We are Marc and Jennifer. We both work as physicians at an academic medical center in the USA. In the year 2001, Marc was invited to China to give lectures on advances in cardiology at meetings in Fuzhou (Fujian Province) and Weifan (Shandong Province). While arranging our flights we realized it would be a shame to go so far and see only two, similar cities in China. We decided, therefore, to end our trip with a taste of the less developed part of the country. But China is a big place, and it was hard to decide where to go. Every guidebook we consulted described Yunnan Province as having unspoiled natural beauty, tremendous biodiversity and half of the ethnic minorities within China as a whole. And as China’s most southern province, the climate is very comfortable all year long.

How to travel in Yunnan was a dilemma: we did not have any contacts there, but we knew we did not want luxury or tourist traps but a taste of real, rural Yunnan. So we did what anybody else would do at the beginning of the twenty-first century: we went to Google.com and typed in "Yunnan" and "Ecotourism". Google spit out only one response: White Pearl. The pictures on the White Pearl website suggested that previous travelers had a tremendous time kayaking down the Nu River, and although we were not kayakers, we e-mailed and received a warm response to our inquiries. White Pearl put us in touch with Dr. Wu of the Southwestern Forestry University in Kunming, the capital of Yunnan Province. Dr. Wu would be our interpreter and guide for a ten-day journey up the Nujiang River. We would like to emphasize that Dr. Wu and his wife became our friends and we had the pleasure of seeing them a year after our trip when they visited their son, a graduate student at the University of Delaware.

Fuzhou and Weifan are two rapidly growing cities in the industrialized provinces of eastern China. There realized almost immediately that our images of Communist China were seriously wrong. The large cities of eastern China are like all big cities, with traffic, congestion, smog, rampant industrialism and commercialism. We were amazed to find rampant consumerism; shoe stores offered a hundred or more different styles, for example. Along with a very western lifestyle we also found that the Chinese living on the eastern coast were starting to experience epidemics of heart disease, not very much different from what we know in the US. But it should have come as no surprise; we witnessed bicyclists crowded out by motor vehicles and Kentucky Fried Chicken outlets on every other corner. After our successful visits to the very modern hospitals in Fuzhou and Weifan, we were ready to journey to someplace rather different. We hoped to see the old China, and the remains of the barefoot doctors. We also wanted to enjoy the natural beauty of the land and promote values of conservation.

We arrived in Kunming and were welcomed warmly by Dr. Wu, his wife, and Liu, our driver. In Kunming we visited the botanical gardens, where we enjoyed in one place many of the plant species native to the province and learned much about conservation efforts. We then flew to Baoshan, a portal city to the western part of Yunnan. Baoshan is a small but growing city that appears to be prospering as a result of the development of natural resources (deforestation?) in the region. We saw construction all over the place and it felt like a boomtown undergoing rapid change. From Baoshan we took off via Stevens Road (see more on the White Pearl website about this road) to the Gaolagongshan Natural Reserve. There we hiked through moist tropical forest and then, at higher altitude, boreal forest. We saw many birds, a bamboo snake and lots of butterflies, and stopped at three different waterfalls and hot springs. There was a magnificent rainbow in the sky as we returned back to the lodge. We were heartened to see such a rich ecosystem now under government protection.

The rest of our journey would best be described as a trip up the road that parallels the Nu River (Nujiang, in Chinese). We traveled in a four-wheel drive vehicle and made many stops to meet the people living along the river, although high above it. The river slices through tall mountains, some so high that they have snow on their peaks. Up near the tops of the mountains are small villages where local tribes live. On market day, over the crests of the mountains and down the muddy tracks come the people, first so small you can barely see them, and then closer and closer until you can see that they are carrying heavy packs and have animals too! They bring their produce to market and they walk miles and miles to the road so they can buy and sell life’s necessities. The bridges are barely wide enough for a person to cross on foot, but then come goats and pigs crossing too! And even more amazing are wire cables stretched across the river, with men and women, clutching their animals, rappelling across on a pulley to reach the road and the market on the other side.

The people who live in the small villages high up in the mountains are desperately poor. They have not been touched by modernity, no less Communism or the current post-Communist ideology. Rather, they live a hardscrabble existence tilling the land by hand. The slopes on which they live are too steep to plow even with oxen. There is no running water and no electricity. The children are malnourished as a rule and the dogs are runty, even emaciated. School occurs once a week if the teacher can get there. There is widespread illiteracy. "Barefoot doctors", extinct in the rest of China, serve the small communities of people in the highlands. They are trained just enough to know how to immunize the children and how to recognize when someone is seriously ill. They haven’t much in the way of medications, but they gamely do their best to oversee the health of the people they serve. Malaria and tuberculosis are widespread, and rumor has it that AIDS is a growing problem, largely a result of drug trafficking across the nearby border with Myanmar (Burma).

As part of our journey White Pearl asked that we make a donation to the desperately poor local tribes that live on the peaks of the mountains that fringe the Nujiang. As physicians, we felt a donation of medicines, mainly antibiotics, would be the most appropriate gift. We also brought toothbrushes for hundreds of children. During each day of our journey along the Nujiang, we traveled from one community to the next, up very steep roads, to distribute medicine and toothbrushes and to meet the barefoot doctors and their patients.

The health infrastructure in western Yunnan is limited to the barefoot doctors and to a regional hospital. But in contrast to the developed parts of eastern China, we found little use of western medicine. Drugs that are not terribly expensive here in the U.S. were not available at all in the regional hospital. We ran into a group of people from Medecins sans Frontiers working with local physicians to stem an epidemic of tuberculosis. We had on hand some medical textbooks in English that we were able to give to the MSF interpreters. We were incredibly lucky to have met them and to hear firsthand about the spectacular work they were doing.

Since the construction of the two-lane highway that parallels the Nujiang was completed, life in the region has become focused on that road. It’s where things happen: on market days, the market is on the road. Clinics are along the road, food is sold along the road and there is a school built along the road. It’s over the peaks and down to the road that ethnic tribes people come, bringing their produce and animals. But all of the stores and restaurants built on the edge of the road belong to Han Chinese, who have immigrated into the region and brought with them their entrepreneurial spirit. The two-lane highway has clearly already had an impact on life along the Nujiang. The road brings "development" to the region, along with immigrants, small industry, traffic and pollutants. Clearly the way of life of the tribal people has already changed and will change even more as industry moves in to western Yunnan.

But the impact of the two-lane highway along the edge of the river has been modest compared to future impact of a modern superhighway that we saw being built in western Yunnnan. This four-lane American-style interstate will link Shanghai in the east with Myanmar (Burma) and the rest of Southeast Asia. Amazingly, we saw no heavy equipment used in its construction. Rather, thousands of men and women, along with burros, horses, wheel barrows and pick axes, were building the highway -- stone by stone -- with their own hands. This handmade superhighway, four lanes complete with a divider and retaining walls, will connect with the area’s local roads and change everything about western Yunnan. Clearly the currently unspoiled areas around the Nujiang River will likely be changed profoundly.

The highway will no doubt bring everything to western Yunnan province. In some ways, the highway will be a great development, facilitating the transport of food and medicine to the region, amongst other desirable goods. It will bring jobs and an improved standard of living for many. But the highway will also bring environmental despoliation, disease and an influx of Han Chinese that may further displace the tribal peoples and bring an end to their way of life. If you look at the photos accompanying