Adam Daniel Mezei, a friend, and time to time contributor on Asia Healthcare Blog put together a list of what he calls the China Blogospheres ‘A Team”.  We were humbly included on that list.

Yes, I am linking to it because we are on it, but also because its a great list and the bloggers listed on it are every bit as good as Adam claims that they are.

I encourage you to check it out.

Excerpt about us below.  To dispel any potential rumors…the book I am working on is a fantasy.  Though it draws on Chinese elements, it’s not directly related to the work on this blog.

Asia Health Care Blog (AHCB) has truly lived up to its once-humble origins. Perhaps a small anecdote would suffice before launching headlong into why AHCB is soaring into the stratosphere at supersonic speed.

Story goes that DeNoble met Flanagan back in Beijing while Damjan was still slinging pizza pies and lager steins at the city’s popular Kro’s Nest, a bi-level bistro that serves Beijing’s 2nd-best crispy pizzas and beer (and a place I had the good fortune to spend several hours with James when I was last in Beijing). The two of them met, sat down, and realized the both of them were deeply interested in China health care issues. They observed the astonishingly glaring vacuum of online information about the surging Chinese health care sector and decided – on the spot — to start blogging about it. Hence AHCB was conceived, gestated, and born all on the same evening, an Immaculate Conception that’s delivered the duo no uncertain internet celebrity.

Rumor also has it that AHCB’s “long march” — from how it began, to how it appears today — is the premise of Damjan’s future novel. And if sneak previews – which have since, and smartly, been pulled down from the main AHCB site – are anything to go by, expect a small press page-turner.

What I respect most about AHCB is how fastidious the both of them – like china/divide — are with their source materials. They coax stuff in from practically all corners to bolster the topic under discussion, whether it’s:

• the perplexing Chinese penchant for abortions and C-sections.
• medical malpractice in the Chinese hospital system, or
• the rampant graft which hampers and devastates the chronically-underfunded PRC health sector, more generally.

Their writing is long-form newsy and the intelligence which imbues the various pieces shines through clearly.

In “Letting Go of My Father,” Jonathan Rauch presents an honest look back on time spent taking care of his

“… I imagined checking on him by phone every day, stopping by his apartment several times a week, and regularly going out with him to restaurants and theater. It could work!”

Within a few days, hope gives way to reality, as Jonathan quickly realizes that taking care of his father is a full time job.  As time goes by, and his father becomes increasingly more debilitated,  responsibilities start to wear away Jonathan’s emotional resolve, and he begins to feel isolated.  On a particularly bad day, after  his father collapses in a supermarket but still refuses help, Jonathan’s anxiety triggers anger at his father for being a burden, and not wanting to move into an assisted living home.

“That was the day I realized that he could not cope and I could not cope and, emotionally, he could take me down with him. And I discovered in myself an awful determination not to let that happen. From that moment, I was determined to get him out of his apartment and under professional eyes, or, failing that, to protect myself. How to protect myself, I didn’t know. Hire help over his objections? Take him to court and seek to have him declared incompetent? Report him to Adult Protective Services? Use my ownership of his apartment to force him out? All I knew was that, at that point, I believed myself capable of doing such things, or even of washing my hands of the situation if he would not listen to reason. I imagined telling an indignant world that I had tried my best and could do no more. You have no idea what a thing it is to have that sort of conversation with yourself about a parent.”

In turn, Jonathan’s anxiety is further magnified by the anger. Feeling like he has nowhere to turn to, his coping mechanism becomes talking.  Talking about his travails to anyone that will listen. Unprompted or not.  He finds a surprising number of people willing to patiently listen;  other people like himself, middle aged adults either taking care of elder parents or already having taken care of them, who themselves badly want to talk about their experiences.

He realizes that he is far from alone.  Rather, he is a member of a large and invisible American group.

“As I walked the streets, did interviews, conducted business, I took to wondering which of the middle-aged people I encountered were quietly struggling to cope with their own crisis. How many of them felt utterly out of their depth? How many others, having come through an ordeal, had experience that they had no ready opportunity to share? According to the National Alliance for Caregiving, about 50 million Americans are providing some care for an adult family member. I was swimming in an invisible crowd of caregivers every day, but, like streams of photons, we passed through each other.”

From here Jonathan describes his search for answers about why if the population of caregivers is so big, everyone seems to  “pass through each other”, and no one knows where to turn to.  The answer he hints at is that everyone, both the caregivers and the parents receiving the giving, are too used to being independent.  His father finally agrees to enter an assisted living community only after being told, in so many words, that he is impeding on his son’s independence.

The retirement facility turns out to be very good.  And, Jonathan finds, high quality is no longer an unusual feature of long term care.  His father dies shortly thereafter, in December of 2009.

On the face of it, having ensure that his father received high quality end of life care, the matter seemed solved, and Jonathan, socially, was absolved.  But, the struggles that led up to this point still demanded an explanation.

How can it be that so many people like me are so completely unprepared for what is, after all, one of life’s near certainties?

It is at this point that Jonathan gives his most powerful insight. He  draws on an analogy with the invisible housewives of the 1960s;

What we need even more than that, though, is for our nameless problem to be plucked out of the realm of the personal and brought into full public view, where help can find us. In the years after Betty Friedan named their problem, women who work in the home (formerly “housewives”) demanded and got a new infrastructure for support: opportunities to study and work at home, part-time job opportunities, public and private help with child care, social networks, and so on. Perhaps more important, they demanded and got society’s recognition that they were providing an indispensable public good. As a result, they are not isolated or silent anymore, and they do not need to put up with being lonely or bored. Keeping today’s invisible infrastructure of caregivers out of sight is as stressful and wasteful and pointless as leaving millions of women feeling stranded at home once was. My mother’s friend and the feminists of her generation fundamentally had it right. There should be no need for anyone to go through this alone, and no glory in trying.

Through advocating for the empowerment of caregivers and for greater social recognition of their burden, Jonathan realizes that there is  not just a need for a strong medical infrastructure but also for a social infrastructure to help the caregiver.

There is a need, in effect, to lessen the obligation American’s feel to be independent. An over reliance on independence encouraged Jonathan’s father to refuse help even while he could barely dress himself, and a similar sense of obligation drove Jonathan to feel isolated with his burden because sharing his experience somehow felt as if it violated the freedom and independence of other people.  Only when he started sharing did he realize that everyone who shared his experience in some way, needed support.

