Global Health Graduate Eyes Changes in Drug, Alcohol Awareness

24 January 2019

Duan Zhao is from Dalian, Liaoning province, and graduated as part of the Class of 2019 from the master of science in global health program at Duke Kunshan. The photo was took when he received Outstanding Student Award in 2019.

Could you tell us a bit about your personal and academic background?

I love classical music, photography and reading nonfiction books about science, history and political economy. As for my academic background, I had formal training in biology for my undergraduate degree at Nanchang University, and I am in the final semester of my master’s program in Global Health at DKU. Much of the work I have done in my field is related to alcohol use and abuse. My two favorite traits about myself are my curiosity and my passion for eliminating inequality.

In the fall of 2014, as an undergraduate, you took part in DKU’s Global Learning Semester (GLS). How was that experience?

The four months I spent in the GLS program were amazing. Not only was I able to learn substantial cutting-edge knowledge from Duke and DKU faculty, but I was able to meet talented students from different fields, which motivated me to study harder. I think the biggest difference between a typical Chinese university and Duke Kunshan is DKU’s emphasis and attention on teaching and students. My favorite thing about the GLS program was the close relationship between the students and faculty. I had never before heard of a place where students could have meals with professors every day.

Why did you choose the Duke Kunshan’s master of science in global health program for your graduate work?

While I was a student in the GLS program, I became friends with some American students. One of my classmates was curious about whether young people in China used marijuana. At the time, I didn’t know what the word meant. After we figured out the translation, I realized that was the first time I’d ever heard of recreational marijuana use.

In China, with the outcome of the Opium War and China’s status as a ‘no-drug country’ since 1952, most Chinese people have two ingrained beliefs: Drugs are evil, and China does not have a drug problem. As I started to look up more information, I soon realized my own naivety: There was an estimated 14 million drug abusers in China, more than 1 percent of the total population. I wondered, why had my peers and I received so little education about drugs and alcohol? An alcohol knowledge survey I created in my junior year proved Chinese people know much less about safe drinking than Americans. Because my social science research skills were limited at the time, I didn’t write a journal paper, but with my survey report I convinced the Jiangxi provincial education office to add alcohol education into the textbook.

However, I was not satisfied with just making small changes. I wanted to provide people with sufficient information that gives them the ability to choose rationally. I realized I needed to become a researcher in order to carry out more influential and high-quality research, or to become a decision-maker in order to change our education system regarding alcohol and drugs. Both of these aspirations required me to pursue a higher degree to build a systematic research knowledge framework. This is why I chose to pursue a master’s degree in global health. I applied to Duke Kunshan because of its affordability, high-quality, and my familiarity with and favorable impression of DKU.

Can you tell us about your academic experiences in the master’s program?

Although I’ve transferred from biology to global health, I read a lot of books in related fields before I came to DKU. The global health program curriculum is very reasonable and friendly for people from a variety of fields. The program not only arranged meetings for us to talk with our supervisors every month about difficulties in life and study, but also encouraged interaction between students and faculty to help us get to know each other better. These are some of the reasons why I like Duke Kunshan. At DKU, everyone has meals together, so you can easily have a chat with the leading figures in different fields every day.

My favorite course was ‘Culture, Health, and Illness in a Global Perspective’ taught by Professor Allan Burns. We learned social science theories that intersect with the practical concerns of public and global health. We also read extensively about the history of policy, anthropology, community participatory research, and concepts of structural violence, social change and the application of anthropology to health problems.

What have you done for your field work?

Our goal is to create sustainable reduction of alcohol-related injury in Moshi, Tanzania. Industrial production and home production of alcohol are extremely common in Tanzania, and the price of alcohol is low. Alcohol use is ingrained in the culture there. Moshi has at least 600 bars. Data show approximately 30 percent of patients with injuries were consuming alcohol at the time of injury. Therefore, we are working on developing alcohol interventions at the Kilimanjaro Christian Medical Centre to reduce future alcohol-related injury. My project is a mixed-method study that explores perceptions of alcohol and alcohol-related risky behaviors and their associations. I hope to get more information about the local culture and perceptions to work toward developing interventions.

I did two things in Moshi. The first was my qualitative research of seven focus groups at KCMC about alcohol perception. My team has four research nurses and five research assistants. I was both the leader and the student of my team. I was the leader because I had to coordinate many research projects and lead my own research. I was also the student because my team members had much more hands-on research experience than I had.

The second thing I did was my Moshi survey. I conducted an ethnography of Moshi to understand its social and cultural environment, including production, economy and exploitation status. Through dozens of interviews, personal observation and extensive reading, I gained a deeper understanding of East African culture and identified the root cause of many development obstacles. With the start of neoliberal reform in the 1980s, not only have local industries been suffocated but medical systems have also deteriorated due to meager allocation of funds and privatization. Encouraging consumption rather than saving, the ever-encroaching capitalism into all areas of life in Tanzania fostered a drinking culture via the media’s promotion of alcohol. This resulted in increased poverty, health problems and a harmful culture of alcohol use.

How has Duke Kunshan’s global health program influenced your plans?

Coursework, fieldwork and writing my thesis at DKU made me realize the extreme imbalance of rich academic knowledge in light of increasing disparities, not only in China but in many countries. Despite the increasing knowledge about health, health care disparities in China are widening and alcohol consumption is rising. Gaining knowledge of health systems, ethics and sociology from my global health coursework, together with my solid qualitative research skills, has enabled me to apply theory and data to reduce health disparity and further prepared me to be an activist in human rights. Therefore, I decided to apply for Ph.D. programs in health policy and labor protection so I can further my research. I hope to advance my understanding of labor protection as a window into changing exploitive working conditions in China and beyond, as well as providing free health care, as it is a basic human right. I wish to work either in the government or in academia to speak for the poor.