By Richard V. Lee
I have been going to Kashmir and Ladakh for 20 years—usually every other year, but sometimes on an annual basis—taking a group of students ranging from high school to college to graduate students, including medical students.
Kashmir was once a focal point of Buddhist scholarship, especially in the fifth to seventh centuries, and contributed to the spread of Buddhism throughout Asia. Ladakh, still referred to as “Little Tibet,” has a long Buddhist tradition probably dating from the florescence of the schools of Buddhist scholarship in Kashmir. It is located in the Northwestern Himalayas, along the Upper Indus River and is west of Mt. Kailash and Lake Manasarovar. Its principal city is Leh, which used to be a trading point along the north-south silk roads. It is a remote, high altitude desert, sparsely populated and away from the river and roads.
Traditional Tibetan Buddhism is still the dominant life pattern and, since the acquisition of Tibet by the People's Republic of China, Ladakh may be the best place to observe traditional Himalayan Buddhist culture. Ladakh is in India, which explains the preservation of traditional cultures and religion.
Dr. Lee examines a woman for goiter in Ladakh in India, where one can observe traditional Himalyan Buddhist culture.
Many of the monasteries and nunneries in Ladakh are very old. Hemis and Thikse are perhaps the most famous since they are located closer to Leh and are accessible by road. Our expeditions have gone to the more remote villages and gompas (monasteries). We have set up temporary clinics in tiny hamlets—like Dibling and Photaksar—but many of the trips were to the Lingshed Gompa and villages, where we became friends with the monks and the nuns, and where we carried out some simple skin tests for tuberculosis (TB)—documenting the presence of TB in the communities, and documenting a serious problem with streptococcal impetigo and deeper skin infections among the children.
In these remote villages, subsistence farming—in a most inhospitable environment—is the rule. Winter is harsh and long; the growing season short, rainfall sparse, and water must be channeled from glacial and snowfield meltwater. The altitude of the remote villages is usually above 12,000 feet. The villagers are hardworking and hardy; it is no surprise that frail children and chronically ill adults do not survive long.
The senior monk, Geshe Ngawang Jangchup (geshe is an academic title awarded to monks who pass a long and arduous training program in Tibetan Buddhist philosophy, practice and ethics), has visited Buffalo twice and has been an advocate for improving the lives of his people in the Lingshed area. Unfortunately, his health has been failing, so we have not gone back to Lingshed in his company for three years. He had served in Dharamsala on the Dalai Lama's staff, and it was because the Dalai Lama recognized Geshe Ngawang in a photograph of mine that His Holiness quizzed me about our travels and work in Ladakh. His Holiness maintains a residence outside of Leh, close to the large Tibetan refugee community of Choglamsar, which is a suburb of Leh. His visits draw enormous, enthusiastic crowds.
It is impossible not to admire the Ladakhis and the Tibetan nomads who traverse the high passes with their flocks of yak, sheep and goats—they are tough folks, devoted to their Buddhist beliefs and traditions, and surprisingly successful in their partnership with the environment.
Richard V. Lee is professor of medicine, pediatrics and obstetrics in the UB School of Medicine and Biomedical Sciences.