Gearing up to tackle health issues in China

Michelle Lu, Public Health in China, Summer 2014

The last three weeks in Beijing have been eventful and fun! Last week, for our Public Health in China class, we visited a local CDC and hospital to learn more about the public health system in China.

Instead of having one central CDC like in the US, China has several levels of CDC: national, provincial, and local. Part of the reason is because China is so big, and when faced with an emergency outbreak, this system is faster at identifying the source of an outbreak. I thought this system would be very inefficient because of the lack of communication between so many different offices, but to my surprise, China has a fairly effective system in place. Every CDC is required to send updates and therefore the spread of different diseases can be tracked in real-time online. We visited the Xicheng CDC in Beijing and learned a lot about its day-to-day operations and some of the logistics of tracking a disease.

Xicheng CDC

Here’s me all geared up and ready to collect samples for suspected respiratory diseases! Don’t I look dashing?

The day after, we also visited a local hospital in the Xicheng district of Beijing. The hospital itself was a lot smaller than I expected, but very well organized. I think the aspect that was most surprising for me was the inclusion of a whole ward for traditional Chinese medicine. Our presenter for the day emphasized the fact that patients in China have a lot more choice in their hospital care, which I found very interesting. Patients can choose their own physicians as well as choose between being treated with biomedicine, traditional Chinese medicine (TCM), or a combination of the two.

The different choices available at the pharmacy incorporated into the Xicheng West Hospital:

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Memories and Smog

Joseph Hsieh, NU in China, Summer 2014

Two weeks have passed like a whirlwind. We visited many places, ate a variety of foods, and learned much about Beijing’s history and culture. While the days may have slipped away like the wind, the memories and experiences are here to stay like the Beijing smog.

We visited Tiananmen Square and the Forbidden City on our first Saturday here. Aside from the grand buildings and historical artifacts, we also witnessed a colorful sea of umbrellas and “umbrella hats” as crowds of people fill up the square. It was a beautiful day with the air pollution level much lower than usual; the sky was actually blue! Seizing on this rare opportunity, we climbed up Jingshan Park (景山) north of the Forbidden City. From that vantage point we could survey the entire awe-inspiring panorama of the Forbidden City complex and much of Beijing.

The Forbidden City

The next day we had the famous Peking duck at Quanjude (全聚德), a restaurant serving the delicacy since 1864. The chefs sliced the duck meat right beside our tables, showcasing their years of expertise. The skin was crispy and the meat juicy. Wrapped in a thin slice of steamed pancake (春餅) with some scallion, the Peking duck did not disappoint. After the scrumptious meal, we watched a variety show at LaoShe Tea House (老舍茶館), featuring “face-changing” and “Chinese yo-yo” among many other jaw-dropping performances.

Delicious Peking Duck

Two weeks have passed like a whirlwind. I have experienced so much in this short two weeks already. Similar to the Beijing smog, my memories are blurry and fuzzy, even overwhelming at times. But like the pervasive blanket of smog covering Beijing, I hope to continue to be immersed in the culture and vibe of the city.

Mapping the city

Jeffrey Bilik, Public Health in China, Summer 2014

Where to start. It’s been almost two weeks now since I’ve arrived in Beijing, and there’s been so much packed into the last few days. Friends back home are asking me to describe the city to them, and it seems to possess so many contradictory characteristics all at once; sprawling and spread out in low-rise “hutongs” (alleys), but tall and imposing with massive malls and ‘hyper’ markets. A city that preserves its traditional culture in places such as the central Forbidden City, but features modern subway systems, diverse neighborhoods, and growing ex-pat hotspots. Some nights awe-inspiring in the sheer magnitude of lights, images, screens – and sometimes just glazed over with deep smog. Even in wealthier and more Westernized areas such as Wudaoko, you can find dozens of local street vendors setting up makeshift shops under an elevated road. Another aspect that sticks out is how many people here (especially older adults) do outdoor activities – morning Tai Chi, or just moving to the radio in parks, playing music, and singing.

So far the program itself has been great. Our Politics and Economic Development class went to the National Museum, where some of these contradictions could be even seen in Beijing’s official account of its history, moving so quickly from Maoism to the much vaguer ideas of a ‘harmonious’ and ‘moderately prosperous’ society. All of us visited Tiananmen this weekend too. It was so clear that you could see the entirety of the city from the nearby park’s hill, a huge conglomeration between the mountains.