The debate of what qualifies as an American value is better left for the college campus, so suffice it to say that independence is a core aspect of the American mythology any way you cut it. Jonathan’s insight is critical because it cuts through the myth of independence as it pertains to how we live our lives surrounded by other people; it’s not advisable to live life independent of everyone else, and the nuclear family is really part of a greater organic whole.  Sooner or later we all need help.

Boiled all the way down to its core, Jonathan’s argument is  that our cultural values shift from the self to the family; and that we embrace care giving for our parents, and, conversely, one day being care for by our children, as a cultural value, precisely because it is.

Confucious would be proud of Jonathan’s epiphany, albeit disdainful that all of America doesn’t share the view. He might also note how nice it would be if China’s medical facilities for elderly parents were as nice as those in the United States.

Chinese adults caring for parents have, in all likelihood, anticipated this time their whole lives, owing in no small part to the ailing parents who, when healthy, were careful to steadily remind them of the obligation.  Filial piety is a cultural staple of Chinese life that’s survived multiple cultural revolutions and/or national rebirths.  The value was enshrined in Confucius’s dialects from nearly two and a half millenniums ago, but is likely far older.

These principles have since then permeated throughout the world, and saturated Asia, so that it is no overstatement to say that all Asian countries have a culture of filial piety.

But, as this excellent four part series by Samuel Green points out (Part 1, Part 2, Part 3, Part 4) modernization, and a rapidly aging population, is taking its toll on China’s ever more extended filial networks, and what’s needed now is a safety net of medical infrastructure for the elderly.

Instead of looking up China and others in the developing East, and scoffing at their lack of medical infrastructure, Americans would be wise to look at  the family strength that the East does have.  Meanwhile, the Chinese, and their Asian neighbors who share both their reverence of filial piety and rapidly growing populations, shouldn’t waste any time in studying the blue prints of American assisted living facilities.

Both sides have much to learn from each other.

That’s because today, no one in the world is immune to the effects of an exported food and drug safety scandal.  When Country A exports melons, tainted with a nasty human pathogen because Country A’s Food and Drug Safety Commission failed make the necessary inspections, for whatever reasons, Country B’s through Country M’s citizens become at risk of getting sick, or worse.

The importing countries fate is determined partly by the strength of their own Food and Drug Safety apparatus and partly by luck.  Food and drug safety is not an exact science, but one thing is for sure, in today’s economy – where, if I am so inclined, I can order an overnight shipment of Malaysian citrus to Ann Arbor, from a Malaysian citrus farm, even though at the time of my order my selected citrus is still hanging off a tree – one country’s Food and Drug Safety scandal can quickly become a global food and drug safety problem.

On some level, most people with access to international news are increasingly becoming aware of this dynamic, with China in the role of Country A.   The problem is that by the time the news cycle is finished covering one of China’s food and safety scandals, the average consumer of news is ill informed about the story layer which has to do with her own well being.

More often than not, international news stories about China’s food and drug safety issues are reported in a way that scores  points for economies doing trade with China , and, in the worst cases, China’s food and safety problems are unceremoniously grouped in with to a long list of China’s human rights issues.  It is the classic case of elites writing for other elites.  The politically and economically expedient information is seized upon while the truly important aspect of it is let go by the wayside.

China’s baby formula melamine scandal and its various precursors (for contaminated toothpaste, see here, and for Diethylene Glycol poisoning scandals which have received less media attention but were probably responsible for more deaths worldwide, see here) did not make front page news across the world because of the many intertwined story lines of captivating political intrigue and corruption, but because, all across the world, products in every day use were now in danger of really hurting people.  Billions of people, and millions of household pets, were are risk of being adversely affected. 

The  corruption and structural frailty of China’s SFDA which led to the global poisonings was certainly put on display for all to see, and the potential economic impact on China and certain domestic industries was worthy of coverage, but the sexiness of those news angles obscured the fact that the story’s usefulness for the majority of people was contingent upon it remaining healthcare story.

While sensationalizing China’s food and safety can be justified, in some instances,  like when international pressure is put on China’s regulators to crack down on certain offenders,  too often the issue is myopically focused down on just China’s SFDA. From the Americas to Japan, various countries’ FDAs, too, are part of the regulatory mechanism that help protect consumers from dangerous products, and they certainly aren’t the only link.  There are also the middle men, the merchants who buy chemicals from Chinese manufacturers, the traders who package and ship the chemicals, and the industrialists who unwrap the packages and use their contents to make products that end up in private households.  It’s never just one person or group.  Catching manufacturers who substitute product with poison requires a global effort, otherwise the trail quickly goes cold.

A more politically savvy strategy requires planning, not reacting.

First, heavy handed criticism should be saved for private exchanges with China’s SFDA , while public coverage should involve more measured  criticism, with a focus on the public health ramifications for the populace.

There is no need for overly humiliating public criticism from leaders because, in recent years, the Chinese have proven more than willing to hold their food and drug safety officials accountable, executing Zheng Xiaoyu, the SDA/SFDA chief from 1998-2005, in 2007.  The PRC government, too, is aware that creating a reliable Food and Drug Safety Administration is crucial if China is to transition from a factory economy to one that can thrive in hi-tech sectors like drug development and medical devices.  The incentives for reform are already there, and if the endless restructuring of its SFDA (2003, 2008) is any indication, China seems to be working on it.

Second, leadership should publicly embrace food safety as a global issue.  Public leaders should demand higher merchant accountability standards of all merchants dealing in food and safety products, and look at the way their FDA reviews products from China, as well as the practices of  other countries that use chemicals and food stuffs from China.   Politically, there is nothing to lose domestically; both Democrats and Republicans love to rally around China.

Third, the FDA should do everything it can to integrate its operations with China’s SFDA.  I don’t know what form this cooperation would take, but a good place to start is coming up with a mutally agreed upon system of tracking and labeling. No package enters or exits either country unless the origin of the product is clear, and all intermediate transactions are detailed, in full. At the very least, closer oversight by the US might speed the pace of reforms up.  Then again, it might not, but it’s still worth a shot.

To be sure, some of this is already taking place and most of it is easier said than done.  Per the former, America’s FDA recently opened up its first office, in Beijing.  Per the latter, China Daily reports today might spark a whole new food safety scandal;

Every year, two to three million tons of swill-cooked dirty oil, soaked with poisonous carcinogens have sneaked back to our dining tables through an underground muck-money network so rampant that it’s an open secret in the industry, the China Youth Daily reported Wednesday.

