Thursday and Friday July 11&12
On these days we were able to experience clinical at Sir Run Run Shaw Hospital. On both occasions I had the fortunate opportunity to shadow nurses on the cardiovascular care unit. There were 31 beds on this ward and nearly every bed was constantly full. Each nurse had between 3-4 patients per shift, a much lower amount than typical for most Chinese nurses. I was amazed to learn that nurses started IVs and drew blood. In hospitals in America, the lab team does IVs and blood work. Other unusual things I saw were the nurses didn’t wear gloves to prepare or give any medications or to give patient care. I also noticed that the families did most of the work that techs would do in the states. They would bathe, feed, move and take care of other basic needs the patient might have. A daily routine for a nurse on this unit was meds in the morning, vitals every hour, lunch, meds and vitals. Of course there were constantly new doctors orders to fill and take care of, which adds to their work load significantly. Another additional ability these nurses need, is the ability to read heart monitors. Each patient is on a heart monitor and it is up to the nurses to watch and document the rhythms. I know at the hospital I currently work at they have techs trained to sit and watch heart rhythms. This frees up the nurses significantly.

After only a half day in the cardiovascular care unit on the second day, Tasha and I had the opportunity to watch some different procedures in the outpatient department. Our first two stops were for PICC line insertion and wound care. All of the patients had already been seen for the day so we headed over to watch some EKGs. The procedures were quick and the patients were lined up outside the curtain. Next we visited the endoscopy area where we watched a gastroscopy. The patient receiving this procedure had a very rough time and the doctor didn’t seem to pay any attention to the patients reaction. His main concern seemed to get the procedure done as quickly as possible in order to get the next patient in. As a nursing student, such a careless reaction to the situation was frightening. The doctor stood as if he was a robot and offered no support to the patient. Our last stop was an ICU. The ICU was a big room with all the patients in it. This is unlike ICUs in the United States where each patient would have their own room in a closely monitored and sealed unit. The ICU was sealed from the rest of the hospital, but I was still surprised to see all the patients in one common room. I am curious if the percentage of nosocomial infections is higher than in the United States, due to the increased number of patients in a room.
During my first day of clinical, I was with a preceptor who spoke very good English. During our lunch break I asked her if she had always wanted to be a nurse. Her response was surprising to say the least. She admitted that nearly none of the nurses including her probably sought to be a nurse. It is a very low income job and isn’t respected as highly as in the United States. She became a nurse because she didn’t know what else to do, but she wasn’t happy their. When she revealed this to me I couldn’t help but wonder how their patient care may suffer due to their lack in happiness with their work. I did however enjoy the actual lunch break. The nurses took about half an hour for lunch then got a half an hour break time. This is in accordance with traditionally Chinese thought of having a afternoon rest from 11-1. Another interesting thing about this career in china is the work schedule. There are only 12 hour shifts available and the nurses spend two months out of the year working nights.
Over all this was a once in a lifetime experience that I am happy to say I have received. I enjoyed all the experiences I was able to,have and learned a lot from my visits to Sir Run Run Shaw.

Thursday July 11th and Friday July 12th, 2013

On these two days, Kathy and I woke up very early and rode Bus 21 (which we are very fond of by now!) back to Sir Run Run Shaw Hospital for a clinical experience that we will never forget. Having only finished one year of nursing school, this was my first ever clinical experience, and I had the joy of sharing it with my new Chinese friends and nurses Jun, Elvin, and Miao Miao of the General Surgery Recovery Ward. This ward receives patients who have just had any sort of gastrointestinal tract surgery (on their abdomen).

I started the first morning with Jun, who is the Nurse Educator. Her job at the hospital, along with being a nurse, is to educate incoming nurses and orient them to their new ward. She showed me both wings of the ward, each with six rooms with four beds in each room. Then she showed me the nurses station and the four rooms in that hall, which only had two beds in each room. Nurses here are responsible for around eight patients, which shocked me at first. But it makes sense because China has a nursing shortage (just like the United States) and a HUGE population.

