Week 10 (The Final Post)

At 5:30am on Tuesday, Graham and I crammed in a small Chinese van with Jin Shu, a doctor, a nurse, a driver, two staff members, and a reporter and cameraman from the Jilin TV station. We spent the day traveling to the rural towns, speeding by flattened corn fields and rice paddies, dilapidated and mud-filled cinderblock homes, wide-eyed farmers, and distressed families. We delivered supplies and performed a few minor procedures for a small clinic that had been devastated by the recent flooding. Although my purpose here is public health education—and I have no emergency medical skills—I was grateful for the invitation to join the team, even if the most that I could do was carry a few boxes and offer condolences in shaky Chinese.

Unfortunately, after a five day reprieve, heavy rains came again on Thursday. The bridges closed, and Jin Shu allowed many staff members to leave after lunch. However, we were awakened by sunny, cloudless skies on Friday morning, and everyone is optimistic that the worst is over.

In two days, we will fly to Shenzhen and cross the bridge to Hong Kong, where we will spend our last few hours in China (or perhaps I should say Asia, since few mainlanders or Hong Kongers say the city is truly Chinese).Yesterday, I spent the morning writing notes and preparing the American pins, pens, yoyos, books, candies, Beanie Babies, and other trinkets that we bought for the staff at the Clinton Museum store in May.

As we shopped for these goods in Little Rock and have collected gifts for family members back in the States, Graham and I have discovered that it is truly more blessed to give than to receive. We are well aware that the “perfect” watches, tea sets, mugs, and wallets that we are so sure that our family will love may be discarded as souvenir junk in a few months. After months of laughing at awkward translations on advertisements, warning signs, purses, and clothing, the matching t-shirts with cutesy creatures and sappy sayings will remind us of nightly walks through the city, trips to the crowded market, and dinners with friends from Bo Hua. Our friends back home, however, will probably just think that they are ridiculous.

The departure from Jilin will be bittersweet—with much to miss, yet much to look forward to in the months ahead. Although there is little that we can do to aid the flood victims, something seems wrong about leaving before the crisis has been resolved. The “I’ll probably never see you again” goodbyes are always clumsy, yet we sincerely anticipate returning someday (once Graham has finished his residency and I have a real job).

We have been blessed by the kindnesses here. While I hope that I have contributed to the systems of public health education and the planning for the new diabetes center, I am well-aware of the hours of work that have been done by Jin Shu, Li Wen Gu, and Ms. Wang just to make life possible for us. I won’t simplify or exaggerate the experience by trying to identify the impact that the past 10 weeks will have on my life in the years to come. But I know that I will always be grateful that these few months were a part of the journey.

Week 9

The worst floods in a decade have hit Jilin province, and according to the English news sources, anywhere from 29 to 928 people have died and over a quarter million people have been evacuated. Several rural villages have been wiped out, destroying homes and crops, and carrying livestock down the Songhua River. Apparently, CCTV (the state-sponsored television network) has arrived in town and is reporting on the event, but they are not giving many numbers to prevent too much panic. I think the lack of information may have the opposite effect.

According to my sources at Bo Hua, the River is regulated by a series of dams, and the local mayors have been hotly debating how much water should hit their cities. The federal government stepped in to resolve the problem, sending troops from a nearby city to maintain order and care for refugees. They are opening dams, but because of fears about the increasing pressure, most of the bridges (all of the ones closest to us) will be off limits until August 3. Banks, post offices, and other government buildings are closed.

Still, we feel fairly insulated from the chaos. Limited language skills keep us from eavesdropping on the crowds that line the river each evening and listening to speculations about the long term impact on the region. Our location in the city is relatively high, and although the flooding has submerged all of the paths, parks, picnic grounds, and festival tents that we frequent along the Songhua River, it still has about 10 feet before it reaches street level in our section of town. As I sit on the 6^th floor of the hospital, I can hear fireworks, announcing a new marriage, motorbikes scooting through the street, and the hospital staff conducting business as normal. Hospitals have been ordered not to perform surgeries because of concerns about the cleanliness of the water, but the inpatient and outpatient departments appear to be running smoothly. I am continuing to prepare a Power Point on the quality and cost-efficiencies of diabetes centers that I’ll be sharing with Jin Shu and the hospital planning/marketing department next week.