A deadly toxin found in swill-oil is aflatoxin, which is among the most carcinogenic substances ever known and is 100 times more poisonous than the forbidding white arsenic.

The stomach-turning news report quoted a veteran food professor as saying “about one in ten meals” at the country’s restaurants is cooked with such dirty oil, a calculation based on China’s annual oil consumption of 22.5 million tons.

But, the takeaway is that food and drug safety is an issue that requires advocacy on a global scale.  The market in dangerous, fake drugs and chemicals is growing exponentially, and barring any catastrophic demographic changes, international trade in foodstuffs will only continue to grow, as well.  Small problems now will not be hammered out by the market.  With seven plus billion people in the world, the market for cheap, dirty goods will always exist, because pockets of poverty will, most likely, always exist.

The task ahead is to recognize the need for constant vigilance, which, in turn, necessitates constant global cooperation.  People define Global Health in a lot of ways, but maybe the easiest way to think about it is that the first victim of globalization is our health.  This is easy enough to understand when SARS or other seasonal villains like the avian/swine flues are involved, but we tend to forget it when the health threat is integrated within the organs of our economy.

Two days after a coughing, poisoned butterfly on the floor of black market chemicals manufacturer coughs, in China, the emergency room in Anytown, USA runs out of beds.

When it comes to bloggers, I like those who not only write well and give timely information, but also  give me an experience.  If the website looks like its stuck on an IE 6 platform I will not hesitate to click away.  I understand that I may miss a lot of good content this way, but we all miss a lot of good content on cable public access channels and no one makes a fuss about that…except for the people who have shows on public access channels.

Next, I Google in English. So, these are necessarily English language blogs.  In the future, I’ll try to vary up the offerings.

Finally, I have not included many of the blogospheres most established members.  I hope the folks who run those publications, and they should know who they are, aren’t offended by being left off.

With that said, here is my top 10 up and comer blogs.  All of the blogs here consistently churn out good material that makes me think AND they have innovative blog designs, or something that *pops*.  At the very least, the blogs here represent  the future of the China blogosphere in terms of design and content.  Fading are the days of all-text webpages.

1. Aimee Barnes

Aimee’s and our blog started up around the same time, in January of 2009.  She is one of the first blogs I started reading, and her work has only gotten better with time.

Simply put, she makes news and breaks stories like no one else’s business.  Over the course of 15 months she tallied hundreds of interviews with interesting people working on the intersection of China and the US.  She contemplated retirement in November of 2009 but, luckily for us, came back in January of 2010, refreshed and ready to write again.

Her blog has a distinctive look, and her pieces are long.  But, they are damn good reading, and her posts will definitely take you more than one commercial brake to finish.  Be warned, you will finish her post.

2. 10 Ton Funk

Previously known as MSGED, 10 TonFunk is just what it purports to be, in the title – 10 tons of mothercoddling funk for your brain.

As far as artistic design goes, no one holds a candle to Blogger Fred Distenfass’s eye for color and lay out. I find myself clicking over to this blog just to stare at it.

Topics range from hip hop to geo-politics and Fred always makes sure that his personality is out in full force, but is wise enough to not let his personality get in the way of the information.

3. HaoHao Report

HaoHao Report is a metablog for news stories.  The man behind it, Ryan McLaughlin, has two other  creations, Lost Laowai, an expat community, and the Humannaught, a personal blog named after Ryan’s alter ego.  Both should be considered honorary members of this list – their design is equally nice as HaoHao and after visiting them you should notice the similiarity.

HaoHao report has grown into a dedicated community of sinophiles that comb the deep recesses of the internet for the best English language stories on China. The site is sleek, fast, and one hell of a bargain for bloggers.  Right now, even when a story is not voted up to the front page, it can easily rack up a hundred hits.

Ryan is very good about soliciting feedback and then acting on it, so HaoHao Report will only get better. Look for this to quickly become the Huffington Post of China stories within the next two years.

His work has turned the, by contrast, unresponsive and uninspired Chinalyst into an anachronism (they can’t even register my blog because our RSS feed is too modern).

4. Adam Daniel Mezei

Once you notice Adam you’ll be surprised that you ever missed him in the first place.  That’s certainly been our experience here at Asia Healthcare Blog and at China Healthcare Blog, where Adam has become an honorary member of the team.

Though his site offers a mix of commentary on Prague and the two Koreas, in addition to China, the real reason to visit his site is that the man is a human information magnet.  If its worth reading, seeing, or hearing, Adam is there.

Name a good writer, Adam has read her.  Identify an important niche source of news, Adam is already the site’s top contributor.  Want an thought out opinion on a really popular story that the big media outlets have thrown into an echo chamber, but haven’t got the time to fully analyze, Adam has found someone who has, or he has done the work himself.

Did I mention that he’s an excellent writer, with an impressive publishing pedigree?

Coming up with this list would have been much harder without Adam’s amazing help.

5. Shanghai Street Stories

If 10 Ton Funk is a feast for the senses, then Shanghai Street Stories is the  countryside pasture owned by you Great Aunty, where you always hope to visit during the spring time, and once you get there you don’t want to leave because the day to day reality of your life in the city suburbs pales in comparison to the beauty of the pasture’s fractal simplicity.

The photos are always presented in stark hues of gray and red.  The give you a lens through which you can see Shanghai as you imagined it before you found a local Starbucks and the city became just like everywhere else.

Whether you’re in the mood for reading or not, Shanghai Street Stories is always a place you can visit during your online surf session.

Bottom line, the visuals are amazing because they don’t only give us pictures of Shanghai, but also paint the city and present it within a certain alternate universe that is even better than the everyday thing . (Recommended by Adam Daniel Mezei.)

6. Shanghaiist

What is it about Shanghai that inspires innovation.  Shanghaiist boasts writers that could do stories for Newsweek or some other high powered international magazine.  I particularly dig their investigative healthcare stories and wish that they made this a staple of their coverage.

The design is easy on the eyes despite the high number of ads.  This is no easy feat.  Without fail, however, I find myself focused on the story and not the surroundings.

Though they write a lot, and a lot of the material is of the quick type nature, their long, thought out  articles are more than worth the price of admission.

