Traditional Medicine: Preserving An Ancient Practice

Features Issue 16 Aug, 2010
Text and Photo By Cherry Bird

Some of you may have done the amazing trek to the ancient walled city of Lo Manthang, in the restricted area of Upper Mustang. Perhaps as you strolled around the narrow streets of the city (which takes about 7 minutes to cross, so hardly qualifies as a city in western terms), you may have seen a simple wooden door set in one of the stone walls, bearing the sign “Lo Kunfen Mensikhang and School”, and vaguely wondered what that was all about.

If you had ventured behind the door you would have stepped into a traditional courtyard, overlooked by a balcony, behind which 24 local children study classical Tibetan and medical texts, memorising huge tracts of complex material, in order to fulfill the ambition of becoming an Amchi, or traditional doctor of Tibetan medicine. These children have been given a very special opportunity, thanks to the vision of the two Bista brothers – Amchi Gyatso and his younger brother Lama / Amchi Tenzin. With the support of their main donors, a small British charity called KINOE (Kids in Need Of Education), and other friends and supporters who have given smaller amounts of money and different items, such as solar lighting, books, and machines for grinding herbs and making herbal medicines, the two Amchis are working to maintain the tradition of Tibetan medicine, which has served the residents of this remote district for generations.

The students are all from local families in Lo Manthang and the surrounding villages, except for one boy from the neighbouring district of Dolpo. Some are from extremely poor families, and could never afford to go to school if their costs were not  paid by the donor or by sponsors. None are wealthy. Thus the school fulfills a triple objective of keeping a local tradition alive, providing a much needed medical service to the local population and providing an education and opportunity for a worthwhile career to children from poor families. An important factor is that the children are able to remain in their home area for most of the year, those from the city still live at home, but those from farther away, who need to board, are still able to see their families regularly. Thus they remain in touch with their own culture, which is almost more pure Tibetan than Tibet itself, since its remoteness has ensured little influence from outside.

If you had visited the school in the early morning, you would have been treated to the wonderful melodious sounds of the students chanting their morning prayers – a truly moving experience. Their ages range from around 10 to 17 years, and almost 50% are girls. After assembly, they move into the small classrooms, where they study Nepali, English and maths, in addition to the classical Tibetan and medical texts. Some afternoons you may see them out on the dry rocky hillsides gathering herbs for making medicines, or working in the experimental garden just outside the city wall, where they are experimenting with the cultivation of herbs under different conditions, to supplement the limited supplies of naturally growing herbs, and thus avoid their depletion. If you had spent time talking with the senior students, you would surely have been impressed with their dedication and motivation, although they will acknowledge that they never expected the course to be quite so tough. Meanwhile, when not teaching, Gyatso or Tenzin will be taking consultations in the small clinic, prescribing pills, herbal teas and other medications to sick people, who may have travelled for many hours, even from Tibet. The two brothers are highly respected locally, as they come from a long line of Amchis, their family having served the Royal family for many generations.

Tibetan medicine is based on the herbs and natural products of Tibet, and has existed in some form for thousands of years. It is a rigorous discipline, requiring years of hard study to attain mastery of the Gyud Shi, the Four Medical Treatises, augmented by other texts and clinical practice under the tutelage of a master. Diagnosis is by pulse and urine analysis, and treatments are based on the Amchi’s assessment of the functions of the three “humours”: wind, bile, and phlegm. Imbalance of these is considered to be the cause of disease, and total health is understood as a relationship between mind, body and physical environment. This holistic approach combines the body’s need for physical wellness with the quest for spiritual balance and mental peace. The teachings of Buddha are considered to be the foundation of Tibetan medicine, and it is written that the historical Buddha spent four years studying medicine, before sharing his knowledge with his disciples. In addition to medical skills, a qualified amchi must also have knowledge of religious philosophy, astrology, and traditional art-work.

During the harsh winter months, when many of the local population go out to India or lowland Nepal to earn a small amount of cash to supplement their basic agricultural activities, the school migrates down to Pokhara for 3 months, where they rent a modest house set amid rice fields, to serve as both home and classrooms. The children were initially fascinated to see the lake and boats, both quite new to them, though they admit to missing their families, and are glad to return to Mustang for the summer.

Amchi Gyatso is also the current Chairman of the Himalayan Amchi Association, which works to preserve and develop Tibetan medicine, through networking, research and teaching activities. They receive support from WWF and other donors, and are in contact with renowned Tibetan doctors from as far afield as Lhasa and Dharamsala. This year 11 of the senior Lo Kunfen students have had the opportunity to follow a one-month teaching with a distinguished Amchi from Chagpori Tibetan medical institute in Darjeeling (established in 1992 based on famous ancient Chagpori Institute in Lhasa). Gyatso was delighted when they took all the top places in the course exam, out of over 30 students. It is particularly inspiring to see the motivation and active participation of the girls, who are proud to be pioneers in a context where very few women become Amchis.
The school has only been running for 3 years, and the agreement from the donors is limited to a further 3 years. By keeping things simple and local, the Bista brothers try to keep expenses down, so that they can cover the costs of the students fully, no fees are charged, although those who are able bring some of their own staple food and fuel. In the same way, in keeping with tradition, no fees are charged for the services of the clinic. Clients may donate as they feel able, in cash or kind, but there is no obligation. In the longer term, the school needs to generate a more sustainable income and become independent, through sponsorship of students, and other small income generating activities, and this will be a tough challenge.

(For more information, contact Cherry Bird, email: )