After getting oriented to the setting, I was able to sit and listen to a nurse present a new patient case to the rest of the nurses. She talked about patient history, recent surgeries, the surgery she had just had, and about doctor’s orders, such as diet and activity. It was all a bit confusing for me because I don’t speak or understand Chinese, but my translator spoke very good English, and filled me in well.

I also learned the importance of family in the Chinese healthcare system. All of the rooms were filled with family members who had obviously stayed overnight with the patient. Family members are even allowed to assist the nurses with some basic duties. This is a lot different than in the United States, where family is not as completely involved with patient recovery.

On the second day, I started out with watching an IV being removed from an 83 year old woman’s neck. The procedure is very precise, with many exact steps that nurses are required to follow.

Then Kathy and I met up before lunch with our Chinese friend and nurse Jenny, who took us on a tour of the entire hospital. We watched an EKG and a gastroscopy. I was once again shocked, because the patient receiving the gastroscopy was not administered any sort of anesthesia. Kathy told me that in the United States, patients are put completely under when taking this test.

This experience was so amazing and I am feeling so thankful and fortunate for the opportunity to have had my first clinical at a hospital in China. My eyes have been opened to a new way of nursing. This experience was definitely a positive one.

Tuesday July 9 This entry is a little delayed due to a busy week with clinicals. We learned painting and calligraphy on Tuesday. We learned that the official Chinese flower is the peony. The instructor created a beautiful portrait of pink peonies effortlessly. Then it was our turn to try our hand at some simple painting and then calligraphy. The Chinese make their paints from natural materials, but do not make a green paint. We were instructed to make bamboo. We first had to mix green paint. Bamboo should be easy to paint, but being a science and math person even simple lines with the correct shading was a difficult task. The calligraphy practice was even more interesting. We learned the characters that create our names and practiced mimicking. The strokes of a character are important. There is a certain order they should be written as well as a certain direction each stroke is written. After using two sheets of paper practicing, my characters slowly began to resemble the true characters. This was by far the most challenging class for me. I learned how artful the Chinese written language is and why preserving this art is so important.

Monday July 8, 2013

China has kept us so busy!! It has now been one week since we were at this lecture. It was definitely very interesting. Here are some of my notes that really stood out to me:

First, some vocabulary. “Tian” means heaven, nature, or the highest power in the world. “Dao”, or “the way”, is the natural and moral order of the universe. I remember reading the “Dao De Ching” in my Freshman Year Seminar class, so I was glad to learn about something at least somewhat familiar. In that class, we learned that one doesn’t really ever know what “dao” is. “De” means virtue and it enables the possessor to pursue and promote the dao. “Qi” (pronounced chee) is an energy and a vital force. It is the eternal primary stuff of the universe. Qi is also associated with yin and yang. “He” means harmony and is the model of unity between tian and humanity.

The general characteristics of traditional Chinese philosophy are a this-worldly, humanistic emphasis, a focus on dynamism and the constant changing of the universe, and a focus on contextualization.

We also learned a little bit about Confucianism. This philosophy was started by a man named Confucius, who lived from 551 BC to 479 BC. He focused on the “six arts”, which are ritual, music, archery, charioteering, writing, and arithmetic. Confucius had 3000 students throughout his lifetime, and along with teaching, he wrote “Lunyu”, which is basically the Bible of Confucianism. The temples that we see today are more like monuments rather than places of worship. The most important aspect of Confucianism is “ren”, which means people. He taught that you should “love the people.”

We also learned about Daoism. A man named Zhuangzi, who lived from 369 BC to 286 BC, began this philosophy, which mainly holds that one should be at ease with his or her destiny. For Daoists, accepting your destiny is the first step to reaching a state of mind that allows one to enjoy true freedom. “Ming” tells us that humans are bound by external inevitability. The Daoist “Theory of True Knowledge” states that knowledge is intuitive and its realization is a union with the dao.

I personally like the ideals of Daoism. Having read the “Dao De Ching”, it was a little easier for me to understand the second time around. I like the idea of being at ease with my destiny, however, I believe that my destiny is not set or predetermined, that I have the will and ability to change it.