But I cannot stop thinking about all of the lives that have been ravaged over the past week. Families have not only lost all of their material possessions, their entire livelihoods have been destroyed. I cannot think of a single that I can do to help, except sending up a prayer for their safety and peace.

Week 8

A confession. I should not have boasted of an “I’ll-eat-anything” approach to international cuisine. I cannot stomach hardened ox blood, anything that is still alive when I put it in my mouth, or the packaged pig’s ear and thirty other unidentifiable meat products in the corner market. The stir-fried ear in Shanghai wasn’t bad, but I something about slimy red vacuum-sealed pieces of animal that I just can’t handle.

Last week, as Craig and I sat down for dinner at Bo Hua (Graham was away—he had been kidnapped by a local surgeon to attend a conference in Changchun, but that’s another story), we saw the typical plates—dumplings, stir-fried leeks and eggs, and a typical spiced-chili dish. (Just in case you are still worried about Graham—I promise, he’s okay, but when he jumped in the doctor’s black Audi, we expected him to return later that day, not later that weekend.) The first two were delicious, and we shoved our chopsticks on the third plate and began to chow down. The dish was heaping, filled with julienned strips of something tough and rubbery. It was impossible to chew; I realized that I simply took each bite, moved it around my mouth for a few seconds, and then forced it down. Craig speculated that it was some kind of mushroom, and I thought maybe a weird version of hardened tofu. But the flavor was good—you can’t go wrong with oil and chilis here in Jilin—and having just returned from a long walk, we easily downed the whole serving.

When we brought the dishes to the kitchen, we asked the chef what we had just eaten. “Mo gu? Dou fu?” (“Mushroom? Tofu?”) Neither of us could understand his explanation, and it was not until he began pointing to his arms that we realized that we had just inhaled an entire plate of cow’s tendon.

I admit—cow’s tendon is definitely not the most bizarre food in China. And obviously, we had survived the texture and enjoyed the taste. But usually, when I eat something abnormal, I feel that I have full control of the situation. I prepare myself mentally and physically and take a bite or two, just to add it to my “Yeah, I’ve eaten that” list. But something about knowing that my belly was full of tendon was disturbing. Moreover, Craig and I had been completely oblivious. We hadn’t even been able to determine whether what we were eating was an animal, vegetable, or a fungus.

In light of the zillions of delicious meals I have enjoyed, it seems unfair to dedicate an entire post to a bad experience. If I had to choose between life with Chinese food and life with American food, Chinese food would win hands down. I’m loving the fact that I’m served three delicious meals each day, and I think that I’m going to have a much more difficult time adjusting back to my kitchen than I did to the “cafeteria food” at Bo Hua Hospital. I have become accustomed to rice with every meal, and I had no clue that there are so many ways to cook eggplant, cucumber, and celery. Even the pea and red bean popsicles have grown on me—and some nights they even beat out my typical peach and date frozen concoction.

Week 7

International experiences feel unforgettable. How could I fail to remember practicing my “rip stick” (yes—I do mean those flexible skateboards ridden by third grade suburban males) skills in the shadow of Mao Zedong, surrounded by four-year old speed skaters and Koreans dancing to “Jingle Bells”? How could I forget dinner with surgery director Dr. Zhang and his team, toasting everything from my husband’s future career as a “famous American doctor” to the Chinese language to the day when Dr. Zhang’s son has dinner at our home in the States?

But the truth is—many of these experiences will soon be hidden away somewhere in my memories, maybe to be recalled by a familiar smell or taste, maybe to be lost forever. We will share stories with friends, and retell them to family members as we show pictures and give gifts. We will write about our trip in applications, essays, and reports, and ask Chinese-American friends if they have every visited Jilin City. But soon, names and faces will begin to fade.

But there is one name, and one face, that I will not forget. Jin Shu came of age just as the Cultural Revolution was ending, and was one of the 1 or 2% of high school graduates in the late 1970s to attend college. After graduation, she was assigned to a job in the country, but when she decided she’d prefer to move back to Jilin, she quickly (within a week) found and married her current husband to obtain a new residence permit. She then spent nine years working in a chemical plant, until she grew frustrated with the company, who, unlike most state-run businesses at that time, did not providing housing for its workers. After working with her husband for a few years, they decided to open their own restaurant. Tired of the long hours, Jin Shu gave the restaurant to her brother and founded the Bo Hua Heart Hospital, one of only about three private hospitals in a city of 4 million.

