Dear Dr. Loper and members of the BMDF Scholarship Committee,
It is with pleasure and gratitude that I submit to you this summary of my summer internship in China, which your generous grant helped to make possible. I arrived in China on June 6, 2011 and returned to the United States on August 2. The eight weeks I spent in China are some of the most memorable of my life. In addition to enriching me both personally and professionally, this experience has benefited many others through the healthcare and educational services I was able to provide.
My journey began in Beijing, where I intended to visit the first and only student-run free clinic in China, which was founded by acquaintances of mine at Peking University Medical School. Unfortunately, my friends were unable to accommodate me as they were in the middle of final examinations, so I did not have the opportunity to visit the clinic. I was, however, fortunate enough to visit a few of the capital city’s famous sites, including the Forbidden City, Tiananmin Square and beautiful Beihai Park. Three days after arriving in Beijing I boarded a train bound for Xining. The westward journey took 20 hours and I had no choice but to sit in the hard-seat section, as all the sleeper car beds were sold out. Needless to say I arrived in the Qinghai capital exhausted and slightly dazed, but not before making a few friends and glimpsing some beautiful countryside along the way.
In Xining I spent three weeks shadowing physicians at the Qinghai Red Cross Hospital (QHRCH). The hospital was founded in 1949 and has grown to 1,050 beds. It will soon be one of only a few Joint Commission International (JCI) accredited hospitals in China. I had the privilege of working with three of the hospital’s international staff—Dr. C. an American who graduated from Harvard Medical School and coordinates a family medicine clinic at the hospital; Dr. M., a Namibian who trained at Stellenbosch University in Cape Town, South Africa and works in the emergency department; and Dr. J., a Swiss orthopedic surgeon who founded and chairs the pediatric surgery department at QHRCH. I spent two mornings a week with Dr. C. in the outpatient clinic, seeing a combination of expatriates, members of the local community, and villagers from remote areas of the province. Dr. C. has a wide breadth of practice, from managing systemic lupus erythematosus to testing for and treating STDs and parasites. He even delivers babies on occasion. I enjoyed seeing a true generalist at work. Two days a week I worked with Dr. M. who, in addition to staffing the ER, has trained the entire hospital in basic life support. I had the opportunity to assist with a number of these trainings, as well as respond to a trauma call in which we rode in an ambulance to pick up a construction worker who had fallen from a height of 7 stories. On the remaining day of the week I did rounds with Dr. J. on the pediatric surgery unit and accompanied him to his outpatient consultation clinic. The highlight of my internship at the Red Cross Hospital was assisting Dr. J. with two surgeries, the first the removal of a neuroma from the shoulder of a girl who had previously had her arm amputated and the second the resection of a lipoma from the leg of a toddler. As a result of working with Dr. J. I have begun to consider pediatric surgery as a potential specialty.
After three weeks at the Red Cross Hospital in Xining I traveled to the city of Yushu with a team of physicians 
from a clinic in Macao. Yushu experienced a devastating earthquake in April, 2010, and many of its inhabitants are still living in tents provided by the government and international relief organizations. In Yushu I worked with an organization called Love Qinghai Tibet Relief and Aid (LOVEQTRA), an NGO based in Xining which provides medical care and education to displaced persons in Yushu and other areas of Qinghai. The day following the 14 hour drive to Yushu, I traveled with a medical team to the remote village of Nang Qian hidden high on the Tibetan plateau where we set up a clinic at a small boarding school. The journey to the village involved 6 hours of driving on dirt roads over mountains 15,000 feet high. We slept in tents provided by the school and opened the clinic for several hours in the morning and afternoon over the course of 4 days. We treated children attending the school as well as local villagers of all ages. The team consisted of two physicians—one from Macao and 
another from Xining—a nurse from Sichuan, our driver, and me. I spent most of my time filling prescriptions written by the two physicians and passing along the doctors’ orders to the patients with the help of faculty members from the school who volunteered as interpreters. Many of the villagers and students only speak Tibetan, so I would give instructions in Chinese, and the teachers would translate the instructions into Tibetan for the patients. While it seems we were only able to scratch the surface of the medical needs in this village during the few days I was there, LOVEQTRA has established a long-term relationship with the school, and intends to send medical teams there on a monthly basis.