First, I apologize for this being such a long post – and I empathize with anyone who reads the whole thing! I have not posted a blog for awhile because I have been doing a lot of thinking and reflection of all our experiences. I think I have finally wrapped my arms around at least a little bit of our experiences now so I can blog with at least some wisdom.

Professor Ting is a friend of ours – Bill met him on one of his first trips to China, and their friendship has strengthened over time. Professor Ting teaches in the school of public health at Zhejiang University and his research focuses on the evaluation of interventions that encourage people in China, especially those employed in health fields and universities, to stop smoking. His current study is building upon multiple studies he has done in the past and is funded by the Bloomberg Foundation. He has shown the effectiveness of culturally-appropriate interventions in helping people quit smoking. We meet with Professor Ting and his graduate students every time we come to China. During this current visit, Professor Ting is the person who organized our visit to Xuzhou. Professor Ting told Bill a story about his childhood that has really stuck with me and has made me piece together quite a bit of information I have learned while we have been in China; I have thought a lot about Professor Ting since hearing this story.

Professor Ting, Bill and I sharing a laugh while we look at our big red sign at Xuzhou Medical Center

Professor Ting, Bill and I sharing a laugh while we look at our big red sign at Xuzhou Medical Center

During our visit with Professor Ting and his graduate students this past week, the professor took Bill out of our big meeting room to talk. The professor wanted Bill’s help in editing a research paper he is planning to submit to a journal published in English, and he needs help to ensure his paper has the right meaning in its translation. During their private meeting, Professor Ting told Bill a story about his childhood. I am not sure how old Ting is, but I believe he is most likely in his late 50’s or early 60’s. He is a kind and gentle man. His ability to speak English improves every time we meet with him. I don’t always understand what he says, but he is quick to smile and is someone who I really admire. The information about China’s history which I have presented below is based on some things I have read and a lot of what I have heard in the different classes, experiences and conversations I have since I have been here. My interest in piecing all this together was cemented by Professor Ting’s story. Better understanding this part of China’s history really has helped me better understand the Chinese culture.

During China’s “Great Leap Forward” (1958 – 1961), Mao Zedong, leader of the Chinese Communist Party from 1935 – 1976, created policies in an attempt to modernize China’s economy. Mao’s goal was to create an economy that rivaled the economy of the U.S. by 1988. Mao went out and visited people all over China and decided that the Chinese people were capable of doing anything. So Mao decided to focus on agriculture and industry. Industry was the most important part of his plan, but he knew in order to have a successful industry, people needed to be fed. China was formed into a series of communes. Each commune consisted of about 5000 families who had to give up all their personal possessions; people worked for the communes and not themselves. The communes were encouraged to set up production plants in addition to their farms. Some farms ended up producing huge amounts of steel and other industrial products. The Great Leap Forward initially resulted in a large increase in the production of industrial materials as well as a major increase in agricultural production, such as grain and cotton.

However, in 1959, bad things started to happen in China. Political decisions were not always practical and people in the communes were forced to do things they could not humanly do. Farm machinery that was produced very quickly didn’t always work, and thousands of steel workers were injured due to their long working hours. In addition, the growing season of 1959 was not as good as the season in 1958 due to flooding in some areas and droughts in others. The growing season in 1960 was even worse. The time from 1962 – 1966 is called the Four Hard Years. This is a time of Chinese history where there was great famine. Some estimate during this time that 20 million people died from starvation or starvation-related diseases. It was a very challenging time to live in China.

The Cultural Revolution occurred in China from around 1966 – 1976. Mao knew he was losing power – the Great Leap Forward had not accomplished the goal he had intended, and many had died in the previous four years due to the famines, so he urged the creation of the “Red Guards” to punish communist party officials and anyone else who openly was against him or the communist party. The purpose of the revolution was to get rid of the “Four Olds”: old customs, culture, habits, and ideas. Mao believed this revolution was needed in order to prevent capitalist ideas from moving into China. Students, some as young as elementary-school aged, were the first Red Guards. Eventually they were joined by workers and soldiers. The Red Guards first began to target Buddhist temples, churches and mosques – these buildings were either torn down or converted into other uses. Sacred documents and texts, including works from Confucius, were burned along with religious statues and artwork. Anything that was associated with China’s past was ordered to be destroyed.

