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Observations of Health Care in China: Four Perspectives iDOCUMENT :RESUME 'ED 254.643 CE 040 842 AUTHOR . Attwood,. Maag, Ed. TITLE Observations .of Health ..CaTe,in China: Four PerspOtiVes. - INSTITUTION 111inAxs Unip., Urbana. Dept. of Vocational and technical Educition. PUB DATE, . May 61 NOTE 83p.' . PUB TYPE Viewpoints '(120) .-2 'Reports -.A0Bscriptive (141) .EDRS PRICE MF01/PC04 PluS'Postage., DESCRIPTORS *Allied Hedith OccupativOns.EdutatIon; Comparative . Analysis; *Delivery Systems; Educattonal Practices *Ethics; Foreign .Countries; *Futures- '(of Society); Health Facilities; Health Needs;-Health Personnel;,. Health Progrdms; Services *Physical Disabilities; Postsecondary Educationi,PrOgram. .IMprovement;.Public Policy; Trend Analysis . 'IDENTIFIERS *Chini; Yugoslavia ABSTRACT This collection consits of four papers dealing mith the delivery of health care in thePeople's Republic of China. The papers resulted from a study tour of theChinese health care system in J ne .1980. Included in the volume arethe following papers: "A Comp rison of Selected Aspects of the Health Care Systemsof the Soci ist Federal Republic of Xugoslavia and the People's Republic of China," by Ellen Hooker;,"Ethics and Health Care in the. People's Republic.of China," by Bobby E. Adams; "Observations on Care of the Physi'tally Disabled n th'e People's Republic of China," by Ann McElroy; and "China's Revolution' in Health Care:Will It Continue?" by Madge Attwood. Extensive referencesare-included. (MN) G ***************************w***************************************** * Reproductions supplied by EDRS are the best that can'be made *. * * from the original document. *****************************************************.********4********** /'1 ft ."*.Office of Observations of Vocatio,oal EductAion Research Health.gare In China: 0.* Depaitmtmt.ot Vocational arid A Four Perspectives tr) :Technical Education " (Ni Co 111'w 01 ikclucation * , Po University of Iiiinois 1...14 at Urbana Champaign t " AadgeAltwood, Editor May,. 1983 - U.S. DEPARTMENT OF EDUCATION NATIONAL INSTITUTE OF POUCATION E UCATIONAt filtS01.1ACESIINFORMATION (INTER 11111CI aft ..his Mammo:I ilea boon reproduced as waived from the poison or oThanizallon onomattno it iMinor chant), Mom boon mado,ta improve ',production quality Poune of view or opinions Hato) m thisdocu mom do not nacoseartly moment official NIE positionOfpolicy '"PERMISSION TO REPRODUCE THIS MATtiRIAL HAS BEEN GRANTED BY Ti THE EDUCATIONAL RESOURCES IFORMATION CENTER (ERIC) Preface The Division of Health Occupations Education was established In 1972 within the Department of,Vocational and Tectmical Education.The mission (is of the division to 'prepare health professionals' for leadership in educe-, tiortalroles. Hallmarks, of leaders are creativity, imagination 'and vision; imagination and vision In turn are stimulated by explorlyg, Investigating, and analyzing promising trends and practices. Firsthand observation of the profound changesinhealth careInthePeople's Republic of China (PRC) since 1949 and exploration ofthe factors that led to change Is a fitting area onnguiry for health ,professionals.The PRC has succeeded in improving the health ofIts people to an extent greater than any pf the thirdworld couniries. What happened, 'howIthappened, and whyit' appened are the topics of this monograph. .0 , . ) Madge Attwood, Chair Division of Health Occupatiorft Education University of Illinois May, 1983 I r' 4 BEST COPY. AVAILABLE 1 4 3 Table of Contents Page Introduction Madge AttWood A Comparison of Selected Aspects of the Health Care Systems of the Sodalist Federal Republic of Yugoslavia and the rPeople's Republic of China . 10 Ellen Hooker. Ethics and Health Care In the People's Republic of China 36 Bobby E. Adams Obiervations on Gare of the Physically Disabled in the People's Republic of China , 57 Ann McElroy China's Revolution IA Health Care:Will it Continue? 69 Madge Attwood p r le* t 5 Introduction In June,1980:13 health professionals from 6 different health disci- . plines and one professor of medical ethici traveled fory6 days through the People's Republic of China (PRC) studying a portion of China's health care system represented by health, facilities and personnelIn5cities and 2 rural communes. Our group consisted ofphysicians, 6 nurses, 2 physi- cal therapists, an occupational therapist, a medical technologist, a m'edical records administrator, ahealth educator, and a clergyman. The study totirwas anexperiencebasedcourse,"ComparativeHealth. Systems," sponsored by the University of Illinois/Urbana Extramural Programs Office and the Department of Vocational and Technical Educatio". The purpose of the ,course was to gain firsthand knowledge of China's remarkable ad- vances in Illness prevention /Ind health care. In preparation