At our favourite local park 李村公园 in Qingdao this past weekend, a little Chinese sidewalk water calligraphy magic:
At our favourite local park 李村公园 in Qingdao this past weekend, a little Chinese sidewalk water calligraphy magic:
Health is one of the biggest worldview disconnects between Chinese and Western cultures. Another is ethics. Putting it simplistically: To us, their stark pragmatism sounds amoral and selfish. To them, our abstract principles sound naive and heartless. It’s mutually appalling, and mutual understanding is nigh impossible. (Parenting has gotta be in the top 5.)
We’re halfway through a week in the hospital, and I thought this anti-“hongbao” signage was interesting. “Hongbao” (红包) is an ingrained aspect of Chinese culture where the patient’s family slips extra money to the surgeon in a “red envelope” to encourage better treatment. It’s illegal in Chinese countries, but that doesn’t stop it.
Front and center on the nurses’ station:
Honest medical treatment; Refuse to accept hongbao
Despite this, the translator assigned to us (she’s helpful, but her English is harder for us to understand than the doctor’s Chinese) says, “Sometimes, it still happens.”
Apparently there are a lot more ways than hongbao for doctors to earn extra ethically-suspect income. This poster is at the entrance to our floor:
To Strengthen Medical Treatment Clean Behaviour Customs, Construct “The Nine Forbiddens”
I don’t think hongbao is good despite what the authors linked below argue. But simplistically dismissing it as a bribe without first understanding it isn’t that helpful either. Looking more closely at the reasons and dynamics of this old practice also provides a helpful window into Chinese culture and common ethics. Here’s a bit from an American hongbao apologist:
From China, With Pragmatism
It is very common for a Chinese family to give hongbao to a surgeon who is about to perform a procedure on a family member. Everyone knows to do this, and everyone does it to the extent that they are able. The Americans in our group thought this practice was unethical bribery, because it sought to bias the doctor in one’s favor. The Chinese people at the table replied, “Of course it biases the doctor. That’s why we do it.” Not only were they mystified by the censure, but the Chinese were prompted to ask if the Americans had any children — for every parent surely uses any means necessary to protect loved ones.
When one embassy officer (working his best “hearts-and-minds diplomacy”) suggested that the Chinese switch the giving of hongbao to after the successful operation, rather than before, the Chinese were struck dumb with astonishment. Of course, you have to give the hongbao beforehand because it motivates the doctor. The gift tells the doctor: (a) to take special care with our child (b) we respect your surgical skills/education and “give face” accordingly (c) we are devoted to our child, will hold you responsible and have the means to do so. The fact that not everyone can afford to influence their doctor with hongbao is not grounds for withholding it, since we’re trying to protect my child here and now. The parent, according to the Chinese, should never weigh the child’s well-being against something so arcane as an abstract principle.
And here’s another piece that spreads the blame around:
Bribery serves as life-support for Chinese hospitals
Bribery is the lubricant that helps keep China’s public hospitals running, and the health system would struggle to function without illegal payments to poorly paid doctors and administrators, say medical practitioners and industry experts.
A doctor fresh out of medical school in Beijing earns about 3,000 yuan ($490) a month including bonuses — roughly the same as a taxi driver. A doctor with 10 years experience makes around 10,000 yuan a month, according to Peter Chen, chief executive of privately run Oasis International Hospital in Beijing.
“Without the grey income, doctors would not have the incentive to practice,” said Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations in New York.
Dealing with the problem is not so easy:
Should Doctors Be Rewarded for Refusing Bribes?
hongbao is adding to the financial pressure most patients are already under, at a time when medical and health cost is very high. The public has long expressed their dissatisfaction with this accepted practice. The government has already taken a number of measures to save the deteriorating patient-doctor relationship resulting from hongbao by announcing that doctors who take bribes will be struck off the doctor roll. In some parts of China, it is announced that those who report this practice to the government can receive a reward worth thousands of yuan, while the doctors concerned will be dismissed. However, despite these kinds of measures, it seems the hongbao tradition is entrenched and likely to die a very slow death in China.
