By preventing Western doctors into Tibet, the lamas kept the nation of Tibet from getting the help it needed and as a result a large percent of the population (30% or more?) was riddled with syphilis from birth.
This would also have contributed to a low birth rate in Tibet as many infants would have died in utero or early in infancy. Not least, many people would have suffered late stage syphilitic insanity, if they lived that long.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5168030/?page=1
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