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Welcome to the online world of PittMAP -- University of Pittsburgh’s Multi-regional Academic Program. We invite you to join us in a globalstudy tour examining public health issues in Buenos Aires, Argentina; Cape Town, South Africa; and Beijing, China.

Three faculty members, 22 students and a student advisor will spend five weeks in each city, attending classes, visiting clinics, hospitals and research centers, meeting with people in the business and medical communities as part of a curriculum focused on global health and the global economy, with special attention to HIV/AIDS. And, in our spare time, we plan to learn what we can from three of the world’s historically great cities.

The faculty are Peter Veldkamp (School of Medicine), Svitlana Maksymenko (Economics) and David Bartholomae (English). The student advisor is Lauren Scott (GSPIA). The students are drawn from a variety of academic programs. You’ll learn more about them and their discoveries in the weeks and months ahead.

 

Around the World in 120 Days

I am writing this final posting in Pittsburgh.   What an amazing semester!   (I’m still buzzing with all that we learned, all that we saw, and all that we did.)   And I’m grateful to everyone who helped to make this trip such a success—our 22 remarkable students (brave, funny, smart, eloquent and resourceful); my colleagues (Peter Veldkamp, Svitlana Maksymenko, Joyce Bartholomae, and Lauren Scott); and the faculty and staff at Pitt who created and who manage this remarkable program (with a special nod to Vanessa Sterling and Nancy Condee).  

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The PittMAP concept is brilliant.   Provide a focused curriculum to insure that the trip is truly a study trip.  In our case, we were studying issues, research, and practices relating to Global Health, with particular attention to infectious diseases, including HIV/AIDS.   And put the group on the ground long enough that they can become more than tourists.   With five weeks in each city, we got to know people and neighborhoods.  The students could follow their interests in politics, sports, culture and the arts; they found soccer games, fencing matches, running trails, museums, jazz clubs, and concert venues.   They made friends, some of the them lasting friends, and partied with students from every corner of the globe.  Over the course of our 120 days, we were offered a rare and precious opportunity to enter into the life and rhythm of three of the world’s great cities:  Buenos Aires, Cape Town, and Beijing.  

three_ba_small-1_irfamThe long line of blog posts preceding this one has told the story of our travels.  The images in this posting show our three campuses:  the University of Belgrano (in Buenos Aires), the University of Cape Town (the medical school campus), and Capital Normal University in Beijing.    So much of what we learned, however, we learned off campus, in the cities, through excursions (or field work) enabled by our local support groups.   We visited hospitals, clinics, pharmaceutical laboratories and biological research centers; we met with government agencies, physicians, nurses, and public health officials.    And we hit some tourist stops along the way.  We visited Iguazu Falls, climbed Table Mountain, and walked a piece of  China’s great wall.    

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The highlights for me include a visit to the cattle market in Buenos Aires (the Mercado de Liniers), the opportunity to eavesdrop on a meeting of regional public health officials at the Ministerio de Salud,  and an afternoon visit with Malena Araneo, a young woman who works for the World Bank and who provided, I think, a way for our students to imagine themselves working in a global environment.  In South Africa we visited one of Cape Town’s historic black townships, Langa.  The poverty was staggering; the living conditions unforgettable.  And later in the visit we had a presentation from a young, black PhD student in economics, Cecil Mlathsheni, who grew up in a township, who is affiliated with the South African Labour and Development Research Unit, and whose research considers poverty and unemployment in the townships, including the one we visited.   We had a presentation by Stavros Nicolaou, a senior executive from Aspen Pharmaceuticals, telling the remarkable story of his successful struggle to bring affordable ARV drugs to South Africa.  Our students attended lectures with 2nd year medical students.   

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In Beijing, we visited an organic farm on the outskirts of the city, toured studios and galleries of China’s contemporary art scene, met with the former director of the Chinese version of our CDC, and watched while one of our own, Kerri Bell, received acupuncture as part of a presentation at Guanganmen, a hospital that features traditional Chinese medicine.  None of us will forget the pharmacy in the hospital’s basement, where medicinal potions are concocted from herbs and roots and things that creep and crawl and fly.    White coated lab assistants worked at long wooden tables in a room with a thousand drawers.   We entered a laboratory with steamers and pressure cookers and ran up against a wall of pungent smells. three_bj_small-1_irfam

I’ve been working with undergraduates since 1973.   This was by far the most memorable and important and productive semester of my teaching career.   I’ve very grateful to have been a part of PittMAP.   To our readers:  please help spread the word.    There will be new PittMAP groups forming every spring semester—each with a different faculty, a different focus, and a different itinerary.   The program provides a once in a lifetime opportunity and you can find it through the Study Abroad Office at Pitt. 

