A China Story

top 10 concerns & major apprehensions (revisited)

1) I’m concerned about how the Chinese view Black Americans, especially since we were told during a class that they were known to ‘not have the best opinion’ about us. I’m curious as to what influences and experiences lead to this opinion, and if I’ll find it to be true when I touch down.

This turned out to be far less of a concern than I assumed during the trip. I have this sense that I’m on Weibo given the amount of pictures that I took with strangers, but that was really fun. After the first few days I began to be accustomed to the curiosity (which ran both ways), but I never felt uncomfortable due to this.

2) Data theft: We’ve been warned to be very cautious in bringing our devices with us on the the trip. Doing some research on my own, I’ve read that Americans (especially Americans) travelling to China on business should either a) Not bring a computer with sensitive data or b) bring a clean device with an encrypted hard drive in case anything needs to be saved there.

I took some basic precautions regarding encryption of work data, and I haven’t noticed anything that would lead me to believe that any theft had occurred. Of the people that asked about this before the trip, most reassured me that much of the risk would be mitigated by the fact that there wouldn’t be much of an incentive for anyone to mine data from my day-to-day work.

3) Flying: I’m not the biggest fan of flying, and although I’ve flown to Hong Kong before I’m certainly not looking forward to it again. In addition, I’ll be flying solo so it will be up to me to navigate the airport and find my way to the hotel. Sounds like an adventure to me..

Well, it certainly was an adventure. I had to catch a regional flight from Beijing to Shanghai which added a layer of complexity to the trip home but everything went smoothly. I was too apprehensive about missing a flight to catch a nap during some seriously long layovers, and the flights were bumpy—-but I made it. Again, 100% worth it.

4) Closed doors: One issue that I’ve already run into is the lack of open access to healthcare facilities, management, or anyone in the government willing to answer project questions. I was asked for a list of questions, and when I provided them multiple times I heard no response. I don’t think that the government is comfortable with an American poking around the inner workings of their healthcare system.

This was an actual problem—attempting to see the side of China that was outside of what I believed they wanted us to see. Its difficult to go ‘off the grid’ during an arranged trip, and trying to build guanxi over the semester leading to the trip was not as effective as I hoped. I wanted to get an unbiased and unchaperoned view of some of the dysfunction of the health industry that most Chinese utilize—-but I was told that I had to get permission from varying groups, organizations, and leadership to which I could not manage to get access. This began to make sense over the trip, the importance of saving face was likely a factor in how little information I could get about the problems faced in their system.

5) What I might see: The possibility of touring a state-owned hospital is still there, and if it happens I worry that I might witness poorly run facilities and very sick people waiting.

This ended up being the least of my concerns here, as I wasn’t privy to the state-run facilities. What I did end up doing was relying on speaking to residents about their experiences with health professionals, national insurance, and the government’s role in the national health system. 

6) Poverty: I do have a soft spot for the disenfranchised, and China’s wealth inequality has been widely publicized. Although I don’t think that much of our program will have us in rural areas, I know based on my research that poverty is everywhere. I’ll just have to prepare myself as though I’m entering a developing country and may see some disturbing things.

I did see some poverty and homelessness, but far less than I would have assumed in cities of 20+ million citizens. Granted, our trip was very structured and many of the areas that we concentrated in were essentially high-dollar areas whereby (like in America) the poor had been priced out of living there.

7) Language: You’re always at a diadvantage when you don’t speak the language. The original plan was to work twoards a conversational understanding of Mandarin, but life took over. I hope I’m able to navigate the places that I need to know by pointing at various things and perhaps taking along a buddy.

One of our classmates had an impressive grasp of the language that surprised many of us when we got there. The level of access and immediate positive reactions that he got made me with I would have actually used the language software that I purchased far ahead of this trip in order to learn what I could. Now that I’m back and the program is ending, I’ve committed to myself to learn conversational Mandarin in order to improve my own abilities, expand my international marketability, and make my next trip to China that much more meaningful and accessible.

8) Scale: I have never been to a city of more than 8 million (New York), and that city is so dense and crowded I’m immediately uncomfortable when I’m there. When I consider we’ll be in cities 300% more populous it gives me pause as to what that looks and feels like. I am both apprehensive and curious.

I am still telling whoever will listen about the scale that we witnessed there. Oddly enough, I didn’t feel as uncomfortable in Shanghai or Beijing as I do in cities like New York. There’s an uncanny organization in the way that these giant cities were planned and constructed that belies the huge populations. That being said, there was no way of hiding the scale when we attempted to get a cab ride back to the hotel during rush hour.

9) Pollution: I was warned about the poor air quality in China, particularly Beijing and Shanghai. We always see Chinese walking around cities of these sizes with breather masks on—I wonder if I should do the same.

Again a non-issue, and I didn’t notice as many air masks as I thought I would when I got here. When we got off the plane in Beijing, we immediately noticed a strange taste to the air and the sun was nowhere to be found. Since the Olympic games, I’m aware that the Chinese government has made huge efforts in reducing pollution in both the air and water supply and I believe it showed. City streets were not littered with anything, and although much of this effort appeared brand new I still got the sense that they are moving in the right direction in order to protect the health and landscape.

