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skittykittie · 8 years ago

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Kaiyuan to Jianshui

July 30, 2015 (written on the day)

My alarm went off at 7. I actually was able to make myself get up and make it down stairs for group breakfast... but it was only me, Jessica, and Sophie. Little by little, everyone else was getting too lazy to get up early to eat. Our hotel didn't provide breakfast, so the three of us got the task of finding a decent local place to find something to eat.

Luckily, Jessica was able to spot the entrance to a local farmer’s market not too far from our hotel. We walked across the street (through crazy traffic) through a small gap between the strip of stores and businesses. I couldn't tell from the outside, but the entrance led into a huge farmer's market. They had set up all behind the strip of buildings. There was plenty of fresh and hot food as well as vegetable and meat stands.

These were definitely where the locals came. We passed by a lot of people on bikes with baskets of their fruits they had picked. There were families that were shopping for the day's ingredients. We walked around a bit until Sophie found a rice noodle shop she liked. She ordered from there, and Jessica and I got some steamed buns for ourselves and the rest of the group. It was so cheap! Only 1 yuan (about 15 cents) for one bun, and they were big buns!

When we got back, it was time for our morning routine of putting all of our stuff into Dr. D's room, transferring all of our equipment for the work day downstairs, and checking out of our rooms.

It was a nice morning so I decided to walked the short distance to the hospital with FangQi, Jess, Zhangrui, Landy, and Sophie. The streets were much more alive than the evening previous. I'm starting to get the impression that these smaller Chinese towns really like the "the early bird catches the worm" saying.

Once at the hospital, we were warmly met and welcomed by the hospital staff, most of which we had met the night before. At the entrance of the building was an rolling banner of LED lights that read, "Kaiyuan welcomes the China California Heart Watch!" Wow. These people really knew how to impress.

The meeting with the head director and co was equally as impressive. We were brought to a large conference room with a huge table that was able to accommodate our whole team of 10 and their staff, who I didn't count. We were served tea in glasses, instead of plastic cups. They also introduced themselves one by one, making us do the same. There was applause after every person was introduced. Their head director spoke before we started our proposal and conditions for work, and it seemed as if he had memorized and pre-rehearsed it. Maybe he was just very articulate? I'm not sure, but it was pretty professional. Lastly, at the end, they had the typical photo taking with Dr. D and the directors, but they had them take it in front of another room where there was already big screen with a fancy background set up.

Kaiyuan really, really, knew how to welcome us.

We separated into our clinic and training groups. Clinic was set up on the pediatrics and OB/GYN floor. I don't actually remember how many patients we saw that day. Maybe 7 or 8? Half of our patients were infants, less than a few months old, making our job fairly simple. A lot of them didn't have much of a problem, some were just follow ups.

There was one family in particular that stood out to me that day. It was an 11 year old girl who came in with her parents. I could tell by her father's extremely dark skin and over worked hands and her mother's traditional outfit, that she was from a very poor family. As we interviewed them, Sophie and I realized they didn't speak Mandarin well. We had to get one of the other doctors to interpret for us. They had traveled hours from their small village to come into town to have her examined. They were also of an ethnic minority group, which explained why they spoke a different dialect of Chinese.

The reason this girl really stood out to me was because they were so extremely poor (well, most of our patients are) and she was very sick. We found several heart issues on her that were operable. With the funds and resources ChinaCal has, we were able to help arrange to send them to Kunming and accommodate her for surgery. They were worried because they had never been to Kunming and would most likely get lost, they were also worried about having to take time off work, but Shanshan and the other doctors helped work out a plan for them to get her the help she needed.

It is cases like this that make me remember why we are here and my motivation for coming in the first place. She is a prime example of what good all the donations went to. Many of the kids we see don't usually have anything direly serious wrong with them. Our purpose is to find and help the unfortunate few that do. I was extremely happy to see them get what they needed for their little girl. Without this organization, I don't think she would have ever even been seen for her issues.

Sophie and I finished well before 12 pm (our designated lunch hour), so we opted to go get a tour of the maternity ward. Similar to the NICU in Mile, we had to dress up in the whole gown attire. Unfortunately, this woman we toured with didn't realize I didn't speak Mandarin well. Sophie and I also didn't get a chance to really tell her, either, because she kept talking... and talking... But it was kind of cool to at least walk around. The ward was empty (thank Jesus), so there wasn't really anything for us to see besides the rooms and a little bit of equipment.

We hung out a bit longer, finding things to watch in the ultrasound room and the hallway. Pretty soon we went to lunch. Lunch was almost exactly like the day before, welcoming staff, lots of pre prepared food, and toasting. Most of us chose not to drink wine this time, though, including myself. My redness gets embarrassing.