Her story of success is not typical. Jin Shu is not a member of the Party, and she refuses to accept or give money under the table. But she is willing to play the game. On Sunday night, we ate dinner with her and the head of a government agency who were meeting to discuss a recent incident at the hospital. To make a long story short—the government had originally fined her 100,000 RMB (6.8 RMB = 1 USD), but by the end of the night, she was confident that the fine would be greatly reduced. She explained to me that she doesn’t consider him to be a friend, but here in China, they have the kind of relationship where they help each other out.

As the CEO (and default CFO) of a hospital, Jin Shu knows all about the bottom line. But she also knows about compassion, justice, and mercy. By offering screenings for Christians, ethnic Koreans, and rural farmers, she seeks ways to expand and improve her operations while also expanding access to the most vulnerable populations.

Most people that we meet ask us if we like China. Many people say that they think Americans have misperceptions about their government and people and they hope that we will return home and tell us what a great place China is. Jin Shu says that China still has many problems, and she wants us to have a realistic picture of life here. She is cautiously optimistic about the future, grateful for the significant strides in human welfare that have occurred since her youth but worried about excessive economic growth and materialism.

Jin Shu says that she thinks that Chinese and Americans have much to learn from each other. I know that I have much to learn from her.

Week 6

Graham, Craig, and I traveled south for the weekend to hang out with three Clinton School classmates spending the summer in Shanghai—Becca, Trenia, and Mircha. Not only did Becca and Trenia house and feed us—in only three days, they gave us enough good stories and serious laughs to fill an entire summer.

In the early 20^th century, Shanghai was known as the “Paris of the Orient” and with the emergence of capitalism on steroids since the end of the Cultural Revolution, it has become the preeminent symbol of wealth and consumerism in China. Mammoth Louis Vuitton and Armani shops line Nanjing Street, and luxury cars of every shape and style cruise down the congested streets, barely avoiding the throngs of scooters, bicycles, and taxis.

To showcase its economic status and solidify its standing on the international stage, the city is hosting the largest and most expensive World Expo ever until the end of October—with over 192 countries represented. Each country has constructed a pavilion to represent their culture and style. In the interest of not waiting in line all day, Becca, Graham, Craig, and I made it our mission to walk past all of the pavilions—and only journey inside if the line was either nonexistent or continuously moving.

With only a few short breaks to eat ice cream cones, curried ostrich, mutton wraps, fried squid, and mango iced tea, we spent six hours wandering through the site, which covers 5.28 square kilometers. The architecture was fascinating—from Japan’s purple mounds topped by a pair of gigantic antennas to Mexico’s field of thirty-foot rainbow colored mushrooms to Germany’s geometric industrial complex to Spain’s two-story lumps covered by Pringle-shaped woven baskets to India’s golden mound of grass surrounded by red brick waterfalls.

From my travels, I’ve found that sometimes the most memorable cross cultural experiences are what I would call the “Three Worlds Colliding” phenomenon. These are the moments where it’s not just me, the American, interacting with you, a Chinese person. It’s the moments when another foreigner or unexpected influence jumps in the picture. When I came to China, I was ready to experience American meeting China. But when you throw another language and culture into the mix—that’s when you feel globalization first hand. Those are the moments when the world feels so much smaller, yet so much more interesting, than you ever imagined.

The entire expo was one of those “Three Worlds Colliding” experiences—more like the entire world colliding along the Huangpu River. We watched a Burundian drum performance and a Vietnamese percussion ensemble, Becca practiced her Spanish with a Chilean guard, and we oohed and awed at a water and lights show set to classical European orchestral music.

Another classic “The World IS Flat” traveling experience occurred at 3:00am on Monday, July 12. Although I must confess utter failure as 2010 World Cup fan (I just haven’t been able to make it through the 10:00pm games, much less stay up until 5:00am), we showed some serious commitment to the final match. After spending a rainy morning at the Shanghai aquarium with the masses and rocking our bodies through a traditional Chinese cup massage, we took a quick late night nap before walking from Becca and Trenia’s apartment to the Dutch Cultural Center. Arriving 25 minutes after kick off and without a piece of orange clothing among us, we were serious Dutch posers, to say the least. Nevertheless, the endless cries, gasps, and screams from the crowd kept me up through the night.

