Sunday, January 31, 2010

one foot in the future and a butt stuck in the past

This is the beautiful, well-resourced AIDS Care Center for Yunnan Province, which has 230 AIDS ward hospital beds and HIV viral load and genotype capability. The clinicians here are older, experienced and well-trained. They are supposed to provide support to all the HIV/AIDS care sites in Yunnan province. It's a castle on a mountain. They have one foot in the future (and definitely want both feet in the future soon).

These are two of the young doctors at the Kunming city Infectious Disease Hospital AIDS ward. Their ward looks nothing like the AIDS Care Center, and resources much fewer. A career in infectious diseases, and especially HIV/AIDS, is *not* a prestigious one in China. There's a ton of stigma simply for being around people with communicable diseases. (Though it certainly hasn't stopped millions of Chinese people from openly picking their noses and publicly spitting up in the streets.) I've been told that sometime doctors end up in the infectious disease department because they couldn't get a job elsewhere after medical school. Hopefully some of these young doctors will be inspired to do good work in the realm of HIV/AIDS care. I see part of my job to make HIV/AIDS care and treatment cool and sexy. Everyone will want to do it!

Compared to the AIDS Care Center above, most other HIV/AIDS treatment sites are quite under-resourced. Despite the rapid development in China, with all the glitz and shine of new cars and high-rises, the public health infrastructure here remains old, poor, ignored, and deeply entrenched in cadre politics. There are more doctors and better facilities in China than in Kenya and Tanzania, but the level of care at many places resembles much poorer and less experienced cousins in Sub-Saharan Africa.

I brought my stethoscope for what...? I spent countless hours in meetings such as this one, watching one powerpoint after another. It was necessary and good to meet all the public health and hospital leaders - and understand their perspectives and data... but I definitely experienced serious powerpoint burn-out.

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