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May-June 2008
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< previous | 1 | 2 | 3 | 4 Across the society, Pan said, citizens refer to the “four-two-one” family (grandparents, parents, child), an abrupt shift from the past resulting from the strict family-planning policy. Its consequences range from altered family experiences to China’s looming rush toward the uncertain demographics of hundreds of millions of elderly citizens—living longer, but bereft of traditional domestic supports and as yet unprovided for in other ways. Amid so much rapid dislocation, Chinese experts report more mental-health problems: depression, pervasive anxiety, drug abuse, eating disorders, even Internet addiction. There is also greater willingness, at least in urban centers, to recognize and address such challenges—best symbolized by the new Shanghai Mental Health Center (SMHC), a treatment and teaching complex considered the standard-setter for China. The 900-bed facility, and a larger unit where geriatric, rehabilitation, and combined mental-infectious-disease cases are cared for, now handle more than 4,000 hospitalizations and a third of a million outpatient visits annually, according to Xu Yifeng, professor of psychiatry and incoming chair of the Chinese Psychiatrist Association. In China, proposed national legislation on mental illness has been through 10 drafts since 1985 but remains unadopted, and medical training is less specialized than in the United States, so fellowships for one or two professionals annually to study at Harvard have played a significant role in educating SMHC’s staff members, and in advancing care. (Xu was one of the first such fellows, in the late 1990s.) In a group meeting with several former fellows, center president Xiao Zeping emphasized, “All the candidates come back as a master of the hospital,” prepared to lead a unit or department. She said of her colleagues that the Freeman Foundation Fellowships, coordinated through Kleinman in his Harvard Medical School (HMS) capacity—he is professor of psychiatry and professor of medical anthropology—and Fogarty Fellowships underwritten by the National Institutes of Health, “change their mentality and their knowledge.” The returning fellows, she added, “have a large influence on students, policy, and the culture”; several play significant roles in advising on China’s mental-health policies and care system. Chen Jue, a 2004-2005 Fogarty Fellow, conducted research on eating disorders. After observing group therapy at Harvard hospitals, she introduced group-therapy techniques in her eating-disorders clinic at SMHC, and reports “much better success.” Cheng Wenhong, a vice professor, used part of her fellowship year, in 2003-2004, to observe at Children’s Hospital, before she established a clinic for adolescents. Predating even the earliest exchanges for mental health were joint efforts to strengthen the foundations of modern public health in China. At Fudan University’s School of Public Health, near SMHC, Professor Chen Jie recalled studying at the Harvard School of Public Health (HSPH) in 1985-1986. Her focus then was on hospital management and health economics; today, she teaches graduate courses in hospital management and in the assessment of new healthcare technologies and practices. Her Ministry of Health-affiliated laboratory evaluates the efficacy of drugs, devices, and procedures proposed for use throughout China’s medical system (and advises on such topics throughout Asia). Chen has chaired the Harvard affilates of the Shanghai Overseas Returned Scholars Association, a role now passing to Qian Xu, the school’s vice dean. Qian studied maternal and child health at HSPH and Tufts in 1992-1993. Both speak passionately about their continuing contacts with colleagues in Boston and their strong desire to keep in touch more closely and regularly. Underscoring the point, SMHC’s Xiao said the center maintains relationships with dozens of academic institutions worldwide, but Harvard’s training role is the most extensive and important—of particular value because “the U.S. is the engine of the world” for the development of science.
Many similar professional and academic ties, some directed at pressing new priorities, were evident throughout a week’s travel. On a weekday afternoon, a presentation on the nation’s truly alarming air pollution began at Tsinghua University, in northwestern Beijing. Seated at tables supplied with bananas and bottled water, with tea nearby, Chris Nielsen, Wang Yuxuan, and Mun Ho outlined the findings from Clearing the Air, the latest product of a multiyear, interdisciplinary collaboration between Harvard and Tsinghua’s department of environmental science and engineering. The trio—Nielsen, executive director of the China Project at the School of Engineering and Applied Sciences; Wang, who will join the Tsinghua faculty after receiving her Harvard doctorate this June; and Ho, an economist who is a fellow at Harvard’s Institute for Quantitative Social Science—were presenting novel research. Theirs is the first detailed model of Chinese air pollutants by source (electrical power, mostly from coal; cement; steel; chemicals; and China’s burgeoning vehicle fleet), the health impact of each, and the effectiveness and costs of economic means (“green taxes”) to mitigate the problem. Their audience was novel, too: not environmental scientists, but faculty and students from Tsinghua’s School of Economics and Management—people who will help shape China’s energy, environmental, and global-warming policies. In the ensuing discussion, none of the audience members undercut the researchers’ basic assumptions or market-based approach to pollution control. Rather, they questioned details of the scientists’ model, their health data, and projections of economic impacts from various uses of green-tax revenues—points the Harvard speakers embraced as they seek to further refine their projections and demonstrate remedies for troubling pollution and global-warming trends. Interviewed separately, Deborah Seligsohn ’84 underscored the sense that Chinese policymakers are addressing energy, environmental, and global-warming problems, to a degree not widely acknowledged in the United States. Seligsohn, who recently left the Foreign Service after 21 years so she could remain in Beijing and focus on the environment, now directs the World Resources Institute’s China program. The nation, she said, “is at this major overall inflection [point].…There is a new idea of what development means”—not just raw gains in output, but all the aspects of “creating what looks like an affluent society” in terms of citizens’ health, education, the physical environment, and income equality. “That’s what they want,” she said of the leadership, whose ranks have recently broadened to include new disciplines and greater administrative experience; they have carefully embraced new goals as well (including such terms as “harmonious society” and the “scientific concept of development”). “What’s needed,” she said, “is more serious international action to help China succeed” in attaining its energy and environmental goals, beginning with American commitments to develop and deploy new technologies. There are tangible signs of the kinds of changes Seligsohn identified. Tsinghua’s School of Public Policy and Management, established in 2000, is busily educating administrators using a curriculum and case-teaching method developed in cooperation with Daewoo professor of international affairs Anthony Saich and Harvard Kennedy School (HKS) colleagues. (Saich, who also directs the University Asia Center, runs executive-education programs in the United States and China for public officials at all levels of the Chinese government.) During a recent morning class in the school’s new master in international development program, associate professor Cheng Wenhao—a 2003 HKS fellow—led students from China, Ethiopia, Korea, South Africa, Taiwan, and Zambia through exercises in performance management for a police department and other agencies. Elsewhere, his colleagues were using sharply drawn case studies on such hard issues as public opposition to relocating the Beijing zoo, farmers’ demands for price supports, and compensation for people displaced by redevelopment. A few minutes away by taxi, at Renmin University of China School of Law, the country’s largest, Wang Liming was advancing a two-front humanitarian agenda. As dean, he has established China’s first legal center and clinic devoted to disabled persons. As a member of the National People’s Congress, he is helping to develop a comprehensive revision of the 1990 law on “protection of disabled persons”—a landmark, but too generally worded to promote effective action. In describing his work, Wang—a Harvard Law School (HLS) fellow in 1998-1999—cited Stimson professor of law William Alford, who directs the graduate legal program and international and East Asian legal studies at HLS. Alford has been involved with the Special Olympics for 30 years, and has extensive contacts in disability issues. 1 | 2 | 3 | 4 | continued >  
 
 
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