When we got back, we had only one or two more patients to do an ultrasound examination on. The last child was one of those that was so afraid of the doctor's, he'd cry just by entering the room. He was really cute though, a little 2 year old boy. He had been so fussy before lunch that we told the family to go out, get him really tired, and come back after lunch. They came back and he was less fussy, his dad was carrying a large toy truck that was still new in the box. It was a cute attempt to try to calm him down, but he didn't care for it once we got him in the examination room. Poor kid.

I actually had to help with this one, he was so bad. He kind of reminded me of how I used to be with needles. We finally were able to get him to lay still and stop crying by playing a few episodes of Tom and Jerry that Jessica had on her iPad. It was like magic. He was mesmerized by the cartoon. His mom was also there next to him narrating the whole thing to him. It was adorable.

Once we were finished, we packed up and then... nothing. It was only about 2 when we finished. The training team had finished, too. We had 2 hours to kill while waiting for our car that would bring us to the next city at 4. I spent my time working on blogs out on this nice patio they had and watching the baby yoga and swim session.

What? Baby yoga swimming?! What's that you ask?

Probably one of the cutest things I've ever seen. It's an out patient service where parents bring in their babies to be given a thorough bath and let them swim around. Babies obviously can't swim, so what they do is put a round floaty right under their chin and around their necks. Then, the nurses have a huge sink of water, and let the babies float in there. It's seriously the funniest and cutest thing I had seen all trip. The babies are literally just floating heads. A lot of them really enjoyed it, they were kicking and swimming around, one even fell asleep. After their designated swimming time (maybe 15 or 20 minutes) the nurses would come over and give them a good washing. The entire team was so fascinated by this whole procedure. We stood at the viewing window taking pictures, video, and coo-ing over how funny they all looked.

Car came right on schedule at 4 pm to pick us up at the entrance of the hospital. I was confused at first because on the outside, it was just an ambulance van. But then the door slid open and I saw that it had been remodeled on the inside. There were enough seats for all of us, plus two extra! We were amazing able to fit every person and every one in that one van. It was also the most comfortable ride thus far. We each had individual seats, AC, cushioned with SEATBELTS (something that is not often seen in public transportation, let alone used at all in China).

This ride, I was less tired than before. I was actually awake for half of it, but that also could have been because the road was extremely bumpy at times. The road was very wound around the mountains, as well, causing me to get constantly bumped against the side of the van. Nonetheless, I was awake and able to watch the scenery. It was beautiful. We were finally IN the mountains, not just driving through them or by them. There were several turns where one wrong slip of the tire would mean us tumbling down a cliff.

We arrived at our next city Jianshui, our 5th city of the week, and it was only Thursday. We weren't greeted with a parade like Kaiyuan, but the hotel was extremely nice, the nicest so far. We had a western toilet (a valued commodity for Donna and I), a shower that was closed in (most showers just pour out onto the ground and everything gets all wet), a coffee table and a couch, breakfast was included in our stay... the only bad part was the wifi. It was terrible. I had to go out into the lobby to actually be able to use it at all.

Oh well, you win some, you lose some. We were staying there over the weekend, so I was extremely happy about that.

Around 7:30 we went out for dinner. We had to walk a bit to find a Muslim restaurant for Zhangrui's sake, but I'm so glad we did. We ended up at a place that had HOT POT. Even though it was the middle of summer, it was SO GOOD to have some real hot pot. I ate to the fullest I've felt all trip. I can't describe to you how amazing that place was. A group of people actually went back the next day for dinner again haha.

When we got back, our stomachs stuffed, Donna decided it was time to do laundry... by hand. She had brought soap to wash some clothes in the sink. Everyone in our group did it that way, too. My dad had told me to find a place with laundry service, but honestly, I couldn't find anything that said they had laundry service. The only place that had was my 5 star hotel in Kunming, and they charged, like, $2 per SOCK. Shirts and pants were even more.

Nope. I was going with Donna's plan.

We were going to be there over the weekend, so we'd have plenty of time to make sure our clothes dried. They had plenty of rails and a laundry wire where we both hung our clothes to dry. I also felt very safe and clean at this hotel, so I washed everything I could. It surprisingly did a pretty good job. Some of the water I washed in actually turned dark because of the dirt I was getting out.

After I finished that and showered, we got ready for bed and our last work day before our first "free" day!

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skittykittie · 8 years ago

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Mile to Kaiyuan

July 29, 2015 (written actually on this day)

Oh my gosh, my days are already starting to blur together. I began writing about today, but realized I was actually recounting YESTERDAY morning instead of today. (I even used the same words to describe it!)

Anyway~ This morning I woke up at 7:30, not feeling like going out to find something to eat. I had the sweets I had bought at the bakery from the night before so I filled myself with dantat and the sweet rolls with pork in the center. I know, so nutritious, right? I'm really not that into breakfast.

