embodiment, gender, socio-political hierarchy, religious ontology, and spiritual progress. Through the lens of embryology, this book examines how these concerns shift as Tibetan history moves through the formative 'renaissance' period of the twelfth through to the seventeenth centuries.
This paper analyzes the "disappearing sheep" phenomenon that has occurred due to the selling of! of entire flocks of sheep by nomadic households, as observed in Domkhok Township in Golok Tibetan Autonomous Prefecture of Qinghai Province, and relates it to the rise of the caterpillar fungus economy. Gathering and sale of the fungus, as well as leasing the land use rights to gatherers, bring for local pastoralists an income unmatched in size by anything else available to the rural population of Golok. The paper shows how the availability of this new source of income changes the local nomadic pastoralists' ways of managing livestock production which, prior to the boom, was the basis of their households' budgets. The paper contextualizes different decisions made regarding yak and sheep production in terms of the pastoralists' own cultural and economic rationales. Although in the last decade state investments have changed the economy of the area, the changes discussed in this paper have been possible due to the emergence of the new caterpillar fungus- related economy rather than because of this state investment. This paper furnishes comparative data for studying economic performance and social change throughout rural Tibet in the first decade of the Open Up the West campaign.
This full-length study of the Premi, the first in a language other than Chinese, makes a valuable contribution to our ethnographic knowledge of Southwest China, as well as to our understanding of contemporary Chinese religious and cultural politics.
This article investigates some of the socio-economic dimensions of contemporary Tibetan medical practices in the rural areas of the Tibet Autonomous Region (TAR), China. The article is divided into two parts. Part One, printed in the last issue of the journal, deals with traditional medical practitioners and their medical practices within the governmental health care system in the TAR. It sheds light on the workings and the effects that the commodification of the official health care system have had on its Tibetan medical practitioners, most of whom now work as hybrid practitioners and incorporate Chinesestyle biomedicine into their practice. I argue that several historical, social and political factors have brought about unequal access and availability of Tibetan medicine as compared to Chinese style biomedical care in the rural areas. Special attention is given to the role of the reintroduction of the Cooperative Medical Services (CMS) scheme in the sidelining of Tibetan medical practices in the rural areas. Part Two describes the work of private Tibetan medical practitioners and explores some of the social dynamics and ethical dilemmas that have arisen for them due to the commodification of the official system and the reintroduction of the CMS. Both parts focus on the situation in the Tsang or Shigatse region of the western and central TAR, hence enabling there to be useful comparisons with medical practices in the capital Lhasa, where most of the anthropological literature has focused on so far. Both contributions are based on extensive anthropological fieldwork in Lhasa and the Tsang region of Tibet.
This article takes as its starting point the outbreak of the SARS epidemic in 2002-2003 in the People's Republic of China (PRC) to ask pertinent questions about the politics of identity in the Tibet Autonomous Region (TAR), and to connect these issues to the circulation of, as well as the social and economic value placed on, Tibetan medicines within China and abroad. We aim to connect the global pharmaceutical industry—including the ways it shapes science, disseminates knowledge, increases market demand, and influences clinical and social practice—to the production of Tibetan identities. We discuss dramatic increases in the production and sale of Tibetan medicinal products, specifically protective amulets, 'precious pills', and incense, during a particularly traumatic and widely publicised public health crisis in the PRC. These products clearly demand that we rethink the category 'medicine'. The popularity of these products during the SARS epidemic also points to the complicated positions of Tibetans and Tibetan cultural forms within contemporary China. What was it about these products that gave rise to the perception among Chinese and Tibetans alike they could 'save' or 'protect' people from contracting SARS. In more general terms, we ask if this exponential growth of the Tibetan medical industry in China—heightened during the SARS epidemic, but continuing apace since then—is allowing for cultural expression that highlights Tibetan uniqueness difference within otherwise contested social and political arenas. Or, is the global pharmaceutical industry in China in the process of encompassing and reformulating Tibetan medicine? Finally, we explore connections and distinctions between the rise in highly marketed Tibetan medicinals in China and their availability and appeal in the West.
Yartsa Gunbu (Cordyceps sinensis) and the Fungal Commodification of Tibet’s Rural Economy. Cordyceps sinensis is a mushroom that parasitizes larvae of Thitarodes (Hepialus) moths, which inhabit the alpine grasslands of the Tibetan Plateau. Tibetans have used the mushroom, which they call yartsa gunbu (“summer-grass, winter-worm”) for many centuries, if not millennia. A 350% increase in the price paid to pickers between
1997 and 2004 has turned this tiny mushroom into the single most important source of cash for rural households in contemporary
Tibet. On average, 40% of the rural cash income in the Tibet Autonomous Region is derived from its collection, which government
statistics figured at 50,000kg in 2004, contributing at least CNY (Chinese yuan) 1.8 billion (USD 225 million) to the Tibet
Autonomous Region’s GDP. A dramatic fungal commodification of the rural Tibetan economy is occurring, as the income from sale
of Cordyceps often accounts for 70%–90% of a family’s annual cash income in areas where it grows. The ever-increasing harvesting pressure
raises the question of sustainability. The fact that Cordyceps has been collected for centuries and is still common argues for its resilience, but the lack of harvest studies for C. sinensis precludes a definite answer as to whether the harvest can be sustained at its current level.
