China-India Border Dispute: How One Doctor Coped With Conflict and COVID-19 on the Front Lines of a Face-off Between Two World Powers

Fifty-three-year-old Nyima Tenzin was wearing a combat uniform, wrapped in a sleeping bag, when his body was brought to the Chushul Primary Health Centre on August 30, 2020.

Once inside and unwrapped, it could be seen that the soldier was without his right foot, with bones, neurovascular structures and muscles exposed amid the flesh.

Hailing from the Tibetan community in Ladakh, an Indian-administered territory at the far north of the subcontinent, Nyima Tenzin served in the Indian Army’s Special Frontier Force, and had stepped on a 1962-vintage landmine while patrolling the areas along the ever-contentious Line of Actual Control (LAC) that divides India and China.

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The Indian Army officials who brought Nyima Tenzin’s body to this tiny hospital south of Pangong Lake, 8km (5 miles) from the LAC and 4,225 metres above sea level, asked 44-year-old Dr Jigmet Wangchuk to perform a postmortem. Wangchuk did not know who Nyima Tenzin was or what had led to his death. The officers told him the victim had died an unnatural death near the porous border with China, nothing more.

When the Ladakh-born doctor called his seniors in Leh, the territory’s capital, to say he lacked the equip­ment or facilities to conduct a proper postmortem, he was simply told, “You have to do it.”

On May 5, three and a half months before Nyima Tenzin’s body arrived on Wangchuk’s bare-bones examination table, hundreds of Indian and Chinese soldiers engaged in fist fights and stone throwing at the border near Pangong Lake. Dozens were injured, some gravely.

On June 15, troops clashed again in the Galwan Valley, atop mountain ridges nearly 4,300 metres high, with some soldiers dying after tumbling down rugged cliff sides into the Galwan River.

Video later released by China and open-source analysts showed both Chinese troops and Indian soldiers aggressively stomping through a river at each other, wearing heavy winter clothes, some wielding shields and batons, either charging or preventing each other from advancing further.

Notably, even in such a fraught situation, agreements from 1996 and 2005 that either side would abstain from using firearms within 2km of the LAC were observed.

In its annual review report, the Indian Defence Ministry would claim that China used “unorthodox weapons”, after photos circulated online showed barbed sticks with protruding nails that were reportedly used to club combatants at close quarters.

Just days after the June incident, Chinese Foreign Ministry spokesman Zhao Lijian gave a detailed account of events claiming that Indian soldiers had “violently attacked the Chinese officers and soldiers who went there for negotiation, thus triggering fierce physical conflicts and causing casualties”.

On June 20, Indian Foreign Ministry spokesman Anurag Srivastava responded, accusing Chinese troops of breaching the status quo, and “when this attempt was foiled, Chinese troops took violent actions on 15 June 2020 that directly resulted in casualties”.

Indian officials were quoted in reports confirming that 20 Indian soldiers had died in the clash. It took China eight months to acknowledge that four of its soldiers had also been killed.

Another confrontation between the two countries had taken place in 2017, thousands of kilometres to the east, over a Chinese attempt to construct a road on the Doklam plateau, which India recognises as Bhutan’s territory and where Delhi had sent troops at the request of the Bhutanese government.

But the June 2020 incident marked the deadliest skirmish between the two regional powers since China defeated India in a series of battles along the LAC in the 1960s.

The Galwan Valley clash led to a series of military-level talks, but in an already tense situation with Covid-19 battering both countries, the timing of a perceived breach of sovereignty was not ideal.

As the stand-off continued into July 2020 – both at the LAC and in the halls of power in Delhi and Beijing – Wangchuk, based in Leh at the time, was informed that he had been assigned to the Chushul Primary Health Centre as lead doctor.

His first concern in taking up the remote post was for his mother, at home in Leh, whose legs had been paralysed in an automobile accident in 2005. Her care had been a priority ever since, but “my father and wife supported me”, says Wangchuk. That the tiny outpost was near the border was not lost on him either. Rather it emboldened him. “The LAC is just five miles away from Chushul, I thought, ‘I will go and give my best to the people.’”

The son of government employees, Wangchuk was raised in Skurbuchan village in Ladakh, received his early education in Leh and moved south to neigh­bouring Himachal Pradesh state for secondary school. In 1998, he attended medical college in Jammu City and, in 2010, he joined the Jammu and Kashmir Health Department, where he has served since.

With his wife still in Leh, the orthopaedist set off for Chushul, 200km from the capital but a world away in terms of development. His colleagues in the health department were sceptical. “When friends found out where I was being transferred to, they would say that I’m a doctor, and doctors don’t go there,” says Wangchuk. But “I wanted to prove all of them wrong, and to some extent I did.”

Of the fewer than 200 families in Chushul village, most work for the nearby Indian Army stations as labourers. No doctor had been posted there for more than two years, and the 19 paramedics running the clinic assumed Wangchuk would leave before long, just like the others sent there before him.

