Orphanage Adventure

Today my parents left to return home, leaving me with an empty apartment once more.  In an attempt to stave off the post-visitor blues, I decided I was going to go see an orphanage named Harmony House where we will be expanding the Magic Hospital Storytelling program.  I had quite the adventure getting there, as I didn't really know quite where I was going, managed to find the long distance bus station, get a ticket, get on the bus, and then realized that I didn't have my phone to call the orphanage director upon arrival at the bus stop as I was directed.  And then I realized I didn't actually know the name of the stop I was getting off and it wasn't listed anywhere on the bus.  And then instead of leaving at the time listed on the ticket, the bus trawled for passengers in one gas station after another...for 20 minutes...then 10 minutes...then 15 minutes...as it got slowly later and later, past the time I was supposed to meet Lily.

Eventually, I managed to get the nice girl next to me to lend me her phone, called Lily, who picked up after a frightening 7 rings, who then exclaimed that she'd called me 3 times and sent me an email trying to cancel my visit!  All of this, of course, just after I'd left my apartment, with my phone sitting on the desk.  She very graciously told me to come on, and sent the orphanage driver to pick me up at the bus stop.  It wasn't really a bus stop actually, more like a corner, and I spent a scary 10 minutes wondering where the driver was, but he showed up eventually, and I made it to the orphanage at last.  

 I've never actually seen an orphanage, even in the US, but after recently reading Jane Eyre, my experience today was reassuring.  There was a cozy play room with oodles of toys, a rack of coats hanging up, and upstairs 4 rooms with cribs and beds and a nannie in each room.  Lily seemed very fond of the children, picking them up and playing with them during our tour.  And she is determined to get volunteers to play with them; after expressing concern about my 2.5 hour journey to get to the orphanage, she offered the services of her driver every week to pick up the volunteers in Beijing!  Her dedication was really inspiring, she has already adopted one of the children from her orphanage and was obviously very involved in providing a warm, happy home for them.  I am looking forward to returning to play with the kids!

ps. pics from "The Tiggelaars in China" coming soon...

Quick Update

My parents just arrived in Beijing for a 10-day Christmas holiday, so the next couple days might be fairly blog-less, just fyi.  Today we went to the Forbidden City, Tianenmen Square, and Wangfujing street where everyone was shocked at the grossness of the food on offer, including snakes, tiny squid, sea urchins, and seahorses.  I think the most shocking thing of the day for my mom though was the baby split pants - babies here wear pants with a hole on the butt so they can pee and poop at will, which they do pretty much anywhere, including grocery store floors.  I don't understand how this is compatible with being held by adults, but hey, it must because I don't think people would stand for constant soiling of their clothes.  I've heard Chinese babies are potty-trained at an insanely early age!  We have a full range of activities and sightseeing lined up for the next few days, including a trip to Xi'an to see the Terracotta Warriors.

 Right before my parents got here, Adam, Alison, and I went on a trip to a 'yearly forum' for all the epidemiology departments affiliated with the Peking Union Medical College.  It was a cross between a farce (sitting in hours of lecture in Chinese when everyone knows we can't understand, plus giving lectures of our own in English that no one understands/cares about) and hilarity (the hotel had hotsprings, bowling, karaeoke, etc) -- please see Adam's blog post about this as we had a hilarious towel adventure that would take too long to relate now. http://faruppereastside.blogspot.com/2010/12/our-trip-tobeijing.html (Thanks Adam!)

And one random picture to share: on the way to CICAMS to go on the trip, I realized that the city government has again decided to tear up my neighborhood for construction...but that doesn't stop the residents from going about their daily business, including shopping for vegetables literally inches away from a trench being dug for pipes!  DIC! (Dude its China!)