When we visited West Lake on our hike with Mara and Taffin, they took us to Lin Feng Mian’s house. He was a famous Chinese artist who lived in the West Lake area. We learned during that visit that Lin Feng Mian studied in France and was one of the most influential contemporary Chinese artists of his time. I really enjoyed his paintings and found them quite beautiful.  Unfortunately, he destroyed many of his paintings by flushing them down the toilet in the late 60’s because he was afraid he would be arrested. His fears were realized, and he was one of many political prisoners during this time. Fortunately, he survived this experience and continued painting great works upon his release.

 

A portrait of Lin Feng Mian, a contemporary  influential Chinese artist

A portrait of Lin Feng Mian, a contemporary influential Chinese artist

In addition to destroying anything religious and a lot of artwork, the Red Guards focused on attacking others with capitalistic thoughts, including teachers, monks, and other educated people. Many times these people ended up dying or being held in reeducation camps for years – I am pretty sure this is what happened to Lin Feng Mian.

By the end of 1968, Mao realized that the Cultural Revolution was not working very well. According to one of our Chinese classes we have had on campus, we learned the Chinese government sent businessmen and other prominent city dwellers at this time into the rural areas and brought rural dwellers into the city. This was an attempt to reduce the negative effects of the Red Guards. Mao’s health began to fail, so he developed the “Gang of Four” which was composed of his wife and three of his best friends. This small group of people controlled much of the media at this time. Several key events happened next – there was a big earthquake and Mao eventually died in 1976. The successor who Mao had selected, Hua Guofeng, ordered the arrest of the Gang of Four, thus ending the Cultural Revolution.

It took China a while to recover from the Cultural Revolution. Schools in China were closed down, so the educational level of its people suffered. The highly educated people had been sent for reeducation or were sent to farms, so there were limited human resources left in the cities to spur economic growth. Confucianism was challenged, and people were not allowed to participate in formalized religion. No one really knows how many people were killed during this time, but it is a time that many people I have talked with have said was a very sad time for China.

With my curiosity peaked about how Chinese people currently feel about Mao and his rule, I spoke with Jing, another one of our friends today about Chairman Mao, the Four Hard Years, and the Cultural Revolution. Jing grew up in Hangzhou; she and her family still live here today. She is close to my age, so she was born during the Cultural Revolution and does not remember a lot about this time in China’s history. She told me that her parents were very well educated. During the late 1960’s, her parents had to stop doing their research every now and then to work in the fields. They were in the fields the most during harvest times. She does not remember anyone in her family starving but her parents still talk about how they had to work on the farms. I asked her what people thought about Chairman Mao and his leadership. Some of the things I have learned about him are not always presented in a very positive light. She said that her parents really respect Mao and all that he did. I then asked her if he was the person ultimately responsible for all this suffering, how could people still think he was a great leader? She responded that he did great things for China, especially in the 1940’s. He helped lead the fight in the 1940′s to free China from Japanese rule. He also helped to improve literacy and increased access to health care after the war. He tried hard to minimize the difference between the rich and the poor. According to Jing and some of the sources I have read, it was this desire to even out the social classes that was Mao’s ultimate goal during the Cultural Revolution. Unfortunately, his efforts were not successful but ultimately he was and still is considered a great leader by some because of the good things he did for China. I am not really sure where I stand on all this yet – but at least I understand the Chinese perceptions of General Mao a little bit better now.