Week 5

On Sunday morning, Graham and I walked along the Songhua River, across one of the four bridges that connects the east and west sides of the city, and into small but prominent Catholic cathedral. The church faces the river and sits next to a busy roundabout, which circles a classic Communist statue—peasant worker atop a twenty-foot red pedestal. According to the plaque in front of the church (which marks it as a local historic site), it was built under the supervision of a French priest nearly 100 years ago. It was damaged during Mao’s Cultural Revolution (c. 1966-1976) but has since been restored.

We arrived shortly after a service had ended and wandered among worshippers gathering on the lawn before we entered the church. I’m no expert in medieval architecture or French Catholicism, but I have seen a few European cathedrals, and this fit one the mold. The statue of Mary, paintings of a blonde-haired, blue-eyed Jesus, confessional booth, hymnals, rosaries, vaulted ceilings, and stained glass were all there.

As a person of faith, I’ve struggled to learn what it means to be a follower of Jesus here in China. Compared with 30 years ago, religious believers are remarkably free to read their sacred texts, gather publically, and openly express their faith. However, all citizens who attend church are listed on a government roster of Christians. This identification effectively limits their ability to advance in society, since they have no chance of ever joining the Communist Party. Most Christians are uneducated and poor, and the vast majority are women. As a form of community outreach, Bo Hua Hospital offers free health screenings for members of local churches, knowing that they otherwise may not be able to access and afford these services.

In the United States, and especially down in the Bible belt, politicians and business leaders claim a religious affiliation for a step up in society. In China, announcing your faith takes you a step down. However, the country has been shifting from anti-religion to slowly affirming some of its Taoist and Buddhist spiritual roots, as leaders recognize that belief systems encourage social stability and morality. Being faithful follower looks very different in this culture and socio-economic system. The one-child policy, cutthroat education system, rapid economic growth, swiftly shifting cultural norms, and political system raise questions about integrity, justice, love, and faithfulness that I have never had to ask.

It makes me despair to see that missionaries of ages past defined faith as a type of architecture, painting, and style of music, rather than a life of love and peace. Yet, when I hear my Chinese friends talk about pursuing a life of purpose beyond personal achievement and hedonist pursuits and when I see people embracing life together, supporting one another, and reaching out in love to their community, I have hope that there is a way to bridge the cultural divide and share our common beliefs, hopes, and experiences.

Week 4

Jilin is not a hot spot for Western, or really any non-Chinese, tourists. I’ve seen three non-Asian people since I arrived—two girls with matching braids and long skirts, and one guy in a hair salon getting a serious mullet. China may not be the fantasy travel destination for most American tourists, and I doubt that Jilin has made any “Top 10 Places to See Before You Die” lists. But during the past few weeks, I’ve been convinced that maybe that needs to change.

Here are a four reasons that Jilin should be your next vacation destination.

1. Family-style dining. Who hasn’t agonized over trying to select the perfect dish at a new restaurant? You know you’ve been torn between your old favorites and the delectable, innovative adventure described on the menu. Who hasn’t sat at a restaurant and envied a neighbor’s meal as you force down a subpar dish—that was more expensive than that close, yet so far gem. Here in China, you never have to make those choices. Every meal is eaten family-style—plates crowd the center of the table for a small group, and they spin around a lazy Susan for easy access for a larger party. You’re never committed to a single dish, and if you find something you love, you can take as much as your chopsticks can handle.

2. Fireworks. If you love firecrackers and cheap fireworks, this may be the place for you. Every new restaurant and shop announces its grand opening with a quick round—and you can hear them frequently throughout the day.( I’ll admit, that I was a little worried when I first heard them, but I was quickly reassured: “No, those aren’t gun shots.”)

3. Public Dancing. There’s a comedy group in the US that regularly organizes choreographed dances in public places just to bring a smile, and perhaps confuse, the people passing by the mall, train station, or other selected public space. (They’ve documented their work on YouTube—which you cannot access in China, but may be able to find if you are stateside). Here in Jilin, public dancing is no joke, and it’s definitely not out of the ordinary. Pick your flavor—line dancing or traditional Chinese dancing? Modern clothes or classic costumes? Ancient instruments or guitars, drums, and the occasional piano? Even though it’s not surprising any more, it still brings a smile to my face.