Research Update

I thought as I head into the holiday season and my slightly stolen holiday with my parents and sister (there's no real 'Christmas vacation' here, but I'm not gonna hang out at the office my parents in Beijing!) that I would recap what I've done in my research so far this year.  As most of you probably know, I am working in the department of epidemiology at branch of the Peking Union Medical College, called the Cancer Institute, Chinese Academy of Medical Sciences, or CICAMS for short. I am on the team that focuses on cervical cancer, and I have several projects on different aspects of detection, prevention, and awareness, which I will outline here (sorry for the length!).

1) Review paper about serology and DNA prevalence of HPV (the virus that causes cervical cancer) around the world.  My US mentor gave me this project to work on in July, before coming to China, so I would have a project from the beginning and something to work on when things are slow around here. She seemed to think that this would be a quick project but it has been anything but; however, I have come a long way.  I have finished finding new papers to include the results of, have written the results and discussion sections, and am currently editing, formatting, and designing tables and figures.  We hope to submit this to a journal in the next month or so.

2) Survey about women's response to cervical cancer screening and results from screening tests. I designed the study based on prior studies done in this area in the US, visited the site where the study would be carried out earlier this semester, and it is currently underway in Yangcheng, Shanxi Province. Designing this survey took multiple attempts and revisions, especially since I don't speak/read Chinese and it was hard to communicate exactly what I was trying to ask!  Grace, an awesome grad student in the epi department who is in Yangcheng is helping me input the data into a database and will translate it for me.

3) Sexual debut in China paper. Sexual debut, or the age when a person first has sexual intercourse, is an important fact to know about a population when dealing with a sexually transmitted disease like HPV, especially when there is a vaccine.  The vaccine will only be effective if we vaccinate girls before they become sexually active.  The Chinese government is currently deliberating about approving the vaccine (already approved in a large part of the world some time ago, just approved for men in addition to women in the US last year) so now is the time to really figure out the age of sexual debut, so a national vaccination program can be designed that will work. The epi department did a survey assessing the age of sexual debut in thousands of women last year, and the data was just waiting for someone to write up.  I have written a manuscript with Shangying, Adam's Fogarty twin, and we are waiting for input from other authors (people at the research sites) before we submit to a journal.  Our idea was to submit this week, but as tomorrow's Friday and I will be gone afterwards, I imagine we will submit sometime in early January.

4) HIV-HPV screening trial.  HIV infected women are much more susceptible to HPV infection, and thus cervical cancer, because they have no immune system to fight the virus.  Now that antiretroviral therapy can extend the lives of HIV+ women, they are living long enough to die of cervical cancer.  There is a large population of HIV infected women in Yunnan Province, and we are designing a trial to test different screening methods in this population.  We also want to see the effects of antiretroviral therapy on the progression of cervical lesions and cancer; this is a new factor in the recent past and the scientific community does not completely understand it yet. I have written the protocol for the study, designed the data collection forms, and met appropriate people in Yunnan last month. We hope to launch the study at the end of February. I also have some data from a pilot study in this same population with 95 women that I am currently analyzing to publish a short descriptive paper.

5) VIA/VILI paper - VIA/VILI stands for Visual Inspection with Acetic acid/Visual Inspection with Lugol's Iodine, and is a very cheap and easy screening method for cervical cancer.  Its a great technique for resource poor areas, and has been shown to be much more effective than no screening at preventing cervical cancer death.  There have been many studies proving its worth in other areas of the world, but none in China so far.  Several years ago the Chinese government launched a pilot screening program using this technique, and data has been gathered about the number of cases of cervical cancer and lesions among those screened.  I have written a first draft of a paper about this, but we are currently waiting for all the field sites to send their data to the epi department so we can finish.

And that's it folks, that's what I've done at work in the last 4 months!  Nothing finished yet, but a few things nearing the end of the tunnel, and many more things getting going.  I hope to have a very productive year!

Random tidbits

Just some random tidbits of my life recently that I thought photo-worthy.

A interesting/scary menu in Pingyao...my favorite, and all-too-true for my culinary experience in China, is on the upper right.