7. My Health Beijing

Dr. Richard Cyr is not your typical expatriate, in Beijing.  But, he can tell you better than most people what the typical expatriate, in Beijing is like.  He’s even coined a medical term that covers the symptoms of life abroad in china, expatitis.

He is a new breed of China English language medical blogger.  As far as I know he is the only doctor blogging from inside the country. When he wants to, he uses that to his advantage by writing really innovative pieces that talk about life on the job,  in country.  I have him on my RSS feed just in case one of these pops up, and I have high hopes that this can one day become the focus of his blog.

For now he still spends a lot of time writing about what people should eat to stay healthy/stay in shape/etc.  With more articles on his life in the hospital, this blog jumps into the top 5.

8. Joop.in

Joop.in is Dutch for “Jump In!” says Adam Daniel Mezei who recommended it, but Adam is just kidding, but it would still be a very clever name for a site.  This blog does not always have  the best written English but its eponymous writer, Joop Dorrensteijn,is between China, Japan, and Korea and that alone is worthy of praise.  The content is full of personalized stories that are page turners and the design manages to stay clean.

Throw in the fact that he lives in Shanghai and is dating a Korean girl, and what you’re looking at is one of the truly globalized bloggers on the internet today.  It’s one thing to live in another country, and its completely another to be globalized.

A lot of wisdom to be had here.

9. Far West China

Admittedly, with its pixelated shapes, and sharp edges, this blog’s look is dated.  But, Far West China has been on top blog lists for as long as I can remember because blogger Josh Summers gets down and dirty into Xinjiang life and over time has honed his craft and become a real-deal investigative journalist.  Like other blogs on this list he breaks news, he doesn’t echo it.

Even during the riots, in 2009, Josh gamely sought ways to give the world updates through his twitter.  When that was shut down, he scoured the city for an internet connection with which to communicate to the world what was happening.

He is on this list for all of the above reasons, and because he represents an ideal – the entrenched blogger with a well developed biche niche and a sense of purpose.  The longer he reports, the better off we will be for it.

10. New Dynasty

Strictly speaking, this is an online magazine.  Loosely speaking, an online magazine is a collection of journalists moonlighting as bloggers, so New Dynasty’s place on this list is perfectly in line with the standards I put forth at the start of this list.

The writers for this site are truly excellent, Atlantic Monthlyesque even, and this kind of pen firepower is rare on the China side of the news.

Their design is very new age, and they are really doing pioneering work, China writing community speaking, with their logo.  I only hope that they figure out a better layout for their fonts.

Like HaoHao report, ND has a chance to become the Huffington Post of China news.  I think they could use a china healthcare writer, don’t you?  Bottom line, clue in to them and you won’t be sorry you did.

Article: China’s Naked Government Experiment Is Revealing, By Stan Abrams, blogger/founder of China Hearsay talking about article in China Daily, Township officials list all spending, By WANG HUAZHONG (China Daily)

Officials, in a Sichuan township, have initiated a public accountability experiment, posting their personal expenditures for the first two months of the year online.  Netizens have dubbed the effort China’s first case of ‘Naked Government’. AKA, transparent government.  The Sichuan township’s efforts are significant because the officials, so far, have been very open about their spending.

Besides exposing the high level of expenditure, which often hold the potential for abuse of public assets, the official website of Baimiao town, Bazhong city, is also reporting breakdowns of town’ budgets and officials’ salaries.

In China, officials reportedly spent at least 120 billion yuan ($18 billion) in 2004 on private use of government vehicles, extravagant dining and wining, as well as frequent trips abroad – all charged on government accounts. Premier Wen Jiabao said in February that this kind of spending “should be and can be controlled” through transparency and democratic monitoring.

Stan Abrams points out that though the reporting is not perfect, the very fact that Baimiao town is reporting how much they spend on dining – 65 percent of their spending in the first two months of this year – is something worthy of our attention.

For that item alone [dining expenditure disclosure], the whole program is worth it. Lots of people will rightly start asking why that sort of expenditure is necessary for local government officials. This is not new information, but now it has been quantified. Seems like kind of a big deal to me.

It seems like a big deal to me, too.  Here’s the healthcare angle.  This precedent can and should be applied to China’s public hospitals.  All sources of revenue at the hospital should be disclosed, department by department.

Right now it is common practice for hospital departments to hold off on referrals to other departments that make more sense to the patient, resulting in patient overload within certain departments while other departments remain empty.  This patient hoarding is the direct result of something called the doctor’s allowance.  In the past I have defined it like this;

Essentially, departments within government hospitals are clearly demarcated into separate administration zones.  This extends to hospital accounts – almost every department has their own.  Every time someone gets treated within the department, a part of their payment goes into the department account.  At the end of the month a fraction of the funds earned by the department are given out to the doctors as an ‘allowance’ – basically, a sort of salary subsidy.

Public reporting of department earnings, along with the ratio of medical personnel to patients in those departments would help ease pressure on the health system by revealing to the public where the less burdened hospital departments.  Right now if I go to Chaoyang Hospital to see the ENT doctor, but there is a six hour wait to see that doctor, no one there will refer me to a clinic or hospital down the street, wanting to keep the funds for themselves.  If I could see, online, where there are less burdened ENT departments I could save myself several hours.

This makes sense to me.  What about you?

I’ve never been, but co-managing editor of Asia Healthcare Blog, James, assures me that the conversations are vibrant.

There’s a meeting this week, the details and directions are below.

The article that this discussion draws from can be found, here.

Dear Beijing Healthcare Forum,

We’re excited to continue our bi-weekly meetings after a very long hiatus! We hope you’re well rested from the break.

Our next Beijing Healthcare Forum will be Thursday, March 18th. It will continue to be at Luce Restaurant. 周四晚(3月18号)会议的地点是Luce餐馆, 从鼓楼大街地铁站往南走300米, which is 300m south of the Gulou subway station on the east side of the street (see below for details and attached map). This week’s presentation will be in English.  这次演讲人要用英文讲话。 We will have participant translators available for non-English speakers.

Meeting Details 会议的细节:

Language: English
Date: Thursday, March 18th
Time: 8:00PM (Discussion starts promptly at 8:45PM.)
Where: Luce Restaurant
Address: 138 Jiugulou Dajie, Dongcheng District, Beijing (The building is bright red; See attached map)北京市东城区旧鼓楼大街138号 (房子是红色的; 请看附件内的地图)
Ph #: 8402.4417

“What is Child Survival and How is it Relevant to China?”
“儿童存活是什么? 跟中国有什么关系?”