After finishing my snacks, Donna returned from breakfast and we packed our stuff. Like the day before, we put all of our things into Dr. D's room and checked out. We made our way to the hospital by about 8:15 am. As we drove through the city to the hospital, I was surprised that I didn't recognize where we were. I felt like I had seen a good portion of Mile when I came with Jason a few days before, but I guess Mile was larger than I had first thought.

When we got to the hospital, we were received by a couple of the staff on the first floor. We were taken up to a floor that was pretty empty. I'm not sure what the floor was supposed to be, but there was a large meeting room that suggested it was mostly used for more business than patient care. We were taken into this room for our meeting with the hospital staff. Though the arrangement of desks and chairs suggested that this room had not been used in a while (nor was it prepared for us, we had to arrange the tables and chairs ourselves prior to starting the meeting), and half of their staff came without white coats on, it still felt more "official" than the small cramped room in Luxi.

The meeting went similarly to the day before, Fangqi gave her proposal and the reason for our visit, they listened and asked a few questions, then the contract was signed. There was a lot of picture taking at this meeting. This seemed to be a bigger deal than Luxi.

Then it was time to get ourselves set up. Sophie and I got stuck in the hallway between the waiting room and the ultrasound room. It was alright, though, as long as it was away from the waiting room. We also had enough desk space to put our new toys, candy, and the triage equipment. Most of the patients we saw were babies, it was really fun yet challenging. Babies don't like it when you take their vitals. But the toys that Sophie and I had picked out proved to be fairly successful in distracting them! Good idea, Sophie.

A big difference between today's clinic and yesterday's was that the hospital staff was hovering over our shoulders. It was a bit annoying because I felt like we were being judged. They also didn't quite understand our system we had going and were sending us patients before we were ready. They were a big help with managing the sign-in list, though. They gave all the patients numbers and made a roster of the order of patients.

We got through most of our patients for the day before we were called in for lunch. It had been a busy morning, but it was nice to have a break. We didn't have to be back to see patients until about 1, and it was only early noon when we finished eating. One of the men that had greeted us that morning offered to take us around the NICU of the hospital. Most of us were extremely eager to see it, including myself.

Now, I had only been to two hospitals in China so far, but I had the impression they are less sanitary than American hospitals. However, the NICU was probably the cleanest place in the entire city. Donna even commented that it seemed more strict than the American NICUs (I've never been in one, so I can't agree or disagree). They didn't even let parents come in to see their child. Instead, they had cameras set up at each bed so parents could at least watch their child via video streaming. They dressed us up in pre-packaged and sanitized hospital gowns, put shoe covers on us (the shoe covers weren't even allowed to touch the ground in the entryway), we had to put our hair up and wear hair nets, face masks, and of course wash our hands up to our mid-forearm. All of these procedures were for the sake of reducing risk of giving the infants any other illnesses.

We were brought inside a large room with probably 20 small "baby cages." Many of them sadly were filled with infants. I have never seen so many newborns in my life. They were all so tiny and precious. Our tour guide was a nurse who worked in the NICU. Unfortunately, I couldn't understand what she said, so I just observed and asked Jessica questions when I could think of them.

We didn't spend a long time in the NICU since there wasn't much to see past that room. It was definitely cool to see, though. We exited back through the way we came, disposed of our protective gear, and headed back to the clinical site to see the remainder of our patients. In total we saw about 12 kids today. Many more of them gave me the impression of "village" people. I think it's because Mile is a bit more rural than the last place. Our last patient was a cute little boy, about 2 years old? He had a twin brother, too. They were so much fun. Sophie and I played with them once we finished triage.

Once he was taken into the ultra sound room, Sophie and I had a lot of spare time. Apparently our car to pick us up for the next place wasn't supposed to come for a few more hours. We spent our time in our corner talking about life. Well, mostly me answering her questions about college and life after high school. I'd like to think we bonded a lot during that time. I can tell she is a very driven kid, but still has a lot of years of experience to gain. I hope I can be a good example for her! Gosh, I'm getting old...

At 4:30, we packed up the ultrasound room and went downstairs. We were met by two cars, one regular sized one and one large van. I was ushered into the van with Dr. Li, Sophie, Landy, Fanqi, and Zhangrui. It was a bit squished, but somehow we were able to load all of our equipment and luggage that was at the hotel. We were headed to our next city called Kaiyuan. Despite being squished in the back of the van, I was able to sleep the whole way there. I don't even remember how long the drive was.

I woke up to the noise of the side door opening. Had we arrived? I opened my eyes, and all I saw was an aggressive looking Chinese man dressed in a military uniform staring at me, barking something that I didn't understand. I was confused because he was looking straight at me, but I had no idea why or what he was even saying.

All I was able to say was, "Huh..?" as I took out my earbud that was playing music. Thankfully, Dr. Li was sitting next to me and answered for me, "We're from Kunming." The others followed her example saying their respective cities. "Harbin." "Shanghai."

The guy glanced around our car and nodded, closed the door, and we were back on the road.

