yanpu's Journal

Julie and I stayed in Beijing to wait out the riots in Tibet. Now that things have calmed down, we are going back to Qinghai. Before I get into our trip back to Qinghai, let me update you on what we've been doing here in Beijing. Last week Julie and I spent created a volunteer training program for HBV volunteers. The volunteer program is called Sunshine Volunteers.�A few years ago the Beijing HBV Foundation set it up to promote HBV awareness amongst college students in China. This year the Foundation asked us to put together a training program for the new volunteers. They wanted us to utilize training experiences from the US to create a fun and interactive training program. Julie and I dug through our previous experiences, asked some friends and came up with a training program with a lot of interactive games. We also brainstormed various HBV promotion activities they could organize on their own college campuses. The training session was a great hit. The volunteers had a lot fun, learned a lot and were excited to put together their own campus activities.

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Tomorrow Julie and I are returning to Qinghai for a week. We will be assisting with the education program in Xining and monitoring the final shot in the 3 shot HBV series.

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Here are links to pictures from my last trip to Qinghai: http://www.facebook.com/album.php?aid=2068596&l=ed32d&id=13301826

http://www.facebook.com/album.php?aid=2068595&l=c50ca&id=13301826

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Back to the Field

Julie and I are back in Qinghai. We flew in a few days ago and have really hit the ground running. The day after we arrived we were off into the countryside starting the second part of our education program. The groundwork we had laid last year really came in handy. All the heads of the CDCs and local health departments remembered us. This time around we didn't have to jump through so many hoops to get to our final destination. Instead we were lead right to the schools. We could pretty much do as we pleased, set our own schedules. Everything has just been going so smoothly. I am so glad we spent last year really working on building relationships. It has really paid off.

The weather here is surprisingly warm and pleasant. It turns out we arrived just as the bad weather was leaving. The temperature here is a brisk 30 degrees. At such a high altitude, the strong sunlight has melted most of the snow. Last year we had heard about Qinghai's spring sand storms. Thankfully we have not had to personally experience one...yet.

For the last two days, Julie and I have been going from school to school giving HBV health education seminars to students grades 3-6th. For each of the seminars we first assessed their baseline HBV knowledge and then proceeded with the HBV class. The curriculum is pretty basic. We have4 main points:

1) We want them to know where the liver is on the body and what it does.

2) We want them to understand that the HBV virus attacks the Liver.

3) We want them to know the 2 main ways of transmission: birth and blood.The 3rd way is sex and we decided it was a little beyond their understanding.

4)We want them to know toprotect themselves from the HBV virus by getting vaccinated.

Julie and I have devised, I think, creative ways to teach the kids the information. We have an HBV song which is set to the tune of farajaka. Wehave an activity where the kids can stick cut out body organs onto a paper body. We also encouraged a lot of participation during the class by asking the kids to help teach the class using their own de scriptions of ways of transmission and what the liver does. It's been really fun watching these kids learn and interact with each other. At first they were quit shy, but after we pulled out a couple of prizes such as pencils and pens, the participation dramatically increased!

I am keeping my fingers crossed that the rest of the project will be just as smooth!

Hello Again

Ni Hao from Beijing. I am back in the land of 2008 Olympics about to embark on the 2^nd part of my China HBV vaccination and education project. Julie and I arrived in Beijing about a week ago. The weather here is similar in temperature to the Bay Area, however the winds are crazy. They say the worst season in Beijing is early spring time when the winds from Inner Mongolia send dust storms whirling into the city. Apparently we are going to be facing similar dust storms when we are in Qinghai. I am so looking forward to that. =/

The roads in Qinghai are still blocked with snow, so Julie and I have decided to stay an extra week in Beijing. We’ve spent most of out time planning and setting goals for this second leg of the program. Our goals this time around is to monitor the final shot in the 3 shot HBV vaccination series, personally teach at rural schools and asses the success of the overall education program by visiting and surveying randomly picked schools. Hopefully we will have gathered enough data to produce a publication or two.

On a different note, in our spare time, Julie and I have been taking walking tours discovering various parts of Beijing. We were disappointed to find that a very historical area of Beijing has been torn down for more modern developments. It is an area referred to as Old Beijing. The neighborhood is made up of Hutongs (small lane or street lined with traditional 1-2 level houses). The neighborhood was known for its history and culture. Julie and I went to the hutongs in hopes of finding a great restaurant known for its Peking duck. Luckily we did find it. It was residing in the part of the neighborhood that had been saved from the destruction. The restaurant definitely lived up to its historical reputation. The Peking duck was Amazing! The restaurant has a traditional coal oven where it roasts the ducks. Everything is done the traditional way with lots of care and attention to detail. The walls of the restaurant are lined with pictures of foreign ambassadors, which seemed unusual considering the restaurant is really a hole in the wall. The dining area fits about 8 tables and pretty much everything’s worn down. The duck though…the duck makes it all worth it!

