THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Sunday, July 16, 1995 TAG: 9507140080
SECTION: DAILY BREAK PAGE: E5 EDITION: FINAL
SOURCE: BY KAREN NAPIANTEK WHARTON, SPECIAL TO THE PILOT
LENGTH: Long : 151 lines
At the time she wrote this, Karen S. Napiantek was a fourth-year medical student at Eastern Virginia Medical School in Norfolk. In April she accompanied Operation Smile, a Norfolk-based medical mission, on a three-week mission to the People's Republic of China. On May 20, she graduated to become a doctor.
JOURNAL ENTRY for April 12 - Nanchang, People's Republic of China: . . . Got in last night after a grueling trip from Hong Kong. Not only was the trip physically tough, it was frustrating as well. . . . From the airport we had a 30-minute ride across town to the hotel in an ancient van. Roads in Nanchang are apparently not paved, but if they are, they are in poor repair. . . . We were literally flung up and down in our seats the whole time, and there were no seat belts. At the end of the trip it was 2 a.m. and my kidneys had been jarred into their new position. . . .
So began my expedition to China, as a medical student traveling with Operation Smile.
It was a wildly hectic three weeks, with 191 surgeries in five days and 350 interviews and examinations prior to that. Yet we had time to see the city, travel into the surrounding countryside, and meet countless Chinese citizens and officials.
The main purpose of the trip was to make cleft lip and palate repairs in Chinese children, ages 1 to 20, so many of my memories are of the children.
As we went to and from the hospital on the streets of Nanchang, a city of 1.5 million in Jiangxi province in southeastern China, small children followed us in bunches and stared. If we bowed and said, ``Nee how,'' or ``Hello'' in Mandarin, the major Chinese dialect, they giggled and started running around us, their initial shyness gone.
Like the children, my impression of the Chinese people was that they were at first aloof, then remarkably friendly once you made an effort to get to know them. Then they became warm and effusive, touching your arm or holding your hand. They laughed easily and often, and showed tremendous generosity.
My first impression of the city of Nanchang was chaos, far greater than that of New York City or London: car horns continuously honking, bicyclists everywhere, people hawking their wares, odors of on-street cooking combined with urine, smog and exhaust.
Much of the city life was routinely familiar - people going to and from their jobs, opening and closing their shops, small one- or two-table restaurants off the street serving a few patrons lunch. Many of these small restaurants were mom-and-pop operations set between small grocery stores, with pull-down garage doors in front.
Nanchang's downtown was within walking distance of JiangXi People's Hospital, but most of the time we practiced our rudimentary Chinese by taking local taxis. This is an adventure in itself: Driving takes place with one hand on the wheel and the other on the horn at all times. Police officers stood at large intersections, ostensibly to direct traffic, but I never saw any traffic directing going on. Many times I witnessed near misses involving livestock and pedestrians, and such novel tactics as passing a car that was also passing a car.
In the downtown shopping district, merchants with push carts sold ice cream, spiral-cut pineapple on a stick, and steamed bread in a variety of shapes, ranging from people to flowers. Small children walked around eating another Chinese innovation, pigeon on a stick.
Crammed together in alleys off the main shopping district were the open-air food markets. Merchants sold mesh bags full of live frogs, squid drying on racks or on the ground, fish so fresh it was still swimming, bushels of dried peppers, and endless varieties of meats, fruits and vegetables. Most interesting were the snake stands, where you could buy a live snake that would be killed and dressed on the spot. They would also vivisect cobras, selling the gall bladder separately as a Chinese delicacy.
If one thing surprised us the most about Nanchang, it was the amount of garbage and human waste. In our forays through the city, garbage in the streets was commonplace. We also often saw children and some adults urinating and even defecating in public on the streets. Infants and toddlers wear no diapers, just leggings with the crotch missing, allowing them to do what comes naturally whenever and wherever they like.
