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Interview: Battling heart disease in rural Yunnan

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China's health care system has received a major upgrade in the last decade, but this improvement in health care options has yet to make its way into the countryside. A growing number of domestic and international organizations are working throughout the country to raise the quality of health care in China's rural areas – where the majority of its citizens still live.

GoKunming recently spoke with Dr Robert Detrano, founder and director of China California Heart Watch, a Yunnan-based NGO focused on improving basic cardiac health care throughout rural Yunnan:

GoKunming: What is the basic mission of China California Heart Watch?

Dr Robert Detrano: Our over-arching mission is to serve the rural poor in China through: medical research regarding heart disease and hypertension, education and training of medical professionals about heart disease and high blood pressure, providing free healthcare to those with heart disease and high blood pressure and overseeing hands-on, once-in-a-lifetime, goodwill overseas experiences for individuals interested in any of the above.

Activities of China California Heart Watch generate no profits. We can operate solely through the generosity and vision of donors, participants, philanthropic foundations, and granting agencies.

GK: How did China California Heart Watch come about? Why does it focus on Yunnan?

RD: During the 2005 Spring festival I was teaching at a hospital in Beijing. I took a trip to Yunnan to escape the frigid winter. In Kunming, I purchased a bicycle and started cycling south. After two days, people who were on their way to a pre-nuptial party in an impoverished Hani village invited me to celebrate with them. I left my bike in a cheap hotel. The road to the village was long and bumpy and we did not get there until the sun was setting.

The bride's family fed me and treated me like one of their family. They refused money when I offered it. The drivers drank quite a bit and nobody was able to take me back so the family put me up for the night. The house had no running water and no electricity. The heating was a wood fire in the middle of the floor, no chimney. There was no doctor in the village and the clinic had been abandoned. Their hospitality and universal love in the face of great hardship was my inspiration to come back and work with the poor farmers.

GK: What is the state of health care in rural Yunnan?

RD: Rural Yunnan has very inadequate health care. Village doctors receive training for three months after they graduate from high school. Township doctors are only a bit better educated and trained. Hospitals are poorly equipped and sanitary conditions are poor. Since doctors must make much of their living from a percentage on medicines they prescribe, they often prescribe medicines that are both expensive and inappropriate. Chronic diseases like high blood pressure are largely untreated.

The rural cooperative health insurance system is inadequate to cover procedures and surgeries that must be done at high level hospitals in Kunming or in other provinces. Kids die from heart conditions that are easily curable because their families cannot pay for life saving procedures that are available in Kunming.

GK: What heart diseases are most prevalent in Yunnan?

RD: We have surveyed over 1,000 farmers. High blood pressure is by far the most prevalent heart disease and in general the most prevalent chronic disease. More than 20 percent of adult farmers have high blood pressure. In some areas this approaches 50 percent. Fewer than 5 percent of those with high blood pressure have their blood pressures under control with diet and/or medicines.

GK: What are the most surprising things you've learned through your experiences with China California Heart Watch in Yunnan?

RD: The most surprising thing that I have learned is the good heartedness of the Chinese people. China is rapidly rising from extreme poverty and there is a misconception that Chinese people do not care to help their neighbors because they are so busy getting rich.

Though it is true that those, who in a lifetime rise from poverty into the middle class, are reluctant to give up what they have worked hard for, Chinese people, when they are touched by the poor conditions of the farmers, are quite ready to donate their time in our traveling clinics and in their hospitals.

Cardiologists at several hospitals in Yunnan and elsewhere donate their time to repair the heart defects of the rural poor. This is as inspiring as is the kindness of the villagers who fed me and put me up during the spring festival of 2005.

GK: What can be done to improve cardiac health in rural Yunnan and elsewhere in China in the coming years?

RD: The first step to a solution is awareness that the problem exists. If nothing is done, by 2050 ten million Chinese people – the population of two Kunmings - will die every year from heart disease and stroke. Through research, teaching and publicity, we must increase awareness of the problem. When the Chinese people and the Chinese government are sufficiently aware, they will solve this problem.

I invite all readers to go to our website www.chinacal.org or to write to me at robert [at] chinacal.org.

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