There’s so much more to say – and I’m still taking the city in, but so far I’m really impressed and hope to get more chances to explore and meet a few locals. (The food’s not bad too! Family style hotpot might be a little much for a hot Beijing summer, but it’ll be the best meal you’ve shared with friends.) Can’t wait to see what the next few days here will bring!

Approaching Public and International Health from a Global Perspective

Pooja Garg, Public Health in China, Summer 2012

My experience with the Public Health in China program has prompted numerous exciting conversations and reinforced friendships. As I was interviewing for graduate schools this past year, I was able to talk about how my study abroad experience strengthened my communication skills and enabled me to think of healthcare delivery from a global perspective.Screen shot 2015-02-25 at 12.25.32 PM

The immersive, field-intensive aspects of the program still stick out in my mind. As a part of the Public Health in China course, we visited the CDC branch in Beijing, and met with health care officials who were happy to answer our questions. They talked about the major public health issues currently afflicting China. There is a growing incidence of cancer as a result of pollution and smoking, as well as increasing obesity rates and high rates of mortality due to traffic accidents.

As China is rapidly industrializing, it faces health issues similar to America. Access to health care is also a major issue, since about 50% of the population lives in rural areas, according to the 2010 census report. While Beijing is certainly not rural, the immense population must face long lines and crowded hospitals when trying to seek care. During our visit to the Peking University First Hospital, I remember thinking that the waiting area looked more like an airport, with masses of people waiting in seats and providing paperwork to different agents. Doctors commonly work for 14 hours straight seeing patients.The Peking First Hospital had some very useful common aspects. In the picture below, a patient is seen printing out her blood test reports at a health kiosk. These kiosks have a high degree of utility since patients can independently check their reports quickly and efficiently.Screen shot 2015-02-25 at 12.25.45 PM

Traditional Chinese medicine was another class that had memorable field trips. We learned different TCM techniques, such as acupuncture and were able to practice these newly learned techniques on each other (but not without a little pain). We learned about how TCM and Western medicine can have a collaborative purpose when used together. TCM is rooted in centuries of ancient Chinese practice and is an integral part of home practice. Home remedies are passed on through generations.

 

Traditional Chinese Medicine Classes

Liang Gu, Public Health in China, Summer 2013

This is a post about my experience in Traditional Chinese Medicine classes. For other parts of the study abroad TCM experience, please refer to:

TCM Theory 

TCM Field Trips and Herb Collecting

The TCM class replaced the Public Health in China class that took place on the first month abroad. The TCM class will last for about 4 weeks and counts as 1 credit towards the Global Health minor. The class usually meets 4-5 times a week in the afternoon, and 1 or 2 of those days will be a field-trip (sometimes to the TCM museum, sometimes to the Beida medical school). The professors rotate to teach different aspects of TCM, and at the end of each professor’s rotation will be an assignment to complete before the end of the program (usually an open-ended essay).

In class we learned the different techniques of TCM, including acupuncture and moxibustion (针灸), massage (推拿), cupping (拔罐儿), and Qi Gong (气功).

ACUPUNCTURE AND MOXIBUSTION

Our acupuncture and moxibustion unit was very hands-on; immediately after walking into class we observed that our professor had a toolkit with him with mysterious contents. Halfway through class he opened it and took out some acupuncture needles. That’s when I knew things were about to get interesting.

He gave us a brief history of acupuncture including the tools that were used back in the days (it makes me cringe to see how thick and dull the needles used to look like), and the theory behind acupuncture. TCM established the body’s theoretical model for acupuncture – 12 regular meridians, 8 extra meridians, 15 collaterals, and 361 extra meridian points could all be targets for acupuncture. Moxibustion, on the other hand, uses a lit moxa stick to hover over specific areas. The moxa produces a gentle heat that warms up the flow of Qi.

Savannah getting moxibustion treatment

Not long into class, the stabbing and burning began.