4. Dogs. I do not have a dog, and I do not want a dog. If you have a dog, I’m sure that I love it, and I want to pet it every time I come to your house, but I have to admit, that the dogs in my neighborhood in Little Rock have made me resent those furry friends more than ever. But Jilin is changing all of that. All of the dogs that I have seen are extremely well-behaved, and moreover, especially cute. Even though leashes are rare, I’ve never been barked at, chased, or otherwise harassed (as I am every time I walk by my neighbor’s monsters on Pine Street). And although I do like the look and potential usefulness of a large dog (see Disney’s “Iron Will” or Jack London’s “To Build a Fire”), I prefer to interact with smaller critters. I’ve seen one husky here, but most of the others may be pushing four or five pounds.

If you still aren’t convinced—just ask me directly, and I’ll give you a compelling reason to book Jilin for your next international experience. (Just make sure you fly into Changchun, since there’s not actually an airport here.)

Are you in Memphis? Come to Jilin—it’s much cooler in the summer.

Are you into locally grown foods? Come to Jilin—it’d be tough to eat any fruits or vegetables that are not grown in this country.

Are you an early riser? Come to Jilin—the sun is up and waiting for you by 4:00am.

Do you want to learn Mandarin? Come to Jilin—it’ll be tough to find many people that speak English, and you’ll be forced to work on your language skills.

Are you stressed and overloaded at work? Come to Jilin—there’s an hour for “resting” after lunch, and the work day ends at 4:00pm.

I’ll admit that these reasons may not all be unique to Jilin—other regions of China share similar features. But this is a good place, and I’m right where I want to be.

Week 3

CCTV, state-sponsored TV station

Temple of Heaven, Beijing

I returned to Jilin on Monday morning at 7:15am after a weekend in Beijing. We took the overnight train-- not a bad way to travel for a 12 hour trip.

If you asked an American to name Chinese tourist attractions, I bet that most of them would be in Beijing—Tiananmen Square, the Great Wall of China, and maybe the Temple of Heaven. The Ming Dynasty’s Imperial Palace, more commonly known as the Forbidden City, is also there. Built in 1420, it has all of the opulence and luxury of Louis XIV’s Versailles, in an entirely Chinese style.

With 17 million residents, it is the largest city that I have visited. From what I have heard, it has transformed in the past 20 years. To prepare for the 2008 Olympics, the government pumped billions of dollars into development and infrastructure. Despite the smog, the city has avoided turning into a concrete jungle by maintaining trees along most major streets, flowered walkways beside canals, and expansive parks for tai chi, martial arts, and the occasional group of elderly polka dancers.

There are many more Westerners in Beijing than in Jilin—mostly tourists and businesspeople trying to get a piece of the excitement and expansive growth in capital city. It’s about as crowded as you would imagine; car owners are only allowed to drive on specified days (which are marked on their license plates). Many of the main streets are divided by small white fences to protect the pedestrians who would otherwise ignore the specified crosswalks.

One of the more bizarre experiences on the train occurred shortly after I boarded my car on Sunday night. To pass the time before climbing up to my third level bunk, I was reading a book (thanks to David Monteith) by a journalist who studied abroad in China as a college student and later returned to the country as a reporter. Just as I was concluding a chapter about a certain government crackdown in 1989, and the journalist’s subsequent arrest and expulsion from the country, the book was pulled from my hands. I looked up to see an unsmiling policeman standing above me, who proceeded to spend several minutes flipping through the pages. Of course, I immediately began envisioning the hours of intense questions and preparing my responses to the authorities—“No, I didn’t buy the book; it was a gift. No, I’m not involved in politics, and I don’t even know anyone in the government.” He closely examined the few pictures, and then pointed to the one white guy on the cover. I then pointed to the name of the author written across the bottom. He never spoke to me in English, so I had no idea whether he could understand anything that he saw or read. Finally, he shoved the book in my hands and walked away.