Jing preparing a special Hangzhou treat for us at her apartment

Jing preparing a special Hangzhou treat for us at her apartment

All of this brings me back to Professor Ting. During a conversation, Ting told Bill about his childhood. He grew up during this very challenging time in China. He told Bill that he and his family suffered greatly; they had to eat roots to survive because there was very little food. He ended up losing his mother and two siblings to starvation. At some point in his childhood or young adulthood, he was able to join the Chinese army. I have a feeling that this is what saved his life, at least physiologically. I am under the impression that once he joined the army, Ting was able to have a more reliable food source. At some point either during or after his army career, he ended up attending medical school in Xuzhou. Upon graduating from medical school, Ting decided to further his education in public health and he ended up being a professor at Zhejiang University. He is a Christian but being a Christian has not always been easy for him. He has raised an incredibly bright and talented son named Josef, who was Bill’s translator and helped us understand what we were seeing during all our cultural field trips in Xuzhou. Josef is now a doctoral student at Purdue – he is incredibly delightful and intelligent, just like his father. Ting is an excellent and well-respected teacher and researcher – he includes his students in his research and he is doing great things to improve the health of the Chinese population.  I never realized everything he had been through to get to this point in his life. I look at him now and am in awe – how did someone with such a difficult childhood end up being where he is today with that infectious smile always on his face? He is a true inspiration.

 

Professor Ting playing with fish at the lake in Xuzhou and smiling as always!

Professor Ting playing with fish at the lake in Xuzhou and smiling as always!

This is the first time that I had ever heard personal stories that related to the historical events we have learned about since we have been here. Before this moment in time, I simply thought of the Chinese famines and Cultural Revolution as events that happened in the past and never really gave them much thought. I had never heard the human side to this story. So it just never seemed real to me until now. As I reflect upon the history we have learned about China, Jing’s life as a child, and Professor Ting’s story, I have begun to realize at a deeper level the effect that the Cultural Revolution and the time surrounding it has had on the Chinese culture. I wonder now about everyone I meet – how did they or their families survive this time? What all was destroyed and who all was killed or died? If these events had not happened, how would China look today? Would it be different or would it be the same? How many more people would there be in China? I remember when I was little how my mom used to tell me to eat all my dinner because “there were children starving in China.” I better understand now why she would say this and I am thankful that I did not have to live in China during this time. I may not have survived…and I probably should have been grateful my mom gave me Brussels sprouts to eat at dinner instead of refusing to eat them :)

As our time in Hangzhou is coming to a close, I continue to be aware that the people we meet and the culture we are trying to better understand have been influenced so much by historical events that they could not control. Many of these events are things that I have never experienced before or have truly understood. I want to learn more, experience more, and understand more. My summer Chinese adventure has helped me put together more pieces of the puzzle. This is one of the reasons I enjoy coming to China – the students and I would never understand all this if we simply came to Hangzhou as tourists to see the beautiful historical landmarks. The benefit of being involved in a study abroad program is that I get to see great things while coming to a much deeper understanding of the world around me. I am blessed and hope that other people come to better understand what an incredible nation China is – this experience has truly changed me and how I think about China. It has made me a much better informed and educated teacher, nurse, and person. I better understand China yet at the same time, I realize that I have so much more to learn. I wonder what tomorrow will bring!

Tuesday July 9th

Here are some things I have noticed while staying in China:

1) Everything flows. A good example is ba duan jin, which is a series of moves that flows from one to the next. Another example is traffic. Traffic lanes are basically nonexistent and cars flow around people, bikes, etc.

2) There are not a lot of pregnant woman.

3) There are not a lot of grade school children. This could be because they are still in school, or because we are on a college campus.

4) Everything is very cheap, except for Western food.

5) There is a great sense of community. People practice ba duan jin and exercise in public parks full of other people.

6) Dental hygiene does not seem to be as important as it is in America.

7) Girls wear heels everywhere. I don’t know how they do it. Someone told me it was because they want to look nice in pictures.

8) PDA is almost nonexistent.

9) Despite crazy traffic, I have yet to see an accident or someone get pulled over. I don’t think that policemen are for traffic regulation.