Qinghai is also a land of untouched natural beauty and home to many thriving cultures such as Tibetan and Mongolian. I am excited to explore this cultural diversity and natural richness. Through this trip I hope to paint a more vivid picture of Qinghai.


August 26^th

I forgot to mention that I have a traveling partner. Her name is Julie Len. She is also apart of the project. We are the eyes and ears of the mother organization Stanford Asian Liver Center. The two of us will be ONLY ones on the ground from the US assessing and monitoring the project and then reporting back to the US.

The project has two parts: vaccination and education. The idea is that vaccination protects the body and education protects the mind. Julie and I will be watching over all aspects of the vaccination and education program.

On top of assessing and monitoring the vaccination portion of the project, Julie and I have also developed and will carry out the HBV education portion. Since there is such a large area to cover we are planning to coordinate with the local CDC to have them hold teaching seminars that can be attended by each school's health teacher or principle. This way they can learn the information and teach it to their students in their own manner. To evaluate the success of the education program, Julie and I will conduct pre and post surveys on the childrens' HBV knowledge.

When this project is complete, Qinghai will be the first province in all of China that will have an entire generation of children vaccinated and educated against HBV. We hope that the success of this project will encourage other provinces to also take part in helping to eradicate this deadly disease.

August 27^th

After a month and a half of training at Stanford University, Julie and I took off for China on August 21, 2007. Our first stop was Beijing. The Chinese Foundation for Hepatitis B Prevention and Control is located in Beijing. It is the Chinese counterpart to the Stanford Asian Liver Center. We usually refer to it as the Foundation.

The Foundation is located within the Beijing CDC building. It is a nonprofit run by 6 staff members from two small offices. It is really impressive to think that these few individuals with such meager resources are working to change the course this monstrous epidemic.

Julie and I plan on staying in Beijing for the rest of August. This way we can work with the Foundation to finalize plans for the project and prepare necessary materials to bring to Qinghai. We will also be attending various press conferences so that this project can get much needed publicity.

During one of our first meetings at the Foundation we met with two British film makers, Aaron and Adam. It turns out they will be making a documentary about the HBV situation and this year's project in Qinghai. The documentary will be shown on BBC and cable networks in China. These two film makers both reside in China and mostly cover Chinese healthcare issues.

After the meeting the two film makers and some people from the Foundation took us out to dinner. During dinner, Aaron shared with us stories from all his travels throughout China. In one story he told us about how he filmed in Mongolia in the middle of winter. It was snowing so badly no one would drive him to the place where he needed to film so him and his crew all rode on horseback up the mountain to the filming location. This turned out to be a terrible idea. One false step and Aaron was thrown off his horse. He broke his ribs and was stranded in the middle of nowhere. The nearest hospital was a plane ride away. There were no cars so he had to be dragged by a snowmobile to the nearest town to catch a plan to fly to a major city. During this whole time he had no medical attention, no pain killers, just faith that he would get through it all.

Note to self: do not ride horses!

August 28^th

For the past few days Julie and I have been working at the Foundation and also touring around Beijing. Since both of us have been to the major tourist sites, this time around we wanted to get more of a down home Beijing experience. Here are some stories from our Beijing exploration.

The taxi drivers in Beijing are notorious for their ruthless driving, but never had I encountered a narcoleptic taxi driver. This guy would fall sleep at every stoplight only to be woken by all the beeping from the cars behind him. I'm not talking about light dozing, it was full on snoring! He would literally start snoring in less than 30seconds after he stopped at a red light. It was totally unbelievable.

On one of the days Julie and I went to register at the American Embassy. When we got inside we saw a Starbucks. This was our second day in Beijing and the first Starbucks we had seen since we left the US. We were both really excited and started to walk towards it, but before we could get any closer a Chinese officers spoke to us in a very stern voice and told us we were not allowed to go inside. Apparently it was reserved only for embassy staff members.

My birthday is March 15, which most people in the US associate with the Ides of March. The day Julius Caesar, Dictator of the Roman Republic, was betrayed and stabbed to death by Brutus. In China, March 15 has a whole different association. It is the Chinese day of markdowns. I was told by people at the Foundation that March 15 is the day of the national sale of commercial goods. "We love March 15^th because everything is one sale and everything is real. Nothing is fake!" Apparently on that day the commercial goods officers are on patrol so merchants are less likely to sell fake goods.

September 5^th

Julie and I left Beijing on September 1st to fly to Qinghai. We have been in Qinghai's capital city Xining since then. Before I talk more about Qinghai I want to update everyone on events that have occurred since I last wrote.