He probably saw a white girl on the train and was curious, like many of my fellow passengers. Just a few years ago, I would have been considered a threat to the system and the party, but these days, the government spends much less time worrying about the negative influences of 24-year-old American students. The political, social, and economic transformation that has occurred in China over the past 30 years is incredible. Everyone—including the people—are still trying to figure out the good, the bad, and the ugly from these changes. The impact of the most significant factors—from membership in the Party to the one-child policy to state-sponsored media—is not always obvious to Americans who cannot speak the language and who bring very different assumptions about “the way things are.” But, through watching, listening, and talking with my new friends, it has been fascinating to try to understand.

Week 2

I’m sitting on the top floor of the Bo Hua Hospital listening to Korean pop music to prepare for our next trip to KTV (a.k.a. karaoke) with the hospital staff. Karaoke is a big deal here in China. Just in case you are ever invited to KTV, you should know that your group will have its own personal room, complete with microphones, a large flat screen TV, and a smaller touch screen that you can use to can pick your songs and adjust the volume. Don’t worry if you can’t read the Chinese characters—you’ll recognize plenty of artists, from the Backstreet Boys to Michael Jackson to Avril Lavigne. But if you really want to be cool, you’d better brush up on the latest Korean stars. And don’t be surprised if the meekest and mildest members of your group transform with a microphone in their hands. I have never seen anyone sing to the Backstreet Boys as passionately as Dr. Jin, a internal medicine doctor here at the hospital.

When I’m not doing karaoke, attending the Dragon Boat Korean Festival (photo: Korean dancers waiting to perform at the Dragon Boat Festival in Jilin City), or eating some type of cucumber, I am continuing to prepare for the public health plan that I hope to create for the hospital. The health issues facing Jilin City are a little different than the ones in Little Rock. On one hand, many people already do many of the things that doctors, trainers, coaches, public health leaders, and even Ms. Obama with her Let’s Move Campaign, are begging Americans to do. Most eat more than five servings fruits and vegetable and avoid processed foods. Biking and walking are the most common forms of transportation. Along the Songhua River, which runs through the city, there are “playgrounds” for adults, complete with monkey bars, stations for stretching, and my very favorite—something very similar to Tony Little’s “Gazelle” exercise machine (I apologize if you’ve never seen the infomercial, but if you have, you know you’ve wanted to try it. It is as fun as it looks.).

On the other hand, many basic health practices are ignored by the majority of the population. Hand washing, even after doing you know what, is rare. 75% of men, and an increasing number of women, smoke regularly. Calcium deficiency is common, and high levels of sodium cause dangerously high blood pressures.

But, just like in the United States, there are plenty of smart people who know what people should do to live healthier lives. The challenge is turning that knowledge into action—through education, encouragement, empowerment, and policy changes. At this point, I’m focusing on gathering that information, and perhaps providing some models from other countries and other regions that we can use here at Bo Hua to educate the patients.

Jilin City

Week 1

According to the White Pages, there literally thousands of Johnsons in Little Rock (of a approximate total of 184,000 residents). Johnson is the second most common surname in the United States. In the twenty three months that I have been a Johnson, I have grown accustomed to meeting and working with lots of other Johnsons. To be a Johnson in Little Rock—really, a Johnson anywhere in the United States—basically means that you’ll blend in with the crowd.

But being a Johnson in Jilin is a little different. It implies standing out, not fitting in, especially for a taller than average white girl, who can only count to ten and say “Thank You” and “Hello” in Mandarin. There are lots of Lees and Lius, but I have yet to meet another Johnson, or find someone who can pronounce my first name.
No matter how much time I spend here, my name is not going to change. I’ll always be American-born and bred, and even if I learn to speak like the natives, I’ll never look like a local. But for now, I am here to learn—and to enjoy tofu, squid, pickled cabbage, and rice soup, to stroll along the river at night watching old woman play hacky-sack and teenage boys play badminton, and to hear the stories of the doctors and nurses at the Bo Hua Hospital. I am here to learn what I can bring and give and take in this new place with new tastes, new smells, new faces, and new friends.

Since I arrived on June 9th, I have scrubbed in to watch a few surgeries, visited a traditional medicine clinic in a rural village, watched a teenage girl receive acupuncture, and toured three hospitals. I am trying to take in as much as possible before actually making any recommendations or doing any real work for the hospital here. I am still at the steepest part of the learning and adjustment curve and eagerly anticipating the weeks to come.