Friday July 5, 2013

Mei, our instructor today, taught us about Chinese health culture. Traditional Chinese health culture believes that a balance between nature and man will bring a longer life. Most of the lecture was based on yin and yang. Yang represents heaven and yin represents earth. On the body yang is the back because when they worked their back was to the sky and the front is yin because it was to the earth. Other things yang stands for are daytime, light, warm, active and male. Yin also stands for night, dark, cold, passive, and female. Next we discussed Meridians and collaterals. These are lines that divide the body up. There are 12 meridian lines. They are broken up into five zang organs and six fu organs. The five zang organs are heart, lungs, spleen, liver, and kidney. The six fun organs are gall bladder, small and large intestines, stomach, urinary bladder, and sanjiao. You may be thinking this is only 11, but the heart counts for two because it contains the spirit.
In Chinese health culture another important idea is the 12 hours of the day. Originally the Chinese had 12 hours, so every hour was two of the modern day hours. Each hour has an animal associated with it. The hours of the day can also be broken into the four seasons. Spring represents morning, summer is afternoon, fall is evening, and winter is night. There are two specific times of the day the Chinese associate with yin and yang. 11 to 1300 and 2300 to 1 represent the two small dots in the yin yang sign. The two hours from 11 to 1300 are the dark circle in the light yang side. It is represented by the horse and is believed that during these two hours you should rest. The hours between 2300 to 1 are the light circle in the dark yin side. It is represented by the mouse because it is active at night. It is believed that if you weren’t asleep by 2300 than you should stay up until 1. I thought this was interesting because many cultures have siestas in the afternoon to rest. They believe it makes them more productive in the afternoon and evening.
We ended the class with bā duán jîn. This is similar to tai chi, but only has 8 movements. It is done slowly to feel the body and calm the heart. Mei believed that with this exercise she would lengthen her life span. I learned that many of the people really think about ways to make their lives longer and this is the reason for some of the traditional medicine and therapies.
After class, a few of us headed to get blind massages. In china, the blind are limited to only a few jobs. One of these jobs is a masseuse. It is unfortunate though because they don’t receive very much pay. Due to the increase in other senses, the masseuses can feel more. Mine detected that my neck was often sore and tight.

The blind masseuses and our group

The blind masseuses and our group

After the massage, Amy Hall and I decided to try cupping. Cupping is an ancient practice in china. It is a glass bulb that is heated by placing a flaming stick in it. Once heated, the stick is withdrawn and the bulb is placed on the skin. As the glass cools it creates a vacuum sucking the skin up inside the bulb. It is left on the skin for about ten minutes and then pulled off. It leaves red marks for a couple days. The belief behind this practice is that it pulls excess water and toxins to the surface to be released from the body. It is also believed to increase blood and lymph flow. I was surprised when it was not painful, but kind of enjoyable.

Starting the cupping process

Starting the cupping process

In the morning, we had a lecture on Chinese Consumer Behavior. According to the professor, consumption in China is decreasing. There are several possible reasons for this decline, the most likely being the Social Security system. The system in China provides little help to the aging population, which has led to an attitude of thrift (which is also a cultural behavior) and saving for the years of retirement. Another possible reason is that prices are rising in China, but wages are not. Housing now costs 30,000 RMB per square meter.

On the medical side of consumption, we learned that China has a goal to provide 100% of its population with medical insurance. Before 2003, there was no insurance for the rural population.

We also learned about the New Medical Reform of 2009, which aims to solve the problem of hospitals relying on drug sales to make money, among others. Through the reform, the privatization of hospitals has begun as a way to reform them, not as another way to make profit.

The professor also told us about the Chinese preoccupation with color. Red stands for happiness and good luck, and is the color of envelopes given at weddings filled with money. Gold is for money and wealth, which often accompanies red. White is the color of a funeral.

Don’ts for China are: don’t be late for an appointment, don’t give a clock as a gift, and don’t give a green hat as a gift to a man because it means that his wife is cheating on him.

We visited Sir Run Run Shaw Hospital in the afternoon.

Sir Run Run Shaw Hospital

It is the first Joint Commission International accredited hospital in China, which is very impressive. Sir Run Run Shaw is a Hong Kong philanthropist and he donated this hospital to Hangzhou. It has many western influences, and continues to grow and become more westernized. We met with several of the nursing staff, including the nurse educator. Similar to America, there is a nursing shortage, and not many nurses are men.

