Over the past several months I have not been able to post to the blog I started after first arriving in Chengdu for the Fulbright. I am not sure what the problem was but now I am able to access the site. I have been blogging to a class through the University of Louisville and I will include that blog at this site. I will also try to add other information, photos, ect to this site as the term progresses. I have posted a few photos of meetings I have recently been to and places I have visited. Tobacco control is a major challenge here and one of the more interesting Fulbright stories was from a student who was trying to do a survey of local residences about tobacco use in a rural area. His first attempt to do the survey was a failure because no one would participate. He talked to his adviser who suggested they have a dinner with gifts for the local officials. The dinner worked, but the adviser recommended that among the gifts they include cigarettes (a very common and welcome gift in China). Sure enough, when he went back the following week to deliver the survey, everyone was willing to participate. Tobacco control is a major challenge. One of the photos I have included is of a restroom at Kunming University. Please note the tile ashtray by the urinal. The other ‘public health’ photo is of a mosquito net at the foreign visitors residence when I was visiting Jinan University in Guangzhou.
The first blog to the class was focused on ecosystem services and how they play a role in environmental health. The blog follows with some questions for thought:
Recently it was reported in the Chinese press that 62% of the Yellow River Basin was impacted by soil erosion. The report said nearly 90 percent of areas in the country that are suffering from severe water and soil erosion are in the Yellow River basin, making it one of the most-eroded areas in the world. From 1950 to 1999, more than 9 billion tons of mud and sand flowed into the lower reaches of the Yellow River, raising the riverbank by 2 to 4 meters. Some improvements have been made. The latest statistics showed that during the period of the 11th Five-Year Plan (2006-2010), more than 2 billion tons of mud and sand had been prevented from flowing into the river, helping to improve conditions for plant and human life in the river basin.
On a broader scale, the total area affected by water loss and soil erosion amounts to 3.57 million square kilometers (convert this to acres), almost one third of China’s total land, and of this, nearly 2 million sq km are in urgent need of treatment. The annual economic losses from water loss and soil erosion are estimated at about 2.25 percent of the country’s gross domestic product (GDP). Despite the government’s efforts at the national regional, provincial, and local levels much remains to be done regarding awareness and actions the local governments have taken to conserve water and control soil erosion.
Vast parts of China’s interior are mountainous. China’s rapid economic development has resulted in activities, such as mining mineral resources, that have progressed without robust regulatory controls and have resulted in disasters such as mudslide and floods. Mudslides in Zhouqu in Northwest China’s Gansu province and Gongshan in Southwest China’s Yunnan province have sounded the alarm about soil erosion.
A recent new Chinese law on Water and Soil Conservation (2010) specifies the responsibilities local governments and the penalties that will be imposed should they fail to meet them. The law increases the accountability of local government officials for water conservancy and soil erosion control and requires those local governments whose territories are vulnerable to soil erosion to set specific targets to keep soil from being washed away because of the loss of trees and grass. Punishments will be enforced if the targets are not met. The maximum fine for those who violate the regulations has been increased from 200,000 yuan to 500,000 yuan (6.5 yuan/$). The law also stipulates that profits from extracting soil, sand and rocks in places vulnerable to the loss of soil and water will be confiscated once they are identified. The first law on water and soil conservancy was adopted in 1991. The Ministry of Water Resources administers the revised law in China.
Some Discussion Questions:
- What do we mean by ecosystem services? Note the Millennium Ecosystem Assessment a United Nations initiative was designed to assess the consequences of ecosystem change for human well-being and the scientific basis for action needed to enhance the conservation and sustainable use of those systems and their contribution to human well-being. The following links to the website for this assessment. http://www.maweb.org/en/index.aspx
- How does erosion impact ecosystem services?
- How do ecosystem services impact public health and specifically how would erosion impact public health?
- Where in the U.S. is erosion a problem? In Kentucky?
- How is erosion managed in the United States?
- Does the U.S. have penalties associated with erosion control?
Qingtai Recreation Zone
Today is national day. It is a quiet day around campus as it is the beginning of a week long holiday. The weather is turning slightly cooler and the leaves are beginning to change. Apparently the fall is a brief season in which you move from the hot humid summer to the cool damp winter, at least that is the way one expat has described it after living here for several years.
