Lately I’ve been traveling (A LOT!) to different parts of China. Just over a week after getting back from Thailand, I spent a few days in a city in central China to visit a project that reaches out to vulnerable women in the entertainment business. I am not at liberty to say where or the name of the organization because security in there is particularly tight. Nearly all of them have been to prison (due to suspicion of their activities as followers) at least once, but they faithfully continue, and what they are doing in the face of adversity is remarkable – and growing! It was such a privilege and an honor to work with a group of people who have sacrificed so much to love the unlovable. I have never have I been asked to risk or sacrifice so much in my work or to defend my faith. Some of the staff had been trafficked themselves and are now reaching out and helping to get others out of slavery. I was able to go over some basics of reproductive health as well as give an overview of some of the common mental health disorders that they see. I also spent quite a bit of time with some of them in one-on-one sessions discussing anything from insomnia, issues in rearing children and child behavior, and other medical issues. Every minute of time there was a blessing. Remember to ask me about it if I get to share with you in person.
Less than a week after that trip, I left for a 10-day trip to SE China to help facilitate and develop Pediatric work with a family medicine training program in Macau. Three of us (two pediatricians and a resident) traveled from our program in Shenyang, and one pediatrician came all the way from Texas to participate. The family med doc and one of the residents came from the Hope Macau program. Six women traveled by van to several places in Guangdong province visiting various places that serve abandoned children in China.
Like anything in China, a wide variety of situations exist among these types of places. A couple places we visited were at government child welfare institutions that had various levels of cooperation with foreigners to help in the daily care and education of the children. Other places were foreign-run foster homes that care for children outside of the institution. Our visits involved a combination of evaluating children with acute as well as chronic health needs, teaching the local physicians about the problems we diagnosed, and training the staff and nannies in basic CPR and other techniques in caring for special needs children.
For example, I diagnosed a child with Apert syndrome, and Turner syndrome, and a colleague diagnosed another with Bloom syndrome. We gave an overview of these syndromes, what the doctors need to check for soon, as well as some anticipatory guidance. Every child was reviewed with one the local physicians regarding their specific care – be it a congenital heart defect, Down Syndrome, or one of the many other problems often seen. We also gave some recommendations for general care of all the children, such as hearing screens and dental care. Whether or not they follow up on any of these recommendations is anyone’s guess, but it seems like they were more invested than at other places I’ve visted.
Generally speaking, many of the doctors assigned to child welfare institutions (if any are assigned at all) are not specifically pediatricians (a few are), and learn about the problems of these children through on-the-job training. Some I have encountered are very eager to learn about pediatric medicine, and some are not teachable at all and just want to keep their low-risk government job. A medical problem is a (if not THE MOST) common reason why a child in China is abandoned, therefore equipping physicians in caring for special needs children is a big need here.
Before the pediatric road trip I spent a couple of days meeting with organizations that outreach to and care for vulnerable women in Macau. The situation for women in the “entertainment business” Macau is quite different than on the mainland – it is a bit more “open” and “less illegal” and the rule is conveniently ambiguous. Also, mainlanders still need to ask permission to travel to Macau and then can stay only two weeks. Therefore, the temporary service people have a very rapid turn-over. They return over and over again, but not always to the same place. However, it is somewhat difficult to explain well in a blog because I still have to be sensitive in reporting on the situation and who is doing something about it. “Conveniently ambiguous” means that the rules can bend far one way or another – in one’s favor or not – so I’m going to err on the side of providing less information here. Suffice to say that because of the different situation there, the girls, and the outreach to them needs to be creative and adaptive.
Since I had last visited, one particular outreach group has started a clinic for the women! It was good to check in on how things are truly going, encourage the physician and give input in to how best the non-medical people may maximize their impact through health counseling and follow up. I also visited a Sister of the Good Shepherds, an order that is dedicated to serving women in difficulty. As you can guess, this also includes women who have been trafficked in the entertainment business. She was a delight to speak with and since she had been there for over 20 years, I learned quite a bit about life and work there!
Always, the travel is not glamorous, it is not easy, and can be fraught with frustration. However, at the end of a trip, no matter how exhausted I am, I come away with blessings – gifted more than I have given for sure.