No idea...

Out to dinner at a German-looking Brazilian-BBQ name actually very Chinese food restaurant with some people from work and Lara right before she left for Thailand.

The world's largest and smallest citrus fruits, I could not resist taking a picture. The one on the left is called a youzi, or Chinese grapefruit.  The one on the right is a really small Clementine (I think).

Nan Shan Skiing

On Saturday I decided to try out Chinese skiing with Esther, another Fogarty scholar and a friend of hers named Ionel who she met in Beijing. I had heard that the ski resorts around Beijing were not that great, and its true that it was very very small even compared to the resort in Kentucky and not very steep, but I still had a great time getting my ski legs back for the day.  I consider it my trial run before skiing in Harbin for the new year at the mountain where the Chinese Olympic team trains, which I figure will be sufficiently steep!  They play commercials and music from speakers throughout the park, people occasionally cut me off while skiing like they do on the roads here, and the lift attendants were much stricter than at home with whistles and directions to go here and there, but otherwise it was pretty much like skiing anywhere else in the world.  I have been so sore for the past few days!

Ionel is also a boarder

The slopes of Nan Shan Ski Resort

Esther and I 

Esther having a great time learning how to snowboard!

Hua Xin

Today I went on my first visit with Magic Hospital to a hospital called Hua Xin, in the northwest part of Beijing. A lady named Pauline has been visiting once a month and she offered to let me accompany her to see what a visit is like. The hospital looked surprisingly new, and the children's floor was clean and nice, but not very bright-colored.  We went into a small toy/play room, and Pauline spread out the toys she had brought, including home-made playdough.  There were three parents with little babies, and a few 6-7 year-old patients, and one nine year-old patient.  

It was interesting to see the way the parents and nurses interacted with us while we were there.  Part of their reticence might have been the language barrier (Pauline's Chinese was better than mine but not by much), but they seemed much less likely to jump into the activities the way American parents would. We read several stories, and I admire Pauline immensely for having translated The Very Hungry Caterpillar into pinyin so she could read it along with the english!  The parents just sort of sat there, they didn't seem willing to say anything or try to get their kids interested in the story. After reading, we played with playdough and had a drawing session.  I feel like at home, parents would have sat down to draw too, talked about the pictures, and tried to get their kids interested, but not so here.  They just watched us drawing, and trying lamely to talk to the kids (one of them turned out only spoke a dialect of Mandarin and couldn't understand a word we were saying anyway). Even the nurses just stood in the background, if they weren't holding one of the babies. They did get excited though about my hand puppet frog that I learned how to make in high school - there are now 6 or so Chinese people in Beijing who can make versions of Chuck! 

 Overall it was a very fun time despite not being able to communicate in words with the kids that much; kids are still kids and they enjoyed make believe and excited voices even in another language. Loads of smiles go a long way with sick kids everywhere.

Pauline and I with a very precocious patient who knew way more English than I know Chinese

Magic Hospital

During the past two months I have become involved with an NGO in Beijing called Magic Hospital, which is a program to support sick and/or underprivileged children.  (outdated website www.magichospital.org, new one coming soon) We have many different programs at varying institutions around Beijing, all of them hospitals, orphanages, or schools for migrant children (which are not funded by the government and hence perennially short on supplies and resources).  Some of the programs we sponsor at hospitals are clown visits, art teacher visits, santa visits, an abracadabra program which is basically like Make-A-Wish, and something called 'Inner Olympics' which awards outstanding courage in the face of chronic illness to inpatient kids.  We also have several programs focused on orphanages and migrant schools such as Outdoors Days, a music enrichment program, and english teaching.  

 I have been brought on board as a coordinator for the Storytelling Program, a new program which is really more like Playtime visits for kids in the hospital. It reminds me of when we used to visit the playroom at the vandy children's hospital with APO.  Basically the idea is for groups of volunteers to plan out a 1.5-2 hour visit with storytelling, crafts, songs, puppets, etc to entertain the kids and provide a little distraction from why they're in the hospital. 