Public Health: One of the items we did in our indoor air class was to ask the student to construct a log of the amount of time they spend indoors. They were asked to monitor the time they spend in their homes (or apartments), in taxis or buses, in the classroom or workplace, and in other indoor environments, plus how much time they spend outdoors. In the late 80’ early 90’s the U.S. EPA estimated that people in the United States spend around 90 percent of their time indoors (22 hours/day of which 16 hours/day were in their homes). The students monitored where they spent their time for one week, accounting for 168 hours. There were four indoor categories: Residences, Transportation, Classroom/Workplace, and other, plus outdoors. Students spent (on average) 95 hours (57%) in their residences, 3.8 hours (2.3%) in transportation, 39 hours (23%) in classrooms of businesses, and 10.7 hours (6.4%) in other indoor environments. Outdoor accounted for almost 20 hours per week or 11.6%. So the total time spent indoors was about the same as reported by the EPA. One of the big differences however, it the lack of air conditioning in most of the indoor environments. For example my office at the university and the lecture hall in which I have been teaching are ‘naturally ventilated’ (the windows are open!!), so while much time is spent indoors, it is likely that outdoor generated pollutants play a much greater role in indoor air contamination in Chengdu than in a similar city in the U.S.
China Daily: A report from an early September edition of the China Daily stated that: ‘Another five people have been sickened by a cholera outbreak in an east China county’. The reported indicated that this had raised the number of total cholera cases in Mengcheng of Anhui province to 38, most of who had been effectively treated. This is apparently at the end of a larger outbreak as they reported that the cholera outbreak had been brought under initial control as new cases declined sharply as of August 30 from the first identified cases on August 16. The sentinel cases were identified in three people who had eaten at three different restaurants. The provincial health and disease control experts were still working to trace the source of the epidemic in the county of 1 million people. Some local residents blamed low hygiene awareness among the public and street food peddlers and stalls which offered poor quality food for the outbreak. Earlier local authorities have closed all street food stalls and restaurants for disinfection as the disease is transmitted through water and food. There was not follow-up report confirming the sources of the outbreak.
My Day: As indicated earlier, this week represents the 100th anniversary of the founding of the
West China Medical Center, and the 10th anniversary of the merger between Sichuan University and the West China Medical Center. The medical center had its beginning in 1905 when missionaries from (the U.K., the U.S. and Canada, initiated an ideal to establish an institution of higher learning in Chengdu. It was established in Chengdu at the Jinjiang River and named Huaxibsa (or flatland). It is known now as the Huaxi campus of Sichuan University. In 1910 it was founded as “West China Union University” and remained so until 1949, and in 1951 was handed over to the People’s Government. There was an extensive period of readjustment from ‘a private comprehensive university’ to a multi-discipline socialist university of medical sciences’ over the intervening years. In 2000, the medical university was joined with the Sichuan University. Much more detail is available about the history of the university and the merger, and I will be happy to answer questions you might have. To celebrate this anniversary several events were planned. On Monday evening, September 27 there was a ‘student and faculty’ talent show held in the outdoor soccer stadium. It was a combination of parodies of the faculty, karaoke, student dancing and singing, including some dances from different ethnic groups in the region. However, the highlight was a group of students dressed in ‘men in black’ outfits doing karaoke and moon walking. University students are university students, no matter where!! Thursday, September 29th the actual anniversary of the founding, started with a program in the morning in another stadium where there were a number of speeches by various representatives of the National, Provincial, and University governing bodies. Then that evening they had another show celebrating the campus with some very outstanding dance and skit performances.
100 year celebrationSpeeches
100 Year Celebration of Founding of Huaxi Medical Campus
Lecturing In Chengdu
100 year celebration 'variety show'
Public Health: In my last indoor air class we discussed the health effects associated with radon. At the end of the first class of the semester, I had asked students to talk a minute and answer two questions about the lecture. What was the most important ideal they got from the lecture and what was the most important question they had about the lecture. I had mentioned radon in the first lecture and one of the student questions was what is radon and is it a risk in China. In the following week I was able to go to the literature and found a paper titled: Radon Levels in China 中国氡气水平 from the Journal of Nuclear Science and Technology, Vol. 39(6):695-699, 2002. It reported on a survey of homes across china including Sichuan Provence. The range in Sichuan was <LLD-374 Bq/m3 with a mean of 20.8 Bq/m3 for over 2600 homes surveyed. To compare that to the U.S recommended guideline of 4 pCi/l we can convert Bqs to PCi with 4 pCi/l = 148 Bq/m3 . So the bottom line is that for all houses in Sichuan the mean is far below the recommended levels in the U.S., but there are houses in the Province that do have levels in excess of the recommendation. The levels of radon for other areas surveyed in China are in the same range as those for Sichuan.