Yet if the city was crowded and dirty, it was a short drive to beautiful areas of the countryside.
In our little time off, we explored some of the history and culture of the region. Ten minutes by cab from our hotel was the beautiful Tengwang Pagoda and its gardens. The pagoda was built in A.D. 653 during the Tang dynasty, and renovated in 1989. The main structure is nine stories high with a commanding view of the Ganjiang River. The pagoda includes a large, beautiful wall carving depicting Wangbo, one of the four poets of the Tang dynasty, who wrote a famous poem about Tengwang Pagoda.
Surrounding Tengwang Pagoda are gardens of weeping willow, bonsai trees, and bamboo, interspersed with gazebos and large scale models of the animals from the Chinese calendar. The cost of touring the pagoda is 30 yuan, about $3.75.
One Sunday after all the surgeries were performed, we hired a car and took a drive into the mountains surrounding Nanchang. Much of the time, unfortunately, the view of the mountains was obscured by smog.
On the road leading up to the mountains was a large Buddhist temple, where we lighted incense and had our fortunes read by the temple fortunetellers. We passed rice paddies with water buffalo, farmers plowing rich, red clay, and arrived at what our translator described as the ``summer palace.'' This is a resort area, tucked high up in the mountains, which was built by the government for the people to use as a summer retreat away from the heat of the city.
It wasn't exactly Disney World. The mountains were cool, green and beautiful, but the three-story apartment buildings appeared run-down and in need of repair, at least from the outside, and the grounds were strewn with garbage.
Nearby was a sprawling home that, according to our translators at least, had been a retreat for Madame Chiang Kai-shek.
The JiangXi People's Hospital, where we spent much of our time, was amazingly dirty and old. The preferred antiseptic was formaldehyde, which is used in only limited situations in the United States, and its odor stung our nostrils every morning upon entering the main building.
This was usually combined with the smell of food, which was catered in three times a day for staff, patients and their families as well.
Families typically gathered at the patient's bedside, with parents sleeping and eating in bed with their recovering child. Indeed, most of the patient care was performed by the parents, not the nursing staff.
Equipment in the hospital is old, in poor repair and scarce. Needles are used many times over after placement in an antiseptic solution. Syringes are glass, practically an antique curiosity to American doctors long accustomed to disposable syringes. Anesthetic machines in the operating rooms dated back to the 1940s.
Even in the hospital, toilets were either holes in the ground or tiled trenches that one squatted over. There was no toilet paper anywhere (I found pocket packets of tissues invaluable), and no flushing either. A few times a day water from a single tank in the room would rinse the trench in an attempt to flush waste, but not nearly often enough, as by late afternoon the stench was usually unbearable even from 50 feet away.
Despite the common Western view, I witnessed no acupuncture being practiced. I did see quite a few dental procedures in storefront dental offices on busy city streets. The Chinese medical personnel were familiar with penicillin but preferred traditional Chinese herbal medicines. Indeed, our team brought Tylenol for pain control, but we had a great deal of difficulty explaining even its concept to the Chinese.
The kindness and generosity of the Chinese people were demonstrated to me on one of the last days of the trip. When I sometimes used the hospital's one elevator, I would greet the kind old man who operated it and attempt to make idle chit-chat - mostly with sign language, owing to the language barrier.
On my last day, he came up to me and placed a sheet of paper in my hand. The paper contained a poem in beautifully scripted Chinese letters, and through an interpreter he explained its meaning.
He told me I became a doctor to help people, and sometimes patients will come to me who aren't physically ill, but only sick at heart. As a physician, the poem reads, it is my duty to remain happy so I can make my patients happy, whether they are physically ill or simply sick at heart.
I thanked him through my tears, but he could never know how much those lovely Chinese letters meant to me. ILLUSTRATION: Karen N. Wharton, left, an Operation Smile volunteer, visits a
patient at JiangXi People's Hospital in China.
KEYWORDS: OPERATION SMILE by CNB