This next meeting’s speaker will be Barbara Bale. A brief bio of Ms. Bale is below:
下 次会议的演讲人是Barbarba Bale. 演讲人简介:

Barbara Bale has been living in SE Asia (Hong Kong, Ha Noi, Phnom Penh) since 1987. She obtained her BA Hons and Registered General Nurse qualification at Sheffield Hallam University in the UK, then undertook a further 18 months training to qualify as a Registered Midwife. Following practice as a hospital based midwife in the UK and Hong Kong, she moved into social development and NGOs by joining the Vietnamese asylum seeker and refugee programme of Save the Children UK in Hong Kong.

In 1996, she completed her MA in medical anthropology at the School of African and Oriental Studies (SOAS), University of London. Mrs. Bale moved to Viet Nam and spent the next decade working for a number of different health and development agencies (Save the Children US, PATH, UNFPA, WHO), mostly on maternal-child health.

Mrs. Bale moved to Cambodia in 2006 and to Beijing in September 2009. She is currently the newborn and child survival director for the China Programme of Save the Children (UK).

从1987年起一直生活在东南亚（香港、河 内、金边）。

在英国Sheffield Hallam University本科毕业并获得注册护士资格，之后经过18个月的培训成为注册助产士。在 英国和香港的医院作为助产士工作一段时间后进入社会发展领域及非政府组织，在英国救助儿童会设在香港的越南政治避难者及难民项目工 作。

1996年在伦敦大学非洲及东方研究学院获得医学人类学硕士学位。之后为越南的多个卫生及发展机构工作（美国救助儿童会，PATH, 联合国人口基金，世界卫生组织等），工作主要侧重在妇幼保健方面。

2006年搬到柬埔寨，并于2009年9月搬到北京-目前是英国救助儿童会婴幼儿健康项目总监。

Homework 功课:

Summary of The Lancet Child Survival Series : BASICS II; Basic Support for Institutionalizing Child Survival; 2008.

We encourage everyone to take advantage of Ms. Bale’s expertise and invite your friends! Thanks and please let us know if you have any questions.

请邀请你的朋友,同事和任何对于医疗保健事业感兴趣的人来参加我们的活动！谢谢！

Ray and Jared
邓 腾和高志忠

A recent Kit Eaton post in Fast Company

But why does no one mention the abject fear most Chinese face — especially the leadership — about the country suddenly crumbling from becoming awash in stuff that can legitimately destabilize the country? The Chinese have this hard-coded, or is this more propaganda?

I began to explore the links between the American abortion debate and China’s abortion problems after coming across a wide swath of misconceptions about Chinese attitudes towards pre-natal life; from unrepentant Chinese and Taiwanese baby fetus eaters, to super secret Chinese government conspiracies which encourage the aborting of female babies in order to amass testosterone for a future global war. To me, these sorts of accusations and descriptive generalizations are clear examples of modern day blood libel, an ancient practice of falsely accusing already persecuted and discriminated groups – and, primarily people of the Jewish faith – of human sacrifice and/or cannibalism. One cannot help but be acutely aware of the tactic because today blood libel has become a favorite tool of opinion leaders when they chime in on a whole host of American domestic issues. Also, it must be pointed out, in America, Pro-lifers use it with special vigor. It would be easy, therefore, to chalk up the extremism of the blood libel claims levied against the Chinese people as just another case of lazy reportage. But I have come to believe that the truth is more complex. The truth involves a lot of shared history and is intimately related to America’s abortion debate.

North Koreans eat babies too...

The roots of a full explanation are to be found within the annals of antiquated history. For hundreds of years the Chinese were accused of and were, indeed, active in some ritualistic and survival forms of cannibalism, but no more and no less than other societies during similar stages of development. Like societies elsewhere, the Chinese were regarded as a civilized people, and cannibalism was widely regarded as a practice that the destitute resorted to in times of extreme violence and/or famine. Then, in 1849, the Opium Wars initiated a one hundred year long decline of Chinese power, and China began to lose much of its clout. By the end of the 19^th century China’s general decline allowed the Japanese to systematically vilify the Chinese as still active “learned cannibals” so that they could to help justify the Japanese army’s increasing presence on the mainland. During World War II, blood libel propaganda was even being produced internally by Chang Kai Shek’s nationalist government, but it had, of course, a decidedly anti-communist twist. Though the Japanese and Generalissimo were eventually forced out in 1949, thirty years of disastrous Mao policies and the ensuing Cold War exacerbated any previously formulated stereotypes of China under communist rule. Incidentally, The Great Famine of the 1950s, one of those periods in Chinese history where cannibalism very likely did happen, added a Swiftly poignant grain of truth to the rumors of Chinese culinary preference.

Owing to widespread xenophobia and legalized anti-Chinese policy, America was ready to accept rumors about the Chinese more readily than most other countries from the last quarter of the 19^th century on through to 1943 when China became an official WWII ally. Ironically, after the war, with the help of influential exiled Chinese nationalists like TV Soong, two of his three famous sisters, and their sympathizers in the United States like powerful media mogul Henry Luce, anti-Chinese sentiment morphed into anti-mainland communist Chinese sentiment. This second wave of Chinese vilification reached its early peak right before the end of the Cultural Revolution in 1976, but had already started to wane by the early 1970’s with the dismissal of Taiwan from the Security Council in 1971, and Nixon’s famous visit to China in 1972.

Yup, 19th centure Uncle Sam did not take kindly to the Chinese

Quite coincidentally the fall in China-directed opprobrium and the rise of the modern Chinese state coincided with the rise of the modern abortion debate in 1973, when the decision handed down in Roe v. Wade marked the birth of the Pro-Life movement. In 1979, China reiterated its commitment to modernize by introducing the One Child Policy; a set of regulations that through sometimes prohibitively expensive fines and legal repercussions encouraged certain couples to only have one child, and implicitly advocated abortion as a stopgap measure. It is at this point, propped up against a multi-hued backdrop of antiquated and modern history that America’s abortion debate started to add to the library of misinformation concerning China. By simultaneously managing to provide choice and to take it away, the One Child Policy successfully irked both Pro-Lifers and Pro-Choicers enough that they came together, albeit in an unexpected way.