I am currently in the midst of negotiations with big children's hospital in Beijing, Er Yan Suo, to try to get our program started there.  I went to a meeting last week with the director of a floor, who ended up being very busy and giving us instead to his head nurse.  She listened to us, was very excited, and then said she had to ask her boss, who said she needed to have a meeting with us and have an official proposal.  We had a meeting with her tonight, and it seemed to go very well…until we got to actually ironing out details of when volunteers could come.  It turns out they really don't think weekends are a good idea - they don't have any staff there in the leadership who can make decisions in case of an emergency…and they have the busiest inpatient load of all week…(does that seem like a bad combination to anyone else?!)…and really only T-R afternoons are good.  Despite the fact that most volunteers are students or working and can only volunteer in the evenings or on the weekend!  It was an interesting cultural experience, as the nurse administrator was reluctant to actually say anything specific, she wouldn't say weekends were impossible but wasn't willing to acknowledge what I was saying about volunteer availability.  It was frustrating at the time, and eventually we ended with a hazy, "I'll talk to other nurses and important people and let you know".  The Chinese lady from Magic Hospital who was at the meeting with me told me that Chinese people are reluctant to make any definite answers for risk of being wrong/having to change it, which just screams at me as ending a meeting without all the important stuff being worked out.  Its hard to get used to, but hopefully all those important people will realize that a volunteer program with no volunteers isn't very useful it will work itself out.  It will be interesting to see what happens!

Pingyao

Adam, Alison, and I went to Pingyao this weekend, a small town in Shanxi Province east of Beijing.  Pingyao's claim to fame during the Ming and Qing dynasties was its banking, the first draft banks in China.  Today its famous for still being stuck in the Ming and Qing dynasties, as it was deemed too small and insignificant for the government's mass modernization programs, and thus managed to keep its old architecture and city walls intact.  

One of the main streets of Pingyao Old Town

A Ming dynasty courtyard and room

In some ways, there is value to being old, or to representing the past in how you look or how you do things, so that people can learn from and about the past.  Certainly trying to purge everything old and start anew, as Mao tried to do in China with the cultural revolution, risks losing many valuable memories and lessons from prior peoples and customs.  At the same time however, its impossible not to move on, people can't live in the Ming dynasty and in 2010 at the same time, so some of the juxtapositions are quite strange.  Gigantic 5-star glassy hotels just outside the ancient brick and earthen city walls…barefoot people whizzing around on electric bikes right next to horse-drawn carts…incredible dust and palpable coal soot in the air due to rampant coal heating…dirty children playing in the dust with chickens instead of being in school…grotesque religious imagery in a place devoid of fervour and filled with tourists...

Some statues which can only be representing hell...shudder

In some ways it would be good for Pingyao to move into the future a little - certainly better for the lungs of the inhabitants - after Pingyao, Beijing pollution looks sunny!  Its hard for me to see how the children of a village so stuck in the past can plan to move onward into modern things and ideas, but perhaps it was just hard for this foreigner to see past the coal dust to the true heart of 21st century Pingyao.

The back of the Wang Family Mansion outside Pingyao

Pingyao at its prettiest - at night, with lanterns flanking the shopfronts

Pingyao here we come!

My boss suggested that I take my parents to Pingyao when they come for Christmas, but the scheduling didn't work out...so instead I am going with Adam and Alison this weekend.  Pingyao is a UNESCO world heritage site in Shanxi Province, and is supposed to be a time-warped image of old China.  There is an ancient city wall, residences, temples, and a 1400-year-old underground castle!  We are doing a hardcore weekend trip: overnight train Friday night, arrive Saturday and sightsee, overnight in hostel, sightsee Sunday until 6 pm when we catch the overnight back to Beijing to be at work on Monday morning.  I will update with pictures and stories when I return!