Old Tibet, under the feudal serf system, had only three
officially operated, small traditional Tibetan medical establishments,
having simple and rough medical equipment, and a few private
clinics. There were close to 100 practitioners. Even adding
folk doctors of Tibetan medicine, the number totalled only
about 400, averaging less than 0.4 per 1,000 people. These
medical establishments and medical workers chiefly served
the nobility and officials. Absolutely no medical treatment
was given to the broad masses of serfs and slaves when they
fell ill. Deadly infectious diseases such as smallpox and
the plague occurred frequently and even ran rampant. According
to records, in the 150 years before the peaceful liberation
of Tibet in 1951, smallpox raged four times, and the contagion
in 1925 caused 7,000 deaths in the Lhasa area alone. Epidemic
typhoid fever in 1934 and 1937 took more than 5,000 lives
in Lhasa. When some infectious diseases spun out of control,
the former Tibetan local government did not take measures
to save the afflicted but, on the contrary, drove them into
high mountains or deep valleys, whose exits were guarded
by troops. This resulted in the death of the expelled sufferers.
Historical records show that in old Tibet, the average life
span was 36 years, and the growth of the Tibetan population
stagnated for a long time.
The primary task facing Tibet in the development of public
health care has been to gain control over the most deadly
infectious diseases. The Chinese government conscientiously
carries out the principle of "taking prevention as
the main task," with the result that no case of smallpox
has been reported in tibet since the early 1960s. The incidence
of various infectious and endemic diseases has gone down
by a substantial margin, and some serious diseases that
threaten the lives of people have been wiped out or brought
under basic control. In order to assure the healthy growth
of Tibetan children, a planned immunization program has
been widely implemented in tibet since 1986. Over 85 percent
of children have been inoculated.
After the Democratic Reform in 1959, the autonomous region
gradually established a medical and health network throughout
Tibet. In 1991, the region boasted 1,197 medical establishments,
401 times as many as in 1951. There were no hospital beds
in 1951 but 5,077 in 1991. Professional medical workers
numbered 9,740, or 98 times higher than in 1951. Among them
7,749 were health technicians, with Tibetans accounting
for 80 percent of the total. Now, 88 percent of Tibetans
are living in rural and pastoral areas, where there were
850 health establishments containing a total of 2,300 beds
and 3,700 medical workers in 1991. A further 3,500 local
rural doctors and health workers directly serve the masses
of farmers and herdsmen. In Tibet, on average, there are
2.3 beds and 2.1 doctors per 1,000 people, figures equal
to and above the national average respectively, and also
higher than that of middle-income countries.
Traditional Tibetan medical science, comprising Tibetan
medicine and pharmacology, has been handed down and developed.
The government invested 20 million yuan in building a new
inpatient department of the region's Hospital of Traditional
Tibetan Medicine, as well as five local hospitals of this
kind. In 1991, there were 1,015 Tibetan medicine doctors
and pharmacists in the whole region. In order to meet the
needs for the development of Tibetan medicine, the autonomous
region founded the Tibetan Medical College and the Tibetan
Medicine Research Institute, and encouraged and supported
famous veteran Tibetan medicine doctors to write scholarly
books. A chronology of valuable medical expertise was compiled
by a group of aged specialists. The Four-Volume Medical
Code, a famous book on Tibetan medical knowledge, was published
and distributed. Efforts have also been made in the compiling
and publishing of A Complete Collection of Wall Charts of
the Four-Volume Medical Code and Medical Science Encyclopedia:
Tibetan Medicine, plus dozens of teaching materials and
special books about Tibetan medicine, including Physiology,
Pathology, Pharmacology, Dietetics, and Newly Compiled Tibetan
Medicine. Pharmaceuticals production is developing quickly
too. Now, there are three Tibetan medicine factories.
Scientific research institutes of Tibetan medicine have
put more efforts into the study of plateau sickness and
other diseases which endanger the lives of Tibetan people,
and have achieved important research results. Tibetan medical
workers are both domestic and international leaders in rescue
and the treatment of plateau pneumochysis, mountain coma
and chronic plateau sickness.
To train more health workers, the Tibet Institute for Nationalities
has opened a medical department. In addition, the Health
School for the Tibet Autonomous Region has been established
and another two in Xigaze and Qamdo. These schools have
trained more than 6,000 high- and middle-ranking health
workers. Since 1980, more than 5,000 health workers in the
region have received on-the-job training, which has helped
raise their professional and administrative levels.
The government provides free medical care for all Tibetans.
This, plus considerable improvements in medical and health
conditions, has greatly raised the average life span and
health level of the Tibetan people. Average life expectancy
has risen from 36 years before liberation to 65 years at
present. When compared with 1965, the average height and
weight of young Tibetans in the Lhasa area increased by
8.8 cm and 5.2 kg respectively.