Not to worry – it was all voluntary and for the sake of learning! He showed us a few key acupuncture points and what they were good for. I myself received a needle to my Zu San Li, an acupuncture point 3 inches down from my kneecap because I was complaining of lacking energy. The professor inserted the needle first shallow, then deep, and after wiggling it around, I felt strange numbing sensations on my scalp. After the needle I didn’t feel sleepy anymore – but that may have been a natural response to getting stabbed! Several other students also volunteered and the response was mostly positive.

Seeds were used to apply acu-pressure to the ear; parts of the ear also corresponded to various parts of the body, and specific pressure on the ear could have remedial effects.

Peter receiving acupuncture in the abdomen

Needle in the Hegu (acupuncture point)

Ear acupressure diagram and theory

Savannah receiving acupressure on her ear

The interesting thing is, the ticklings sensation from the acupuncture is felt not locally, but at another distant part of the body. However, only about 60-80% of Qi channels are close to nerves, and there is no visible evidence of the channels themselves. This is known as the meridian phenomenon. Perhaps future research will elucidate this aspect of TCM.

MASSAGE (TUI NA)

Next we were introduced to the therapeutic massages, or Tui Na. Tui Na literally translates to “push, pick” or “push, pull.” Tui Na in general refers to the massage, but there are also specific techniques within Tui Na, such as kneading, brushing, rolling, pressing, pinching, hitting, and vibrating. Tui Na also targets the meridians and the places where Qi accumulates in the body in an effort to free up the flow of Qi and to reduce Qi stagnation.

Massage train!

 

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Neiguan acupressure point for hiccups

Pro-tip: Here are some of the most useful pressure points I’ve learned about. If you want to stop hiccups quickly, find this spot on your wrist and apply medium to heavy pressure to it for about 20-30 seconds.

If you get a head-ache, apply pressure here

Hegu for headaches

If you have a stomachache, apply pressure here:

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If you feel tired, apply pressure here or here (about 2 inches below your knee)

Zusanli for more energy!

CUPPING

We were also briefly introduced to cupping, a technique that uses the vacuum generated by the air cooling inside of a cup to apply suction to certain parts of the body. The cupping unit was more of a show-and-tell, with our professor performing the technique at the clinic on volunteers as she talked. The theory behind cupping is more or less the same as acupuncture and moxybustion, to free up the flow of Qi and prevent blood stagnation.

Cups used in cupping

Cupping in action

QI GONG

Finally, we were introduced to the breathing exercises of Qi Gong, which has its foundation in Chinese martial arts. It attempts to align the breathing through movement and meditation to foster healing. If you ever wake up at 6AM and decide to walk by the lake or to a park, you will witness lots of people, especially the elderly, practicing Qi Gong. In class we followed a video showing us the forms and movements of some basic stances of Qi Gong. Our professor enthusiastically practiced alongside us.

Qigong in class!

Traditional Chinese Medicine Theory

Liang Gu, Public Health in China, Summer 2013

I will apologize in advance for the long post – even this is only the rough sketch of what the Traditional Chinese Medicine class will cover! In this post I will attempt to cover the theory behind TCM that we covered in class. For other parts, please refer to:

TCM Classes 

TCM Field Trips and Herb Collecting

The class on Traditional Chinese Medicine isn’t something you can just pick up on CAESAR; it’s taught in China by actual TCM practitioners and professors of the medical school of Beida. In other words, this is the real deal. In class we are introduced to the theory, practice, as well as a brief history of TCM. However, the class is a crash course at best. TCM as a profession takes tens of years to master, but we attempted to cram the theory as well as application in the short period of one month. The professors rotated constantly, each introducing us to specific subjects such as theory, acupuncture (needling), moxibustion (therapy through burning the moxa stick), or tuina (massage).

CORE THEORY

TCM in China is not regarded as a “complementary” or “alternative” form of medicine. In fact, a stroll through major cities in China will take you to hospitals that are exclusively dedicated to TCM (known as 中医院). The theory behind TCM is formulated through thousands of years of experience. The central principles of TCM revolve around the concept of “qi” (气) and the balance between Yin (阴) and Yang (阳).

“Qi,” for the lack of a directly translated English word, is the manifestation of energy in all matter. Yin and Yang are the manifestations of Qi. Yin is the substance that gives the material basis to Yang, and Yang is the function that consumes the Yin. TCM stresses the harmony between the Yin and the Yang to achieve health.