During field research in 1998, a Tibetan medical doctor accompanied me to Lhasa's book market in order to help find some medical texts of which I had become aware. Working through my imperfect Tibetan and his equally strained English, we found some books at a street side stand along the way. One that caught my eye was published in the "new" book style, eight by ten inches, with a dark blue cover and gold printing, as opposed to the old pecha style Tibetan book made with thin strips of white paper from carved woodblock prints. The book was a modern reprint of a 17th-century medical treatise of explanatory commentaries on the gSo Wa Rig pa, the medical components of the Buddha's teachings. I told my companion that I thought I should buy this one and moved to get my wallet from my pack. Seeing this, my friend raised his eyebrows and with cautionary surprise asked quietly, in English, "That one? Will they let you take it out? At the airport, they will stop you?" I knew that it was customary in years past for foreigners to be searched during their airport departures from Tibet, but usually this was for materials that incriminated the government (videos or photos of human rights testimony or sensitive political information). Knowing that he was already nervous helping me, a foreigner, shop for Tibetan books, I considered just putting the book down and moving on. His helping me could have been construed as a politically dangerous act under government rules that condemned association with foreigners who stayed longer than the average tourist visit in Lhasa, especially Americans. In the government's view, one never knew which foreigners harbored anti-Chinese, splittist sentiment and might, secretly, be working to displace the existing rulers. But then he said, knowing the bookseller could not hear him, "The old books give us problems. They have religion." "But isn't this is an important medical book?" I asked in English, stressing the word "medical" and repeating the whole thing in Tibetan, "Sman gyi thep gal chenpo red pe ?"
Responding to an Unfolding Pandemic: Asian Medicines and Covid-19.” Society for Cultural Anthropology
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藏醫人體解剖學的科學思想試析” (Zangyi renti jiepouxue de kexue sixiang shixi, A critical examination of the scientific ideas of Tibetan medical human anatomy)
- Linghui Ding
- 丁玲輝
Integration or Erasure? Modernizing Medicine at Lhasa's Mentsikhang
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突發疫情下的政府治理研究: 以新冠疫情為例” (Tufa yiqing xia de zhengfu zhili yanjiu: Yi xinguan yiqing weili, Study of government governance in the sudden outbreak: Taking Covid-19 as an example)
- Zhe Chen
- 陳哲
中藥板藍根與病毒感染性疾病” (Zhongyao banlangen yu bingdu ganran xing jibing, Chinese medicine banlangen and viral infectious diseases)
- Jianguo Fang
- 方建國
- 萬進 Wan Jin
- 湯傑 Tang Jie
- 王文清 Wang Wenqing
- 劉雲海 Liu Yunhai
甘孜藏區醫療狀況分析” (Ganzi Zangqu yiliao zhuangkuang fenxi, Analysis of medical condition in Kandze Tibetan area)
- Lang 何朗 He
- 禹健 Yu Jian
- 陳志嚴 Chen Zhiyan
- L I Quankang
Ethnic Tourism and Ethnic Politics in Tibetan China
- Ben Hillman
Bodies in Balance: The Art of Tibetan Medicine
- Theresia Hofer
Mountain Cults and National Identity in Tibet
- Samten Karmay
- Gyeltsen
新冠肺炎疫情對世界的主要影響” (Xinguan feiyan yiqing dui shijie de zhuyao yingxiang, Major impact of Covid-19 epidemic on the world)
- Jianguo Qi
- 戚建國
A Tibetan Village on the Sino-Tibetan Borderland: A Study of Social Organization, Narrative and Local Identity in Lhagang
- Wangmo Sonam
SONAM, Wangmo. 2020. A Tibetan Village on the Sino-Tibetan
Borderland: A Study of Social Organization, Narrative and Local
Identity in Lhagang. PhD Dissertation. Oslo: University of Oslo.
蓮花清瘟膠囊對流行性感冒合並支氣管肺炎的作用” (Lianhua qingwen jiaonang dui liuxing xing ganmao hebing zhiqiguan feiyan de zuoyong, Clinical study of Lianhua Qingwen capsule in treatment of influenza combined with bronchial pneumonia)
- Chunjuan Ye
- 葉春娟
- 張帆 Zhang Fan
- Zhu Yuyin
The ‘Brilliant Moon Theriac' (Zla zil dar ya kan): A Preliminary Study of Mercury Processing According to the Vase of Amrta of Immortality ('Chi med bdud rtsi bum pa) and its Influence on Tibetan Pharmacological Literature
- Carmen Simioli
信息不對稱與非典時期的公衆反應” (Xinxi bu duicheng yu feidian shiqi de gongzhong fanying, Asymmetry of information and public reactions during the SARS period)
- Xueqin Min
- 閔學勤
The globalisation trend under the dual influence of the new coronavirus pneumonia epidemic and technological progress)
- Dong 王棟 Wang
- Jia Zifang
新冠肺炎爆發前期武漢外流人口的地理去向分布及影響” (Xinguan feiyan baofa qianqi Wuhan wailiu renkou de dili quxiang fenbu ji yingxiang, The geographical destination distribution and effect of outflow population of Wuhan during the outbreak of Covid-19)
- Xiaoke Xu
- 許小可
- 文成 Wen Cheng
- 張光耀 Zhang Guangyao
- 孫皓宸 Sun Haochen
- 劉波 Liu Bo
- Wang Xianwen
Covid-19 and Tibetan Medicine: An Awakening Tradition in a New Era of Global Health Crisis
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Awakening Tradition in a New Era of Global Health Crisis."
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