Child care in China: lessons for the west?

Abstract

Helen Warner DipHE Nursing (Child), SRN is early intervention nurse, East Kent Hospitals Trust China – the word itself evokes thoughts of the exotic and a culture many thousands of years old. Yet since the 1990s China has undergone continuous and rapid development during what has been the most peaceful decade in the whole of Chinese history. Although still officially a communist country, the old structure has gone and a new one is emerging. In the words of our Chinese tour guide, ‘three centuries of growth and change have been experienced over the last 30 years’. In spite of this China remains a third world country and people living in western parts of China still have to walk three to five kilometres just to fetch water. Some of the population still live in caves. It is a land of huge contrasts and there is the biggest divide between the ‘haves’ and the ‘have nots’ than anywhere else in the world. There is also the largest generation gap when you consider that the older generation lived under strict communism and the younger generation do not even know who Chairman Mao was. As part of a paediatric health study tour organised by Master Travel Ltd (www.mastertravel.co.uk), I joined a group of 18 paediatricians, GPs and paediatric nurses who wanted to see for themselves how their profession is practised in this fascinating country. Tours are accompanied by a British tour leader, in this case a retired paediatrician and an experienced Chinese national guide. Our Chinese guide was a mine of information, having specialised for 12 years leading health study tours, and his local knowledge and contacts opened doors to places not readily accessible to the typical tourist. In addition his knowledge of China’s culture, history, health and social care helped provide real insight into everyday life in modern China. Among the places we visited were the Shanghai Paediatric Hospital, a neighbourhood paediatric and family planning centre, and a state Chinese kindergarten. In Beijing we saw the Beijing Children’s Hospital, the largest hospital of Traditional Chinese Medicine (TCM) in the world, the Xi Yuan, a medicine market, the Care for Children Foster Project, the Xian Orphanage for Children with Special Needs, and visited a traditional ‘barefoot doctor’ to learn about rural health promotion and immunisation. My particular interest was in how TCM and western medicine are used in combination for children with disabilities, and how western medicine can learn from this. This article gives an overview of the visit and aims to increase readers’ understanding of China’s progress in the health care of its children, including the place of nursing. The photographs illustrate some key issues: we were careful to request parental permission before taking photographs in spite of being informed that in a communist country this was not necessary as long as permission is sought from the doctor in charge.