Late November, 2007

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Among the post-1949 changes in China has been the tremendous improvement in people’s health and well-being. People live longer, are not dying of infectious diseases, and one important cause has been the great increase in the availability of food, especially since the economic opening starting in 1979.

As with all things in nature, there is another side of the story. People are eating much more, they can afford meat, a former luxury item that was only sparingly enjoyed, and their intake of refined foods has multiplied. A once rare sight has become common, that is people eating while they are walking down the street, often a sugary bake good or other confection.

The presence of over-eating was brought home to be this afternoon when I was returning home from an adventure (I had to bring my computer in for a repair, which I negotiated mostly myself in English and pantomime), and I spotted a rather large (obese) man carrying a cake carton which was labeled “low calorie cheese cake”. This presented an apt summing up the presence of marketization in China and its negative consequences.

As a pubic health matter, obesity is increasing and as it was when it first appeared in the developed world, for now it affects mainly the well-to-do. Business people and government officials place great importance on noontime business meals, lavish events with much more available than can possibly be consumed. We have had students express their concern for their parents and their over-eating and lack of physical activity. Along with high calorie diets has come an increasing reliance on motorized transportation, and that increase further diminishes the possibilities of bicycle use on the traffic clogged streets.

Our various discussion groups continue to be excellent forums for us to have open discussions with Chinese students, mostly from Social Work and Public Administration. This past week, in our general groups (Ellen also does two Labor groups each week, one on each campus that she works at) the focus was on health care. There was no sparing the student initiated criticisms of how the Chinese get and pay for their health care, the corruption that mars it and their attentiveness to the idea that something drastic has to be done. Doctors are widely mistrusted, with a sense that they prescribe things that will make them money.

This issue was recently highlighted when a hospital in Shanghai was closed when it was revealed that doctors there had ordered many women to get hysterectomies for benign conditions. It only came to light when two sisters were told to undergo this expensive procedure for vastly different conditions. This was one of the new profit-making hospitals established to serve people with some resources.

China is currently holding high-level, closed talks about health care reform and their public hints about the process are not encouraging. It appears likely that they will implement an insurance-based, profit-seeking system as a solution, one that bodes poorly for the hundreds of millions of Chinese who have not greatly benefited from the economic growth. We are trying to inoculate all those we come into contact with against the Neoliberal ideas that the market has anything to offer health care in any country. The American system serves as a good example of the bankrupt notions espoused under this the Neoliberal policy of legalized robbery that masquerades as a political philosophy.

Last week we were back to the Children’s Palace to talk to a group of parents about autism. This is such a bizarre and wonderful experience, given my relative ignorance about the diagnosis or treatment of the disorder. But we are willing and willingness will go a long way here since many people with knowledge are unwilling to leave the confines of their academic offices. This is in part a consequence of the incredible pressure that it put on them to publish; they are always looking to do survey research, something that can be quickly done and tabulated back in the office. There is very little interaction between the research academics (mostly sociologists and psychologists) and the people in the world who are struggling with the problems.

We faced a group of about 40 parents, mostly middle class but some exceptions; one particular mother stands out. Ellen imagined her to be a “school secretary who has been misused and maltreated at work and at home for years”, she was feisty and not one to be placated. At one point, after making frequent looks at her watch she stormed out of the room. Much to our surprise, she returned a few minutes later and stayed to the end of the meeting.

I led off with a 20 minute discussion of the nature of the disorder and the types of treatment and education that represent the gold standard today. Ellen then talked about how special education came to be an issue in the US and the essential role that parents played in changing the law and the attitude of educators, in her clear and convincing popular education mode.

Sometimes in China you can believe that you are in a so-called developed nation, the avalanche of consumer goods, the advertising, and the crush of autos on the road. But the look on the face of these middle class parents, people whose lives superficially mirrored the lives of middle class people in the developed world, revealed their distress at what they were hearing. They saw a huge chasm open between where they thought they were, in relation to the developed world and where they actually were, at least when it cam to social services that are (at this time) taken for granted in the West.

