FOR SOME TIME the assembly hall of the Méru Nyingba monastery in Lhasa was full to the brim with stale tsampa, which [the authorities wanted] to use up by selling it as the citizens’ monthly grain ration. Although very old, that tsampa was basically of a good quality that was supplied to the officials’ grain shop or tsampa store for officials’ rations, but it was said that when the tsampa was delivered from the different mills they did not bother to distinguish between the old and the new, and once they had accumulated a stock that was too stale for the officials to eat, it was sold to the ordinary citizens. There was another story that for a time, Chinese military rations included a special convenience food that was tsampa-based but had many nutritious things like butter, mushrooms, nuts, and so on added to it, but since it contained butter it could not be kept for long periods, and later they stopped making it. When the stocks of that special tsampa in the army food processing factory went stale and they could find no other use for it, they sold it in the citizens’ edible oil supply store.
In my opinion, the stale tsampa came from the military ration stuff, because the officials’ edible oil supply store didn’t have enough outlets to have accumulated such a huge quantity. Either way, it had a very damaging effect on the health of Lhasa citizens. When they went to buy their monthly ration, people used to pray that whatever quality of tsampa they were given, it would not be stale. That tsampa was so old that it would just stick to a cotton bag, and getting it out was like digging earth with a pickaxe. To say that the stink of stale tsampa filled the whole city would be a slight exaggeration, but it did pervade the area for some distance around Old Méru. That stale tsampa was supplied to each of the three administrative divisions in Lhasa city in turn for monthly distribution, so everyone ended up buying it [at least] four times a year, and [even at that rate] it took about two years to get through it all.
Since grain oil was tightly controlled at the time, if you wanted to buy slightly superior grain direct from the farmer, it cost over 20 yuan per [Khal = 28 lbs.] at least, and it had to be done with the greatest secrecy. If the authorities came to know about it, they would condemn it as “black marketeering” and “economic vandalism” and both buyer and seller would be prosecuted. Thus there was nothing to do but close your eyes and swallow the stale tsampa. So mealtimes became depressing occasions, but how much more so for those with small children, because in Tibet tsampa paste is the only food for suckling infants, and their refusal to take to stale tsampa paste was an unbearable hardship for parents. Likewise, having to eat stale tsampa for long periods gave many people stomach pain, and many of them went to the hospitals for treatment. Indeed, if one were to list the various types of illness at that time, stale tsampa would definitely account for the highest percentage, but there was no way for anyone to say that it was a cause of illness.
There were four hospitals under the so-called TAR Health Bureau (‘Phrod bsten las khungs), and patients were allocated strictly according to the administrative division of the city they belonged to, regardless of preference or suitability [of the facilities], which deprived people of any entitlement or say in their medical treatment. In any other country in the world, it is considered fundamental that the patient himself chooses which hospital and doctor to go to. In Lhasa at that time there were facilities for Western medicine and traditional Chinese medicine, as well as Tibetan medicine in the Mentsi-khang, and normally one would opt for Western medicine in the case of critical illness, injuries such as broken arms and legs, and operations, while traditional Chinese or Tibetan medicine would be preferred in the case of noncritical and chronic illnesses. But under the regulations there was no choice, which was just like treating the foot when it is the hand that hurts.
Even worse, under the hospital allocation regulations, citizens were issued a medical identity card, which was red for ordinary people and black for “class enemies.” The significance of this was that ordinary people did not have to pay for treatment or medicine while “class enemies” did, and the different-colored cards were supposed to make hospital administration simpler, but in reality, in a situation where it was not actually stated that “class enemies” had no entitlement to medical care whatsoever, the black pass served as an indication to the doctor that the bearer’s life was of no value. “Class enemies” were commonly told by the Chinese authorities, “One less of you people is one less mouth for the state to feed.” It was also said that one reason “class enemies” were allowed into the hospitals at all was that black pass holders who needed operations could be used for the practical training of students, and the well-being of those patients was of no more concern to them than an animal or a corpse. That is what was said in society at large, and there is no way of knowing that it was not so. Most doctors in all the hospitals at the time were Chinese; generally speaking, the Chinese regarded Tibetans as very inferior; and on top of that, they saw “class enemies” as something abominable.
Anyway, in my own case, after the medical pass system was introduced, I never planned on going to any official Chinese hospital, and through the mercy of the Three Jewels I never had any medical problem serious enough to require treatment in a hospital.