Original URL: http://www.theregister.co.uk/2008/11/30/tzu_chi_foundation/

The Tzu Chi Foundation – the world’s largest Buddhist charity

Monks, cadavers, typhoons and earthquakes

By John Oates

Posted in Science, 30th November 2008 08:02 GMT

Taiwan might be best known to Reg readers as the home of the major DRAM manufacturers and other computer component makers but it is also home to the world's largest Buddhist charitable foundation.

The Tzu Chi Foundation was founded in 1966 by a 30 year-old female monk called Dharma Master Cheng Yen. It runs international emergency relief operations, longer term aid programmes, as well as recycling centres, a TV and radio station and magazines within Taiwan.

It has very few paid staff, but thousands of volunteers give some, or all, of their time each week. They are expected to pay all their own expenses.

The Register went to Taiwan to see the Tzu Chi Foundation in action, courtesy of Stan Shih, a founder of Acer, a major supporter of the foundation. A big thank you to him, and to all the Tzu Chi volunteers who made our visit possible.

Starting with the support of 30 housewives contributing a few cents a day, the Tzu Chi Foundation now brings in millions of dollars in donations. It is the largest organisation which embodies “socially-engaged Buddhism”. Several broadly similar organisations have emerged in Taiwan in recent years. They call for Buddhists to actively engage in improving society rather than just seeking personal, religious enlightenment.

It does this with next-to-no paid staff but with the help of around 100,000 full and part-time volunteers. Even the 170 female monks at the Tzu Chi monastery are expected to support themselves. They make crackers and other foodstuffs which are sold around the country. This means the Foundation, and monastery, have minimal overheads, which is one reason they attract support from so many Taiwanese business people.

Tzu Chi volunteers work all over the world – from providing free medical care to illegal immigrants in the US, distributing emergency supplies in New Orleans after Hurricane Katrina, to work in Afghanistan, Myanmar and mainland China. Its, and Taiwan’s, unique international position mean it is often allowed into places where traditional Western NGOs would not be welcomed.

International relief is based on the principle of “direct giving” – Tzu Chi does not just chuck around sacks of rice but, where possible, prepares hot food for people in need. The foundation aims to maintain the dignity of victims of natural disasters in the way that food is distributed and also by getting the victims help in helping each other.

A senior figure in Tzu Chi's international volunteer programme, an ex-financial consultant at Merrill Lynch, told us the group tries to buy food and fertiliser locally for emergency relief operations - if it can do so without inflating prices. He said this was usually possible in areas where the UN's World Food Programme was not working.

If local buying begins to increase prices then supplies are brought in from Taiwan and elsewhere. Tzu Chi has successfully negotiated direct donations in some surprising countries like North Korea, Myanmar and Iran. After long talks North Korea allowed the group to distribute food in some areas. Myanmar also relented, for some areas, after six days of negotiating to allow Tzu Chi in to help people left hungry after Cyclone Nargis in May 2008. As well as emergency food aid the group provided fertiliser and seed to get fresh crops planted.

Tzu Chi always aims to provide long-term help not just a few days of food. They try to treat recipients with respect and dignity - haircuts and perms are organised alongside more practical help. There is, we were assured, no attempt at evangelising or pushing the Buddhist message except by example. After the Ban earthquake in Iran in 2003, after providing 2,500 tons of rice, blankets and medical care, the group built five schools for 2,000 pupils which were then handed back to the Iranian government.

Taiwan’s largest recycler

The Foundation became interested in environmental protection in 1990 and now runs 4,500 recycling centres across Taiwan, all run by volunteers. We started our trip in Taiwan with a visit to a centre in Taipei run by Mrs Chow:

Recycling centre Taiwan

Paper is divided by hand into white or coloured - shiny covers and book spines are recycled separately. The centres provide almost a third of the running cost of Tzu Chi radio and TV stations.

Paper recycling

Video cassettes are dismantled by hand – they contain eight different recyclable materials.

Copper wire is stripped of its insulation

Copper wire stripped of its insulation.

Apart from helping Taiwan reduce its need for landfill sites the centres aim to provide fulfilling work for the mostly elderly volunteers. This considered as true in the recycling centres as it is for Tzu Chi’s international relief work – it is considered an honour to be able to give.

In 2007 Foundation centres recycled 95.7 million tons of paper, one million kilos of aluminium, 13 million kilos of iron and 7.1 million kilos of plastic bottles.

Some of the plastic bottles are made into blankets and shirts, using volunteered time, expertise and equipment from local textile firms. Whether this was really an environmentally positive process bearing in mind the amount of energy presumably required was not entirely clear. The blankets are distributed as part of Tzu Chi’s emergency relief efforts. The seven stage process was perfected by the Foundation with the help of several different textile companies.

