“We Live in the Same Global Village”
Junlin Zhou and his team are the #1 radiology department in the multi-ethnic Western Chinese province of Gansu. Their clinical work is too little-noticed, says Junlin Zhou.
Radiology.bayer.com (rbc): How do Lanzhou and the Gansu province differ from the rest of China?
Junlin Zhou (JZ): We are similar to other provinces in Western China and compared to the three most developed cities – Beijing, Shanghai, and Guangzhou – our hardware equipment is the same. However, our research level is lower, and we do not have that many network and platforms. Regarding radiology, the standardisation of our workflow is not as advanced as in these metropolitan areas.
rbc: In which respect does standardisation differ?
JZ: Scan protocols and contrast media management differ between hospitals, image quality as a whole varies. Standardisation is a long process and we are right in the middle of it. It takes time.
A Multi-ethnic Environment
rbc: The population in Gansu is multi-ethnic. How does that influence your work?
JZ: Well, besides the biggest ethnic group, the Han, we have mostly two different ethnic groups of patients. One is Hui people, an Islamic culture, and the other one is Dongxiang, which are people of Tibetan origin. Dongxiang patients usually have their own translators or family members to accompany them. Hui people have lived so long in this area and are so integrated that we don’t have cultural or language barriers between us. We have doctors and radiologists with Hui and Dongxiang background who help us to communicate with patients.
rbc: So you are a multi-ethnic department?
JZ: Absolutely. Ethnicity does not influence our diagnostic daily work in a bad way.
rbc: Does religion play a role?
JZ: None at all.
Urban And Rural
rbc: Is the disease spectrum in Gansu different from other parts of China?
JZ: Yes. This is mainly due to the living habits of the different ethnic groups. We have more parasite diseases. Of course this depends on how people live, on their culture and hygiene conditions. We see more cases of echinococci than in any other province, for example. But then we are more experienced in dealing with that kind of disease and we intervene at an early stage.
It mostly see infants and children suffering from parasites, because hygiene is not in their mind-set; they don’t wash hands and don’t take care of what they are eating.
rbc: How many of your patients come from rural areas?
JZ: Fifty per cent come from remote regions, many with parasite related diseases. The other fifty per cent are from the city, with a different disease spectrum, such as tumours.
We have limited medical resources in Gansu. We are one of the biggest and best hospitals here.
rbc: Is the education level in remote areas a problem for healthcare?
JZ: We don’t see any difficulties in communicating with less educated patients. They trust our authority and just follow our advice.
rbc: Lanzhou is an industrial hotspot that has first been known for environmental pollution, then been awarded for climate progress. Did that process cause any health effects?
JZ: There has been a lot of progress in recent years. The environment in Lanzhou is now a lot better than in Beijing. Jinchang in central Gansu, for example, has many days with crystal clear blue skies, and climate conditions will improve the further west you go.
We do not see any changes in disease patterns either. There aren’t any raid changes in lung cancer incidence, for example
rbc: Lanzhou is also a chemical industry hub. Does that influence disease patterns in any way?
JZ: No, we do not see any measurable effects either.
rbc: What are the major challenges of practising in a smaller megacity like Lanzhou, compared to the big shots like Beijing or Shanghai?
JZ: I think we in the Western provinces pay more attention to managing our department, because we are still a little behind with the standardisation of our processes and protocols and the diagnostic level in general. We need to do much more work to catch up, and we also have the ambition to catch up.
rbc: What are advantages of working in Lanzhou?
JZ: Our geographic location is a disadvantage, but at the same time it might also be an advantage. We see many patients who come from farms and are less educated, so we see more and very different kinds of diseases. Being far away from the centres also makes us very ambitious to go forward.
rbc: What do you like best about your department?
JZ: What I enjoy most is my team here. They have a very positive attitude.
rbc: If you could add anything to your department, what would it be?
JZ: I would like to have more time. We have good equipment, we have no problem attracting elite experts, we are a good team that has grown a lot in recent years.