Here’s a little larger, current context for the hongbao practice:
Under the Knife — Why Chinese patients are turning against their doctors
Violence against doctors in China has become a familiar occurrence. In September, 2011, a calligrapher in Beijing, dissatisfied with his throat-cancer treatment, stabbed a doctor seventeen times. In May, 2012, a woman attacked a young nurse in Nanjing with a knife because of complications from an operation performed sixteen years earlier. In a two-week period this February, angry patients paralyzed a nurse in Nanjing, cut the throat of a doctor in Hebei, and beat a Heilongjiang doctor to death with a lead pipe. A survey by the China Hospital Management Association found that violence against medical personnel rose an average of twenty-three per cent each year between 2002 and 2012. By then, Chinese hospitals were reporting an average of twenty-seven attacks a year, per hospital.
Monday was the first day of a new Chinese preschool school year.
And that pretty much sums it up. But I’ll share some special highlights below anyway.
First day of the school year means the opening ceremony. The school yard is ringed with parents (mostly grandparents) peering between the iron bars. We have to make a good impression.
As a 6’4″ foreign male at a preschool with an all-Chinese-female admin & teaching staff…
…I totally fit in.
This is where we teachers all pledged to do something, but I’m not sure what:
Chinese sound systems are for noise, to make an event sound like a Big Deal, not for clearly amplifying sound so large numbers of people can understand what’s being said. Plus at the time I was thinking: Oh hey, so this is what Chinese do instead of placing one hand over your heart and raising the other palm-out…
The kids had to turn around and bow to the teachers:
But only about 1/4 of them got the memo.
The Expensive English-speaking White Guy and the Obligatory English Song:
(I want it noted in my annual review that my feet actually left the ground.)
“Foreign teachers” (外教) are the bottom of the Anglo-American expat barrel, I suspect even below 4th-rate amateur Russian models and, at this preschool, hovering somewhere in the vicinity of the only other males on staff: the cook, driver, and gate guards. And I’m pretty sure I don’t outrank the cook.
More Chinese preschool stuff:
We were walking along the shore of Qingdao’s Shilaoren beach （石老人海水浴场） today, just past that drainage river thing near where the ATV rental guys who think they own the beach are, and found THIS:
That is the biggest honking jellyfish （水母 or 海蜇） I’ve ever seen in my entire life. I flipped it over with my shovel:
From a distance I thought it was just some garbage (there’s lots of garbage). But man. Can you imagine bumping into this in chest-deep, murky Qingdao beach water?
And keep in mind that my size-13 foot isn’t hovering *that* close to it, so the photos’ perspective makes the jellyfish look smaller that it really was.
I’d heard from friends about a local jellyfish infestation and checked the Chinese news yesterday. One guy has died this summer from jellyfish. And people we chatted with while taking pictures of this one said there was a 300斤 one on a beach east of here. I’ll give you one guess regarding it’s fate…
P.S. – UPDATE:
Special thanks to science writer and jellyfish expert Dr. Juli Berwald, who’s ID’d this thing for us. It’s a Nomura’s jellyfish (Nemopilema nomurai), one of the two largest jellyfish species in the world. According to the internets, it’s got a painful sting but doesn’t *usually* kill people (?!) and is edible but not considered tasty enough to go to all the trouble it would take to harvest them. They’ve capsized fishing boats and shut down at least one nuclear reactor. And you can’t just go killing them, because whenever one gets stressed it releases billions of sperm or eggs into the water. It’s not the most venomous jellyfish in the ocean, but it is perhaps the most notorious for economic impact. Do an image or video search for “Noruma’s jellyfish” or “Nemopilema nomurai” — fascinating stuff.
More importantly, these recent and massive “blooms” of jellyfish have scientists’ attention. Jellyfish are an “iconic animal of our time”; scientists like Dr. Berwald are currently researching what these jellyfish blooms reveal about the future of our oceans and our role in shaping that future. You can check out her project Spineless here.