China Daily: A a recent report from China’s Shandong Province reported that tthirteen people had died after contracting infections from tick bites. The 13 people were among 182 reported cases of human granulocytic anaplasmosis (HGA) since the provincial Center for Disease Control (CDC) started monitoring in 2008. The paper reported the patients were bitten by hard ticks. Hard ticks are of the family Ixodidae and are characterized with up to 6 life stages. They include the common dog tick. Soft ticks are of the family Argasidae. The Province health officials are educating the public about the disease and training doctors for the disease’s treatment. This report came after several deaths from tick bites were reported in China’s Henan Province. .
Henan’s CDC said Wednesday 18 people in the province had died of the disease. The victims were among 557 reported cases of suspected HGA since May 2007. HGA reduces white blood cell and platelet counts in the blood, leading to organ failure and death.
My week: This has been a very interesting week for two big reasons. First it is the beginning of the Fall holidays with National Day. This year National Day (October 1st ) is the celebration of the 61st anniversary of the founding of the Peoples Republic of China (in 1949). October first kicks off a week long holiday for the Nation. I was fortunate enough to be invited to the National Day Reception organized by the Sichuan Provincial People’s Government on Sept 29th, at Jin Jiang Hall. Dress was “Lounge Suit or National Dress”. After some confusion about the location, and a very hasty taxi ride, I made it just as the speeches started. There were three speeches given by different leaders of the provincial government. The speeches were simultaneously translated in English and focused predominantly on the economic progress being made in the Province. One of the speeches did focus on the recovery after the major earthquake that occurred in 2008. Sichuan Province was at the epicenter of the earthquake which was located to the west of Chengdu in a mountainous area. The earthquake remains a major focus of the recovery for the area, but apparently they have met their reconstruction goals early (according to the speech). Based on reports I have see from people who have traveled to the area, they have made much progress, but there can be delays to the area due to construction. Also at the reception was one of the current Fulbright students. She recently graduated from Brown University and is working at another University in Chengdu called Southwest Jiaotong University. She is focusing her research on transportation issues. By January, 2011 there will be three other student Fulbright students doing research in the area. Also occurring this week was the 100th anniversary of the founding of the Medical School , but more on that in the next blog.
Public Health: We have been in the midst of the Mid-Autumn Festival holiday (Wednesday through Friday) this week, so the university has been somewhat deserted. This coming week we will continue our seminar series with t he post-graduate students and Saturday evening I have class to make up for the class missed during the holiday break. No, I am not making the students come to class. It was explained to me that this is a normal process for the holiday. Classes normally health during the week, either get made up the Sunday through Tuesday before the holiday or the Saturday and Sunday after the holiday. Mine happens to fall on Saturday evening. The paper we will be discussing this coming week is from the NIEHS journal Environmental Health Perspectives. I think I have mentioned this before, but we are using this because it is available on –line and has both Chinese and English versions. The paper being discussed is: An Emerging Role for Epigenetic Dysregulation in Arsenic Toxicity and Carcinogenesis; doi: 10.1289/ehp.1002114, August 2010. We are using a format similar to what we use for students in the states where one student will take the lead to prepare and make a presentation, then we will have a discussion about the paper.
China Daily: Coal mining is a major industry in China, due in part to its need for an abundant and cheap source of energy for both industry and home heating and cooking (particularly in rural areas). However, it remains a very dangerous industry that the government is trying to address. In a recent article in the China Daily, the headline read “105 Prosecuted for Deadly Mine
Accidents”. The State Administration of Work Safety (SAWS) announced that 105people will be prosecuted in relation to three deadly coal mine accidents in the past 12 months. Two of the mine accidents happened in China’s Henan Province and the other in Hunan. The three accidents were all caused by illegal operation (the article did not specify what illegal operation meant), which led to 159 deaths and 87.5 million yuan (US$ 12.81 million) of direct economic loss, according to Huang. Another 71 people not directly responsible for the accidents have been given disciplinary punishment by the Communist Party or the government. All the coal mines involved in the accidents were closed down and licenses suspended.