Sickness in TCM is believed to be the disharmony of the Yin Yang dynamic. As can be observed from the Yin Yang symbol, the waxing of one inevitably leads to the waning of the other. However, an excess or deficiency of one of the elements will cause normal body functions to break down. An example diagnostic: Yang excess is usually caused by stress, over-exertion, or hot natured food and can lead to fever, reddened tongue, increased heat production, and increased body fluid consumption.

The Yin – Yang Symbol

 

TCM does not focus on the reductionist view of identifying the cause of a set of specific symptoms and locating the exact manifestation of the disease, but instead tries to restore balance to the body’s own immunological functions.

THE THEORY OF THE FIVE PHASES

In TCM there are five elements: wood, fire, earth, metal, and water. Each element has certain symbolic properties that correspond to the five major internal organs. The heart is fire, the lungs metal, the spleen earth, the liver wood, and the kidney water. The five organs are related to each other through the symbolic relationship of the five elements: water checks fire, fire checks metal, metal checks wood, wood checks earth, and earth checks water. Some of the organs also are believed to perform different functions than what is known through biomedicine. For example, the kidney is believed to perform a vital role in reproduction.

This is the theoretical model of TCM governing the human physiology. When a disease occurs, the practitioner will attempt to identify the organ that is affected, followed by the disharmony (imbalance of Yin and Yang) and prescribe methods to help restore the order (acupuncture, moxibustion, tuina, herbs, etc), targeting the other organs in relation to the five phases.

THE THEORY OF THE CHANNELS AND MERIDIANS

Channels and Meridians on the human body

In TCM, the Qi is believed to flow throughout the human body. However, there are concentrated paths of Qi known as “Jing Luo,” or meridians. The meridians are believed to be physically unobservable channels in the human body that energetically connects all parts of the body to each other. The concentrated parts of Qi are places that are targeted by acupuncture, moxibustion, tui na, gua sha, and cupping.

ADVICE REGARDING CLASSES

A word of caution: do know what you expect from class, especially those pre-medical students. This class will be drastically different from the biomedicine that you have been exposed to for most, if not all your life. There is lots of knowledge in TCM that do not have a direct scientific explanation that would satisfy your curiosity – a lot of things are the way they are simply because they’ve always been and it works for practical purposes. Don’t treat your time in class as a dichotomy between Western and Eastern medicine, but try to think about it as a different take on the philosophy of medicine. Let this experience enhance and not challenge your view of health.

Traditional Chinese Medicine Field Trips

By Liang Gu, Public Health in China, Summer 2013

This is a post about the field trips that we went on as a part of the Traditional Chinese Medicine class. For other posts, please refer to:

TCM Class 

TCM Theory

For once or twice a week during class time, we would meet a little earlier after lunch to board the bus to go on TCM related field trips. Most of the time our destination was the Peking University Medical School, where we would visit the TCM department and the professors who were there would give us a lecture. I will briefly describe some of the more notable field trips that we have been on.

 

Traditional Chinese Medicine Museum

For one of the afternoons we visited the TCM Museum, which was on the Beida medical campus. Our tour included two floors, one containing items detailing the history of TCM and the other, a collection of TCM herbs. We had a very knowledgeable tour guide accompany us on the way. On the first floor, we learned about the important historical figures of TCM, including the TCM practitioners who were responsible for various inventions, such as the figure of acupuncture points.

Acupuncture points and meridians

Acupuncture needles in the ancient days. Look at how thick they are!

The second floor contained all kinds of medicine in the TCM arsenal. Some of them were not too surprising, including Ginseng, mushrooms, barks, and herbs. However, some remedies had us wide-eyed or gagging, including preserved deer fetus, calcified dog stomach, and very large centipedes. The visit was eye-opening in that it contrasted western biomedicine’s factory-produced pills to TCM’s remedies found in nature.

 

Ginseng

Deer fetus

Not the most appetizing

TCM Clinic

For one of the field trips we visited the TCM clinic, which was located at the medical school. After a brief tour, we arrived in a large room that had beds on one side of the room and equipment on the other. One doctor showed us Tuina, cupping, and acupuncture techniques while the other doctor saw his regular patients who arrived for therapy. It was very interesting to observe first-hand the daily activities of the clinic. People arrived complaining of back-pains, headaches, and irregular bowl movements, after which the doctor usually stuck them with a few needles and told them to let the needles sit for a while. The entire visit took no more than 20 minutes.