My mind took a moment to process what had just happened... we had gotten a car inspection. Wow. I guess they are pretty strict here in China. I'm glad I'm Chinese and he believed we were all natives. I wondered what happened to Donna's car. Did they stop them, too? Did she get interrogated? I was a bit afraid that would happen again in the future and I wouldn't be so lucky to get away with saying I'm a Chinese citizen.

I barely had time to try to go back to sleep because soon we arrived in the next city- Kaiyuan. Kaiyuan was beautiful. There was a beautiful view of the mountain sides when you looked down the street, and the city was fairly well kept up. We were in a busier part of the city, but I could tell it was overall more suburban than the previous two cities.

We checked into the hotel with a whole crew of hospital staff waiting to greet us! Wow. There were maybe 3 or 4 of them. They helped us unload the car and bring the luggage upstairs. Afterwards, they ushered us all to dinner at the hospital. That was good with me, I was starving.

We were loaded into a few cars and taken down the road to the Kaiyuan county hospital where we'd work in the morning. It was a pretty short distance, actually. I wish I could have gotten to see more of the city.

Anyway, we were led through the hospital cafeteria into the back where there were a number of private dining rooms. We entered into the largest one, where many more people were sitting, waiting for our arrival. They stood up and clapped to welcome us as we entered. There were 2 large round circular tables waiting for us with hot food and plates and bowls all set up for us. There were even a couple of waiters/cooks. Talk about a welcome party!

The hospital staff divided us all up, half of ChinaCal at one table, half at the other, and then did the same with their staff. I sat at the "foreigners" table with Jess, Dr. D, Donna, Fangqi, and Shanshan.

The food was delicious! It was the first not-muslim food I think I had eaten in awhile. We also had local wine to accompany the meal. And of course with wine came toasting and jingjiu*. I'm glad I had practiced this custom with Jason and his family in Mile. If not, I would have been so confused with what was happening. It was also slightly embarrassing because, like last time, I barely understood what people were saying when they toasted me.

It was still very nice, though. It created a lot of laughter and brought joy to our meal. I only had one glass of wine by the end of the night, but I could feel my face getting flushed as it usually does whenever I drink. It was slightly embarrassing, especially because one of the staff seemed to be taking a liking to my natural blush and kept toasting me to drink more. Donna told me after dinner she thought he was trying to hit on me.

...Awkward.

Anyway. After we finished dinner, the main hospitality guy took us around the outpatient ward on a little tour. He was very proud of this building because it was their newest addition to their hospital. It was pretty nice, though to me it kind of felt like a mall. It was very open in the center with escalators going all up and down the center.

We were able to go in to see their ultrasound equipment, too. That was more interesting for Donna than the rest of us, but we were able to get a glimpse into the patient care rooms.

After the tour, half of us opted to walk the short distance back to the hotel with our guide. I was one of them. I wanted to enjoy the cool evening mountain air. I was able to slightly keep up with the Chinese conversation, but half the time talked with Sophie about other random things. She told me that one of the staff members she sat with at dinner had invited her to see the maternity ward, and if there was a child birth, she could observe. She had asked Dr. D for permission to go after lunch, and he said yes. He also suggested to her I go with her... so... I guess I was going to the maternity ward tomorrow. I wasn't too thrilled at the idea of watching a childbirth and secretly hoped it would be empty when we went in.

We got back to the hotel and wrapped up for the day. We had work to do in the morning!

*Jingjiu: It is a Chinese tradition called jingjiu. It is when people take turns offering drinks to and for certain reasons, usually to one individual at a time.

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skittykittie · 8 years ago

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Luxi to Mile

July 28th, 2015

I can’t believe I’m already finding that the days are already all starting to blur together. We haven’t even had our first day of work yet… Anyway, the next morning I was woken up abruptly at 7:00 am for breakfast by my alarm clock. It didn’t take me long to get dressed and head downstairs to find breakfast. We were told that there would be breakfast provided for us, however, Donna and I couldn’t find the rest of our team (were they not awake yet?) nor could we find other guests. We asked the receptionist, but she kept telling us the same thing, “Go outside and around back there’s another building.”

We did that at least twice by the time 7:30 had rolled around. The building we kept being instructed to go to seemed closed up.

Finally Dr. D arrived and worked some magic - Pretty soon doors were opening for us into a room with a large round table. We were ushered in by hotel staff and seated. We were served an array of items, but all I wanted was my favorite youtiao and sweetened soy milk. An interesting observation I made while eating was that it seemed as though we were the only guests eating at the moment. To this day I have no idea if we were being privately served breakfast or the inn just wasn’t busy...