After returning to Yushu, I volunteered for two weeks at a summer camp for Tibetan children, where I taught English. Some of the children have never attended school. Others were on summer holiday. In addition to learning English, the children who came to the camp took classes in Mandarin, music, and art. We also played lots of games. In the evening, when classes ended for the day, we would accompany the children to their homes (tents) where we 
would visit with the families. These visits were the highlight of the day for me, as the parents of the children, many of whom were desperately poor, would express their gratitude to us by serving us yak-butter tea, goat cheese, fresh fruit and cookies. On one occasion I was given a traditional white scarf, which is a sign of hospitality and blessing. While the children may soon forget the English grammar and vocabulary I taught them, I will never forget their smiling faces and warm hospitality.
During the second week of camp I became incapacitated with stomach cramps, vomiting, and the worst case of diarrhea I’ve ever experienced. The volunteer doctors on staff with LOVEQTRA gave me IV fluids and antibiotics and ordered me to rest for a few days. Three days later and ten pounds lighter I was feeling well enough to resume teaching. While I would never wish such an experience for myself or anyone else, I believe this experience will help me to better empathize with my patience in the future.
When my internship with LOVEQTRA came to an end, I took a 14 hour bus ride back to Xining, followed by a 30 hour train ride to Chengdu the next morning, immediately followed by a 20 hour train ride to Kunming, where I stayed with some American friends for a few days. My friends, Jeff and Lori and their family, have taken in dozens of orphans who have been abandoned and/or neglected because of illness and deformities like cerebral palsy, autism, blindness, and hydrocephaly. Jeff and Lori have arranged for many of these children to be cared for in foster homes and adopted both domestically and internationally. They have also coordinated surgeries and continuing medical care for them at local hospitals. In addition to providing a home for the children in three neighboring apartments, they have transformed a fourth apartment into a physical therapy suite, where each one receives therapy as prescribed in his or her personal regimen created by a licensed physical therapist. I was humbled by the love and personal sacrifice exhibited by this family, and deeply impressed by the joy I witnessed in the children for whom they care, in spite of their physical and mental limitations. I was reminded that my greatest obligation as a medical student and future physician is not to my family or country, medical school or professional society, and certainly not to personal ambition, but rather to those who are most vulnerable and in need, to those for whom there is no one else to care.
After several days with my friends I traveled by train to Guangzhou and then on to Macau, where I was reunited with several physicians whom I had met in Yushu. These physicians work at Hope Medical Clinic, which provides family medicine services to the local and expatriate community in Macau, as well as conducts medical mission trips to underserved areas in mainland China on a regular basis. In addition, the clinic administers a family medicine residency program which trains physicians from all over the world. I only had time to stay in Macau for one day, but during that time was able to shadow at both Hope clinic sites, as well as have lunch and a tour of historical Macau with the
clinic’s medical director, Dr. Morgan. Dr. Morgan is from the United States but has been working with the Hope Clinic in Macau for 23 years. At the end of our time together, Dr. Morgan graciously invited me to return to the clinic for a family medicine rotation during my fourth year of medical school.
From Macau I took a ferry to Hong Kong, where a friend met me and gave me a brief tour of the harbor before escorting me to the airport. From Hong Kong I flew to Tokyo and then to Detroit where I spent the night with my brother and his family before catching a bus to Pittsburgh the following day.
This has truly been one of the most remarkable summers of my life. In addition to eating lots of delicious (and sometimes strange) food, seeing many beautiful places in China, and meeting wonderful people from all over the world, I was given a taste of the healthcare system in China, including experiences in urban and rural areas, inpatient and outpatient settings, administered by Chinese doctors and doctors from other parts of the world. 
It’s difficult to distill into a few pages, let alone a few sentences, the full impact of these two months, but as I reflect on my experiences in China, I notice several themes emerge. The first is my heightened interest in pediatric surgery as awakened by my experience assisting Dr. J. at the Red Cross Hospital. The second is a commitment to care for those who are poor, vulnerable, and marginalized, as I witnessed in Yushu and the surrounding villages, and again in Kunming. Finally, I am grateful for and amazed by the opportunity to meet and work alongside so many talented and generous people from all over the world. I look forward to maintaining these relationships and discovering how I might continue to partner with these friends in the future to provide healthcare, education, and hope to underserved populations.