Electric acupuncture

We were directed to practice Tuina and cupping on each other, and a few of us also volunteered to receive acupuncture. There is a picture of Peter lying down with needles in his abdomen for better bowel movement (which, according to him, worked wonderfully).

The Northwestern Tuina experience

Herb Collection Trip

The herb collection trip was perhaps the most memorable field trip. It was during one of the last weeks in Beijing, and the trip was not limited to students in TCM class. We took the bus for around 2 hours and arrived at a hillside with a small village, where we were greeted by some friendly locals who ran a restaurant there. We hiked to an abandoned part of the Great Wall that was not open to tourists through a trail surrounded by nature. Every few steps, either the tour guide or Professor Gu would stop and explain what herb they’ve just located, match it to our list of herbs, and explain what disorders it treated.

Professor Gu with some herbs

Our hike took us to the actual wall itself, and the view on top was unbelievable. We were surrounded by miles and miles of green, without any civilization in sight. In the middle of the platform that was the wall was an old man who was selling fireworks. How he ever got any business was beyond me, but being as adventures as we were, of course we had to buy some fireworks and light them there. The setting was surreal, us sitting on top of an abandoned portion of the Great Wall of China, surrounded by new friends and traditional Chinese herbs.

Around lunch time we came down the mountain and went back to the restaurant. We caught our own fish out of the pond, and lunch was served. After lunch we had to each present one of the herbs we collected on the trip to the rest of the class, drawing an end to a memorable experience.

Peter catching some lunch

Connor presenting his herb

Elaine with fish

A Trip to Make Every 10 Years

Kingsley Leung, Public Health in China, Summer 2013

I think I’ve been cheating a little bit. Even after the program ended, I was still hanging out with friends that studied with me in Beijing. I met up with them in Hong Kong. Connor had planned to stay with me in Hong Kong for the first week, so we got to be roommates for one final week before he went back to Beijing for his fall study abroad program. Also, some friends from the Wanxiang Program had been backpacking during our closing weeks in Beijing, and their final destination was Hong Kong, so I got the chance to see them again before they left for the States. With Jeff joining us in the middle of the week, it did not really feel like my program ended at all.

Who could forget Jeff? So glad he joined us for our Hong Kong adventures.

It wasn’t until after I sent Connor off in a very sad farewell that nostalgia began to hit me. On the bus ride back from the airport, my mind ran through the past two months, and I felt like it was impossible – how did this program lasts two months? It felt like two days, even though the memories were so numerous and so important to me. My time in Beijing passed by much too quickly…and it is just a testament to what an incredible time I had there.

Sending your brother off to study abroad for 3 more months is no easy feat.

The most phenomenal thing is that learning Chinese and public health was part of all that fun. While having dinner with my family, I was happily reciting the Chinese poems and sayings that we learned in Chinese class. I still remember the massage techniques that we learned from traditional medicine. While the classes could sometimes get very challenging and tedious, it was very rewarding. It also helped that my fellow classmates were so much fun to study and hang out with.

Our TCM class knew how to have fun.

That’s what it all comes down to – the people that I’ve met there. The classes may be fun and the school was amazing, but ultimately, the friendships and connections made are what I’ll remember for the rest of my life. I could have easily just hung out with the people I knew before, but I’m really glad I got to know everyone else on this program, because they are all phenomenal people. I cannot wait for our reunion at school.

Last day in Beijing spent at Beihai Park…it was pretty wonderful.

So far in my life, I have visited Beijing two times – once when I was 10, and this year at 20. I have for that these trips have acted as a summation of what I have done for the past ten years.  I was  I have absolutely no doubt in my mind that when I’m 30, I’ll find my way into Beijing again. I know it’ll be drastically different from this trip, as this trip was from my previous one, but I have no doubt that the fond memories will remain, and that others will be made in this wonderful capital that is Beijing. 再会北京! Until next time!

Until next time Beijing! I can’t wait to see how both of us will change in ten years.