But we still need more time to get mature and train our experts even more and develop even more of that positive co-operating team spirit. I think time and this spirit are the most important things.
Coming Back Home
rbc: Why did you become a radiologist in the first place?
JZ: My original interest was surgery, but to be honest, I didn’t have a choice at that time. So I became a radiologist. Now I know my job with all its responsibility very well and I have grown to loving it. With the knowledge, expertise, and the achievements I have gathered, I love my job more and more.
rbc: What do you personally like most about living and working in Lanzhou?
JZ: Lanzhou is my hometown and I really want to contribute my power to my people. I have got my team here. I have also got a lot of good friends, who are like brothers to me. So, the two most important things are the social connection and pride about working for my hometown people. I get a lot of offers to work in more economically developed cities, but I always turn them down.
rbc: Where are Chinese radiologists compared to their international colleagues?
JZ: First of all, I think doctors in Europe and in America are luckier than Chinese doctors, because they have better conditions; they have every reason to be self-confident. But as a Chinese radiologist, I have also become more and more confident about myself my own work over time. We are definitely on the way to improve our level of research.
We are also getting better regarding international exchange and networks. Doctors are a special in the sense that we live in the same global village, meaning we are the same kind of people, who continuously improve and are dedicated to life-long learning. As a radiologist, I am trying to keep up with my global colleagues.
rbc: How important is language?
JZ: Language is very important for international exchange. Even while we talk, we need an interpreter and have a little barrier because of the different languages. To understand the real meaning behind questions and answers, you need at least to live at least five years in the foreign country. We here in the Western provinces have some doctors with overseas experience, but it is just a very small group.
We are trying to train our people to become more international and advance with the English language, but we have less communication opportunities. We attended international congresses and give talks, but I think the communication is a bit too simple and superficial. Getting deep down into different cultures and understanding foreign doctors’ clinical and diagnostic perspectives takes a lot more time and work. We are trying to improve that.
About Junlin Zhou
Junlin Zhou (5th from left) and his team tackle an important mission: They steadily improve healthcare in the China’s remote areas. The national and international Bayer representatives and the reporter team were impressed by their confidence and determination.
Junlin Zhou (50) is the CT department chair at the Second Hospital Affiliated to Lanzhou University. He is a Lanzhou native, who came back to his hometown after his doctorate at the prestigious Xi’an University. It is now called Xi’an Jiaotong University and belongs to the Chinese C9 league, an analogue to the US Ivy League.
As the current president of the Gansu Society of Radiology, he puts his effort into improving the diagnostic quality and the research level for radiology in Gansu. He has been ambitious throughout his career, but believes there is “still a lot of work to improve my character and sharpen my career directions – it is a continuous growing process”.
Junlin Zhou tries to keep a good work-life-balance, sports being an important counterbalance to his clinical work. During his days at medical school Zhou has won his university’s badminton championship; he remains an avid badminton player.
“Of course, nothing goes smoothly without the support of my family,” he says.
Gansu is in the hinterland of northwest China. It lies between Qinghai, Inner Mongolia, and the Hunagtu Plateaus, bordering Mongolia to the North.
Gansu has long been known as multi-ethnic province. About 90 percent of its inhabitants are Han. Other ethnicities include Hui, Tibetan, Dongxiang, Tu, Manchu, Yugar, Bonan, Mongolian, Salar and Kazakh people. Yugu and Baoan are unique nationalities.
The Salar, Dongxiang and Bao'an are usually referred to as Turko-Mongolian Muslims with their own distinctive languages. Linguists describe the root of these three languages as a form of Altaic, with varying degrees of influence from Chinese and Tibetan. Linxia City, the capital of the Linxia Hui Autonomous Prefecture, is also located in Gansu. Linxia City is known as “Little Mecca” due to its historical importance for China’s Muslim populations.
Gansu is also home to various cultural sites like the ancient Silk Road and the Mongo Grottos in Dunhuang, which are on the UNESCO’s World Cultural Heritage list.