Having given a summary of my internship, I would also like to include for you my answers to a series of questions posed to me by the Baptist Medical and Dental Association Scholarship Committee, who generously supported my internship with a travel grant.
1. What problems did you encounter? How would you correct them?
One significant problem for me was the language barrier. Prior to arriving in China, I had taken one introductory Mandarin course and studied independently for an additional four months. While this provided me with the basics for getting by, my scant knowledge of medical terminology and inability to communicate on a deep level were hindrances to both my effectiveness as a volunteer and my ability to form significant relationships with people who did not speak English. I intend to continue to study Chinese both formally and independently so that the next time I have the opportunity to travel to China I will be able to communicate more effectively.
2. What are needs/issues that could be addressed?
The needs I encountered during my internship, particularly in Yushu and Nang Qian, are tremendous. Many of the families we encountered have minimal access to healthcare. LOVEQTRA is having an impact with the mobile clinics they conduct, but a more consistent and comprehensive form of medical care is desperately needed. In particular, obtaining property, funding, and permits to build a permanent clinic with a laboratory, imaging equipment, and operating room would, in my opinion, be an important step in establishing a more effective medical outreach in this area. In addition to the building and equipment, there would of course need to be medical personnel, which perhaps would be the most challenging aspect of this project. But in the short three weeks I was in Yushu I met over a dozen volunteer medical personnel, including eight medical doctors, which suggests to me that there are medical workers willing to labor in this particular field.
There are tremendous educational needs in Yushu as well. Many of the children displaced by the earthquake have been forced to attend school in distant cities while the schools in Yushu are rebuilt. The schools in Yushu that continue to operate are understaffed and under-resourced. There is a tremendous opportunity for educational outreach to Tibetan children in this region. LOVEQTRA operates a bi-annual 3-week camp for children in the summer and winter, but perhaps this could be expanded to a year-round type of after-school program or community center, where children could obtain educational support, as well as experience the love of their H. Father through healthy relationships and constructive activity.
3. What did you learn?
Perhaps one of the most significant lessons I learned while in China is the importance of being flexible, patient, and willing to adapt. On a number of occasions my original plans had to be set aside in order to meet the needs of a given situation, or in response to certain emergent circumstances. For instance, several days before arriving in Xining I learned that my primary contact would not be there to host me because they had to leave the country suddenly for a medical emergency. Then, in Yushu, I was asked to teach English at a summer camp for two weeks when I had hoped to be assisting with medical work during that time. In these instances and in others similar to them, I found that I was much happier and more effective when I received these changes in plans with grace and cheerfulness rather than anxiety and resistance. I learned to trust that God has things under control, I can rest easy when I submit to Him, even if things turn out much different than I imagined they would.
4. How do you see this experience affecting/changing your personal and professional life?
First of all, experiencing relative poverty in Yushu has caused me to be more aware of the luxuries I tend to take for granted in the U.S.—things like running water and sanitation—and for this reason I am more grateful for the resources available to me, and more conscious of the obligation to be a good steward of these resources. Not the least of these resources is the opportunity to study medicine at the University of Pittsburgh, for which I am now more thankful than ever. Having seen the poverty and illness experienced by the people of Qinghai, I am now more motivated to learn pathophysiology, pharmacology, and related medical subjects that can seem tedious when encountered in the academic setting, but have now for me taken on new significance by virtue of the names and faces I associate with these disciplines and diseases. More specifically, as mentioned above, I was impacted by my experience shadowing Dr. J. at QHRCH and assisting him surgery, and for that reason have decided to focus my studies and research on pediatric surgery. While this may not ultimately be the specialty I choose, I am, for the moment, very excited about working toward that end. Finally, this experience has strengthened my resolve to work among the underserved. Witnessing the needs of the people in Yushu, and the sacrificial way in which my brothers and sisters worked to meet those needs, inspires me to strive for the same attitude that I see in them, which is the same attitude that was in our Lord, as Paul describes in Philippians 2.
