Surmang (or Zurmang) refers to a vast alpine nomadic and farming region, historically a duchy under the King of Nangchen, with vast land holdings spreading over what is today the Tibet Autonomous Region and Qinghai Province. In Tibetan King of Nangchen's realm was called the "nyishu dza nga" or the 21 (provinces). Since 1959 it is mainly within the Yushu Tibetan Autonomous Prefecture of Qinghai province in China (historically part of Kham, eastern Tibet). Yushu Prefecture is 97% ethnic Tibetan. The Surmang region is one of the poorest regions in China ranking it among the world's highest infant and maternal mortality, almost 100% illiteracy, and personal income of less than US 14¢/day.