Great Chinese Signs Strike Again! :)

A sign in a park in Mangshi - I'm not exactly sure how to do that!

Lijiang Old Town was full of helpful tidbits of advice for tourists...this was among the funny ones.

You can have orderly rubbish, just not messy rubbish.

Stepping on the grass is a life and death matter, didn't you know?!

My favorite so far - my name plate at the 70th Anniversary Party for the Gejiu Hospital - it says 'American Expert'!  Haha!

Chinese Thanksgiving

The last several days have been filled with Thanksgiving activities, despite not being home for family festivities.  At work, all the Chinese students were very curious about Thanksgiving; I guess they have heard about it on American TV but don't really understand the reason behind the tradition or how people celebrate.  Adam and I did our best to explain, both about the tradition dating from the pilgrims to the more modern opportunity for families to get together and be thankful for each other and for what we have, and Adam brought in a pumpkin pie to share that he made (it was fantastic! - and the Chinese students thought so too!)

On Thanksgiving night here, some of the other Fogarty students in Beijing and I went to a thanksgiving dinner at an American Diner in Beijing.  They were advertising an American-style thanksgiving dinner, and while it was not as good as my family's recipes, it was decent and nice to have appropriate food on the actual date.  They also had quite nice wine on the table :)

Dinner at Lily's American Diner on 11/25/10

Yesterday, was my actual Thanksgiving however; I hosted a potluck dinner with Fogarty people (mostly American), people I have met through Lara who are in Beijing studying Chinese (mostly foreigners not from America), as well as a few Chinese students from our office.  I have recently acquired a mini oven, so I was able to bake a few Thanksgiving mainstays, namely pecan pie and broccoli casserole, with many substituted ingredients and last-minute adjustments, but they turned out in the end.  Alison made a yam bake, and other people contributed tasty dishes as well.  I also managed to buy a turkey from the diner we had been to on Thursday, so our Thanksgiving feast was pretty authentic!  It was a really good time, it was fun to introduce our traditions to so many people who had never experienced it before, and the food was a hit with everyone.  After eating, we sat around talking and enjoying each other's company and playing games.  It really felt more like the Thanksgiving I was missing at home than going out to eat on the actual day.  

Our Thanksgiving potluck feast

And I now have quite a bit of leftover turkey to eat...hot browns anyone?? :)

Yunnan Recap

 I have pretty much written about my entire Yunnan vacation with the exception of my last day in Kunming, the provincial capital.  It was actually more stressful than necessary due to my excursion across town to see the Bamboo Temple, which had about 500 extremely lifelike statues of arhats, or wise men.  Unfortunately, I was unable to find a taxi willing to bring me back across town afterwards, and the minibus driver that I finally found got lost and had to ask for directions twice and eventually shoved 10 RMB at me and told me to get out of her bus!  It would have been funny except at that point I was stressed about making my plane back to Beijing…but it turned out fine, and I have a new appreciation for Beijing taxi drivers,  as they do not blink an eyelash at hour to two hour long slogs across town, where I had trouble finding one for a 20-minute hop across Kunming!

 I made it back to Beijing around dinner time, and a really nice Chinese lady and her daughter who sat next to me on the plane offered to bring me home, as they live quite near me.  We chatted in broken Chinese in the car on the way back, with many pauses for frantic dictionary looking, but it was a pleasant end to a long journey.  Even nicer was being greeted by dinner when I came back - Lara is still at my apartment for another week and had cooked up a feast to greet me!

 Overall, I had a very fun as well as productive time in Yunnan: I met some people essential to my research, got one of my projects back on track, and got a dataset I can actually analyze.  On the fun side of things, I saw an entirely new part of China that was very beautiful, had clean air, and was not nearly as cold.  I also met some nice people along the way, something i feel happens easier when traveling alone.  I saw more of rural China than I have seen so far, and caught glimpses of the farming life as I cycled through the fields or sped by in buses or cars.  I also now appreciate the government heat in Beijing; it is actually hot in my apartment right now, whereas in Yunnan, although the outside temperatures never drop as low as they will here, temperatures in the 40s at night are quite enough for a cold bedroom!   

As nice as traveling always is, it has been nice to return to Beijing, to my own bed and space, to a good friend waiting for me, and to a work and everyday life routine. 

Please check out the Picasa web album below for pics from my entire Yunnan trip!

Lijiang

Lijiang Old Town

Lijiang is a small maze of cobblestone streets about 175 km north of Dali, and it has about 4 million tourists a year.  Its apparently the UNESCO world heritage protection list, although when the Yunnan government wanted to build a big amusement park just north of town UNESCO threatened de-listing.  Its true - there were many tourists - even some fellow-foreigners - and much of the town was the same 10 shops over and over again, but there was a certain quaint charm about the winding old stone streets and rickety-looking buildings that still made for a pleasant stay.