Sir Run Run Shaw Hospital has several towers and wards. There is even a place for international patients. We visited the ER, which was very small, but according to our tour guide is being expanded. We also saw the ophthalmology ward and got a taste of the out-patient department. When we arrived in the out-patient lobby, it was very crowded, and people were lining up to get a ticket for an appointment.

Kathy and I are feeling very lucky because we have the chance to go back to the hospital and shadow a nurse! That will surely be an incredible experience.

Tuesday July 2

Today’s lecture focused on the Internet and social media in China. The Internet first emerged in 1995, but was limited to who could use it. There are two companies that provide Internet for China, ChinaTelecom being one of them. The biggest share holder for both companies is the government. This definitely surprised me because I always imagined the Chinese government disapproving or restricting Internet.
The web culture is similar to the rest of the world but the companies that make it up are different. Instead of AIM and MSN messenger for instant messaging, the country has developed Tencent. This instant messenger is sometimes used in coordination with healthcare. A person may describe how they are feeling and if their health care provider is a friend they may send a message telling them what to adjust in order to feel better without a hospital visit. Baidu is a search engine used instead of Google or Yahoo and Youku is used instead of YouTube. Youku is used to watch t.v., movies, sports, user uploaded videos and much more. Another web culture aspect is popular forms. Tianya.cn and mop.com are used for discussions about topics such as fashion, politics, economy, and lifestyle. Mop.com is typically used to mock politicians and others in the spotlight.
Social media is also different in China. As most know, sites like Facebook and Twitter are not accessible in China. Renren is used instead of Facebook and Weibo is the equivalent to Twitter. The interfaces on the social media are similar to their counterparts with similar features. Originally Renren was open to just college students, but eventually was opened to everyone. Weibo was first established for news. Some hospitals have a Weibo account and use it for PR. Yang LAN, the Oprah of China, has a powerful video about the empowerment of social media in china.
http://http://www.ted.com/talks/yang_lan.html

China also has their own mobile companies, China Mobile and China Unicom. For every company popular over the world, China has created their own version. The government does monitor the Internet and can delete content they believe to be too politically disruptive. China has essentially created Internet media to bring profit for themselves.

Although small, Taffin & Mara's apartment uses space very well - this is the living room

Although small, Taffin & Mara’s apartment uses space very well – this is the living room

I know this is probably a very strange title to this blog post. But I have had a couple of massages since I have been in China and have learned some really interesting cultural differences between the US and China, and I think after reading this post, you might better understand the title. It never ceases to amaze me where I learn about health beliefs in China. I learn about them most frequently in unexpected places.

When we were in Shanghai, all of us except Bill had a foot massage. Bill and Kathy’s son, Brian, knew of a reputable massage chain that has several locations around China. Most of us decided to do the upgrade from the basic massage and had oil used during our massage. The price was 188 RMB, which is about $30.50 USD, for an hour massage. The massage started out with the masseuse putting our feet into buckets of hot water. Then they massaged our necks and backs. It felt so good after our long plane rides. After our backs were done, they massaged our feet and legs. At the end of the experience, I was so relaxed…it was a wonderful experience. As we were exiting the spa, the students and staff at the spa were getting their pictures taken together. It was a really fun way to end our night. We found out from Brian that many companies support massages for their employees. They believe that massage is an excellent way to preserve health, so some people in China will have massages weekly. I think I could really buy into a weekly massage!

As we were walking through Shanghai, I noticed that there were some store fronts advertising blind massages. I asked Brian what this was all about. He said that in China, it is very popular to have a blind person be the masseuse. The thought is that because these people cannot see, their sense of touch is much more sensitive and they give even better massages and are more in tune with your health needs than sighted masseuses.

When we came to Hangzhou, we met up with Mara and Taffin. They are very good friends of ours that we met at the University of Evansville. Taffin taught Chinese at UE for a year and he brought Mara, his wife, with him. We developed a very close relationship with them while they were in Evansville. During our first week in Hangzhou, Taffin told us that they could not meet with us because “Mara was on her period.” When we were hiking up a mountain with Mara and Taffin, Taffin and I discussed our plans for the rest of the week. During our conversation, he said as long as Mara is not on her period, we should be available for anything this week.There were times when they lived in Evansville that Mara would cancel an activity she had planned with us for the same reason. I am not sure if it is common in China to talk so openly with friends about your menstrual cycle or if this is just something unique to Taffin and Mara and their personal cultural beliefs. But I do find this openness about a woman’s cycle to be much different from the US. Typically women in the US might say they don’t feel well or they have cramps; we just have a different way of expressing this.