But “people there need a doctor, too”, Wangchuk would tell his concerned friends. “They must be facing problems.” And as he would discover, the absence of a resident doctor was just one of many.

The Chushul health centre runs on a 5KW solar plant, feeding the hospital as well as six apartments, each with a kitchen, a bathroom, a living room and a bedroom, but none has running water, with solar-powered borewells supplying taps.

After arriving in July 2020, Wangchuk shared one of the apartments with a dental assistant and a cleaner. The meals they cooked were simple. The altitude means there is minimal opportunity for anything but basic agriculture. Animal dung is burned for fuel, but the smoke caused respiratory problems.

Meanwhile, the bitter cold led to joint problems, and dental problems arose due to the water supply, so in his first few days at the compound, Wangchuk began testing the water for acid, fluoride and iron content to find out where the problem lay. Then, suddenly, 66 Covid-19 cases were added to his usual workload.

But the rest of the world’s struggles with wave after pandemic wave were far from his mind. Any thoughts beyond the clinic were occupied by what he saw as China threatening India’s sovereignty a mere few kilometres away.

Mobile connectivity in the village would often be cut for security reasons, and residents would have to rely on the panchayat ghar — the government administration office — and its one satellite internet connection. Even when service was available, regional security meant that each SIM card was allocated only 4GB per month.

Whenever Wangchuk would register a number to use the internet, his phone would be flooded with videos, texts and images on WhatsApp, using up half of his bandwidth. Wangchuk would go through his allotted 4GB within days and would have to register again from a new number.

“I would text friends in Leh, and use their number to register,” he says. “Each month I would register at least seven numbers to use the internet as the pack would run out quickly.”

This became a real problem when suddenly, from the direction of the border, “troopers would come to panchayat ghar to contact home”, which would tie up Wangchuk’s only reliable mode of communication with his colleagues back in Leh. He knew something was up.

“By late August, I saw a lot of army movement,” Wangchuk says. Then there was a “disturbance on Black Top”, one of the mountains near Pangong Lake. “[China] had invaded,” he claims, “and the Indian Army walked towards Black Top, and one of the soldiers stepped on a landmine.”

That soldier was Nyima Tenzin, and Wangchuk’s postmortem, such as it was, revealed no internal injuries. All organs were intact. The cause of death was blood loss in the absence of first aid for his severed foot. It would have been a preventable death in any but these, the most extreme, desolate conditions.

Each day Wangchuk would rise at 5am and cycle around the village before breakfast. Work began at 10am and patients would visit the hospital throughout the day with a variety of common ailments. Lunch was prepared in the common kitchen and Wangchuk’s shift ended at 4pm. But once coronavirus arrived in the village, his appointments became more often than not matters of urgency. Villagers also feared the Chinese army might appear on the horizon at any moment.

As rumour and anxiety whirled within the village, “I had many patients in Covid isolation centres, and 20 to 25 positive cases with mild symptoms,” says Wangchuk. “I asked the authorities if there was anything happening regarding evacuation, because there was a warlike situation outside.”

Wangchuk’s superiors in Leh assured him that if violence did break out, civilians would be moved, but the doctor’s main worry was how, if this border clash did turn to war, would he keep his Covid-19 patients in isolation while being evacuated?

By September, villagers would become tense whenever friends or relatives from elsewhere in India called to relay information on the border conflict broadcast by the country’s television news channels.

It was clear, these government-friendly broadcasters insisted, that Indian pride was at stake, and nationalist war cries reverberated across the nation; just not as far as Chushul. Wangchuk says he remained oblivious to the news and to any of the pro-government sabre-rattling because he “would be so busy that I had no sense of what else was happening”.

But happening, things were. Flights from Delhi to Leh filled up with journalists hoping to capture the possibly-imminent border war, although the Indian Army forbade movement beyond the regional capital.

Stuck more than 230km away from the border, many television reporters, desperate to report something – anything – climbed hills in and around Leh, angling their piece-to-camera frames to show the city’s signature white-mud houses and Tibetan Buddhist temple in the background.

One evening an army official arrived at a Leh hotel where many members of the media had gathered and announced, “We will be taking journalists on a tour tomorrow,” telling everyone to supply their names and accreditation, to be ready at 6am and that an official vehicle would take them to a rendezvous point.

The next morning, September 17, those journalists whose credentials met with state approval were taken to Leh airport, a few kilometres from the hotel, to report on army vehicles, jets and other military supplies being transported. The message was that the Indian Army was more than prepared for war with China.

Throughout the day, news channels ran stories, seemingly to prop up Defence Minister Rajnath Singh’s speech that after­noon, during which he said, “The Chinese actions reflect a disregard of our various bilateral agreements.”