for their experience, participants were given a reading ' list,asyllabus and a detailed outline of the Itinerary. Recommended as readings In preparation for the tour were Victor and Ruth Sidel's "Serve thePeople,"Joshua Horn's "Away WithAllPests% and David Lampton's "Politics of Health, Care inChina."Letters of Introductionfrorri Spnley Ikenherry, president of the University of Illinois, and key leaders in allied health were sent to the minister of public health, to a well-known atdsor and obstetricianInBeijing,to the president ofthe Academy of Medical Sciences in Beijing, and to the Vice Chief of Rul -Jin Hospital In Si)nghal. We met in Vancouver B.C. the night before departure for China,for a briefing on Chinese protocol and an introductionto China's medical de- vetopments sincetheformation ofthePeople'sRepublicin1949. The following day we flewto Tokyo for an overnight stop atNarita airport. ' From there we flew to Beijing, arriving at about 9 p.m. Our Chinese hosts, eager to make us feel Welcome, greeted us at our hotel with cake and a Chinese version ofIce cream! ThroGghout the tour of the PRC we were accompanied by a Chinese speaking American guide,2 national guides and in each city by at least two local guides. We stayed 5 days in Beijing, from there flying for a 3 day visitto Hefei, a city of 'about 500,000 opened to western tourists only since 1979. from Hefei we flew to Nanking for3 days,. then to Shanghai for4 days, traveled by rail to Canton for an overnight stay, and Concluded our tour f In Hong Kong. Although two of our prospective hosts had responded to the letters of Introduction with invitations to meet with them, we learned .thatspecific appointments had to be made after we arrived In China by the kicalauldes in each city who arranged the itinerary.This produced a high degree of uncertainty and for istime we wondered If our Invitations would be hon- ored.The local guides seemed to have a substential amount of authority, our arrogant Beijing guide only reluctantlyarranging a meeting with Dr. Huang Chin-Ssu, president of the Chinese Academy of Medical Sciences, after I had requested the meeting daily, explaining the purpose of our trip each time.However, after Beijing*, the two national guidets accortspainylng Ju3i COPYAVAILABLE' 5 us throughout our stay wrote ahead to local guides in each city and were ableto arrange seminars, informalmeetings with health personnel, and I tours of health facilities that exceeded our expectations. We spent many hours each day observing different aspects of health care in the cities,the factories, and the communes.Our national guides were tireless in answering questions and on several occasions:Filet with us for evening seminars.Until our fatigue level became too great, we came together each evening as a group to process Our observatiOns and share our perceptions. Formal seminars were arranged with Dr. Huang Chia-:Ssu In Beijing, president of the Chinese Academy of Medical Sciences, and With Dr. Tang Cheng-Ilua, of Shanghaif6Hospital, aspecialistInthe replantation of severed limbs.At Shanghai'sftui-JinHospital we spent a morning with threephysiciansand a nursingadministrator, TheywereDr. Ssu Chia-Yu, ViceChief andspecialist In internalmedicine.,Dr.Chang Chuari-Kiun,ChiefofDermatology,' Dr.Tsung-Kuang,ViceChief of Dermatology and Madame Ssu Chia-Yu, Director of the School of Nursing. At Double Bridge Commune near Beijing and at Dong Fang Hong commune near Hefei, wiconferred with medical and nursing staffs and visited the commune medicalfacilities. InNanking we were taken to the Mei-Shan ironworks factory where we toured the factory, the school, and the hos- pital, discussing with staff the use of acupuncture to treat medical condi- tions, e success rate in replantatlon of severed limbs, and the utilization of health rvices by factory workers. Dr. Iluang Chia-Ssu met with us at Capitol Hospital In Beijing for a 2 hour overview of China's health care policies and her health care history. (tluanglacheerful older gentleman with twinkling eyes, a delightful smile,a sharp sense of humor, and perfect command of English, greeted usIn what we began to consider the Chinese "uniform " -gray slacks and white short sleeved shirt.Our group had decided before this meeting that all queries would be channeled through me as the leader of our group. Prior to the. seminar, we formulated questions, trying to choose those that reflected the common interests of our Varied members. The lack of status differences' In China was forcibly brought home as Cr:/ we obsetved our female guide correct Dr. Huang on a point of history In rri then iddle of a minHecture.They engaged, ariparently quite amicably, in peer dialogue. I found it difficult to imagine such an exchange between a tourguidefrom an AmerNn travel agency
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