Ellen, of course, was stressing the essential role that parents, working together, could play in increasing their children’s access to needed educational services. Her entreaties were cognizant of the small space available for organized community action here. We have seen that the space for this, especially among middle class people, does exist and her efforts were focused on getting the privileged to focus on public education rather than encouraging the thought that they could buy their way out of their problems. (We were asked by one parent if we thought she should take her child to Canada, where apparently she could gain entry; I mentioned the cultural obstacles she would place in her child if she were to do this, but begged off further assessment stating that without knowing her child a useful recommendation was impossible. After all, if it were my child what would I do, wait for change in China or take immediate action to help my child?).

The most striking moment came, when the director of the special education program at the Children’s Palace got up and gave a strong endorsement of parental engagement in the problem, emphasizing that they have been missing from the discussions and their help was needed. She definitely fired them up, getting an offer from one parent to set up a BBS and the ideas for cooperation began to flow. All in all, we think we made a little trouble for the forces of reaction that are trying to keep these disabled children from getting the education they need.

As I am writing this, Ellen is preparing to return to the Children’s Palace this afternoon, for a follow-up with the parents and she will be meeting with them weekly for the next month or so to sharpen their skills at advocacy and from the bottom organizing; that these efforts are appreciated by some in position of authority is a sign of both her expertise as well as the openings that exist for this sort of effort.

Our translator for this event was Sean, a 4th year public administration student who has excellent command of idiomatic English and did two way translations with hardly a missed beat. From time to time I would use a word (psychodynamic for example) and watch a changed expression come over his face as he searched for the word, a groping with which he was almost always successful!

After collecting our 200 RMB taxi fee (we took the metro for 6 RMB), we took Sean out for dinner, along with another undergraduate. We had a lively dinner conversation about China, the Chinese, and the attitudes of students. He stated that students were cynical about government and were searching for meaning in their lives. This came as something of a surprise to us as students often display the affect of anxiety and worry about their future and their need to get a good job. Actually, there is no inconsistency between these two assessments as some of the anxiety can be attributed to a wonder along the lines of “Is this all there is, is what I have to look forward to is a life of work in a system that does not really value my expertise or values”.

OK, this has been sitting around here for a few days waiting to go out, so out it goes. Ellen is off to lunch with a member of the US Consul's Office, discussing her January presentation to the foreign consuls on labor in Guangzhou. Becky is preparing to go off to her volunteer job as part of a social work effort in a nearby community, providing needed services to children and their families. And I am here working on my next presentation which will focus on disabilities, something that China has room for great improvement. More on ll these matters next time.

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Photos

Becky, Chani, and Bi
We had some Vermont visitors, Gregg and Linda along with their two daughters. Chani was adopted here in Guangzhou some ten years ago and they visited the important sites connected with that event while here. It was great to have a few days with them here and earing their experiences.

Single Stream Recycling
All the trash goes into one receptacle (ours gets put out in the hallway from where it is silently collected several times a day) It then gets put into these hand pulled carts where migrant workers sort through it by hand, separating out all that is recyclable, and that means just about everything that is NOT organic.

Recycling Station
Each weekend, there is an on campus recycling station set up. All the plastic, paper, metal, whatever has been salvaged out of the trash appears and is weighed and the trash collectors are paid for what they turn in. By Sunday afternoon there is a mountain of tied up books, newspapers, and piles of old water heaters, fans and other appliances.

Nice Toilet
And it was, this was an outdoor unit in a park and as is true for many of the public toilets in this part of China, a vast improvement over some that we had experienced on our first trip here. It also reveals the penchant for naming and labeling sites and phenomenon.

Dinner
There have been major increases in food prices over the past year, a matter of some concern to the government. Pork prices have been especially had hot, not a problem in the household. This was dinner one night and without the wine the cost was about $3.50. Pea pods with cashews, lotus root with fermented tofu (a bit like blue cheese), cold cuke marinade, "tiger skin peppers", MaPa Dofu (which means "Old pocked-marked woman's tofu)and a rappini like cabbage with garlic and ginger, hen hao (very good).

Ellen doing the laundry
OK, you can change the scene, even put the laundry room outside on the terrace, but there she is getting the sheet draped just right on the drying rack so that it doesn't touch the ground and need to be re-done. Things dry very quickly this time of year, bright blue skies and good winds.

Stuart getting lunch on the table
With the great varieties of fresh vegetables, cooking in has become part of our routine. Today's lunch was peppers, eggplant, tofu and a steamed corn bread. There is wonderful bi-color corn in the markets right now!!