Two waterwheels at the north of the Old Town

Lijiang from above

On my first day in the area though, I headed off by bus to see the Tiger Leaping Gorge, one of the deepest gorges in the world, with the mountain peaks about 3900 m above the waters of the Jinsha River.  The whole gorge measures 16 km long, and I was excited to hike about 4 km of it at the beginning, just to have some amazing views and to say I'd trekked in the gorge, before turning around and heading back to catch the last bus back to Lijiang.  I met a British boy on the bus from Lijiang to the gorge in the morning, Scott, which turned out to be the saving grace of the day, since we never managed to find the hiking trail!  When we got off the bus, we were 'taken straight to the trail' by a local trying to scam us into riding some horses...and then we walked on the road towards the trailhead on the map...and walked...and snagged a ride with another mini-bus, who took us to the point on the map where the trail branched off, and then promptly told us the trailhead was 2 km behind us!  We walked back, at least next to the Gorge on the road by this point...asked a couple people, and was told the trail branched up just past that car...and there were no signs.  We walked up the road for about an hour, and finally gave up when the trail gave no sign of actually going along the Gorge in the right direction.  We ended up returning to Lijiang together, despite Scott's original intention to sleep in a guesthouse along the trail, and had dinner at a Tibetan restaurant back in Lijiang.  I did manage to still see the Gorge, it was stunning, and I met a really nice guy who I talked to a lot, so it was altogether not a terrible day anyway!

Me in Tiger Leaping Gorge

Ancient pools in Lijiang town - the top is for drinking, middle for washing vegetables, and bottom for washing clothes

My second day in Lijiang I spent wandering the town, saw the Black Dragon Pool Park which is the spring for the town's ubiquitous canals, and spent a lovely hour inside the most well-done museum I've been in so far in China - a tiny free one about the locally dominant minority group, the Naxi.  There were many rooms showing their costumes, their pictographic language (the last still used in the world), their religious ceremonies (very nature-centered), and their methods of subsistence.  I also got some of my Christmas shopping done!  That evening after an enjoyable dinner I caught the night sleeper train back to Kunming, the provincial capital.

Black Dragon Pool Park

Naxi traditional clothing

Dali

Last Tuesday, I parted with Dr. Qiao and Adam to do a few days of sightseeing in northwest Yunnan by myself.  I took the overnight train from Kunming to Dali, an ancient town which ruled part of southeast Asia under a kingdom called the Nanzhao Kingdom, ruled by the Bai people, who are today still a substantial minority in the area. Dali was the end of the famed Burma Road, which served as a supply line for Chinese troops blockaded by the Japanese during WWII.  Today, it is a quaint little oldtown which has the added bonus of still having real people living in it, with real jobs and several schools.

Dali Old Town with Er Hai Lake in the background

I had a very full day on Wednesday as I arrived at 6 am.  I stayed at a hostel called the Jade Emu and I must give them a shout-out for letting me check-in and have my room at 7 in the morning!  I then took a cable car up the nearby mountain called Cang Shan, which had spectacular views overlooking the town and the large lake, Er Hai Lake, on the other side.  I spent about 5 hours hiking up and down little creeks, a gorge called 'the Cang Shan Grand Canyon' and seeing little temples and caves.  I actually ran into a party of French people and spent most of the day with a guy named Emmanuel with whom it was fun to practice my French!

Zhonghe Temple on the top of Cang Shan - remarkable for its painted wood carvings on the door panels

Picture taken by Emmanuel on the path around Cang Shan

In the evening I descended the mountain by cable car and walked around in the old town, did some shopping and got some famous Yunnan coffee at a little Tibetan Cafe.  Apparently Yunnan is quite famous for its coffee, and it was indeed the first real coffee I've had since moving to China.  I actually ended up getting Indian food for dinner at a little place called Namaste, which was awesome - its the closest I've ever been to India, after all!

Old Town Dali on a busy street

The next day, I took a bike from my hostel and biked down the hill to Er Hai Lake.  After one minor disaster with getting off the bike (I've never ridden a racing bike before, with the high bar - good thing I had a helmet on!) and getting lost several times, I managed to make it to the lake and had some pristine views across the water to some pagodas on the other side.  I even had the pier to myself for several minutes!  After biking back uphill, I got a bus towards Lijiang, my next destination in Yunnan.

Er Hai Lake

Burma...almost

On our last day in Mangshi, we started out in a Chinese operating room and ended up with our backside's in Burma!

