At more than 4,500 meters above sea level, life in Nagqu, Xizang Autonomous Region, has never been easy. The thin air slows every step, winters bite deep and vast distances often separate people from essential services. Yet, in recent years, I've seen change reach even the most remote corners of this land, not in the form of skyscrapers or high-speed trains, but in the way people live, work and hope.
Nagqu is China's highest-altitude prefecture-level city, with fewer than two people living in every square kilometer.
Two moments from my recent visit stand out, not only for their emotional weight, but for what they reveal about a deeper transformation in Xizang: one about saving fragile lives, the other about reviving fragile lands.
Saving fragile lives in the world's highest NICU
The first took me to the neonatal intensive care unit (NICU) of Nagqu People's Hospital, China's highest-altitude NICU. There, I met a baby girl weighing just about 900 grams, born after just six months of pregnancy in a car half way to Lhasa. A decade ago, her chances of survival here would have been slim to none. The hospital lacked both the technology and expertise to treat such premature infants.
A premature baby in an incubator holds neonatologist Tian Congliang's finger as he listens to her heartbeat in the NICU at Naqu People's Hospital, Xizang Autonomous Region, July 21, 2025. /CGTN
Today, thanks to a "group-style" medical assistance program launched in 2015, specialists from across China work alongside local doctors, bringing advanced techniques and training. Neonatologist Tian Congliang, from northeast China's Liaoning Province, told me they now perform endotracheal intubation on babies this small, something impossible here before 2015.
Neonatologist Tian Congliang (left) listens to a premature baby's heartbeat with a stethoscope in the neonatal intensive care unit (NICU) at Naqu People's Hospital, Xizang Autonomous Region, July 21, 2025. /CGTN
In 2024 alone, the hospital's critical neonatal death rate dropped by 1 percent, and transfers to distant facilities fell by 4 percent. These numbers may seem modest, but in a place where distances are vast and survival is never guaranteed, they represent lives saved and families kept together.
From waste to wealth: Reviving the grasslands
If the NICU speaks to the right to health, then the second story speaks to the right to livelihood, and how innovation can serve both people and the planet.
In the pastoral heartlands of Nagqu, yak and sheep dung has long been dried and burned for fuel, a traditional but limited use. Tsering Migyur, a young Tibetan entrepreneur, saw untapped potential. Since 2017, he has been buying livestock waste from herders, processing it into organic fertilizer, and using it to restore degraded grasslands.
Tsering Migyur picks up yak dung on a grassland in Nagqu, Xizang Autonomous Region, July 27, 2025. /CGTN
It wasn't easy. Many herders initially resisted selling what they considered a symbol of good fortune. Migyur went door-to-door to explain how selling dung could bring in extra income without breaking tradition.
Today, he operates more than 20 collection stations across Nagqu, providing thousands of dollars in additional earnings for some families each year. At the same time, his fertilizers, developed in collaboration with the Chinese Academy of Environmental Sciences, are helping bring green back to the high-altitude steppe.
A photo shows a sculpture made from yak dung, adorned with colorful paintings, created by local herders in Nagqu, Xizang Autonomous Region, to celebrate the 60th anniversary of the region's founding, July 27, 2025. /CGTN
These two stories are deeply personal to those involved, but they are also part of a larger picture.
A bigger picture of well-being
In the past, people in Nagqu either traveled long distances for treatment or had to settle for limited county-level medical care. Today, nearly half a million people in Nagqu can access high-quality medical services close to home. And Nagqu's transformation mirrors the broader progress unfolding across Xizang.
In 2023, the autonomous region's maternal mortality rate dropped to about 38 per 100,000, and the infant mortality rate fell to 5 per 1,000, both reaching historic lows. By 2024, Xizang had built over 7,200 medical institutions, including more than 5,200 village clinics. The number of hospital beds has surpassed 21,000, more than double that of 2012, according to a white paper titled "Human Rights in Xizang in the New Era" released in March this year. Average life expectancy has risen from 35.5 years six decades ago to 72.5 years today.
On the economic front, Xizang is fostering industries suited to its unique environment, from eco-tourism to sustainable animal husbandry. Entrepreneurs like Migyur represent a new generation that blends cultural heritage with modern environmental stewardship. Their work creates jobs, diversifies incomes, and protects the fragile ecosystem that sustains life here.
Beyond the numbers: Stories of dignity and hope
It's tempting to see these changes purely in statistics: more hospitals, more beds, lower mortality rates, higher incomes. But behind every number is a human story: a mother holding her premature baby for the first time, a herder earning enough to improve the family's life, a community watching grass return to once-barren hills.
As 2025 marks the 60th anniversary of the founding of China's Xizang Autonomous Region, it's worth remembering that development is not just about building infrastructure. It's about enabling people to live longer, healthier, and more dignified lives. It's about giving them the tools and opportunities to care for their families and protect their homeland.
On the plateau known as the "Roof of the World," the air will always be thin, and the winters will always be cold. But with every life saved and every patch of grass restored, the future here grows a little warmer, and a little richer in hope.
