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"We need you"
U-M's Chinese Scholar Exchange is leading the way toward greater trust and collaboration between the US and China. And that might just help stop the next major outbreak of disease.
July 15, 2008
Related: Watch slideshow
U-M master's students in the School of Public Health are part of a growing exchange of health experts between the university and China. Click image for slideshow of more images.
A red-and-yellow Chinese flag stands in the corner of a crowded conference room, whose otherwise generic decor belies its setting halfway around the world. At the start of their 2008 spring break, 30 University of Michigan public health graduate students are witnessing the first of many sights that anyone who lived during China's closed-off Cultural Revolution years wouldn't have believed possible.
An epidemiology official from the China Centers for Disease Control types her password and the projected web page whirs into update mode. Reports suddenly appear about the morning's new measles cases in Tianjin, where the 30 students are headed next. Tianjin, a metropolitan area southeast of Beijing with a population of more than 10 million (larger than the state of Michigan), is also the site of a measles outbreak hitting epidemic proportions for February.
This presentation is an introduction for the U-M public health students who have recently arrived in China. They're spending spring break, 2008, as part of an unprecedented project—the first American students hosted by any CDC in China for practice-based deployments.
Within days, the students and their staff advisors will be out of the office and in the field, visiting clinics and homes of recovering measles patients, discussing China's treatment and vaccination schedules to control a disease now rarely seen in the US. They will also examine strategies to provide safe water amid growing environmental problems. And they will marvel at the traditions in China's millennia-old approaches, such as acupuncture and herbal medicine, to non-infectious conditions.
The U-M students were impressed by China's system of preventive care and traditional medicines, ranging from complete pre- and post-natal care to therapies like acupuncture (above). Click image for slideshow of more images.
With a fifth of the world's population and unprecedented growth, what happens in China affects everyone. Because of China's long-closed society, opportunities to work there immerse U-M SPH students in new situations where they can abandon preconceptions and learn to learn anew. And at the same time, the joint efforts by U-M and Chinese health officials are breaking down barriers between the two countries and building trust at important levels. If and when there's a new disease outbreak or public health crisis of international proportions, both countries will be better equipped to deal with it.
Reaching across borders
Even in this era of globalization, such exposure to China's inner workings is remarkable. To begin with, the Internet-based Chinese System for Surveillance & Reporting of Infectious Diseases—which showed the U-M students the latest outbreaks of measles—didn't even exist five years ago when the deadly epidemic of Sudden Acute Respiratory Syndrome (SARS) blindsided China, and then the world. The new system was designed to provide valuable disease outbreak information that could lead to quicker detection and response in epidemics, such as avian flu.
Moreover, the officials' sharing the information with Americans is one sign that the country is seeking a more open, collaborative effort to improve public health.
"SARS attacked us, and it exposed our weaknesses, such as the backward development of public health," a Chinese CDC document states with disarming honesty. A "never-again" resolve led to both the Internet-based disease-reporting system and a huge investment in public health expanding into 3,000 regional Chinese CDC offices across the world's most populated country. China's CDC staff work on some of the country's greatest challenges: environmental health, infectious disease, safety, and mounting chronic diseases related in some cases to Western-style problems resulting from stress, smoking, obesity, and unchecked economic development.
National borders don't demarcate public health threats these days, as we are frequently reminded by the threat of diseases like SARS and avian flu. So it's encouraging that China is willing to share some of its problems along with its triumphs, giving foreigners access to many formerly hidden corners of its health infrastructure.
Here and there
The exchange between the School of Public Health Practice Office and Chinese institutions is more than a matter of U-M students traveling abroad. The SPH's new Chinese Scholar Exchange is a multifaceted collaboration with the Tianjin CDC (TJCDC) that is expanding two-way training opportunities. U-M students and scholars do more than share American methods with their Chinese colleagues. They learn just as much in return.
Over spring break, the 30 students spent their days observing traditional Chinese treatments and learning about China's medical system. They were particularly impressed, for instance, by the attention and care given to new mothers and their babies.
Likewise, Chinese experts come to Ann Arbor to study and share information. Dr. Guohong Jiang is director of Non-Communicable Diseases at the Tianjin CDC. She recently completed a three-month residency at U-M SPH. While she was here, she gave a Public Health Grand Rounds presentation in which she summed up China's public health challenges with emerging diseases, an aging population, and barriers to promoting healthy lifestyles: "We need your help."
U-M's School of Public Health is poised to reap unprecedented benefits from such collaborations. Along the way, both sides are building mutual trust and understanding.
At the same Grand Rounds, sponsored by the school's Office of Public Health Practice, U-M SPH alumnus Dr. Stephen Blount described the areas of increasing collaboration with China that he observes in his work the global health director for the US CDC (he oversees 200 US government staff assigned to 50 countries, and 1,500 locally hired staff and contractors.) For example, after the rash of export food and product safety incidents in 2007, Dr. Blount said China asked US FDA inspectors to come establish dozens of advisory bases throughout the country.
"No question, there's been a big change in communication and sharing," Dr. Blount said.
Trust was part of the Scholar Exchange from its inception. The School of Public Health's Associate Dean for Practice, Matthew Boulton, worked closely with Dr. Jianli Kan at the Michigan Department of Community Health nearly a decade ago. Dr. Kan went back to China after the SARS epidemic, and is now Director of Epidemiology for the National China CDC in Beijing.
Together, Drs. Kan and Boulton formulated the partnership between U-M's Office of Public Health Practice and the TJCDC, in cooperation with Xiexiu Wang, Director General of the TJCDC.
"To my knowledge, we're the first school of public health to formalize an exchange with this level of commitment and cooperation on the part of the Chinese government," says Dr. Boulton. The 30 SPH students who spent spring break 2008 in China went as part of UM SPH's Public Health Action Support Team (PHAST). (You can see a slideshow from their trip here, and read their blog at phastinchina.blogspot.com.)
The exchange program continues to grow. Dr. Boulton and SPH Dean Ken Warner officially opened a new overseas office at the TJCDC in May. Students and faculty are streaming back and forth between the countries, under the exchange's stated goal to conduct applied research, engage in public health practice, and to understand each other's public health systems.
UM SPH has global health bases in many places. But for sharing practice-based experiences and building mutual trust, nowhere is more important than China.
is a writer with the University of Michigan School of Public Health.