Dr. Howe Visits Project HOPE Trained Nurses Caring for Earthquake Victims in Wuhan

The Zhongnan Hospital, overlooking East Lake, holds a special spot in the hearts of the citizens of Wuhan. Soon to number 2000 beds, it is the principal teaching hospital of the Wuhan University Health Science Center. Its President, Zhou Yungfeng, a noted radiation oncologist, is also the Dean of the Medical School. He is a strong supporter of the HOPE Nursing School.

The School's leadership, as a catalyst in the reform of nursing education in China, is being played out in the Hospital. Its well educated Master's prepared nurses are being promoted to Head Nurse positions, within two years of graduation. Their analytic skills and well-honed research training are seen as adding value to the increasing complex management of patients requiring tertiary care.

This was exemplified on the Hospital's patient floor, now named "Ward of Love." Thirty-six patients, recently transferred from Sichuan Province, with earthquake-related injuries are receiving the care of the School's graduates. The nurses are quick to point out that the ward could have been described as the "disaster ward; instead, it's called the "caring ward."

The patients, ranging in age from 26 to 90, have received, or soon will receive, surgery for trauma diagnoses, orthopedic and neurosurgical in nature. We visited three of them. Two were in their nineties, with leg fractures. Each spoke with a Sichuan dialect--and was hard of hearing. Even so, they conveyed a sense of gratitude for the attention they were receiving from the nursing staff. The third was a 50 year old government worker with rib fractures and a hemothorax. He was without pain and easy to engage in conversation.

The Medical Director of the ward is an orthopedist. He described the three surgeries that he had performed earlier in the day. His counterpart, the Head Nurse, was effusive in her pride of the focus of the entire Hospital on the victims and their families. This is reflective of what we witnessed in Chengdu and, later, in Shanghai, as well as Wuhan, a country-wide embrace of those effected by this tragedy.

Photos of Dr. Howe Visiting Earthquake Survivors in Chengdu, China

Project HOPE's President and CEO, John P. Howe III, M.D. visited Chengdu, China located in the Sichuan Province, the region most impacted by May's massive earthquake. Read his May 26 Blog for stories of China's littlest earthquake survivors.

Project HOPE President and CEO Attends Nursing School Graduation in Wuhan, China

Wuhan, China May 27, 2008

The recent rise of China has been fueled by the economic development of its eastern seaboard. Enterprise zones, central government tax waivers and business incentives have contributed to striking economic growth across major industries. Left behind, at least in perception, has been central and western China. This was recognized by the new President, Hu Jintao, as he took office. His priority for the country has been, and is, a "harmonious society." That is, a better balance, in economic health, among all geographic regions.

This has led to the well recognized policy, described as "Central China Rising." Wuhan, a city of 8 million, west of Shanghai, is benefitting from this focus. Wuhan is considered the gateway to the west, much as St. Louis and Chicago played this role, here in the U.S. It is a city whose public and private institutions are now receiving increased resourcing from Beijing.

One of these institutions is Wuhan University. With 50,000 students (30,000 undergraduate and 20,000 graduate), it is one of China's top tier academic campuses. Its President is a member of the National Academy of Engineering and internationally-recognized for his work in remote sensing.

Project HOPE and Wuhan University

Project HOPE has enjoyed an eight year relationship with the University. Its President asked HOPE, in 2001, to join him in creating a nursing school of the first class. It would be one to lead China in nursing curriculum reform, with an emphasis on analytic thinking and decision-making. Its dean would be recruited by HOPE.

Today's graduation ceremony for the Nursing School reflected the success of this partnership. The School has a full complement of students seeking Baccalaureate, Masters and Doctoral degrees. They complete their baccalaureate education in four years, not five, which had been the norm in China. They have their first clinical experiences, in the hospital, in their second year, rather than their fourth year. Their dissertations are presented in English, and twenty had their work published, last year.

By any standard, this young school has been a tremendous success. It is now regarded as leading the way, throughout China, in nursing education reform, with 14 full-time faculty members, 27 part-time faculty, 4 international consultants, 191 baccalaureate students, 21 masters students and 6 doctoral students. The latter two groups come from around the world to pursue their degrees at the officially-named HOPE School of Nursing.

Project HOPE and HIV/AIDS Education in China

Dr. Gui Xi'en, a senior member of the University's medical school, was mentioned in a past issue of Time magazine as one of the world's most influential leaders. The President of China visited him, in his home not long ago, to express his admiration and respect, on behalf of the people of China. He is a partner of HOPE in novel training in the treatment of HIV/AIDS patients in Hubei Province, whose capital city is Wuhan.

It was he who discovered improper techniques in blood exchange, as a cause of HIV/AIDS, in Hunan Province. One of his medical students, from this province, mentioned that many in his village were dying, for unexplained reasons. The villagers were very suspicious of Dr. Gui, when his student brought him to investigate the cause. Fearful that his discovery might create a stigma for the village, he was stoned. He persevered to make the discovery that would change the course of this disease in China.

Today, he introduced us to five of his patients. Their stories were most compelling, as they recounted the appearance of their HIV/AIDS: high fevers--and the inability to get out of bed. Their doctors, trained by HOPE in the use of anti-retroviral drugs, began the treatments that have allowed them to return to work, as school teachers and farmers.

