Perspectives on Diabetes Care
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My Amazing Week in China
Nov 29, 2016, 08:31 AM
I
have returned home from Weifang, China, a second-tier city of (only) eight to nine million people located in the Central Shandong province, about a four-hour train ride south of Beijing. I spent last week at the Sunshine Union Hospital, owned by the Sunshine Insurance Group, a 2,000 bed hospital which opened in the spring of 2016. Within the hospital is the four-floor diabetes center which includes inpatient and outpatient wards. Staff from The Joslin Diabetes Center in Boston have been brought on as advisors to the hospital with the goal of providing first-rate diabetes care. My task within the team was to include safe and effective exercises into the program. I would like to share some highlights from the week.
Food: The first thing people asked when I said I was going to China was “What are you going to eat?” Yes, there were some foods that I chose not to eat (anything looking back at me) but I found the food to be amazing! So many vegetables, seafood, healthy preparations, and a great variety. I ate far better than when I am at home.
- Air: I would check the air quality index each day on my weather app. It varied from “good” to “very unhealthy.” I brought a mask but never wore it; people did have them on, especially pedestrians and those on bikes and scooters. I ran outside twice with no problem.
- Water: Drink only from bottles, which are readily available.
- Smoking: The hotel was a non-smoking hotel but smoking is allowed in many places, including the hospital rooms and public areas. I never saw a healthcare professional smoke and it is certainly discouraged.
The patients were provided with great educational experiences, with hands-on activities and dynamic learning when possible
- People: The people I came in contact with were the most: polite, considerate, caring, helpful and respectful people I have ever been around. I was told in advance that people might offer to carry my bags and would try to anticipate my needs. This was exactly what happened. We wanted for nothing.
Medical Staff: The nurses, junior doctors (residents), and attending physicians were caring and engaged. They were happy to have us there and took part in every activity to learn from us (including nurses and physicians doing strengthening exercises with resistance bands).
- Medical Care: It is definitely different than in the U.S. I’ll qualify this by saying my only exposure was at Sunshine but I think it is fairly typical. People are hospitalized as inpatients for much of what we do in the outpatient setting. Given this, many inpatients are far healthier, they wear street clothes, and can participate in many activities off of the ward. Some even go home during parts of the day and return later for their inpatient medical care.
- Diabetes Care: People stay in the inpatient unit for a week or more for medical care and to learn how to manage their diabetes. Others came as outpatients, waiting to get the care they needed (including eye exams, dental exams, and multiple consults from healthcare providers). The idea of self-monitoring of blood glucose is part of care but not accepted by many. People have access to meters and the technology that goes with them but don’t (yet) routinely do SMBG. The team at Joslin is working to change some of these issues.
The facility is wonderful, with a beautiful exercise room, a demonstration kitchen, a classroom, and access to a conference room. The patients were provided with great educational experiences, with hands-on activities and dynamic learning when possible. I watched a cooking demonstration with a chef and dietitian where patients learned about portions and healthy food preparation, and participated in an exercise session which included a brisk walk in the halls, jumping rope, and playing with a shuttlecock (like a hacky sack with feathers, kicked into the air with the foot or ankle). I did a presentation (through an interpreter) to about 50 patients where we danced to a popular song, “Little Apple,” during the presentation. The patients had a great time in each of these events; they were active and engaged!
- Dinner and Karaoke: We had a wonderful time on my last night with many of the diabetes center staff, as we had an incredible dinner (I counted 22 different dishes) and finished the evening at karaoke. It is a great part of the culture and a night I will never forget!
I am grateful for the wonderful guidance and support from the Joslin team in Boston and to all of the people from Sunshine who graciously welcomed me as I enjoyed this absolutely amazing experience!
About the Author
Karen Kemmis is a physical therapist and certified diabetes educator, and also holds certifications in Pilates for rehabilitation and exercise for aging adults. She is based out of SUNY Upstate Medical University in Syracuse, NY and splits her time between a Joslin Diabetes Center affiliate, an outpatient rehabilitation department, and a PT program where she is an adjunct professor.