The revolution will be televised

Da Ai Television station, and Rhythms Monthly magazine, is the main way the Foundation promotes its work and beliefs. The TV station, founded in 1995, costs $35m a year to run and some $10m of this comes from the recycling business. The rest comes from understated corporate sponsorship – direct promotion of products is not allowed, and from donations.

Its most popular show is The Sunshine of Life, a medical soap opera. It also broadcasts a fifteen minute daily message from Dharma Master Cheng Yen along with documentaries and news programmes. The station is run by 500 paid staff and 2,000 volunteers.

TV gallery

Da Ai Television's main gallery

Medical care, from old to new - acupuncture to brain electrodes

After a day in Taipei we flew to Hualien on Taiwan’s east coast. Historically one of the poorer areas of Taiwan, it is home to what is left of the country’s aboriginal population. The grey-granite city used to suffer from poor medical services – people were expected to travel to Taipei or elsewhere for treatment of serious conditions.

It was an incident here that led to Master Cheng Yen setting up the medical foundation in 1972. The Foundation headquarters and temple are right next door to the Tzu Chi Hospital, which provides a full range of care – from traditional Chinese acupuncture to the most modern treatments. It runs the world’s largest non-government database of bone marrow donors. It treats the symptoms of Parkinson’s by using deep brain simulation via implanted electrodes. And it has one of Taiwan’s only palliative care wards for terminally ill patients. It also functions as a teaching hospital.

Steve Chen, a marketing guy from Acer who helped show us around, volunteered for a bit of acupuncture for a sore shoulder.

Man getting acupuncture

He said it hurt.

The machine behind him can be used to zap the needles with a bit of electricity to increase the flow of chi - the fundamental energy within all living things.

The hospital also provides rather more modern treatment for Parkinson’s disease. Patients are first assessed by walking on a touch sensitive floor surface – Parkinson’s patients tend to walk on tip-toes, take small steps and topple forward. The treatment involves inserting an electrode through a hole in skull into a part of the brain called the subthalamic nucleus – an MMR scanner is used to get it into the right place because it varies from person to person.

A wire from the electrode leads to a battery and pacemaker unit which is usually inserted under the skin of the chest. It releases a 4-6 volt intermittent current which over-rides the abnormally frequent firing of nerve pulses which is believed to cause Parkinson’s. The battery unit can last as long as six years and can be controlled by the patient using a remote control – it can be switched off at night to prolong battery life. There’s a BBC video of a banjo player getting a similar implant under local anaesthetic here.

Pacemaker

Electrode and pacemaker unit

Bone marrow register

The hospital also runs the world’s largest non-government database of bone marrow donors – it started work in 1993. There are 314,000 people on the database which has helped match 1,700 donations. Most of these went to mainland China, but 64 went to the US and nine to the UK, among other countries.

Bone marrow database

Working on the bone marrow database

Donations are usually collected by giving people drugs to increase marrow production which is then harvested from the blood. The older technique involved cutting open pelvic bones to extract marrow. The hospital also has an umbilical cord blood bank with 13,000 entries. These have been used for 35 transplants worldwide.

Bone marrow storage flasks

Bone marrow storage flasks

Cadavers for medical research

The Tzu Chi hospital came up against a problem in the late 1990s – a lack of bodies to teach students basic anatomy and practise surgical techniques. Although Taiwan is not a very religious country Buddhist, or Chinese, cultural beliefs mean that people do not like the idea of body donation.

This belief led eunuchs in imperial China to carry their testicles around in a small bag in the hope they would be buried with them when they died and so they would be restored to them in the afterlife. The remnants of these beliefs meant the only bodies available for medical students were from people whose bodies were not claimed by friends or family.

Dharma Master Cheng Yen started a campaign to get more people to donate their bodies by starting the “silent mentor” programme – repurposing body donation for local tastes. Parts of the scheme might seem outright weird to some readers but it has led to over 20,000 people signing up – the hospital’s 60 students only need a maximum of 14 bodies a year.

Admittedly the majority, 60 per cent, of the volunteers are Foundation members. They use the cadavers not just for basic anatomy but also, because the bodies are frozen, for practising minimally invasive surgical techniques.

Silent mentors: better than Burke and Hare

The Medical Simulation Centre opened just two days before we arrived for our tour but the Silent Mentor programme has been running since 1995. It differs in some major ways from medical school practise in the UK and US. Firstly because medical students visit the silent mentor, or body donor, before they die. They go on several visits to the family of the person they will be practising their surgical techniques on. Photos are taken and the students encouraged to see the mentor as a person. After they die the mentors undergo a rapid freezing process developed with the help of a German company.

