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XI'AN, China — The 3-year-old boy was sick but couldn't get the care he needed in his rural hometown. So his mother brought him to the modern, big-city hospital for treatment of his kidney ailment.
He had been sick for a few months and was spending his fourth day in a hospital where most rooms have four beds.
Similar stories occur often in China, where family practice doctors are rare and most health care services are typically concentrated in big-city hospitals. Only when they're sick do people see doctors, and patients line up to wait for hours for appointments with specialists.
Chinese officials would like to change that model, and the University of Nebraska Medical Center is helping with that change. Later this month, for example, six physicians from Xi'an and nine from Shanghai will be in Omaha for a two-week program at UNMC that shows them how America trains its family practice doctors.
The family practice training is just one of the ways that Nebraska universities are working with China.
Some of the connections have direct payoffs for Nebraska in expanded research or additional tuition payments. Other benefits are less direct, such as more exposure to different cultures or perspectives.
UNMC teaches Chinese students about hospital administration. The University of Nebraska-Lincoln offers English courses in Xi'an and another Chinese city. Its Institute of Agriculture and Natural Resources has an office in Beijing to work with Chinese grain officials. Student exchange programs bring Chinese students to Nebraska, and students from UNL and UNMC go to China. Last fall at UNL, for example, 809 Chinese students enrolled in undergraduate and graduate programs. That was nearly three times the number who attended in the fall of 2006.
And UNL has a partnership degree program with a Xi'an university in which students spend two years at the local school and about two years at UNL, emerging with degrees from both institutions.
UNL also has a new American Cultural Center in Xi'an to allow Chinese students and others to learn more about the United States. China has a similar center in Lincoln called the Confucius Institute.
“Most Chinese know something about America but have little understanding of the background and the reasons for the way things are — or the alternative ways things can be viewed,” said Ian Newman, a UNL professor who heads the American Cultural Center on the campus of Xi'an Jiaotong University.
There just a month, Newman presented Gov. Dave Heineman and other Nebraska visitors on a trade mission a gift: an ear of corn grown in China outside Xi'an.
Newman said the center, which officially opened in April, aims to help Chinese students gain a deeper understanding of America.
Newman said two students from Scottsbluff showed up in Xi'an to attend school. “So we have our first volunteers to help explain ‘American ways,'” he said. “A third student is on the way and maybe five more next year.”
In a few months, Newman said, there will be cultural programs, art displays and other activities, including multiple opportunities for Chinese students to learn English.
In the long run, he said, the center also hopes to identify and facilitate areas for joint research programs.
UNMC can trace joint programs with China to 2000, when a faculty exchange program began between the Eppley Cancer Center and Shanghai University in an effort to develop new ways to diagnose, treat and prevent cancers. UNMC researchers gained access to a much larger sample of cancer cases.
Today, UNMC is deeply involved in helping the Chinese adopt family medicine. The effort, at Xi'an Jiaotong University School of Medicine, is seen as a potential template for other parts of China. The hospital associated with that school has a two-week-old outpatient center.
The Chinese physicians traveling to Omaha will participate in lectures and role-playing to learn methods to incorporate at their own teaching hospitals when they get back to China.
“In my opinion, we have a lot of things to learn,” said Li Fei, a cardiologist who will be going to Omaha.
Haixing Zhong, an anesthesiologist at Xijing Hospital in Xi'an, agreed. “It's important for our country,” she said.
Jialin Zheng, a professor who heads UNMC's Asia Pacific Rim development program, noted that UNMC professors have led family practice meetings in China since 2008. About 200 Chinese health professionals annually attend those meetings.
Zheng said that's a key part of the Chinese government's strategy of shifting the country's health care model toward the approach used in the West.
Historically, Zheng said, Chinese doctors have aspired to be specialists in top urban hospitals and looked down on family practice. Fewer than 2 percent of new Chinese doctors are in family medicine, compared with about 20 percent in the U.S.
It has become clear to Chinese officials, Zheng said, that it's not good for the country to continue on the same path. China wants to have a stronger system of family practice, because that should result in healthier patients and lower costs through disease prevention.
UNMC can help with that goal, because it is ranked highly in areas such as primary care and rural health. A UNMC book on family medicine has been translated into Mandarin, and thousands of copies have been distributed.
“Their health care system is evolving,” said Jennifer Larsen, UNMC's vice chancellor for research. “They're recognizing that they need different approaches to deal with growing health care needs.”
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