Our day: On Wednesday night of this week we went to hear Jane Goodall speak at a local expat bookstore called the ‘Book Nook”. Dr. Goodall has been to china a number of times and to Chengdu as recently as last year. She is 76 years old and travels around 300 days a year giving lectures about her studies on chimps in Gombe, Tanzania and her subsequent interest in conservation. She has developed a youth based conservation organization called ‘roots and shoots’ that has chapters all over the world, including Chengdu. She started her talk with how a chimp would greet you, something that is not exactly translatable through the written word, then described how her interest in animals developed as a child who later translated into her work as a researcher in Africa. First with Louis Leakey and then later on her on. She concluded that after working with chimps for 26 years (1960-1986) she became convinced that because the species was endangered (other species as well) her time and reputation would be better used by fostering interest in conservation and sustainability, so for the past 24 years she has been organizing groups around the world, speaking to different organizations, and only rarely gets back to Gombe. We had a nice vegetarian buffet (Dr Goodall is a vegetarian) and then a question answer session.
Nina and Jane Goodall
Nina at Tian Fu Guang Chang Square
Renmin Park (The People’s Park) Chengdu
Public Health: This week I met with seven ‘post-graduate’ students as the first of a weekly seminar series. As part of this series we will be discussing topics of interest to the students as well as selecting papers from Environmental Health Perspectives (EHS) for review. The reason for selecting papers from EHS is that they publish both an English and Chinese version which will enable the Chinese students to review their papers in Chinese. We will also be comparing how systems operate in China with how the systems operate in the U.S. One of the first areas we will be discussing is how the Chinese CDC is organized and its specific functions. I will be giving an overview of the U.S. CDC and its functions. One of the first topics we discussed focused on water and wastewater treatment and water regulations. There are some very interesting parallels between our approaches and the approaches of the Chinese government. The basic strategies for water treatment are well developed (this is not surprising as the technology is well established, these methods include coagulation and flocculation, settling, and disinfection. We had a lengthy discussion about disinfection and the risk associated with using chlorine. It appears much of the scientific establishment considers the risk from chlorination disinfection by-products is sufficiently large that alternative methods for disinfection should be used. They mentioned ozone, uv, and other forms of chlorine that do not react with organics to form the by-products. However, most of the alternatives do not maintain a residual in the distribution system. Also, it was unclear to me how they handle the sludge from the coagulation and flocculation. For wastewater treatment the processes are again very similar, from primary treatment through secondary treatment. All of the students were knowledgable about some of the tertiary treatment strategies to remove phosphorus, nitrogen, and other chemicals not removed during secondary treatment. As for water, there was not much of a discussion about how sludge is handled. From a regulatory perspective, the government has established standards for coliforms, BOD, suspended particulate, and some of the more common contaminants of supply waters. The levels are comparable to those we have in the United States. There are however some interesting differences. The water treatment agencies are not required to report on the quality of the drinking water (at least as far as I can tell). It is also not clear to me, at this point, how enforcement is carried out to assure compliance with the regulations. One of the interesting observations is that none of these students have ever visited a water or wastewater treatment plant. I have been trying to identify the appropriate contact to see if we can arrange a site visit. The other interesting observation was when I asked one of the students if they drink the tapwater, they said no. .. more later.