In the region of Hubei province where they live, the physicians, nurses and other health workers, trained by HOPE have cared for their infected patients in a way that has resulted in a decrease in overall HIV/AIDS mortality, from 49% to 8%. This training is being extended now to contiguous regions, where similar results are anticipated. It is Dr. Gui who deserves great credit for this experience.

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Wendy Pai Lyle, the new U.S. Consul General in Wuhan, was a prominent attendee at the Nursing School's graduate banquet tonight. Now in her 28th year of public service with the State Department, she has immense popularity in China, from years past. During the Nixon era, there were only one or two means of communication with the outside world. Voice of America was one of them, and Wendy Lyle was the voice for China. In the words, of Yungfeng Zhou, the President of the Wuhan University Health Science Center, "We all, in our generation, learned our English from her." This served as yet another reminder of the importance, and impact, of the "diplomacy of small gestures."

Learn More about Project HOPE’s Work in Wuhan, China.

Project HOPE President and CEO Visits China Earthquake Victims

Chengdu is a city with a distinguished past. Three thousand years old, it holds a special place in Chinese history, as described in the book, Three Countries. At that time, one thousand years ago, its location, and its leader (Kao Ming), played central roles in the war of the then three countries. Chengdu was the capital of one of them, with a smaller warrior force. However, because of the cleverness and guile of Kao Ming, its country prevailed.

Today, it is a city of 20 million (4 million in the city center, 6 million in the surrounding suburbs and, in addition, 10 migrants) with a traditional manufacturing base, now shifting to a service industry. The road from the airport is lined with car dealerships, interspersed with stretches of poverty.

Our destination was the Haixi Hospital, also called the West China Hospital. Located in the heart of the city, it is the largest hospital in China (4300 beds). It is huge and new in appearance, with wailing ambulances coming and going from its Emergency Center. It serves as the principal receiving hospital for the Province's earthquake victims.

Soon after the May 12th earthquake, over 1,300 victims were admitted to the Hospital. The principal surgical diagnoses were open fractures of the extremities; the medical diagnoses were acute anxiety and diarrheal diseases. There are now 600 victims in the Hospital. Of these, 67 await definitive renal dialysis treatment.

The Haixi Hospital is sharing the burden of care of victims with provinces throughout the country. The central government has asked each province to be responsible for one of the effected counties in Sichuan Province. For example, Hubei Province has the responsibility for Ping Yuan county. This extends to food, water, shelter, health and reconstruction.

Project HOPE has had many health education and humanitarian aid relationships throughout Sichuan Province. The staff of the Haixi Hospital participated in our diabetes training programs. Thirty intensivists, (board-certified physicians who are additionally certified in the subspecialty of Critical Care Medicine) from throughout the Province, received training for 3-12 months at the Shanghai Children's Medical Center; ten came from the Chengdu Children's Hospital. The children at the Hospital have received preventive dentistry, modeled after our successful program in Shanghai. Finally, those in the Province, in areas affected by the flooding of 2003, were benefitted by medicines and medical supplies from HOPE.

Because of the patient care demand, created by the volume of earthquake victims, the staff of the Haixi Hospital has been augmented by 300 physicians and nurses from throughout China. While this is meeting the acute care needs of the patients, there is an often-voiced need for rehabilitation medicine, from prosthetics to staff.

In contrast, the Chengdu Children's Hospital is smaller (300 beds) and older (due for replacement in 2010). It is led by a pediatric neurologist and a general pediatrician. It currently has 50 inpatient earthquake victims, whose most frequent diagnoses are trauma-related.

The stories of the patients and their families were most compelling. There was a 3-year old boy with a fractured, right humerus and a most endearing smile. I saw a 7-year-old boy with a fractured right femur, with his twin sister at his bedside; their mother was killed in the earthquake. There was a 13-year-old girl with a fractured pelvis; she was one of 400 at her school, when the building collapsed, where 20 were rescued--of whom four, including this young girl, survived. And an 8-month-old boy with fractures of both femurs, now in bilateral traction.

The doctors and nurses also described stories, from the scene, which can never be forgotten. I was told of a baby born to a mother who died in the earthquake, who was rescued by helicopter, brought to the Hospital and named, in Chinese, "born in earthquake." The medical staff told of the difficulty of extracting another baby from the arms of his mother, who had died violently, clutching him and protecting him.

It was most inspiring to finish the day with six HOPE alumnae: five nurses and one doctor who had trained at the Shanghai Children's Medical Center, as part of our Rural Training Program. The doctor, who heads the neonatal unit, described the impact of her training. It enabled her to care for more patients in the unit, to acquire more sophisticated equipment for use in the unit and to witness a dramatic increase in the survival rate for the unit's newborns.

Looking ahead, the physicians and nurses at the Children’s Hospital spoke to the need for rehabilitation training and care. There is, at present, only one rehabilitation medicine specialist, and there are no physical therapists. Space may be identified for this program, but state-of-the-art equipment is needed. HOPE was able, in the late 1990's, to respond to a similar post-earthquake situation, and make a difference, in Turkey.

En route to the Airport, tents lined the sidewalks in front of nearby apartment buildings. The building residents, fearing another aftershock, were choosing not to spend the night in their buildings. It served as a reminder of a compelling day, just 70km from the epicenter of one of the world's greatest natural disasters.

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