A Chinese friend translated missionary doctor and Ebola patient Kent Brantly’s public statement, which he wrote from the Ebola isolation unit at Emory University Hospital. I’ve pasted both it and the original English version below, plus some related links (Chinese & English). Click the photos for sources.
Ebola = 埃博拉病毒 (also sometimes 伊波拉)
Kent Brantly = 肯特 布兰特利
A related Chinese article 《了无遗憾？》：
“”肯特‧布兰特利医师（Dr. Kent Brantly）因救助病人而染上伊波拉病毒，他坚持把可能救他一命的实验血清，让给另一位染上伊波拉的女宣教士。这不是女士优先的时刻，而是生死攸关的时刻；而这血清是从他所救活的一个病童身上抽取血液制成，只有一剂，他比任何人都有资格使用它来增加自己活命率。但他坚让。
A third Chinese article: 《勇敢的心——感染埃博拉病毒的美国医生布兰特利的故事》
“I am writing this update from my isolation room at Emory University Hospital, where the doctors and nurses are providing the very best care possible. I am growing stronger every day, and I thank God for His mercy as I have wrestled with this terrible disease. I also want to extend my deep and sincere thanks to all of you who have been praying for my recovery as well as for Nancy and for the people of Liberia and West Africa.
“My wife Amber and I, along with our two children, did not move to Liberia for the specific purpose of fighting Ebola. We went to Liberia because we believe God called us to serve Him at ELWA Hospital.
“One thing I have learned is that following God often leads us to unexpected places. When Ebola spread into Liberia, my usual hospital work turned more and more toward treating the increasing number of Ebola patients. I held the hands of countless individuals as this terrible disease took their lives away from them. I witnessed the horror first-hand, and I can still remember every face and name.
“When I started feeling ill on that Wednesday morning, I immediately isolated myself until the test confirmed my diagnosis three days later. When the result was positive, I remember a deep sense of peace that was beyond all understanding. God was reminding me of what He had taught me years ago, that He will give me everything I need to be faithful to Him.
“Now it is two weeks later, and I am in a totally different setting. My focus, however, remains the same – to follow God. As you continue to pray for Nancy and me, yes, please pray for our recovery. More importantly, pray that we would be faithful to God’s call on our lives in these new circumstances.”
Ebola crisis links:
Ebola Crisis in West Africa
Ken Isaacs, Vice President of Programs and Government Relations for Samaritan’s Purse, testified before the House Foreign Affairs Subcommittee concerning Ebola in West Africa.
Ebola: My last day in the isolation zone (MSF)
“I enter, take in the scene and stop to look back at Sara, who has yet to see what lies before me. She said later she knew it would be bad from my eyes.”
Fighting Ebola for Us All (NYT)
don’t see Brantly and Writebol as reckless curiosities who somehow brought Ebola upon themselves. See them as leaders on the front line of an effort to help and protect Americans and Africans alike.
Infected Ebola Doctor Kent Brantly Is an Endangered Hero (The Daily Beast)
Even atheists could find a guide to goodness in asking themselves What Would Kent Do?
I’m the head nurse at Emory. This is why we wanted to bring the Ebola patients to the U.S.
These patients will benefit — not threaten — the country.
Americans with Ebola should be welcomed home (CNN)
There are two epidemics in the world today. The first is a troubling spread of the Ebola virus in poor countries in Africa…But the second epidemic is a more dangerous one.
Ebola in Africa and the U.S.: A Curation
That I am anti-Ebola panic — and especially anti-Ebola media scrum, which was disgraceful — does not mean I am not concerned about Ebola where it is authentically a problem, which is in the expanding epidemic in West Africa. It is a dreadful outbreak, it needs attention…
“Weird Al” Yankovic is promoting his latest album Mandatory Fun with two Chinese propaganda poster spoofs. One poster has Chinese. To find out what it says, mouseover the Chinese characters here or scroll down:
And here’s the other one:
Click the images for the original source.