This is Mara's kitchen - this is a typical apartment in China for young couples - it is about 900 square feet and has 2 bedrooms, a bathroom with washing machine, a kitchen and a little great room with a balcony

This is Mara’s kitchen – this is a typical apartment in China for young couples – it is about 900 square feet and has 2 bedrooms, a bathroom with washing machine, a kitchen and a little great room with a balcony

On our hike up the mountain, Mara mentioned to Kathy and me that she is teaching a blind masseuse how to speak English. She then asked if Kathy and I would like to try a blind massage – after our experience in Shanghai, Kathy and I were ready for the experience :)

We walked into a neighborhood and through some alleys and we finally came upon the massage parlor. The room was large enough for 5 massage tables – there was very little room between the tables. The tables were pushed up against a wall and there was just enough room for one person to walk at the head of the tables to get from the front to the back door. In other words, the massage parlor was very small.

Our massages were wonderful. Kathy and I asked the guys doing our massage if they wanted to come home with us. They chuckled and said they would really like to come with us but they had to stay in China. During the beginning of my massage, my masseuse asked Mara a question which  Mara then asked me. He wanted to know if I was having trouble with my neck. I told her that I was having trouble getting comfortable in the beds here as they are harder than I am used to. Also, I told her I always do a lot of typing because I write and because of my job and I often feel a strain in my neck. She then told me the gentleman doing my massage could tell I was having trouble with my neck.

A little bit later, I heard my masseuse ask Mara another question in Chinese and then Mara asked me if I was having my period. I thought to myself, this guy must be really good if he can tell something about a woman’s menstrual cycle just by touching her. I told her I was as I am always honest, and the next thing I heard was all this exclamation in Chinese and my massage stopped. I looked at Mara and asked her what the problem was. In Chinese culture, it is not considered safe for women during pregnancy or during their menstrual periods to have a massage or do any exercise of any kind. She said it would make you bleed more. You also are not supposed to eat cold foods or have cold drinks during this time. I told her in the US we don’t have this custom – typically women are encouraged to stay active throughout the month and during pregnancy unless there is a medical reason or health risk that would make this too risky and that we are able to eat and drink cold foods.

After much discussion and debate in a language I could not understand, it was decided that my massage would only focus on the upper half of my body just to be on the safe side. I apologized to Mara and told her I never would have thought this would have been an issue. At the end of the massage, Mara said to me that my masseuse could not figure out why I would come to have a massage at this time of the month. I reinforced to her that since I was healthy, there would be no reason not to have a massage according to US culture.

We made our way back to Taffin and Mara’s apartment where Mara proceeds to tell Taffin the story of our massage – nothing like talking about your monthly cycle with friends just before dinner J I must say I have never had a discussion like this in mixed company before – only in China! This story then led into a very interesting discussion where we talked about the differences between Chinese and US beliefs about issues surrounding women’s health (Kathy Lever would be so proud of me :)). Taffin and Mara were amazed I run, swim, and exercise all month long. I explained that I am too busy to let anything really slow me down. Kathy and I also explained that even pregnant women are encouraged to maintain their exercise routine throughout their pregnancy. We explained to him that we believe that exercise keeps a woman healthy. At times you may have to slow down or alter your activity, but for most women, staying active is very important to health. Our discussion actually ended up being a very interesting learning experience for all of us. We learned more about the Chinese beliefs about women’s health and Taffin and Mara better understood the US beliefs.

As we continue our adventure in China I continue to be amazed by how similar yet different we are. I really seem to find more similarities than differences. And just when I think I am finally figuring it out, I find some traditions and beliefs that are very different from ours. I can’t wait until I have my next “aha” moment about health beliefs in China! Heaven only knows when and where it will happen next :)