From the China Daily: Returning to the theme of smoking. A recent article in the China Daily focused on smoking in films and on TV. The article indicated that “ Although smoking scenes are still widespread in Chinese films and TV programs, the number of tobacco-free works showed a marked increase from 2008, according to 2009 statistics (Chinese Association on Tobacco Control). Among the 40 films surveyed, nine have no smoking scenes at all. Compared to the 2:30 ratio in 2008, this reflects an encouraging change that show business has taken social responsibility in promoting healthy lifestyles. However, copious smoking scenes are still prevalent. The movie “The Founding of a Republic” has smoking in up to 11.8 percent of its scenes…. A survey of 11,000 middle school students in Beijing found that 38.5 percent think actors who smoke in TV or films were mature and charming, and 32.9 percent said they would like to imitate them. The WHO Framework Convention on Tobacco Control, in Article 13, suggests restrictions on tobacco advertising, promotion and sponsorship on radio, television, print media, and as appropriate, other media, such as the Internet…..The recently released 2010 Global Adult Tobacco Survey highlighted that China has a 300 million strong smoking population (Note: the U.S.population is about 305 million, my comment). In response to China’s acute smoking situation, the Chinese Association on Tobacco Control offers two broad recommendations: Actors, directors and producers should refrain from smoking, offering cigarettes or starring in commercials for tobacco products, produce tobacco-free works and create positive influences on society and China’s State Administration of Radio, Film and Television needs to strengthen regulations, prohibit all forms of tobacco advertising, promotion and sponsorship in films and TV programs, and undertake legislative measures to improve monitoring and supervision”
My Day: Next week will be fall festival or moon festival. It is a national celebration during which the population celebrates the fall harvest. There are generally numerous celebrations and the exchange of moon cakes. There was a humorous article in a local English paper titled ‘The Mid-Autumn Festival Alternate Uses for Moon Cakes’ Some of the suggestions were to: 1. Stabilize a wobbly chair or coffee table, 2. As a replacement puck for ice or street hockey…. You get the picture. This is the 2nd most important festival after the Chinese New Year. Based on what (little) I have read there is a mythical story that is similar to a ‘pandora’s box’ story that leads to the exchange of moon cakes. We have received a box of individually wrapped moon cakes from the International Office of the University.
The U.S. Consulate also hosted an Autumn Festival ‘Alumni Reunion’ in which faculty and students from U.S. sponsored exchange programs met for a dinner. In addition to the Fulbright program there are several other types of exchange programs, including English language exchange, short term foreign expert exchange… Two of the people we met were affiliated with the West China School of Public Health, a professor in the Department of Biostatistics and a second professor whose research is focused on HIV intervention in the Department of Health Behavior.
Public Health: Friday evening’s class went well, although there were some interesting communication challenges. The period lasted from 7:30-9:30 with about 70 students in attendance. The course is what is called a ‘selective’ course for seniors that are completing their degree in public health this academic year. There were a number of good questions, which, as I understand is an achievement because for the most part Chinese students focus on taking notes and being lectured to. This fits in nicely with my ‘China Daily’ blog. Friday was ‘Teacher’s Day’ and annual day of recognition for teachers. In the paper, the Chinese President, Hu Jintao,’… called on teachers to embrace reform and innovation in teaching and enhance teaching standards. He urged university professors to be more productive… and urged the university administration and teaching faculty to embrace reform and innovation, and improve its education quality’. This ‘call’ is perhaps the beginning of what U of L has been working on for some time in its efforts to foster innovative teaching methods and critical thinking. One of the task I will be involved in this semester is meeting with some of the younger faculty in the School of Public Health to discuss different methods of teaching.
From our weekend: On Sunday we ventured out of Chengdu to visit the ‘Giant Buddha’ at Le Shan, a city about 70miles to the south of Chengdu. It was an all day trip. First, we took the local bus to the ‘tourist’ bus station, where we purchased tickets to for the bus to Le Shan. The city bus is first come first serve and I have yet to find a seat!! On the other hand, the tourist bus, doesn’t assign seats, but everyone has a seat. In fact, if the bus is full it does wait until departure time, it departs. On the other hand, we experienced this on our return trip; if it is not full it will wait around to see if it can fill the seats. We did not have to wait long on the return trip as the bus was full about 15 minutes after departure time. The trip down was uneventful, taking about 2 hours. We were dropped at the bus station and had to catch a taxi to the site. This site is a ‘UNESCO’ cultural heritage site and is reported to be the world’s largest stone-carved sitting Buddha’ its pinky toenail can seat several full-grown people. It is located at the confluence of three rivers facing the sacred Taoist E’mei Mountain. The 71 meter statue was started in 713 AD and took about a century to complete. See the photo. On our trip back, we did encounter a ‘Chengdu’ like traffic jam which made the 2 hour trip a 5 hour trip. We got back about 9 that evening. But all’s well that ends well, We walked to the local Italian Restaurant and had pizza in celebration of a successful trip.
International Apartments Sichuan University
West China School of Public Health
Some of the Faculty and Students in Public Health