Saturday, May 28, 2016

Final day in UB for now

Khongorzul with the new blood pressure cuff and stethoscope.
Today was filled with the happiness of meeting an old friend coupled with anticipation for our trip north. Khongorzul, a reindeer herder from the East taiga who has just completed medical school, stopped by our apartment in Ulaanbaatar to pick up a stethoscope and blood pressure cuff donated by Nomadicare.

Khongorzul taking Sas's blood pressure.
Of course, Khongorzul immediately tried out her new gifts and took Sas's blood pressure.  During her visit, Sas and Chimedee and Khongorzul caught up on news of family and friends, reminisced about past visits to the taiga, and talked about the future.

Afterwards, Sas and Khongorzul discussed Nomadicare's seven-year health database of the reindeer herders, pointing out various health issues that seemed to appear frequently such as dental problems, high blood pressure, and joint and back pain. When riding their horses herders sometimes fall off. Since they don't wear helmets, they are  at high risk for concussions. I asked how often the herders see a doctor - I was thinking about the regular check-ups we have in the US - and Khongorzul laughed and said that they only go when they are really sick.

Looking at the health database.
 Sas mentioned later to me that it may also depend on the location of the camp. In the summer, reindeer herders generally migrate farther away from the sum (county) center where the doctors are located. Khongorzul also told us that the oldest active reindeer herder now in the East taiga is 62. When they get older, most reindeer herders move to the sum center. In the West taiga, one elder woman is still living a nomadic life at 78 despite being blind. Khongorzul would like to practice medicine back in the taiga but currently there is no open position.

Watching the trailer for "Migration"

Sas also showed Khongorzul the trailer for "Migration;" she is the first reindeer herder to see the film. It was very moving, so much so that tears were shed. In particular, she loved the Tuvan music. It is possible that Khongorzul will be in the taiga during the time we are there. Good! We look forward to another reunion.

We are nearly packed. Tomorrow, Chimedee, my translator Chuka and our driver Munkhuu will leave in the morning for Murun by car. Sas and her camera person Urangoo will fly. On Monday we will go to Tsagaan Nuur, again by car. On Tuesday we drive to a meeting place for our horses and with the help of wranglers will travel to the spring camp of the reindeer herders.

Last night Sas and I had a very nice dinner with the resident director of the the American Center for Mongolian Studies (ACMS),  Marc Tasse. Sas and Marc discussed possibilities for showing "Migration" and "Ceremony" when we return to Ulaanbaatar. Summer is a busy time and several university groups will be coming to Mongolia on study tours. These groups get much assistance with their in-country travel from ACMS. There is a complete list of seminar topics on their web site.

This evening we will had a quick dinner with our team. Tomorrow early, off to the taiga!
Sas, Marc and Jeannie
Food shopping - rice and noodles.

Fresh fruit and vegetables.

Just for fun, a gold BMW.

Friday, May 27, 2016

Heartfelt Connections: still packing for the taiga

Sas in Ulaanbaatar with her old friend Head Lama Sanjdorj.

The women of 'Team Nomadicare' are making progress towards our Sunday departure to the taiga, the boggy coniferous forest of high northern Mongolia where about 250 Dukha still herd reindeer. With years of experience, Sas knows what we need and organizes everything in an efficient and calm manner. She also puts great thought into the items we are bringing with us to distribute, keeping in mind her heart connection with the reindeer herders.

The hygiene kits. The bags were made in the local market.
Sas and I cut and tied the twill that will be used for reindeer harnesses. Chimedee and I packed the hygiene kits for each family with twill, toothbrushes and toothpaste, sun screen, candles and matches, soap, fly paper and lotion. In total there are 23 families in the East taiga and 30 families in the West taiga, as well as five bags for Tsagaannuur Sum Center.  Nomadicare's Ulaanabaatar resident board member, Munkhjin, came by for a visit with a gift of delicious Mongolian yogurt and tomatoes.

 All permissions and registrations from border control to the Hovsgol and Mongolian immigration are now completed. In addition, Nomadicare's shopping continued. Dental instruments for pulling teeth, Novocaine and syringes were added to the supplies for the taiga and will be delivered to the local doctor. Dental health is a concern for the adults and children.

Sas and her camera person, Urangoo have examined all of the camera equipment and accompanying accoutrements of batteries, microphones, tripods, cords, etc. in preparation for interviewing reindeer herders and shamans as well.  On her last trip to the taiga in 2014, Sas filmed the reindeer herders migration from their Spring to their Summer camp. It is hoped she can show everyone who participated the finished film, "Migration."
Sas and Munkhjin

This trip will focus on recording the lifestyles and concerns of shamans and reindeer herders "in their own words." In particular, we will see what impacts tourists and others (including Nomadicare ) have made on their traditional norms values and health. These nomadic pastoralists live in harmony with their animals and the land: their migrations throughout the year help sustain the biodiversity of this unique landscape. Keeping life in balance maintains the bonds that reindeer herders have with their network of friends, family and other world connections. Following traditions, honoring the land and ancestors, means health and a good life.

Sas checking the cameras and microphones with Urangoo.
Listening with the heart
Why are these interviews important? In addition to the the very real need to document cultures threatened by the incursion of globalization (capitalism, mining), studies show tourist visits to indigenous communities may lead to exploitation, objectification and commodification of traditional roles and practices. 