To attract more media attention for the project, the Foundation organized three major project kick off press conferences for three major cities: Hong Kong, Beijing, and Xining. Julie and I weren't able to attend the Hong Kong conference, but we were able to attend the ones in Beijing and Xining. Each of these conferences had their own purpose. The press conference in Hong Kong was directed towards current and future donors of the project. The press conference in Beijing served as a national kickoff which was attended by national health department officials. The press conference in Xining served as the kick off for Qinghai province. This press conference was attended by the heads of Qinghai government, health department and education department.

After the Beijing press conference Julie and I flew to Xining, Qinghai. The capital of Qinghai, Xining, is a mid sized city located in a valley surrounded by rolling hills. The city is starting to become more developed. Right now it looks like Beijing in the early 90s, with a much smaller population. The majority of the people are of ethnic minority background such as Tibetan or Mongolian. When roaming the streets of Xining, you can often see a mix of Han (ethnically Chinese), Tibetan, Mongolian and Muslim people. They all intermingle and live relatively peacefully with each other.

The first few days we arrived in Qinghai we went out to see the major tourist sites: Qinghai Lake and Kumlum Tibetan Buddhist Monastery. The scenery changed dramatically as we left Xining. The urban infrastructure gave way to rolling hills and vast grasslands doted with herds of sheep and yak. Along the roads you can see various colored prayer flags strung on strings waving in the air. This is a Tibetan cultural practice. There are five different colored prayer flags representing different elements of the earth, red represents fire, blue represents sky, green represents water, yellow represents earth and white represents clouds. These flags are inscribed with Tibetan Buddhist prayers. The Tibetans believe that as the wind blows through the prayer flags, the prayers are being read and carried through the air.

Qinghai lake is located 2 ½ hours away from Xining. It is considered the largest inland salt water lake in China. Standing at the shore of Qinghai lake you are surrounded by natural beauty. Before you the calm blue water, above you the clear blue sky and behind you the rolling hills in all shades of green. We didn't quite see all that because half the time we were there it was raining. Thus instead of clear blue skies, ours was more on the gray side. The rain also made the weather pretty cold. Qinghai, with its high attitude, is known for cold weather, the rain made it even worse. To combat the cold stores surrounding Qinghai Lake were renting long wool jackets. They weren't the most fashionable jackets, but they sure served their purpose. As soon as I put on the jacket I felt a hundred times better. Since Qinghai Lake is such a major attraction, there were a lot of street vendors selling various Qinghai memorabilia such as combs made out of yak and sheep horns, animal furs (yes, animal furs right out there on the street!) and ethnic jewelry. They also had yaks and horses that tourists could ride and take pictures on. I choose to ride a Yak which was not too friendly. When I tried to take a picture beside it, it hit me with one of its horns. Now I have a sore spot on my head to remind me to think twice next time I consider getting that close to a yak.

The next stop on our tour was the Tibetan Buddhist Monastery. It is located about 30mins away from Xining. It is currently inhabited by the Panchan Lama, which is second in rank after the Dali Lama. The monastery is set up as a complex of temples. Each temple is dedicated to a different Buddha. One main temple, also the largest temple, also serves as the gathering place for all the monks. The day we visited they were at the main temple taking an exam. They sat in rolls on mats and took turns chanting prayers to the main monk. To pass the exam they needed to correctly chant all the required prayers. It was an amazing site to see! The monastery was also filled with racks of hollow barrels that were inscribed with prayers. The barrels have handles at the bottom which can be turned to spin clockwise. The idea is that by turning these barrels the inscribed prayers are being read. Many Tibetans Buddhists come to this monastery each year to pray and pay respect to the Panchan Lama. Tibetan Buddhists have a unique way of praying. It is pretty physically demanding. They start from the standing position with their hands together, palm to palm. They raise their prayer hands to the sky, then to their lips, and then to their chest. They kneel to the ground then spread their hands to their sides and slide onto the ground until they are lying completely flat. Then they slide back up and rise to the standing position. This is one prayer. Traditionally they have to do this prayer for 100,000. We were told we didn't have to do the whole thing, instead we just stayed standing and moved our prayer hands in the three positions and bowed. We were also told to never point at a Buddha, instead to gesture with our palms facing upward. The tour was such an awesome experience!

The last thing I want to mention is the dining experience in Qinghai. The majority of the diet in Qinghai is lamb and yak. While in Xining we are able to eat some vegetables, but we were told that when we go down to the countryside the majority of the diet will be just lamb meat and baked bread. The cuisine can be very spicy! Drinking is a large part of the Qinghai culture. They have this white liquor called bia ju. It is extremely strong. I had a sip of it and it burned my lips and my tongue. Drinking bia ju together builds new friendships, shows respect and trust. It is considered rude if you do not have a drink. The only way you can get out of physically drinking it is to use a hand motion. This hand motion is basically showing that even though you can not physically drink it you are spiritually accepting the drink. This hand motion involves the dipping of the forth finger on the right hand into the cup and then flicking the alcohol towards the sky and the earth. This symbolizes you paying respect to heaven and earth. Then you swipe that same finger across the right side of your forehead. This symbolizes you paying respect to your family and friends. With this sequence of hand motions you are able to not drink but still be respectful.