Later, as Indian fighter jets flying over the hotel added to the jingoistic atmosphere, I left the tricolour-flag-waving frenzy in Leh for a cluster of one-storey mud-brick houses on a foothill a few kilometres outside the capital. Choglamsar is home to a settlement of Tibetans, 7,550 of the 90,000-plus who currently live in India as refugees, their families having fled their homeland after China annexed it in 1959.

Nyima Tenzin had lived in this village for the past 20 years, with his brother, sister and brother-in-law. The grieving family were gathered around dozens of brass oil lamps after praying for his soul to rest in peace.

Tenzin’s older brother, Namdakh, 49, recalled his sibling’s last words before leaving for duty: “I don’t know whether I will be back or not. You stay well. I’m being posted at the border so take care of my family because there is no guarantee.”

Chushul has only 10 shops, all run by locals who drive six to eight hours to Leh to stock up, navigating one of the world’s highest motorable roads, at 5,391 metres, and one that is prone to landslides. But this year, Wangchuk feared, each trip they made posed an additional risk – that of Covid-19.

In the second week of August, one of the shopkeepers visited the hospital, complaining of fever and body ache.

“I had to convince him to take a Covid-19 test,” says Wangchuk. “I cleared the outpatient area to prevent people from coming into contact with him.”

Within three minutes, the rapid antigen test re­turned a positive result. When Wangchuk had arrived at Chushul, he had brought with him 50 test kits as well as personal protective equipment (PPE), which he used in the initial days when people started to show symptoms of the virus.

“Most of the hospital staff had come into contact with him,” Wangchuk says. “I was wearing a mask but not a PPE kit. I locked the hospital’s gate and tested all the patients and staff. Two of my staff tested positive. Nobody in the hospital was trained to take samples for Covid testing. I tested everybody and then looking into a mirror, I took my own swab. I tested negative.”

After disinfecting the hospital, Wangchuk informed higher authorities that he needed an isolation centre for Covid-19 patients. He was given the Wildlife Department’s newly constructed guest house, 500 metres from the hospital.

“All the staff were crying, wondering how the virus came to a place like Chushul. They were saying they have children at home, how could they handle it?” says Wangchuk.

With no internet, Wangchuk would communicate with doctors in Leh via the satellite phone at the panchayat ghar. Then came the night he knew things were not as they should be. “The phone was working fine but then on the night of August 29 there was a disturbance and rumours spread that Chinese troops had come across,” he says.

Tensions eased a little during the first week of September, though Indian and Chinese troops were now in a stand-off just 300 or 500 metres apart.

In the relative calm of the mountains, far from the diplomatic flurry of Delhi, front-line officers requested help from the local population, asking them to carry supplies to the hundreds of Indian soldiers now assembled on the front line. Wangchuk recalls that at least two people from each household volunteered, and a roster was drawn up.

Chushul residents swung into action, transporting water and medical supplies to the conflict area. And although he was overwhelmed at the hospital, Wangchuk, too, decided to help.

On the morning of September 7, with a few staff members in tow, Wangchuk set off for the front line, trekking for more than two hours “with water and medicine that we had in stock”.

“As per the army, [the soldiers] would get only one litre of water a day as they were at the top,” says Wangchuk, having realised how essential these off-the-books deliveries were. “At first I thought I would not be allowed [to go to the front line] but when they heard it was the doctor from the hospital, I was allowed in.

“At the top, the army unit’s commanding officer made me sit, greeted me and gave me a cup of coffee. They also told me not to share any details of the camp anywhere with anyone.”

Back at the health centre, Wangchuk spoke to his friends in Leh and, having seen first-hand what the soldiers required, asked them to buy supplies and send them to Chushul. They “collected products worth around 15,000-20,000 rupees [US$200-US$270]”.

On Wangchuk’s second trip to the front line, on September 19, he supplemented soldiers' basic needs with requested lip balm, sunscreen and pain medication. “The soldiers were at high altitudes that caused sunburn and cracked lips. They had to collect stones to make bunkers, which gave them backaches,” he says.

During that second trip, a temporary outpatient department was set up for Wangchuk to carry out basic check-ups and prescribe medications if needed. Most of his patients suffered from common issues such as coughs, joint pains or backache.

A few who had recently arrived had altitude sickness, and Wangchuk advised them to make the two-hour trip back to base camp. But most of the Ladakh regiment were locals and, as Wangchuk says, “Ladakhis are familiar with altitude.”

Despite having grown up in Ladakh, it was Wangchuk’s first time close to the LAC, and while the rostered villagers’ trips continued through September, once Covid-19 cases reached 40 in Chushul, Wangchuk could no longer make the trek, having become too occupied with fighting the pandemic.

Wangchuk’s photos of his way down after his final trip to the front line, posing in a red jacket and carrying a heavy backpack and two cans of water, went viral on social media.

“My family was worried after seeing the pictures online,” he says. “When I spoke to them, they asked me why I was going there. I made them understand that civilians are going as volunteers, and when you want to do something out of passion … you forget the situation you are in. You don’t listen to anybody.”