Anyway, in no time we had our stuff packed and we were taken in cabs to our first hospital. When we got to the hospital, I was fairly culture shocked. I had been prepared to see many things in China, however, I had never imagined that I would have to be prepared for the vast difference in medical care and facilities. This was not like an American hospital at all. The place was fairly crowded, and the building (inside and out) reminded me of a hospital in the mid-1900s. The nurses were dressed in all white and most even wore the old time hats that I don’t know the name of…

Very similar to this:

We were guided up some stairs and an elevator to a small classroom-like room where there were small brown stools set up in rows facing one large desk at the front of the room. At the desk sat an important looking man who stood upon our arrival. We were all asked to be seated wherever we pleased. I noticed that on top of each stool was a new water bottle for us to keep. As I sat, observing the interactions between our executives and the hospital’s, I couldn’t help but wonder what the rest of the day would have in store for us. But no matter, we had to first get through this meeting.

In case I have not already described, this meeting was the way we were going to start each day at each hospital we visited. The purpose for the meeting was to have our executives (namely Dr. D, Shanshan, and Fangqi, our PhD candidate) present the newly donated pulse-oximetry machines and sign an agreement between ChinaCal and the hospital for participation in the research study. I’m still not 100% sure about the details of this research, but it is largely Fangqi’s work for her PhD thesis. Essentially, ChinaCal is donating a new pulse-ox machine to hospitals and providing education on neonatal congenital heart screening to nursing staff for free with the promise that the hospital will report back to ChinaCal with their birth records data. The birth record data will include congenital heart screening results, as per the protocol that is to be given by our staff.

Long story short: these meetings did not involve me or the other clinical students whatsoever. We were just required to be present.

Eventually the room filled with nurses and other physicians. Introductions were made and the meeting commenced. It was fairly uneventful, especially since I had no idea what was being said.

Before long, we were setting up to see our first patients.

Sophie and I were given a medium-sized desk in the corner of a hallway to perform vitals. We had our papers straightened out and roles established. She did most of the talking since my Chinese is very poor. I did most of the vitals taking, since I was the student with the most experience recording vitals. We were a great team and rolled through our patients with little problems. After we finished with vitals, the patients would be asked to wait back in the waiting area. Then we’d hand off the patient papers to the ultrasound team, who would then image the children’s hearts. This day we saw 13 kids between the ages of 5 months - 9 years. It took us virtually all day (9-4) to do all of this (morning meeting, seeing patients, lunch break - which was catered for us, and more patients).

I was so beat by the last patient. Once Sophie and I were finished, we spent time talking and getting to know each other better. She reminded me a lot of myself when I was her age, but with a better sense of humor. We even got to see some of the ultrasounds being performed in the late afternoon. Donna tried to explain as much as she could as she was working, but I could barely comprehend what I was seeing on screen.

From this day, there was one significant encounter, one that I don’t remember well, but I have it in my notes from the trip. My notes say, “Today there was a father who brought in his son to be examined. Dr. D & Jess (the pediatric cardiology resident) had to tell him that his son has maybe 5 more years to live. His lungs were too weak to operate on his heart for much longer. Father of the boy started to cry…”

It makes me sad that I had forgotten about this event until I reread it in my notes from 2 years ago…

Anyway, once the last patient was seen, we were rushed out of the hospital by Dr. D & co and loaded into a small old bus. We were taken to the hotel to pick up our luggage and then immediately piled back into the car to head to Mile, our next destination. It was about an hour drive, but I slept for most of it…

When we arrived in the next city, I was surprised to see that I didn’t recognize it. This was the city I had been to with Jason just days before. I guess this was a larger city than I had initially imagined. It was definitely larger than Luxi, our first stop. The buildings were taller and streets more busy.

Our van eventually parallel parked in front of a wooden entrance. We unloaded, checked in, and were dismissed to our room until dinner. The first thing Donna and I noticed when we got into our room was that our toilet was a squat. Yup, no seat, just a hole in the ground. It was inevitable that this would happen to me at some point, I had to admit to myself. I had used a few already since being in China, but I was not thrilled to have to use them again. Donna was even more upset than I was. But glad to say, we both got used to it! I’m definitely no expert, but I am okay with the foreign concept.

We all gathered for dinner later that evening at a restaurant a few blocks away. The restaurant was of course, family style, and we all ate our hearts out. On the way back from the restaurant, we made a few stops. We stopped by a toy and candy shop to pick up some things for our patients to play with. Sophie and I had noticed that it was often hard to get kids to stay still for their ultrasound and vitals, so we made sure to get some noisy and flashy toys to distract them. We also stopped by a bakery, and boy do I love Chinese bakeries. I got a couple egg tart treats and a few other bread items to snack on over the next day. We also stopped quickly into a supermarket to pick up some water, batteries (for myself), and browse for snacks.

All the stores we visited were similar to the styles I have been noting in all of my experiences on the streets of Yunnan: Large open storefronts with no doors. Instead, there was simply a pull over door that would come down and lock like a car garage. I’m also starting to get a feel for how to navigate by foot through large Chinese cities! I’m not afraid to cross the street (which is more dangerous than it sounds since there are rarely any signs or lights for crosswalks in these smaller towns). However, I will never be as fearless as Dr. Detrano, though. He just marches across the street without even really looking. He does it so nonchalantly, as well.