The government has special policies on birth control in
Tibet. Family planning is not practiced for the farmers
and herds people who constitute 88 percent of the region's
entire population. The government only conducts publicity
campaigns to inform them about rational births and ways
to have healthy babies. Tibet has a vast expanse of territory,
but few land resources which can be developed. In 1991,
the average amount of cultivated land per person was only
1.54 mu. As Tibet's population has been increasing at a
fast rate, population control is necessary. Since 1984,
the regional government has advocated and carried out the
policy of two children per couple among Tibetan cadres,
workers and the staff of enterprises and residents in cities
and towns. However, among the Han cadres, workers and staff
members in Tibet, the policy of one child per couple has
been advocated and enforced. Only 12 percent of the people
in Tibet are covered by the family planning policy. In the
process of carrying out family planning, the government
always persists in the principle of "mainly publicity,
volunteering, and service," and prohibits any form
of forced abortion.
Over the past 40 years, the population of Tibet has rapidly
mounted. Between 1950 and 1990, there was a net increase
of 1.196 million people in Tibet, with the number of Tibetans
climbing to more than 2 million, more than double the figure
of 1 million in 1950. In 1951, when Tibet was peacefully
liberated, there were no accurate population statistics
provided by Tibetan local government. When China conducted
the first national census in 1953, the Tibetan local government
headed by the Dalai Lama reported that there were 1 million
people in Tibet. The second national census in 1964 showed
that the population in Tibet was 1.251 million, of which
1.209 million were Tibetans, making up 96.63 percent of
the total. The third national census in 1982 said there
were 1.892 million people in Tibet, of whom 1.786 million
were Tibetans, accounting for 94.4 percent. The fourth national
census in 1990 showed that there were 2.196 million people
in Tibet, of whom 2.096 million, or 95.46 percent, were
Tibetans. People of the Han and other non-Tibetan nationalities
have always made up around 5 percent of the total population
in Tibet. Since 1970, the birth rate and natural population
growth have both been above the average national level.
Between 1982 and 1990, there was an increase of 309,800
ethnic Tibetans in Tibet, and the rate of natural population
increase was 17.34 per thousand, 2.64 perthousand points
higher than that of the national level in the same period.
For Tibet, it is impossible to reach such relatively high
levels in terms of birth rates and the natural growth rates
of population in so short a period of time without the abolition
of the feudal serf system, and economic growth plus the
obvious improvement of people's living standards and medical
and health conditions.
On the question of the size of the Tibetan population,
the Dalai clique has spread many rumors. The most sensational
was that more than 1.2 million people were killed after
the peaceful liberation of Tibet. In 1953, the Tibetan local
government under the Dalai Lama reported the population
stood at 1 million people. If 1.2 million inhabitants had
been massacred, it would have been a case of genocide and
certainly the population in Tibet could not have increased
to the present 2 million.
The Dalai Lama clique has also contended that geographically
Tibet extends far beyond the boundaries of today, including
areas inhabited by the Tibetans in Sichuan, Qinghai and
other places, making a total population of 6 million. This
so-called Tibet Major is merely a conspiracy hatched by
imperialists in an attempt to carve up China. As a result
of long historical changes, ethnic Tibetans have settled
not only in Tibet but also in areas in Sichuan, Qinghai,
Gansu and Yunnan provinces. But these areas were not under
the jurisdiction of Tibet in the past, and the former Tibetan
local government never administered any Tibetan-inhabited
areas beyond Tibet. From the 13th century on, the central
governments of the Yuan and Ming dynasties placed Tibet
and other areas with Tibetan populations under separate
administrations. The Qing Dynasty further defined administrative
divisions in Tibetan-inhabited areas. During the period
of the Republic of China, Tibetan-inhabited areas beyond
Tibet remained under the jurisdiction of the provinces where
they were located. These administrative divisions basically
remained after the founding of the People's Republic of
China. In the Tibetan-inhabited areas of the four provinces
of Sichuan, Qinghai, Gansu and Yunnan, ten Tibetan autonomous
prefectures and two Tibetan autonomous counties were set
up. The Tibetan population, including Tibetans in Tibet
and Tibetan-inhabited areas of other provinces, fell short
of 6 million. When China conducted the first national census
in 1953, the overall Tibetan population, including those
residing in Tibet, totalled 2.77 million. The 1990 national
census gave a count of 4.59 million people. As in Tibet,
the numbers of Tibetans in other areas had grown considerably
over the period between the two censuses.
Another lie is the claim that a large number of Hans have
migrated to Tibet, turning the ethnic Tibetans into a minority.
It is very easy to confuse and poison the minds of people
who are not aware of the truth. In Tibet, the natural conditions
are harsh, the air is oxygen-poor and the climate is bitterly
cold. Most of the land consists of mountains, wilderness,
and permafrost and snow zones. Customs there are so different
from those in the heartland of the country that people from
the interior can hardly adapt to them. Tibet is not like
the western part of the United States, where large numbers
of people moved in for development. The figures from various
national censuses have thoroughly exploded the lie that
the Han population in Tibet has already surpassed that of
the Tibetans.