The body is rapidly cooled – the core temperature needs to get down to -30C within two hours or the flesh becomes spongy. They are then stored until needed. After defrosting the bodies will only last four days, unlike in Western universities where bodies are stored and preserved in formaldehyde.

The room for simulated surgery is almost identical to a real theatre and students use new instruments but the room is not pressurised as a real surgery would be. One major difference is that the room contains eight operating table rather than one. Also different from a typical theatre, at the head of each is a flat screen TV showing a picture of the deceased and three paragraphs in English and Chinese about their life.

So students are not going to forget their meetings with the body donors. Medical simulations are run from Thursday to Sunday because more doctors and surgeons are available to demonstrate operating techniques. Family members are also free to watch the sessions.

After having the scheme explained to us the press were hussled into a room - which we understood to be empty. In fact it was a viewing room looking into the theatre where eight bodies were having various simulated operations carried out on them. More shocking was the middle-aged woman standing next to me watching her husband being operated on about three feet from where we were standing. She watched the process through her fingers and was accompanied by her daughter. While we gawked at her husband, students and the Foundation PRs took pictures, it felt like we were intruding on what should have been a private moment.

The bodies, we were told, are very nearly as good as the real thing. They’ve proved particularly useful for practising Minimal Invasive Surgery – using endoscopy techniques, or keyhole surgery. This is a medical student’s blog post about the scheme.

Once the students have finished the bodies are reassembled and stitched back up. Families often choose to watch this process too. The mentors are put in coffins and handed back to the families for cremation. Some of the ashes are then put into the hospital’s Room of Great Giving. There is also an annual ceremony of thanks in November for the surviving family of body donors. Our visit coincided with the annual conference for medical volunteers from around the world - the Tzu Chi International Medical Association.

Tzu Chi volunteers

Identically dressed medical volunteers watch simulated surgery on cadavers via video link

Tzu Chi Monastery and the Dharma Master

The final part of our trip was to the Tzu Chi Monastery and a meeting with Dharma Master Cheng Yen. We arrived at 7am, in time to see her deliver her daily talk, which is broadcast on Da Ai TV. She spoke mostly about the day’s events – Taiwan was in the middle of a typhoon which killed several people – and about what the Foundation was doing to help. The monastery consists of a small cluster of buildings and a temple, just outside Hualien. Monks grow much of their own food and also produce crackers and bean powder for sale. The place is home to 170 tonsured (shaven headed) monks who must spend at least two years as probationers. We were shown round the various buildings by a monk who grew up and was educated in the US – she graduated from Stanford before joining the order.

Monks at their laptops

Two monks working on their laptops

The monks are surprisingly techno-literate - even the Dharma Master is no techno-slouch. She uses the internet and email to keep in touch with the group’s international work – a heart condition means she is unable to leave Taiwan. She even uses PowerPoint to create notes for her speeches – but does not inflict the slides on her audience. Then we were taken into meet the Dharma Master – slightly unnerving after a week spent in the company of people who prefaced almost every answer to a question with “Dharma Master says…”.

She answered our questions gracefully, despite not normally talking to the press. She kept half an eye on a flat screen TV which had the news on in one corner of the room. Her every word was written down by one of the monks, several of whom crowded into the room to hear her speak.

She has a quiet, slightly sing-song voice which is quite hypnotic - especially after four days talking to her followers. I’m not going to attempt to summarise her views here – the Tzu Chi website is a good place to start.

Or how about a couple of Cheng Yen's aphorisms:

Believe in yourself but do not be attached to your own point of view.

or The hardest thing for people to see is themselves.

Whatever you think of her there is something amazing about the scale of the organisation she has created in forty years. And so is the enthusiasm and dedication of the Tzu Chi volunteers and the way they attempt to help and humanise victims of natural disasters. From a Western perspective more used to charity professionals or aid tightly tied to political motives the idea of an international force of volunteers is more than impressive.®

Dharma Master Cheng Yen

Dharma Master Cheng Yen.

Next page: More pictures

More pictures

Volunteers have tea

Volunteers at the recycling centre take a tea break. Those wearing blue shirts are “certified volunteers” with at least two years' service. Probationers, or those who choose not to become certified, wear grey shirts.

TV studio

Da Ai TV studio in Taiwan

Hualien temple

The Still Thoughts Hall at Foundation headquarters in Hualien

Food preparation

Monks and volunteers preparing food at the monastery

Monks preparing ingredients for crackers

Monks and volunteers preparing ingredients for soda crackers

Temple at the monastery Hualien

The temple at the Tzu Chi monastery outside Hualien

Two volunteers

Two of the volunteers who acted as translators and showed us round the Foundation

Monks accomodation

Monks' living quarters and workshops on the ground floor