When we finally got back, I went to my room, took a shower, and went to bed. I was beat and had to be up soon to do it all over again.

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skittykittie · 8 years ago

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Driving, driving, and more driving

July 27th, 2015. Arrival in Luxi

Today was… much less eventful than I thought it would be. Turns out it was a 7 hour drive to Luxi, our first destination. So once we all packed up and ate breakfast, we departed in two separate vans. (Don’t ask me who our drivers were or where the vans came from because I had no clue. In fact, for the rest of the trip, I didn’t question who, what, when, how, or why we were going somewhere… I just got in the car they told me to haha.

I ended up in a car with Donna, Zhangrui (the business side of the team), Sophie, and Landy (the latter two are the high schoolers in our team). The drive was fun because I got to practice Chinese with Zhangrui, the driver, and the other team members. We even got to pass through Shilin again, and I got to tell everyone about how I got to go to the Shilin park a few days prior.

When we arrived it was 4:30. We were assigned rooms, unpacked, and rested a bit, and re-grouped downstairs in the lobby for a team dinner at 6 pm. Dinner was a small restaurant just down the street from where we were staying. I was now getting pretty accustomed to the restaurant etiquette in China. You get a table, you send someone to order at the counter for the group, you sit down and are handed a small package of plastic wrapped (and sanitized) ceramic plates, cups, and chopsticks. Your table is given a boiling pot of water and an empty bowl to rinse all eatery (if you wish) with an extra dose of disinfectant. The food then comes out to you as it is prepared, on large plates, family-style. Speaking of food-- I can’t get over how different all the meals are in China. I don’t think there’s anything I’ve eaten twice yet!

After dinner we had a small meeting in the lobby of the hotel to go over the final game plan for the next day. We each went over our roles once more. Sophie and I had a little extra time together to talk about a few more things about how we wanted to take care of triage since we were given a sample paper of what forms we needed to fill out.

Soon it was lights out, we had to be up early for our first full day of work.

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skittykittie · 8 years ago

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The Orientation

July 26, 2015

{Disclaimer: Entries are going to be much shorter in places, for the sake of the hours of time I no longer have to detail them out… I’ve also forgotten many details since this is now 2 years late that I’m finally writing these. *sigh* I will still work to keep them high-quality, though!}

Jason and I had a very early start. My flight was at 7 am, but we didn’t actually leave the hotel until 6:10. I was nervous that I was getting to the airport with less than 30 minutes until my flight, but my host insisted it would be fine. However, we got to the airport and it was everything but fine. The check-in lines were much longer than anticipated. I’m so happy he parked and walked in with me, because his translation and familiarity of the airport saved me valuable seconds. Even then, we had to run and push past other travelers. There was even a point where Jason got into a small tiff with some security because he was trying to get me through the TSA lines as fast as possible.

That last obstacle we faced (trying to make it to my flight on time) was almost a perfect ending for our time together. I remember standing idly by while he rushed around from staff member to staff member to try to figure out any way to cut corners to check in. I felt very helpless. I realized he had done so much for me, and on such a short notice! He paid for my hotel, he took me out for 3 full days of adventure in his hometown AND to sites 2 hours away, he woke up at 5:30 in the morning to take me to my flight, and now he was pushing through airport security with me, just to make sure I made it to my flight.

Jason, if you ever read this, I owe you more than you can imagine. Thank you.

Finally, I made it through. I found my gate and boarded the plane without additional events. As I sat in my plane on the tarmac, I became overpowered with a sense of anxiety and sadness. Anxious, because of the thoughts expressed in a previous post (here: http://skittykittie.tumblr.com/post/124961439225/truth-is), also because of not knowing what was in store for me once I deboarded the plane, but also sadness because of the home that Cheng and Jason had made for me in Yunnan so far. I didn’t want to leave when there was still so much to see. I had met so many people, so many places, and fallen in love with this city in the past 4 days, I didn’t want to leave. I actually found myself crying a little as I stared out into the last of the Kunming sky.

I spent half of the short flight working on some blog notes and the other half trying to catch some sleep. It had barely been 40 minutes when the captain announced we were preparing for landing -- Yeah, I could have probably taken a more efficient mode of transportation, but I didn’t know that when I made my itinerary.

However, the flight did provide me with this scene that no bus could have given me:

The above photo doesn’t do it justice. There were hills and hills of these windmills. They spanned for several miles. I was in awe of the beauty but also a little shocked to see a stereotypical European landscape in China. The rolling green hills and lush vegetation shocked me, but in a good way.

We landed at the smallest airport I had been to yet. There was only two runways and 4 terminals. It was nicely kept up, however, and sat on a hill that overlooked the city of Dali in the valley below.