With each passing year since 1973, the variables in the abortion debate had changed little. Increasingly, as the political importance of abortion grew in stature, the focus went away from arguing the correctness of one’s own assertions, and went instead to proving the fallacies of the ‘other’ side. This, in turn, required that the canvas size used to paint a picture of just how evil the ‘other side’ of the debate is be increased with each passing moment. The One Child Policy provided a billion new ways for each side to maintain these self-imposed, Ponziesque quotas.

Pro-Choice elements figured out that by presenting isolated and horrific examples of late trimester forced abortions and mandatory sterilizations as the norm for all of China, they could effectively illustrate how Pro-Choice was not necessarily Anti-Life. Pro-Lifers, on the other hand, used these same elements to strengthen already conceived notions of anything non-Christian as necessarily heathen and blood thirsty, thereby exclamating the importance of uncompromised political victory in America. An American public, never, on the whole, noted for its cosmopolitan outlook on the world, and already misinformed for half a dozen generation about the backwardness of the Chinese mainland and communists in general, seized upon these rumors as a factual representation of the mysterious culture from the Far East. From 1979 on, China became a sort of gray area in the abortion debate. Pro-Choicers and Pro-Lifers necessarily agreed that China was evil, but they actively maintained that china’s inherent evilness was propagated by views like that held by the ‘other’. Seemingly, these claims got wilder each year.

Meanwhile, politically in America, abortion quickly became one of the Four Horsemen of the Politician’s Apocalypse along with gun control, any kind of healthcare reform, and cuts in defense budget spending. The wise paid sound bite lip service to these issues while on the campaign trail, and then stayed away from them all together when in office. So, it was really convenient for politicians when Pro-Lifers and Pro-Choicers came together on the evils of China and its One Child Policy. Politicians quickly surmised that pointing the light of shame on China’s abortion policy miscues constituted a political win-win, as long as one did not get too specific on what about China’s abortion situation made it evil. It was and continues to be today, a state sized witch hunt, which has on more than one occasion ended in embarrassment for the United States, like when, in 2001, the FBI opened up an official investigation into Chinese fetus eating.

This new element of forced political calculation on the part of American politicians dealing with the abortion issue loudly reverberated with CCP officials. Their interpretation of this shift in American political life was starkly (and predictably) utilitarian: any sort of organized abortion debate would constitute a threat to the political unity of the country. Debate on abortion could not be allowed to – and still has not been allowed to – become a public matter, but would instead remain confined to debates in the offices of the National Population Planning And Family Planning Commission of China.

If further evidence of America’s influence in this matter is to be found anywhere, one need only look at other, more measured debates like global warming, personal health, and faith, which have clearly impacted the values of the Chinese people. China’s environment is on the road to getting cleaner. The word “balanced diet” has entered the Chinese lexicon. Chinese Christians are thought to outnumber CCP members. And, although, environmental activists and missionaries are persecuted, there is a diversity of opinion and level of tolerance that they enjoy which cannot be said for China’s equivalent of Pro-Choice and Pro-Life activists. Perhaps, if America’s debate was only a little more rational, to the point where the complexity of views went beyond the dogmatic, the CCP’s stance would be more subtle as well; a ceasefire by both Pro-Choice and Pro-Life gunmen would help as well.

However, it is not enough to look for evidence of American influence by analyzing the actions and reactions of just the Chinese government. Indeed, any efforts to do so might actually constitute a needless waste of energy and obscure some of the impact that the America’s debate has had on China’s collective psyche. The Chinese people, one must remember, are predominantly composed of non-party members. Through satellite, pirated DVDs, internet, and more millions are paying attention to what we say and do, and how we say and do it⁶. More importantly, if someone spends enough time in China, they soon find that the psyche of the average Chinese person is finely tuned to getting around government imposed barriers.

Nothing says abortion like pink neon lighting at a bus stop

A search of Chinese forums reveals that Chinese people openly struggle with the emotional consequences of abortion. Forum after forum reveals candid dialogue about the repercussions that abortion has on one’s soul, relationship, and physical well being. Certainly, the financial aspect of abortions is widely discussed due to the pervasiveness of a brazenly open abortion industry. But, one also finds that due to the extremism of America’s abortion debate, any discussion about the abortion debate in America turns instead to its inherent brutality, religious fervor, and hypocrisy. This is the Newtonian reflection hinted at in the first paragraph. Not only have the forces that ensure stalemate of debate in America contributed to the stifling of public debate in China, but, in true American fashion, the Chinese have come to view America’s abortion problems as the true representation of American attitudes towards abortion. Read that sentence again, carefully, to pick out the key distinction there.

The irony of the mirror universe the American abortion debate has created is three tiered. First and most obvious, Americans criticize a large part of themselves when they criticize China’s views on abortion. Second, it appears from the outside that our biggest abortion issues as a nation is the way we debate the abortion issue. Third, and perhaps this is more tragic than ironic, in the end no one gets the full benefit that two simultaneous debates should produce.

The third point bares illustrating, from both sides. Just this past July 30th the China Daily published statements by Wu Shangcun of the National Population Planning And Family Planning Commission of China, who revealed that there were thirteen million hospital abortions in 2008, and that most were being done on young, single women. The report was unusual for its candor, and it seems to have signaled a shift in government policy to seriously start educating people about the repercussions of abortions and the importance of sexual education.

NPPFPPC Institutional Chat....I mean ChaRt

Reading it, an American cannot help but feel that these women, some of whom have had a half-dozen abortions by the time they turn thirty, are hopelessly naïve on even the most basic drawbacks of abortion. Moral arguments aside, the chances of infertility get higher with each subsequent abortion; that fact alone should give someone pause before having unprotected sex after the first one. If, however, the modern American abortion debate was a less violent and radicalized affair, then perhaps fifty or more years of American sex education would have had an easier time to filter down to some of those young Chinese women. It should not be forgotten that fifty years ago Americans, on the whole, were no more knowledgeable about abortion and sexual education than China’s women of today.

On the other hand, for all of the indignation surrounding sex selective abortion in China, American’s tend to shy away from discussing their own sex selective abortion practices. Prescreening has become routine in American hospitals. If a developing baby is found to have Down syndrome or other recognizable genetic abnormalities, parents have the choice to keep or abort the baby. Those who do are rarely shunned.

