Mia Kanak, MPH '11
Shanghai and Shandong, China

I spent two months over the summer with the Yale Global Health Leadership Institute in China researching the impact of community health centers on access to health care in rural areas and on diabetes education in urban areas. In Shandong, I served as one of 16 field researchers conducting household surveys on rural access to medical care, where I witnessed the value of government investment in community health infrastructure. Each of the 17 villages I worked in had its own clinic. Residents of mud houses with no running water surprisingly receive more routine primary care than some residents of urban U.S. communities. This experience inspired me to work with a non-governmental organization to raise funds to build a rural health clinic in BaoDong Village of Guangzhou, one of China’s poorest provinces. I also learned through my research on community health centers that investment in infrastructure is not enough. Under the guidance of Dr. Liebin Zhao at the Jiaotong University School of Medicine, I designed a study comparing diabetes education programs at community health centers in Shanghai. The results indicated that varying levels of commitment and skill among health providers led to vastly different levels of comprehensiveness among diabetes education programs. This result reinforced my notion that physician education must incorporate both clinical and management skills in order to improve patient care. My research experiences in China have motivated me even more to engage in health care delivery to underserved populations with an interdisciplinary public health and medical perspective.
Mia Kanak - Shanghai and Shandong, China

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A community health center nestled in a neighborhood apartment building on Shanghai’s Huaihai Road.
The Ruijin Hospital’s Diabetes Center where I worked in Shanghai.
A diabetes education class at Ruijin Hospital’s Diabetes Center. The classes are kept small to maximize effectiveness.
A primary care doctor in a Kenli village community health center fills out a Tsinghua-Yale team survey on common illnesses, services offered, job satisfaction and training.
Hannah Yoon, my co-GHLI intern, and Zhang Linzhun, a Tsinghua University graduate student, interview a couple on health care access, satisfaction and household income.
Almost all of the survey participants were extremely friendly and invited us into their courtyard or home for the hour-long interview.
The medical records system at a community health clinic in Kenli Xian, Shangdong province. The physician is responsible for keeping written records on all families in the villages.
A standard outpatient room in a community health clinic in Kenli Xian, Shandong province. The 17 clinics we visited were nearly identical to each other, with the same layout, posters and beds in each one.
Hannah Yoon, my co-GHLI intern, and I pose with an elderly couple we interviewed for our survey.
In many of the rural villages of Shandong where we conducted our research, living standards were generally poor—mud walls, no running water and minimal, if any, electricity.
Most of the villagers we surveyed were grandparents at home with young children, as the middle generation was at work cultivating the fields. This shy child hid behind her grandmother, but loved the picture when I showed it to her.
A retired physician in Yonglin village set up his own clinic using part of his house in order to compete with Yonglin village’s community health station.
Hannah Yoon, my co-GHLI intern, and I in front of Yonglin village’s community health station in Kenli Xian Huanghekou Zhen.
A day laborer on Mt. Tai (one of China’s most famous mountains) carries empty cans to be recycled.
The Tsinghua-Yale researchers with the Kenli public health bureau director in front of Shandong Province Kenli Xian’s Red Cross Hospital.