I gathered my belongings at the one baggage claim belt while mentally preparing myself for the challenge of speaking conversational Chinese. That’s when my phone rang. It was Shanshan, the co-director of the program. Up until that point, I actually had no clue how I was going to get from the airport to where I was supposed to be. When I picked up the phone, I managed to communicate with her that I had just arrived and, more importantly, understood her instructions that she was waiting outside the gate for me in a red jacket.

I hung up the phone, grabbed my luggage, and breathed a sigh of relief that I had passed my first language test of the month. Gathering my bearings, I stepped out of the security of the airport exit and found myself with a new sense of courage and excitement for this adventure.

It wasn’t too difficult for Shanshan and her driver to find me. I introduced myself, we loaded the car, and we were off. The road was winding down the hillside and allowed me to get a closer look at this beautiful city. There was a large lake at the center of the city called the Erhai, or Ear Lake, because the lakes are in the shape of an ear, per the locals. Shanshan and the driver were extremely friendly and spoke to me about the city in the 30 minute drive that it took to get to our destination. The conversation was fairly one-sided, though, because of my novice skill. I felt bad for not being able to carry the conversation deeper because I truly was fascinated by what they were trying to describe to me. The feelings of doubt were slowly returning.

After circling about half way around the Erhai lake, we pulled up to a small white building. It was about 4 or 5 stories high and built along side of the upsloping hill. There were vines that grew artistically down the sides of the walls. I wondered if this was headquarters for ChinaCal?

When I entered through the front doors after some effort to climb a few steep stairs, I was pleasantly surprised to find that it lead into an open courtyard. I soon would learn that this was a hostel. The family that owned the hostel lived on the first floor, where I stood now. The courtyard was filled with their personal belongings like patio furniture, a small vegetable garden, and their son’s few run down toys. Across from the main entry way was a screened door, through which I could make out an active kitchen. To my right was a small hall of four doors, two on each side of a stair well. Each door was a private 2 bedroom space with a bathroom and there were 4 floors of these rooms that composed the hostel.

Before I had time to really take in the rest of my surroundings, however, I was guided up the stairwell by Shanshan. The others were apparently eating breakfast (it was still about 9 or 10 am) at the top floor. We had barely made it to the second flight of stairs when an elderly Caucasian man in glasses met us going the opposite way. This, I knew from website photos, was Dr. Bob Detrano. He was the founder and preceptor of the ChinaCal program.

He saw us and smiled. In fairly simple Chinese he asked me, “Are you Emma?”

I replied back to him a simple, “Yes” (in Chinese).

As if he could tell that I was more comfortable speaking English by that one word, he switched his language to English and introduced himself. I was relieved to know he wasn’t expecting me to speak fluently all of the time. We exchanged polite greetings and introductions as he walked me up the stairs, now taking over as my guide instead of Shanshan.

We came to a room and he handed me a silver key. “You’ll be staying here tonight. Go ahead and put your things down and come join us in the sun room for breakfast.”

I thanked him and entered my hostel room. I found that besides the somewhat more Chinese style furniture (ie low beds, futon mattresses), this room was no different than a typical hotel room. It had two twin-sized beds with nightstands in between, a TV with a dresser supporting it, and a bathroom immediately to the left of the entrance. I also found that one of the beds was already occupied. Her name was Donna. I introduced myself, and she told me that we were roommates for this trip. I won’t bore you with detail of our conversation, but in summary I was ecstatic to know my roommate was from America and spoke English. We chatted for about 30 minutes just getting to know each other. I liked her immediately.

I had barely finished unpacking my essentials when a knock came at the door. “Donna, come eat!”

I’d forgotten myself that Dr. D had instructed me to come join them upstairs. Oops.

We made our way to the sunroom, which is exactly what it sounds like. It was at the top floor of the hostel and overlooked the road and the hillsides that rolled down to the Erhai lake in the distance. In the sunroom sat 6 or so people, all of varying ages. Everyone was sitting around a small rectangular table with one single man at the far head. They were being served tea by this older man (a tradition that Cheng had enlightened me about just a few days earlier!). Spread out along the table were plates, bao, tea cups, and remnants of the parts of breakfast Donna and I had already missed.

We walked into a conversation that was, to my surprise, in all English! I was introduced by Dr. D to everyone in the room. Most of the people present were part of the externship, like me, except for one woman who was apparently the mother of our youngest member, Sophie. Sophie’s mom was present for today only in order to ensure the details and validity of this program with the directors.

The meeting was short and casual. Slowly but surely my stresses about this trip were melting away, mainly because it seemed as though our primary language for communication will be English. I still had no idea what was in store for me in the next 3 weeks, but I was less intimidated by my peers. Dr. D and Shanshan had shown me nothing but love, acceptance, and joy that I was present for this externship.