5. What have you learned that can be transferred to the U.S.?
Certainly the majority of things mentioned above—a grateful disposition, an interest in pediatric surgery, and a humble, service-oriented disposition will all affect my daily life and educational/career choices here in Pittsburgh. Perhaps one thing I have not mentioned yet but which has already affected my behavior in the few weeks since I returned to the U.S. is the importance of relationships and the centrality of love in the Christian life. In China I encountered brothers and sisters who devoted significant time and energy into building and maintaining relationships built on love and trust. I think they rubbed off on me, because I’ve noticed myself spending more time with people, being more considerate of the needs and wellbeing of others, and investing more energy in relationships than I have in the past. Granted, this is a tough line to walk when confronted with the pressures and demands of medical school—but I’m realizing that I can’t wait until my education is complete to begin living the gospel. As Paul says in Corinthians 6:2, “Now is the time of God’s favor; now is the day of salvation.” So in addition to returning to Pittsburgh with a renewed vigor for my medical studies, I have returned with a greater passion to be an ambassador for Christ here in my city, among my classmates and friends.
6. What is the significance and probable impact of the project?
I believe the children I taught in Yushu will have a more positive view of Americans, a greater understanding of the gospel, and a deeper knowledge of their worth and beauty as a result of my time with them. Perhaps they will even remember some English! I also believe the students and villagers treated by our medical team in Nang Qian have suffered less as a direct result of the medical treatment they received from us. I also anticipate that they will have a more positive view of visiting medical teams and will therefore more readily visit the clinic when my colleagues return in the future. These achievements notwithstanding, perhaps the greatest benefit my service in Qinghai, Yushu, and Kunming has rendered has been to encourage and engage in relationship with my fellow workers. There is something very wonderful about working hand and hand with brothers and sisters from all over the world in a unified effort to fulfill our lord’s command to “love our neighbor,” even when that neighbor lives halfway around the world. I know that I was deeply moved by my experience working with these people, and I gather from what they’ve told me that they were also blessed by my presence among them. I intend to continue to be in touch with a number of these new friends, in the hope that we will have the opportunity to work together again in the future.
7. How has this experience expanded your world awareness?
This summer internship has most definitely expanded my world awareness. As an undergraduate I majored in anthropology because I love to learn about culture and experience it for myself, and this trip did not disappoint. In Beijing I experienced what modern, metropolitan China is like. In Xining I lived in an apartment owned by a Korean family, was hosted by a Canadian, befriended by a former Tibetan monk, often ate lunch at a noodle shop run by a Hui family (the Hui are one of the Muslim minority groups in China, and Xining is home to a very large community of them—their food is delicious!), and in addition to working with Chinese physicians worked alongside a Namibian doctor and a Swiss surgeon. In Nang Qian I got a glimpse of the breathtakingly beautiful and untamed Tibetan highlands, and in Yushu I witnessed a small city, isolated by rivers and mountains and desert, devastated by an earthquake from which they are still struggling to recover—a city of tents and rubble, but a city with thousands of beautiful children and their determined parents, finding a way to pick up the pieces of what remains of their lives and rebuild a new community. In Kunming I was reintroduced to city life modern China—the Kunming is called the Spring City because the weather is beautiful all year-round. While there I had the great privilege of spending a few days with an American family so full of love that they moved half-way around the world to take care of children that no one else seems to notice—and of course I met the kids as well, most of whom have bodies with broken pieces, but each one with a heart just big enough to take in the love of Christ manifested to them in the form of my friends. In Macao and Hong Kong I discovered the part of China most influenced by the west, and, I must admit, was quite happy to be feeling somewhat “at home” again (and by “at home” I mean, sit-down toilets, hot showers and people who speak English). These are just a few of the interactions that made my experience in China so rich, and expanded my understanding of the beauty and suffering in the world, and the creative, redemptive work of our father, who in his son has reconciled this beautiful, broken world to himself, and promises to make all things new.
Once again, please accept my heartfelt thanks for your contribution to my summer experience. I hope that after reading this report you will be pleased with your decision to support my internship. While I cannot speak for the physicians with whom I worked, the patients I helped to treat or the children whom I taught, I can speak for myself and say with confidence that I am a more compassionate person, a better-informed medical student, and a more devoted follower of our lord as a result of this adventure. I hope in the future I will have the opportunity and means to enable other medical students to realize their aspirations, even as you have enabled me to achieve mine.
Warmest Regards,
J.K.
MS2, University of Pittsburgh School of Medicine