The moral argument in favor of legalized pre-screening assumes that a child with certain genetic abnormalities has the potential to present enough of a burden on parents and on his or her own mental well being. Therefore terminating a pregnancy can be viewed as the humane thing to do. The problem with this is that it can be applied to girls in China. For a lot of poor parents who already have two or three girls, having a third of fourth one appears to them to be a hardship that would likely hurt them and the child. If the inductive logic holds, can it not also be true that sex selective abortion for the poor Chinese peasant is every bit a rationalized, humane decision as gene selective abortion is for the American couple? I cannot help but think that with pre-screening abortions and genetic manipulation currently veering a bit out of control in the United States, that China’s thirty years of experience with pre-screening regulation would have something useful for us Americans to learn from.

Today, twenty years after the end of the cold war, and on the eve of a decade that promises to see history take off again, the proliferation of modern technologies and wiki-world information has made it possible for the people of these America and China to understand one another better than ever before. These same advancements have also made it easier to become misinformed, and to be poorly informed on more, than ever before. As the world progresses, each arable speck of land will become more densely populated, and whether we like it or not, one day the question of population management is going to loom larger than any other question we face. America, its roots steeped in Puritan history and genocidal misstep, has learned a lot about the value of human life and has all the information necessary to play the role of the humanistic voice of future discussion. Meanwhile, China has, for the past one hundred and fifty years dealt with the problems of overpopulation, occupation, and mass starvation, which have taught it a lot about how to confront the practical issues of population planners. Together they can do a lot. Maybe the first step is to stop doing all the things that produce nothing, so that the needed discussion can start with something.

END

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Notes:

¹There does appear to have been an ancient abortion debate though I am unfamiliar with it

² There are two prizes at stake in this conflict, one political and the other ideological. The political prize is up in the air because either side can now lay claim to a law supporting their position; Pro Choicers to Roe vs Wade, and Pro Lifers to the Partial-Birth Abortion Ban Act. On the other hand, the ideological prize is there for the taking and claiming it means forever defining an important component of America’s identity. Consequently, defining America’s identity means influencing policy so that it conforms to that identity, much like our identity as capitalists influences policies surrounding health insurance. Domestic policy, however, is just the tip of the iceberg. In the end game, to truly justify one’s view of ‘how things work’, related to matters transcendent or otherwise, America must also influence the identity of the rest of the world because, in theory, most Pro-Lifers/Choicers believe that they are fighting a battle that is bigger than just themselves.

³Pro-Choice of Pro-Life, either position can be argued from a secular basis.

⁴ I should also mention the unrepentant Chinese baby fetus eaters as reported by Taiwanese in Hong Kong news publications so that one does not get the impression that only America is prone to blood libel of China

⁵None of the Japanese propagandists were more vicious and calculated in their attacks than Kuwabara Jitsuzo

⁶ Once made aware of its presence, you may notice how in the modern day blood libel and stereotyping is being adopted when writing about a range of China issues like abortions and topics having to do with abortions (like the One Child Policy and China’s Missing Women)because many journalists, and American journalists in particular, find it easier to write a sensational story about China than a more rational and informed one. (However, to be fair, blood libel has become a favorite tool of Western politicians and journalist on a whole host of American domestic issues, though in America pro-lifers use it with special vigor (fast forward to 1:30).) And, just to be clear, a sensational story is not simply one that criticizes the CCP or certain aspects of Chinese society. Indeed, informed reports tend to, at time, present a much more damning case for criticism. Rather, what distinguishes the sensational is the need to paint the Chinese as a wholly different species of human – the inhuman. This is especially ironic today considering that the Chinese tend to view themselves first as a race and only then as a nation, a condition that negatively impacts their own societal prejudices.

⁷ Consumerism, dietary norms, sexual promiscuity, faith, and discrimination are some of the most typical values adopted by the Chinese, despite what the government may want.

⁸ The power of the CCP lies in its ability to sensor the what and the who, but not the how – the Great Firewall can sensor a sensitive website, but by the time they do the spirit and the central ideas of the message has already been passed on. Unfortunately for the government, game changing ideas are composed of the how. With close to three hundred million internet users the government is fighting a losing battle since every day thousands of users are learning of ideas whose time has come.

⁹ Undoubtedly there are dark corners of the country where gangs of evil men still forcibly sterilize young, defenseless women. Claiming, however, that this is representative of China, is like claiming that the what goes on inside the compound of Warren Jeff’s Fundamental Church of Jesus Christ of Latter-day Saints is representative of American life in general.

¹⁰Understandably, China under Hu JinTao is sensitive to any instances of modern day blood libel, and to the more common instances of international criticism having to do with China’s human rights record. It can be argued that both criticisms are at times used to promote the same insinuation – that the Chinese are something less than human. But, whereas in the past this sort of criticism tended to prevent Chinese leaders from seeing past their party’s perceived sense of tarnished honor and towards the more imminent needs of their population, increasingly today, and with each passing year since opening thirty years ago, China’s technocrats have been less willing to let pride get in the way of progress. Instead, China’s leaders have only increased their desire to learn from various world wide debates .

¹¹To be clear, reasons for the repression of abortion debate are not solely to blame on America. A part of the repression is certainly attributable to codified state suppression of organized groups and the One Child Policy itself.

10.) Third world prices means third world safety hazards. The  prostitute businesses that the average expatriate, in China, is likely to come across (affordable on a teacher’s salary) are built on a business model that cater to China’ average and below average males; the poor, the migrants, and the men who do nothing but spend their money on prostitutes.  There’s no regulation of these places because, officially, prostitution is illegal and doesn’t exist, in China.  So, typically, the places you’re likely to meet prostitutes are full of germs with a lot of star power; the kind of star power that forces the NIH to dole out billions of dollars each year to study them.

Hint 1 (of 2): If the prostitute establishment has a barbershop-like sign or neon lighting, then that’s the kind of place I’m talking about.

9.) Not to belabor the safety point, but the Chinese are really ignorant about HIV/AIDS. Prostitutes in China regularly have sex with men without using condoms.  Fifty percent of Chinese think that HIV is transmitted by kissing.

8.) In case you do contract a sexually transmitted disease after visiting a prostitute, your travel insurance will likely not cover the cost.  This also holds true for any international insurance you may have.  Typically, only pre-existing STDs are covered.