The rest of the day went by in a bit of a blur. After the morning introductions, I went back to my room to take a nap (I had woken up at 5 am, remember?). The group of us went out for lunch a few blocks away, and then there was another group meeting - this time, more about business and expectations. We were given our roles for this trip, in addition, our medical knowledge and experience was questioned by Dr. D (in order to gather a baseline of where we each were to best instruct us and give us roles). I quickly realized I was almost at the bottom of the totem pole in this bunch. Not only did I speak almost the least amount of Chinese of everyone, there was a Pediatric cardiology resident, a graduate student pursuing her PhD at U Cal Irvine for public health, an economic consultant, cardiac ultrasound technologist, and of course Dr. D and Shanshan themselves, the founders and professionals. Meanwhile I was simply a CNA from America that could barely speak Chinese. Given the group dynamic, I was assigned to be in charge of triage at each hospital and I was to be assisted by the youngest member of our group, Sophie.

The overview of what was to come in the next three weeks was this:

Each day we were to go to a new hospital in a new city. Our plan was to visit 16 hospitals in the southeast region of Yunnan, mostly all in the county of Honghe, named for the famous “Red River” that ran through the prefecture. There were two teams for each day’s work: the clinical team and the educational team. The educational team was responsible for a whole day’s work of orientation and training of the neonatal hospital staff (nurses, doctors, etc). They were re-training the staff on neonatal screening and effective techniques for caring for neonates with congenital heart defects. We also were donating to each hospital a new pulse-oximetry machine for more reliable screening. They were also training them on how to use the machine. This was one of the most important parts of the mission because, as the saying goes, “Teach a man to fish and he eats for life.” That phase was popular among the ChinaCal team.

The clinical team, which is where I found myself, was to see patients (old and new) that have a history of congenital heart defects. They were initially triaged by myself and Sophie. We’d take a general history and basic vitals. Then they’d be sent to the ultrasound room where the child would have cardiac ultrasounds read and translated by the pediatric cardiac resident (Jess), Dr. D himself, and Donna, our ultrasound tech.

Pretty sweet gig we had going here, huh?

After our meeting, I we got another break. I wandered around the hostel a bit more out of curiosity. I discovered the rooftop was where the owners hung their laundry out to dry… that was about the only interesting thing I can remember, actually.

By mid-afternoon I was called down by the older graduate students of the group. They said they had some errands to run before we took off tomorrow and asked if I wanted to join them. I excitedly agreed, as it would give me a better tour of Dali.

The ride to our destination was a moderate one, but fun nonetheless. I noted on the drive there the history that is embedded in this city. I noted that the parts we were in was much more rural than Kunming or Beijing. The buildings were at most 4 stories. The roads were not congested and had much more space for driving. We passed countless fields of vegetables and people carrying their crops to trucks. It was an odd mix between modern and poor, but I liked it.

Our destination was a small printing shop in Old Town, which is one of the more iconic part of Dali. Old Town used to be the city’s center of activity and living back in its earliest days. And on the outside, it still looked as if nothing had changed since the buildings were originally built hundreds of years ago.

There was just streets and streets of shops, craft vendors, street food, market places, and hotels! And in the distance I could see the beautiful outline of the mountains that surrounded the city. It was absolutely beautiful and full of life and culture.

We spent quite some time there. Once I gathered my bearings, I ventured around some of the streets on my own. We spent a good few hours there, taking our time between shops as we waiting on the printing shop to make up our order. What were we printing anyway? - Oh right, they had pre-tests and post-tests for the workshops they were going to hold at each hospital site for the educational workshops.

Once we returned to our hostel with the papers, it was time for dinner. We walked up the hillside of our hostel and went for a few more blocks. It seemed that wherever we were headed for dinner was a common spot for the ChinaCal team because it seemed like everyone but myself was unanimously heading in the same direction. I spent the short walk mostly quiet, but so did everyone else. It seemed as though most of the team was not fully acquainted yet. Instead of making awkward small talk on the walk there, I enjoyed the walk through the Dali neighborhood, observing the night life coming alive around me.

Something happened during dinner because afterwards we were all much less awkward with each other. I began to know Sophie a little more, too. She had quite a spunky attitude. She was very animated and passionate about life. I’m definitely going to like this little one.

The rest of the evening was spent in the sun room, trying to bridge the knowledge gap between the younger members of our group. I helped teach them how to take blood pressures and pulse-ox measurements, what it meant physiologically. My confidence soared - I guess all of my previous clinical knowledge was teaching me something after all. Maybe I am not as useless as I first thought!

I went to bed content, excited, and no longer anxious. In the morning, we were leaving for Luxi, a city on the east way of Kunming. They told me that we were actually going to be driving through Kunming to get there.... I really questioned why I hadn’t just been picked up on the way. Oh, well. Now I know.

Tomorrow, our adventure awaits.

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