 In the morning, we accompanied Dr. Zhang and Li Rong (my Fogarty twin, also a gynecologist in Chongqing) to the operating room to observe a oophorectomy (taking an ovary out) for a tumor.  It was interesting to see because of the differences yet fundamental similarities between the OR in China and in the US.  All of the differences were due to lack of resources, which all combined together to make undergoing an operation a scary prospect, but definitely still better than living with a potentially fatal cancer.  There were still a surgeon, a first assist, and a scrub tech (who was verbally abused by the surgeon, just like at home!).  They ran through a quick checklist before making the incision, although there were no nametags or wristbands on the patient.  The patient was awake with spinal anesthesia due to the cost of general anesthesia, and could definitely still feel her abdomen up to about 2 minutes before the incision.  There were no intra-operation fluids, no antibiotics, and in general, nothing invasive on the patient other than the actual operation.  There were MUCH fewer operating tools; apparently they  have no autoclave so all the scalpels, clamps, etc are thrown away after every surgery.  And lastly, the most noticeable thing was that the room looked just like every other room in the hospital: dingy, poorly lit, and with bad ventilation; it just had a operating table and light in the middle of it.  Definitely no positive pressure here!  However, the tumor was successfully removed in about half the time it would have taken at home, and as far as I know the patient is doing well.

After our 2-hour 'workday' our boss whisked us off on a car trip to Ruili, a small town on the Burmese border.  We went to a park in the middle of nowhere with a very tall waterfall, and in typical Chinese fashion, had about 2 minutes to look at it after taking nearly 2 hours to get there!  It was very impressive however.  After that, we went to the major checkpoint between China and Burma - we could see a huge building with a Burmese flag waving, and a small stone boundary marker.  Dr. Qiao seemed determined to get us onto Burmese soil, and the Chinese border guards, after scrutinizing our passports, said they would let us over, but they weren't sure the Burmese would let us back.  Adam and I decided not to risk it - being in Burmese prison is not on my to-do list for this year!!  But we did get to stand on the border next to the marker and take pictures - so I'd like to think my backside was in Burma!

 We spent the rest of the day making short touristy stops on the drive back to Mangshi - 2 more china-burma border checkpoints, all of which were equally unwilling to let us pass, a Dai village with houses completely made out of interwoven wood strips with holes everywhere (good thing it does not get cold there!), and multiple jade and petrified wood shops.  The Dai are a minority that are from the southern chinese-burmese border area, and they have different language, housing, holidays, etc from the dominant Han people in China.  In fact, there are nearly 20 minority groups who hail from Yunnan, and I will learn about a few more of them over the course of my trip!

Mangshi Workday

 After driving back to Kunming with much less to-do than on the way there, we flew to Manshi on Saturday evening and were met by officials from the hospital.  They took us  to an awesome Yunnan restaurant which was all outside, under individual thatched roof bamboo huts, and the food was the best Chinese food I've had so far.  A wide variety of tastes, including fried silk worms and purple sticky rice were all surprisingly good!

The next day we went early in the morning to the Mangshi Women and Children's Hospital, who are going to be the host of one of the projects I am working on.  In brief, HPV is a virus which causes cervical cancer, which begins as a small irregular cervical lesion and works its way up to cancer in a small percentage of cases.  It has been shown that women with HIV develop more cervical cancer than other women, which makes sense if you consider them as having little to no immune system to fight off the HPV virus.  However, it is not well known what the affect of antiretroviral therapy has on the evolution of HPV infection in HIV-positive women.  The study in Mangshi is going to be a small comparison of groups of HIV-positive women, some with experience with ART and some without, and we will compare the incidence and evolution of cervical lesions and cancer over the course of one year.

It was interesting to see the course of the preparations for the study.  In the morning, they had a planning meeting for the study, and there were actually patients present to give their input on the procedures.  I feel like at home the hospital and visiting scientific experts would not have an important meeting to plan details of a study with patients present!  They might have the patients present later, for an information meeting, but the details between the involved contributing parties would already be resolved.  

 Another step for me with this project is that Dr. Zhang, the gynecologist from Kunming who will be overseeing the actual clinical work of the project, has already done a small pilot study in Mangshi.  She wants my help to publish her results and actually gave me the data to work on!  This is the first real data I have seen in China so I am super excited for this opportunity!  Dr. Zhang seems really nice and I'm excited to get to work with her as well as Vik, from the VIGH at Vanderbilt who is the foreign PI on this project.

 Over the next few days, prepare for more of a travel journal as work temporarily ceases for some vacation in Yunnan!