Sorry this is such a long update. Now that I am starting the settle down in Qinghai, I will update more regularly with smaller chunks of information. I hope you did enjoy learning about Qinghai and its culture. As I spend more time here I am sure I will learn more cultural customs and of course fill you guys in!

Hi Everyone. As you can see I have changed to a new websitefor my online journal. Turns out my original blog website, wordpress.com, isbanned by the Chinese government. Thus I was not able to access the websitevery often even if I had good internet connection. I guess even with all thewestern influences, something about freedom of expression they just aren'tready to adopt yet. I searched around online and found this journal site, whichhas not yet been banned by the Chinese government. Hopefully it'll stay hiddenfrom them long enough for me to finish this program and not have to search outfor another website.

So here is a little update about what I have been up to forthe last two weeks.

Last Week: Julie and I traveled to a district southeast ofthe capital city of Xining calledHai Dong. We toured 3 townships and went to monitor and asses some of thevaccination events in the schools. We also started a random survey of 6500 kidsto asses their baseline knowledge regarding Hepatitis B. The survey willcontinue for the rest of this month after which Julie and I will start theeducation program.

I must say it was an amazing feeling going to the schools toparticipate in the vaccination of these kids. They are the liveliest kids I'veever met. Even though their environment was quite depressing they were filledwith hope and spirit. These kids, ages 6-12, grow up in very difficultenvironments. They live in the most rural areas where they have to walk up toan hour to get to school everyday. Can you imagine, an 8 year old, walking for40mins in the freezing cold of winter through mud filled streets to go toschool everyday? Their shoes are nothing more than a few layers of cloth,patched up from years before. All they have to eat for breakfast is a few steamedpieces of dough with no filling because the sheep that they have raised is tooprecious to eat and instead must be sold in the city to make money. Looking attheir little red wind tore faces contrasted against smiles filled withchildhood dreams; I realized the importance of this project.

The kids were very excited about the vaccination, all liningup and pulling their sleeves up with huge smiles on their faces. The boys wouldfight over who gets the shot first. Some of the girls would be a littlefearful, but after the shot was given they would walk proudly back to the groupand announce that it didn't hurt at all. Of course there were the occasionalcriers, who refused to get the shot, but with a little hoaxing we were able toget past their tears and get them to stretch out their arms.

During the vaccination events, Julie and I monitored forproper practices such as needle disposal, proper handling of the vaccinationand making sure all the kids in the school get vaccinated. This is the firstprogram most of these schools have ever participated in. They were verysupportive and corporative even if it meant disrupting an entire morning worthof classes.

For the most part the project is going very smoothly. Themost difficult aspect we have encountered so far is trying to work through allthe bureaucracy that exists in China.To get anything done in this country you have to go through so many heads ofthis department and that department. No one is intent on getting anything donein a timely manner especially if it is fiscally related. Offices are filledwith people just sitting around chain smoking. And right when you think youhave finally accomplished finding your way through the maze, somemiscommunication or confusion sends you right back to the beginning. It isincredibly frustrating! Thankfully this project is supported by the nationalCDC thus everyone makes more of an effort to help us out.

This Week: Julie and I are working with two film makers fromBeijing, Aaron and Adam. These twoCaucasian guys, one British and the other American, now live and work in Chinamaking films about healthcare and other social disparities. They have beenhired by the Stanford Asian Liver Centerto cover this Qinghai vaccinationand education program.

For the rest of this week we will be the district Hai Dong,in the countryside. Aaron and Adam will be filming vaccination events and alsointerviewing some students, family members and doctors. Julie and I will beserving as translators and somewhat guides in this area which we are startingto become more familiar with. I will write more about it in the next post.

On a different note, I am thankful I have not yet experiencedany food poisoning. I have been very careful to not eat anything I am unsureof. Our living arrangements have been okay. All the places we have stayed at sofar have a working shower and western style toilet (normal Chinese toiletsconsist of a hole in the ground). Sometimes the rooms are a bit dirty or thetoilet is not exactly working, but all in all it is much better than I thoughtit would be.

Here are two sites to check out some photos
From when Juile and I were in Xining: http://www.facebook.com/album.php?aid=2051439&l=5d799&id=13301826
The first round of vacinations: http://www.facebook.com/album.php?aid=2052286&l=b2e92&id=13301826