For example, tourists bring exposure to much needed but also potentially maladaptive resources.  While eco-tourism efforts help locals obtain money that can be put towards school fees, livestock, health care and other everyday needs, tourists also bring gifts of candy for the children, and vodka and cigarettes for the adults.  Specifically, there are myriad blogs of travelers bringing liquor or travel agencies even suggesting that tourists bring candy and cigarettes to the reindeer herders. While appreciated, and in fact expected, these gifts can and often do contribute to poor health outcomes. 

Ganbat on a postcard I found at the post office in Ulaanbaatar.

When sick, people use local medicinal herbs, and Western medicine and, if they doesn't work, they consult shamans. Biomedical health care is limited, both in terms of health care practitioners and medicine, whether for everyday pains or chronic illnesses. Also, children and adults alike have little opportunity to visit a dentist, so gifts of candy are troublesome. As for alcohol, once the bottle is opened it will be consumed, a situation with the potential to unbalance relationships. 

Studies on ecotourism among indigenous peoples show that "a community should benefit socially, economically and environmentally in a sustainable way" (Nault, Stapleton, 2011). To do this the community should have control of the circumstances of tourism in their environment.

Sas purchasing the dental equipment.
For seven years Sas compiled a health database of all the families in the East and West taiga. Many people, young and old, showed evidence of high blood pressure, and these high blood pressures have led to strokes and even death among the herders she documented in the past. This has been a difficult problem to combat because the local hospital does not have the means to measure the effectiveness of hypertensive drugs.The herders see a correlation between living at a high altitude and having high blood pressure. We have not verified this.

For all of us, a variety of factors influence life expectancy and everyday health -  gender, socio-economic status, preventive health care, lifestyle factors (i.e. smoking, diet), and beliefs about what constitutes good or bad health and how to treat or prevent illness. 

For example, even in the US, people living in the same city but in different socio-econimic locations (suburbs vs. inner city) may have up to 15 years difference in their life expectancy - poor people do not live as long as those who are better off (see Unnatural Causes). A major factor in ill health is chronic stress due to a lack of control in everyday life - income, safety, health care. This elevates and keeps constant the stress hormone cortisol in the body, putting a person at risk of heart disease, depression, memory loss and digestive problems.
The pliers for pulling teeth, syringes and other medications.

Rapid changes have occurred in Mongolia since the introduction of capitalism and the free market economy, and in recent years mining interests and tourism have expanded. However, in terms of health, since 1960, while life expectancy in Mongolia has increased each year the country's world rank with regard to health has fallen. This is mainly due to the effects of alcoholism, heart and liver disease, and stroke (see World Life Expectancy Report)

For the Dukha, besides the incursion of tourists and others, the 2013 traditional hunting areas were set aside for conservation. While this stopped mining on sensitive land,  it also brought unpredictability to everyday life. If caught hunting on this conservation land, the Dukha  - who historically got their meat from hunting, not their pastoral animals - face fines or even imprisonment for following their traditions. We hope to learn from the Dukha and share their feelings and attitudes about these changes.

"Time Out" Ulaanbaatar
The day also included time for exploring Ulaanbaatar. I enjoyed a walk through the Mongolian National Museum. Sas, Chimedee and I went also to Gandan Monastery. Sas was also able to connect with an old friend, Head Lama Sanjdorj of a local monastery.

Today we returned to Naraantuul Market to purchase food for our trip and buy last minutes supplies. 

Sas buying a prayer flag of her birth year at the monastery.
Gandan Monastery.

Sas and Chimedee turning the prayer wheels.
My turn at the prayer wheel.
Sas in Ulaanbaatar with her old friend Head Lama Sanjdorj.

Wednesday, May 25, 2016

Working from the Heart with Reindeer Herders in Mongolia

Video introducing, Reindeer Herders in My Heart, by Sas Carey.

I've been on many humanitarian trips around the world in the last 40 years and my present visit to Mongolia to visit the Dukha reindeer herders brings together all aspects of these experiences and more, including work in the health field, tourism and as an anthropology lecturer. The Dukha, known as the Tsaatan, or reindeer herders (though they themselves prefer Dukha), are nomadic and live in the East and West taiga in the north of Mongolia near the border with Russia. In 2012, the United Nations Environmental Protection issued a report entitled, Changing Taiga:

The Indigenous Peoples of the taiga – who live in the fragile belt of coniferous forest of northern Mongolia – are in trouble. Reindeer herding, which since ancient times has provided a sustainable way of managing the environment and is the foundation of their unique cultures, is in real danger of disappearing. . . Only 200 Dukha reindeer herders remain, many of whom are struggling to ensure a future for reindeer herding in their taiga homeland – a hotspot for biodiversity and rich in natural resources. 

...   The difficulties of integrating into a market economy, combined with new hunting regulations and increasing numbers of tourists visiting the taiga, are posing additional socio-economic challenges. Climate change is, in many cases, adding additional stress. This situation calls for urgent national and international attention and action to strengthen the traditional livelihood of reindeer herders and restore ecosystems.

The report notes that there is "an urgent need to engage with the herders to record and promote their traditional knowledge, as well as to monitor biodiversity and land useage changes that are occurring in the taiga." That is in part what we plan to do over the next few weeks.