7.) If you choose to pursue treatment for your STD while in China expect that  positive tests will be reported to the Ministry of Health. This can substantially complicate matters if you own a business, in China, or if you are the type of expat that likes to go in and out of the country often.

6.) It’s not unheard of for businessmen to get blackmailed with photos/video of past prostitute hook-ups anywhere, in the world.   Now just think about the fact that China is reportedly the world’s largest exporter of prostitutes.  If you’re ever ‘offered’ a girl for the night by a potential business partner, you have to ask yourself, who is providing those prostitutes?

Is your luck that night being determined by a random process whereby gangs of young girls somehow find one another and form empowered prostitute gangs?  No.  It’s the hei she hui ren  (mafia) and the government, stupid.  Being ‘offered’ a prostitute is the equivalent of letting someone wire tap your house, finding exactly where all of bugs are located and then reading from a random hate group publication, written in the first person, in a spot where you’re sure the bugs are going to get the best reception.

Hint 2 (of 2): If the prostitute establishment is an expensive KTV, or has no neon lights and serves expensive tea/fruit, then this is the kind of place where you can expect to get blackmailed.

5.) Prostitutes are trustworthy, more so than you, and definitely more than China’s police and government officials – at least that’s what Chinese netizens think.  Don’t expect any sort of public outcry if you somehow get duped by a prostitute.

4.) If you try to  blackmail anyone you have sex with, like this idiot, or anyone you perceive has wronged you,  the same netizens that don’t trust you/like you will use their human flesh engine to find you, and embarrass you…and then further harass you.  When this happens, the best that you can pray for is that you don’t become a popular Chinese meme.

3.) China is not Las Vegas. Just because you don’t speak Chinese, and you think that Chinese people don’t care about what you do, they’ll still notice when you come home with a prostitute and they’ll talk about it.  This point, in as many words, was made to me by an American woman who had lived, in Beijing, for twenty-five years (!!!), twenty of which were spent with her husband.  During the 20th year of their time together, in China, she found out that he had 5 regular girlfriends spread across China, several children, and at least one Chinese wife.  The way she found out is that she accidentally overheard her Chinese neighbors talking about a white man that lived in the neighborhood and frequently was seen with different Chinese women, one of whom, they saw, had a half-Chinese child.

That woman ended up becoming a marriage counselor for expat couples living in Beijing, and she always tries her best to drive home the point that what you do, in China, does have consequences.

2.) Again, China is not Las Vegas. The people that come to see you, visit you, hang out with you, in China, will report everything you’re doing when they get back home.  There is no such thing as a ‘China code’ that secures all of your adventures abroad will not come back home to haunt you.  The bigger your goals, in life, the more this aspect of China (the fact that the rules of decency apply there as much as anywhere else) should factor into the decisions you make.

Moreover, there is no ’safe’ prostitution establishment, where everyone knows your name.  See Hint 1 and 2 above – either you’re putting yourself at high risk for STDs, or for blackmail, or for both.

1.) Prostitution has a stench that can be sensed from far away.  Once you have it, it’s never coming off, and you will get blackballed from many societies and networks.  If your boss wants to take you to have some fun, chances are its not a good boss to be working for anyway, and it’s certainly not someone you want to emulate.  In fact, chances are that his network has already suffered from the many habits he’s picked up in his life.

BON seems genuinely concerned with creating high level, thought out content about China, and have invested money into a studio to try and make it happen.  They could very well push of the game here, by creating a platform (and recruiting the people) that can efficiently integrates all of the current English-language coverage of China into something palpable for mass, global consumption.

The niche to become the exclusive distributor of China news is wide open. I had a classmate from undergrad who worked at the NBC new China headquarters, in Beijing, before the Olympics, and the office only had 8 people.  That’s just not big enough to cover much of anything, in China.  The scene is begging for some serious competition.

Anyway, this friend, from BON, is preparing a story on China’s healthcare reforms (covered extensively on this blog, and if you want more information the search bar is at the top right of this page) and wanted some information about how to proceed, who to contact, etc.

It’s not the first time that media has asked James and I about how to approach a healthcare story.  So, I figured that one way we could help is by providing guides on China story angles.

So, adapted from an email I sent to my BON friend, here is a guide about how to approach China’s healthcare reform.

1) China’s healthcare reform is not politically polarized.  No one party is the obvious health reform proponent and no one  is completely against it.  That kind of divide is uniquely America.  The Chinese actually want healthcare reform

2) To get a better idea of what this might mean for a story,  define ‘reform’

1. A change for the better; an improvement.

2. Correction of evils, abuses, or errors.

3. Action to improve social or economic conditions without radical or revolutionary change.

You see that the meaning of a ‘reform’ is very context specific – a change that produces better in one place, may not produce better in another, and the needs of different places are, well, differnt.  In the US healthcare reform means covering 36 million people, cubing malpractice, sorting out financing.  In China, it means constructing a 1st world healthcare system through infrastructure improvements, sorting out incentives of healthcare workers, medical education expansion, etc.

3) In China people like socialized medicine.  They think its great.  People can’t contemplate spending more than 30 yuan to see a doctor for a regular check up.  Instead, what you will find is widespread fear that China’s health system is getting too capitalistic, and that health reform should stay away from overly privatized models.

4) The actual pipework of the reforms is being constructed by healthcare system experts, not politicians.  So, if you’re actually talking to someone who is familiar with the reform that person is going to give you a nuanced opinion of the major challenges going forward, the problems of today, and the potential pitfalls of the reform.  A professional architect is necessarily more balanced in her opinions than a professional politician.

5) This point is related to point 4.  Everyone involved is well aware that designing a system that works for 1.3 billion people is unexplored territory.  Like all things, in China, they’ll take this slow – there is no point of getting too much wrong at once.

6) This point is related to point 5.  The Chinese are building a new system, and they are aware that problems in the system are better tackled early on, before they compound, and its too late or costly to turn back.

7)  If you want to juxtapose opinions on the reform your best bet is to talk to post 80s/90s youth, with medical students being the clear best choice.  Someone young and idealistic, and informed, is apt to want the very best healthcare for China right now and to be able to clearly express why.

If you want to know whether the healthcare reforms are doing what they’re supposed to, monitor the rural regions.  The thrust of the money is going to fund rural clinics and health systems so that overcrowded tier2/3 hospitals can get some relief.

9) If you want an informed and accessible Laowai perspective, check back to this blog often.