At the end of a week in Fuzhou

On arriving at the airport I found someone holding a sign at the gate with my name on it -- a first indication of my undeserved status of "foreign expert" which can bring all sorts of special treatment that I am not complaiing about at all. We were driven through the hills of Fujian in the middle of the night; the first song we heard on the car stereo was "Hotel California." We arrived at our fabulous apartment in the middle of downtown Fuzhou. Our apartment has balconies onto which one can step out and view the quite unexceptional downtown of a midsized Chinese metropolis, topped most of the day by a grayish haze. The following typically Chinese characteristics (I think) of this apartment are worth mentioning. Nothing like the mound of paper goods (napkins, paper towels, and the like) which the typical American apartment is outfitted with; we have a small number of pink and green rags. No oven! On the other hand, no oven I will have to kasher for Passover.

The apartment building is part of a luxury complex, and there are security guards hanging out outside at all hours -- tall gentlemen loafing at their ease on the plastic chairs ouside. After the first time they see us, the don't need to ask anything about us. We're the foreigners: a six-foot-two-inch tall blond guy with a head covering, his almost-as-tall wife, and their daughter whose blond hair and white skin have already come close to causing innumerable traffic accidents, not to mention the definitely non-hypothetical spectacle of grown men and women gasping in awe and stooping to touch her cheeks. On my way to work, I meet the stares of many curious passersby.

Before I talk about my work, I should explain why I'm here. I'm participating in a collaboration between NYU and the Fujian Board of Health on the topic of gastric cancer, which is quite prevalent in southern China. Why the high prevalence? That's the research question. It certainly has something to do with diet and environment, but the NYU researchers I'm working with are particularly interested in the bacterium Helicobacter pylori, made famous this year by the Nobel Prize for Medcine -- and whether the interacting genetic polymorphisms (diversity) of people and H. pylori might explain the high prevalence of gastric cancer both in Fujian and in Fujianese immigrants, who make up most of the Chinese immigrant pool to New York.

My goal here is to help with the basic, epidemiological analysis of data collected by chart review. How many gastric cancer cases have there been in Fuzhou (or two particular hospitals in this city) over the past few years, of what types (i.e., found where in the stomach), and with what risk factors have they been associated? I have found out that medical care in China, at least in some sectors, is very much pay-for-service. The Fuzhou hospital I am working at now (about which more below) treats mostly middle-class and wealthy Fujianese. Poorer patients go elsewhere, and this bias in the distribution of gastric-cancer cases I'll be analyzing obviously means something to our results. From a broader perspective, this schizophrenia of the Chinese health-care system -- government funding of all hospitals combined with vast inequalities of treatment -- was examined in a recent article in the New England Journal of Medicine.