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The Doctors' Tour

Update from doctors Marc and Jennifer:

The article below we wrote two years ago, but only sent it to White Pearl this last March after we saw the shocking news that the Nujiang was to be dammed, the entire population relocated. We want to encourage anyone who can, PLEASE travel to Nujiang – vote with your feet, see this beautiful area through its own local Nujiang Project and Travel Bureau tours, and then write your own opinion. If you are a member of The Nature’s Conservancy, write to ask for funding to be given directly to Nujiang agencies to help them to prove the Case for Preservation And Properity Through Tourism in the Nujiang River Canyon of Nujiang Lisu Autonomous Prefecture. Our opinion is that dislocation of the people we met will mean the end of their culture and lifestyle and result in disaffected poor homeless on the streets of Baoshan and Kunming as with the American Indians and Australian Aborigines.

We are Marc and Jennifer. We both work as physicians at n academic medical center in the USA. In the Spring of 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. As it turns out, White Pearl, an attorney and riverrunner has the only eco-tour project in China registered with the United Nations whose goal is to prove the Case for Preservation of the Nujiang as a Recreational River Corridor run by its resident Minority Nationalities – Drung, Nu, and Lisu governments.

The pictures on the White Pearl website suggested that previous travelers had a tremendous time rafting, kayaking down the Nu River, cycling down the road and doing scenic road tours. We emailed and received a warm response to our inquiries. White Pearl assigned one of her own English students whom she had trained and paid well to act as our eco-tour guide and to introduce us to the appropriate Nujiang leaders who wanted White Pearl to bring more doctors in if our tour was successful. Because we gave her only two weeks notice of our tour, unfortunately the guide had to be Chinese, instead of a member of the Lisu, Nu, and Drung and Nujiang Travel Bureau. A major funding need of the Project is for English training for the staff of Nujiang Travel Bureau and Gaoligong Nature Reserve.

Fuzhou and Weifan are two rapidly growing cities in the industrialized provinces of eastern China. We 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 our Project guide, his wife, and our driver. In Kunming we visited the botanical gardens, where we enjoyed in one place many of the plant species native to the province. We learned much about Chinese conservation efforts, and that the Nujiang Project was the only realistic conservation project for the area we were going to. Everywhere such as the Kunming airport we saw photos and ads for Lijiang and Dali, but nothing on Nujiang.

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 the Burma Road into a major freeway from Kunming to Myanmar. 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 Nujiang Project website about this road) to the Goaligongshan 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. 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 but at least have clear air and clean water. 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", China’s teacher peace corps, 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 and prostitution of the Burma Road that crosses the nearby border with Myanmar (Burma).

As part of our eco-tour fee, White Pearl asked that our donation pay for medicines 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 antibiotics would be the most appropriate gift. White Pearl tours also distribute 100’s of "favors" to the people and this tour appropriately she chose 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, although readily available in Kunming. The former governor of Nujiang and Red Cross Director, Madame Ya Na arranged for us to meet 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 grateful to White Pearl and Madame Ya Na for the opportunity to have met these physicians and to hear firsthand about the spectacular work they were doing. We only regret that because of translation problems with our Chinese Interpreter (Chinese isn’t spoken at all in Nujiang except by officials), we did not meet with Ms Ya Na and her staff about helping to send more doctors to Nujiang on future doctor tours.

Even since the widening and paving of the two-lane road over the ancient trail that parallels the Nujiang was completed, life in the region remains 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, schools, towns, villages, courts, etc. It is a very colorful and enjoyable road with incredible views the whole way of the turquoise river and mountain peaks. It’s over the peaks and down to the road that ethnic tribes people come, bringing their produce and animals.

In 1996 when White Pearl’s Project began, all of the stores and restaurants built on the edge of the road belonged to Lisu, Nu, and other local governments and individuals. But Chinese have immigrated into the region and are being allowed to buy up these. The two-lane highway has clearly already had an impact on life along the Nujiang. But the road that brings "development" to the region, along with immigrants, small industry, traffic and pollutants is also clearly the key to these local people’s future prosperity as a "Mini-Bhutan" tourist destination. We agree that White Pearl’s Project goals of facilitating this development as a Recreational Tourist River Corridor is the only alternative to the proposed dams.

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 this essay, you will have a sense of the grandeur of the landscape and the desperate poverty of the ethnic minorities that live on the mountaintops. The people we met were so grateful for the medicine we brought and for the toothbrushes – but they were also pleased that we had taken an interest in them, in their far corner of the world that may soon be profoundly changed.

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