If you took “Introduction to Economics,” you know about the Big Mac Index. Developed by Pam Woodall in 1986, this index allows you to compare the cost of McDonalds’ famous hamburger at current prices all over the world. Since then, the report has been published annually by The Economist. In 2010, for example, according to the Big Mac Index tables, out of three countries we planned to visit – Argentina, South Africa, and China -  the burger was the cheapest in China. While in America a Big Mac averaged $3.71, in Beijing  it cost 14.5 yuan, the equivalent of $2.18 at market exchange rates. It suggested that the yuan was about 42% undervalued on the foreign-exchange market, and Americans travelling to China could save extra bucks. The price of a Big Mac in South Africa was about 20% less, while in Argentina it was in a perfect match with the American counterpart.

bj_blog_big_mac_index_small_irfamYet, our life abroad was not about dining at McDonalds’ restaurants. Out of curiosity, I asked students in my economics courses to monitor prices of selected goods and services in Argentina, South Africa, and China, compare them with US prices, and then report on the cost of living abroad. The exchange rates that prevailed  in Argentina, South Africa and China during our visit were 4 pesos, 7 rand, and 6.5 yuan per dollar, respectively. The choice of the goods was left entirely to the students. The  only restriction was that the goods were to be consistent from place to place, or as close as possible to being identical, in order to reasonably compare prices.  I was surprised how diverse the basket of goods and services ended up. Towels, shampoos, postcards, chocolate bars, cell phones, tampons, condoms, 12-inch pizzas, latte, cigarettes, haircuts, metro rides, movie tickets, and many more.

I quickly reviewed the price tables that the students collected.  From the rational consumer perspective, China tops the list, with prices of food and toiletries being a complete joke.  A bottle of water was $0.33, toothpaste - $0.75, laundry detergent - $0.61, small yoghurt -$0.19,  loaf of bread – $0.77. However, you do not want to stay long in China if you want to keep your cell phone up-to-date or if you are a coffee-addict. The prices of these two items in Beijing are doubled compared to the US standards. Even though none of our students smoked, some of them chose to report prices of cigarettes for comparative purposes. China again lead the list. A pack of cigarettes was priced at 1.54 dollar-equivalent in Beijing.  Knowing the strong dependency of the Chinese male population on smoking, could anyone check the quality standards of these cheap packs, please?

About half of the students ranked South Africa the second most-expensive country by cost of living (as indicated by their “shopping baskets”), while the other half claimed it was Argentina. This bias depended upon the selection of goods and services. Those who looked at prices of fresh produce and services (laundry, transportation, manicure, and haircut) found that Buenos Aires offers much cheaper options. For example, a subway or bus ride was only $0.33 in the Paris of Latin America, while it cost more than $0.75 for a ride  from Mowbray to CapeTown. Alcoholic drinks, night clubs, and ice cream were cheaper in South Africa, though.  And condoms?  They were free in Africa.

The Queen in Alice in Wonderland once said: “Sentence first – verdict afterwards.”  No matter how you look – from the Big Mac perspective or from the perspective of a rational consumer with her own “basket”– China remains the least expensive country to live in.

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Traditional Chinese Medicine and Western medicine stand side by side in the modern Chinese health care system.  Most patients prefer treatments that combine Eastern and Western methods, and doctors are trained in both schools of medical practice.  At first these two methodologies—ancient herbs and modern pharmaceuticals, acupuncture and surgery—seem fundamentally contradictory, but the Chinese health care system finds a way to blend the two together.

bj_blog_colleen_acup_sign-1_small_irfamWe had a chance to observe this combination for ourselves at the Guanganmen Traditional Chinese Hospital.  At first glance,  Guanganmen seemed much like the F.J. Muñiz Municipal Hospital we visited in Buenos Aires.   Outside,  a sign points visitors towards the Hepatitis Clinic, the Inpatient Department, and the Enteric Infection Clinic.  Nurses and doctors in their official white coats do rounds, while patients wait in rows of blue plastic chairs—an ordinary day in a modern hospital.

But when I started to look closely I began noticing differences.  As you enter the pharmacy, there are two pharmacies side by side.  The first fills prescriptions with Western pharmaceuticals, while the second fills prescriptions for traditional Chinese herbal concoctions.  On this busy Tuesday afternoon, there are long lines in front of both windows. 

Many patients will visit both pharmacies, while others wait for appointments or consultations with doctors trained in both Western medicine and the techniques of TCM, the latter including acupuncture, moxibustion, cupping, fire-needle therapy, and blood-letting--definitely not ordinary medical procedures by Western standards. 

Our host, Dr. Chen, led us through the acupuncture wing, explaining that good acupuncture doctors can see around six patients an hour, and that moxibustion, the practice of burning herbs over acupuncture points, is also a popular service. 

bj_blog_colleen_pharm_cook-1_med_irfamWe entered the pharmacy, where we  observed the technicians blending together dozens of herbs, flowers, dried scorpions and centipedes, fruits and nuts.   And we visited the decoction center, a large laboratory filled with pressure cookers, beakers and sinks.   Here the mixtures were decocted into a murky brown tea and packaged in plastic bags, each with a patient’s name attached. 

Later, after a presentation by Dr. Cui Yongqiang, a leading researcher and practioner of TCM, we observed an acupuncture demonstration on our friend Kerri’s old back injury.  The more we saw, the more foreign it all seemed, the similarities lost in a sea of differences.

Guanganmen was certainly different any other health care facility we visited over the course of the trip.   The methods may be a different from continent to continent, but the goal is always the same—a longer, happier, healthier life for each patient that comes through the door. 

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