10) Squat toilets: Unique cuisine, lots of travel and work, and minimal break opportunities have me thinking I’ll either need to eat lightly or prepare myself to learn how to use one of these devices. Funny, they’re so much older than the ‘traditional’ toilet Westerners are accustomed to yet we seem to think they are alone in this squat toilet endeavor. I’ve found that most of Asia is the same way, so we’ll just chalk this up to a potential new experience

I ate just about anything I was presented with, and for some reason this concern…never quite came up.:)

9,999 Rooms

One of the things I’ve come to realize in China is that whether modern or ancient, the Chinese have never lost the capacity to build amazing structures. I suppose that could be true in any society where there isn’t so much choice involved in what you are tasked to do, and the labor power required for some of these older, massive wonders likely required thousands over many many years.

So many people, such a huge structure. It surprised me that there were so many apparent rural Chinese that were visiting the Forbidden City for the first time; that’s how big China is. I suppose the same could be said for how many Americans have never seen the Grand Canyon or Mt. Rushmore.

!_!

The Great Wall, just outside of Beijing in a village named Mutianyu. Never thought I’d be standing here.

This was a fantastic experience besides the history nerd inside of me fulfilling a childhood dream. Like I’ve said before on this trip, nothing could prepare me for the scale of such an undertaking. What I didn’t know was that the 100s of thousands of workers who were forced to build it and who died doing such were usually buried under or in the wall. Creepy? Certainly. 

I choose to think that the poeple who were displaced in building it are literally a part of one of the world’s wonders and what they created has lasted through most of modern history. Very few people can say that something they built is still around, even after a generation. The Chinese take great pride in the wall, and as we walked the gauntlet of vendors I kept reminding myself that the Wall is an everyday thing to them.

I took that hard route and walked up, where I was quickly passed by Prof Bolman who apparently has the athleticism of an 18 year old. Luckily I could pass needing to pause for a breath as a ‘photo-op.’ :)

high speed rail woooosh!

It’s becoming quite common here to be awed by something that you see. Today we traveled to Tianjin by high speed rail, and I’ve been excited to ride this thing since the schedule was shared with us.

It really is like something from the future, watching the LED speedometer climb up to nearly 200mph and noticing the countryside whizzing by at incredible speed. The ride was very comfortable, I could barely notice acceleration or the train banking at a very high rate of speed. I was aware that they had a major accident recently on the train but I was too engrossed in the speed to even think of it.

While we were on the train platform on the way back from Tianjin, one of these trains flew by at what looked like top speed. It was fantastic. As if on cue, on the adjacent side of the tracks there was a freight train coming (think Amtrack). The only feeling I could come up with was embarrassment. We still rely on technology from the 19th century to move both people and freight as the Chinese already have in operation this critical infrastructure connecting their country together.

We can barely agree on a budget for the year much less a hugely ambitious plan to initiate high-speed rail. In fact, one of my classmates remarked that it would just be another tax to pay. I truly do not understand that line of logic. Part of what provided the boom in the 50s was the construction of the national highway system, which boosted mobility among the growing economy (in addition to putting people to work in its construction). 

Lights Medical..hmm

Where do I start?

This was an odd visit. It didn’t appear that they actually manufactured or packaged anything except to show visitors (specifically EMBA class). Everything was entirely too cheoreographed, and the building looked otherwise abandoned. We were told there were 300 employees, but we only saw the 6 or so who were involved with the presentation and the walking tour.

• Front Desk looked like it hadn’t been occupied in some time. No computer, phone wasn’t plugged up (and never rung, strange for a company that said they sell 3$0M worth of goods from the facility)
• An R&D ‘laboratory’ usually doesn’t consist of two people studying a beaker of boiling water on a hot plate. Look around too much, and they would persuade you to stay with the tour.
• Sales department had no fixtures in offices, names on doors, and some of the latches still had dust on them—implying they hadn’t actually been opened or used in some time.
• I doubt the delivery truck that just so happened to be loading the last box as we walked up went anywhere but around the block.
• It felt hollow
• Even the manager we spoke didn’t seem to know much about the operations beyond the standard fare. Complex questions went unanswered or dodged from the group

These quasi-government institutions and companies seem to function as a land holding entity for the government and special interests. As Tiajin grows, they must expect the land to appreciate in value so they can sell for a premium. I’d be surprised if Lights Medical actually did anything when tours weren’t arranged. 

As a last note, as we left all the ‘employees’ that we were introduced to were filing out of the back, heading home.

Strange, indeed.

beijing united hospitals & clinics

This morning we met with Alan Kahn, GVP of Marketing and Communications for Beijing United Hospitals and Clinics. Beijing United represents a niche industry in China—a for profit hospital system that provides premium care for patients. They operate a network that spans Shanghai, Beijing, and Guanzou, and are slowly spreading West as opportunities present themselves. 

From what I can tell of their operation, it is a far cry from what a normal Beijing resident would expect with a State-run hospital. No long lines and overworked staff, very clean and newer appointments were everywhere. Kahn believes that the increasing demand for a higher standard of care mixed with an expanding middle class has their company (Chindex, Inc) in the right position to capitalize on a growing segment. They stressed their hotel amenities, LDRP (labor, delivery, recovery, and post-pardum) focus for their pregnant patients, and their adherence to JCI accreditation.

Even with the higher quality components of their setup, BUHC still only charges in the 70th percentile of a comparable U.S. hospital. The barriers to entry in the healthcare field are daunting; approval has to be granted by the district, city, provincial, and Ministry of Health before one can legally operate. It was entertaining to hear that their brand and image had been copied by more rural clinics seeking to capitalize on the clinic’s good name and brand equity.

I’m left wondering how private, premium care will ultimately fit into China’s unique health landscape.