Final Reflections

Liang Gu, Public Health in China, Summer 2013

I am currently in my hometown visiting my relatives. After the end of the program, I decided to stay in Beijing for a few extra days to meet up with a friend. Whenever I had free time, however, I found myself at Beida because the area was familiar, almost as if it’s my home. When I was on the crowded subway that I used to take with friends from the program, I felt empty and scared; for the first time I looked around the subway and didn’t see anyone I know. Despite the place being crowded to the point of suffocation, I felt alone.

Portrait artist on the street!

I spent most of my three days daydreaming about the past two months; the places that we visited, the adventures that we had, and the lessons we learned. I remembered meeting everyone for the first time, being scared that my roommate was a stranger instead of Peter, meeting our language buddies for the first time, going to class for the first time, and our first dinner together when we overpaid by more than 150 kuai because nobody expected for the meal to be so cheap! I walked around and visited Beida, our dorm, and our classes. As I did, I remembered the first time I set my eyes on everything, and everything still looked the same, but felt different. Sure the program itself was fun, but it was the people who made it special.

Wumei, the convenience store that we visited throughout the 2 months

In my three days after, I found myself reading street signs and building names without any trouble. I used to think 2 months was too short to make any significant improvements on my Chinese, but I was wrong. I also saw numerous phrases that we learned in Chinese class including poems and Confucian sayings, and I felt much more culturally aware than before the program.

The front door of Beida, look at the amount of people lining up to get in! I felt privileged every time I whipped out my Beida ID

So future Study Abroad students, look forward towards your fulfilling experience abroad! Put in the effort to make new friends and make every day worth it!

TCM – A Lesson to Understand Myself

Kingsley Leung, Public Health in China, Summer 2013

Traditional Chinese medicine (TCM) is something that has been part of my life for as long as I remember. Ever since I was little, terminology and theories regarding traditional medicine were used in my household as easily as families in America will talk about the common cold or aspirin. When I had a cough I would drink soup made from ginseng. When I had canker sores in my mouth it was because I had too much yang. I applied special Chinese medicine made by my grandfather if I had a bruise. I had drank many bitter medicine and boiled cola for a variety of sicknesses. All of these may seem very bizarre to my friends in America, but to me they were a very simple part of my culture. It was what I did when I was sick, even when I knew I had modern medicine. In fact, often times when I felt like one type of medicine would not work, I would just switch to the other type. One was never more effective than the other for me – it just depended on the circumstances.

That was why I had wanted to take a class on TCM. I wanted to be able to explain what exactly it was about certain herbs that made them effective for certain situations. Why did my mom ask my sisters to perform “gua sha” on her when she felt sick? What was it about sticking a needle into specific points in the body that helped ease a person’s pain, when it seemed like that very action would cause pain? Especially since I had grown up in the American culture, surrounded by Western medicine, and I was learning about the scientific method in school, I needed to understand the theory behind TCM. Surely, trial and error produce the knowledge that it held, but has it ever undergone extensive peer review or experimentation? This and more I had hoped to find out here in Beijing. This class was personally important.

I loved the field trips we went on for this class. We got first-hand experience on many of the methods that we were studying in class. One of my favorite field trips was a trip to take a lesson on the massage method “tuina.” After a brief introduction, the professor jumped right into the different ways to massage and why they were done, and then allowed us to experiment on each other. While it was very fun and occasionally silly, it also felt very authentic and real. I understood the methods so much more when I was applying it on others than when I was just simply reading it out of a book. What better way to learn about TCM than to actually practice it?

At the end of the course, I felt like I had a much firmer grasp on the theory behind TCM. However, I wasn’t sure if this knowledge had led me to put any more or less faith in the power of TCM. On the one hand, there is evidence suggesting that this sort of treatment does work, in terms of its healing effects on patients. However, the theory in which they based the medicine on is extremely abstract, and very difficult to prove scientifically. This shows, of course, a very sharp cultural difference between more traditional times, where methods were questioned less, and modern times, when all theories must undergo the scientific method in order to be deemed legitimate. While I believe cultural integrity is important, I also think it is important for cultures to change and adapt with time. If it does not do that, modern medicine will eventually sweep traditional medicine away from the world, and a great part of the Chinese culture will be wiped away. Hopefully traditional medicine will adapt along with the modern world so it can achieve a new age.

 

Some of us stayed behind class to have our teacher give us a TCM check-up!

This is where you insert a needle for shoulder problems…

TCM class in the hospital