Final Report Summary - HEATH CARE IN CHINA (Between State and Community−Public Health Campaigns and Local Healing Practice in socialist Asia 1950- 1980: Mao’s China, a case study)
In modern times, a well functioning health system has been seen as intrinsic to the wellbeing of any society. Yet, we know little of how to achieve such a system. Health systems by definition are complex and dynamic. In the end they are the work of collections of people, and are designed for the people. Inevitably all health systems carry with them human strengths and weaknesses. While political vision and the leadership’s ability to mobilize the masses may contribute to a better health system, and ultimately better health, political factors can also have unintended, yet real negative consequences.
The People’s Republic of China (the PRC), the country most identified by much of international health stakeholders as a ‘positive deviant’ in the long 1970s in achieving better health outcomes with limited resources, is a prime example of this paradox. This project uses the two internationally acclaimed public health initiatives in the PRC under Mao Zedong’s leadership, namely the Anti-Schistosomiasis campaign and the Barefoot Doctor programme, as case studies to explore the complex and dynamic relationships between politics and health, and equally important, between individual lives and the political system, as well as the health system. covers the period from the founding of the PRC in 1949 to until after Mao’s death in the early 1980s. The project also provides a useful assessment of how public health objectives became an integral part of the Chinese revolution from its outset in the 1920s.The goals of this project is to illustrate how politics and health are interlinked in the PRC; that such shifts were not merely internal. They both responded to global attitudes towards health systems, in particular health care delivery and public health intervention, and shaped them. While the PRC was a developing country, the claims about health care in China also reflected the concerns in many developing countries about the efficacy of their own health care systems.
What is unique about this project is both the reach of the evidence and my methodology. Social scientists (specifically those working in anthropology, development studies, and policy design), as well as historians, deploy history in different ways to achieve different insights. For this project I have tried to find a balance between the pragmatic needs of the social scientist and the demands of the historian that will contribute to a ‘more rounded’ history of health and medicine in the PRC. It uses techniques familiar to social historians of medicine that describe the human stories behind the statistics. More specifically, it uses an integrated approach by analyzing the accounts of local implementation and individual testimonies about health care against the state sanctioned statistical analyses and official party rhetoric. Juxtapose one to the other, we get a fuller sense of what was occurring at the time in different places, as well as how the historical memory shaped individual memories, and how their memories of what happened then continued to impact the life of individuals up to the present day. Based on hundreds of files from rarely seen party archives in eight impacted provinces across China as well as freshly collected oral testimonies from experts, local cadres and villagers of those provinces, we can now illustrate the huge diversity of everyday interactions and the diverse aspects of support, accommodation, and resistance. By analyzing local implementations and personal testimonies against statistical analysis and political rhetoric, we can better understand the many complexities involved in the implementation of large-scale public health initiatives. While my analysis of these cases provides immediate lessons for those seeking to strengthen health systems, it also generates background information for future research.
Project Blog: https://wordpress.com/view/betweenstateandcommunity.wordpress.com
The People’s Republic of China (the PRC), the country most identified by much of international health stakeholders as a ‘positive deviant’ in the long 1970s in achieving better health outcomes with limited resources, is a prime example of this paradox. This project uses the two internationally acclaimed public health initiatives in the PRC under Mao Zedong’s leadership, namely the Anti-Schistosomiasis campaign and the Barefoot Doctor programme, as case studies to explore the complex and dynamic relationships between politics and health, and equally important, between individual lives and the political system, as well as the health system. covers the period from the founding of the PRC in 1949 to until after Mao’s death in the early 1980s. The project also provides a useful assessment of how public health objectives became an integral part of the Chinese revolution from its outset in the 1920s.The goals of this project is to illustrate how politics and health are interlinked in the PRC; that such shifts were not merely internal. They both responded to global attitudes towards health systems, in particular health care delivery and public health intervention, and shaped them. While the PRC was a developing country, the claims about health care in China also reflected the concerns in many developing countries about the efficacy of their own health care systems.
What is unique about this project is both the reach of the evidence and my methodology. Social scientists (specifically those working in anthropology, development studies, and policy design), as well as historians, deploy history in different ways to achieve different insights. For this project I have tried to find a balance between the pragmatic needs of the social scientist and the demands of the historian that will contribute to a ‘more rounded’ history of health and medicine in the PRC. It uses techniques familiar to social historians of medicine that describe the human stories behind the statistics. More specifically, it uses an integrated approach by analyzing the accounts of local implementation and individual testimonies about health care against the state sanctioned statistical analyses and official party rhetoric. Juxtapose one to the other, we get a fuller sense of what was occurring at the time in different places, as well as how the historical memory shaped individual memories, and how their memories of what happened then continued to impact the life of individuals up to the present day. Based on hundreds of files from rarely seen party archives in eight impacted provinces across China as well as freshly collected oral testimonies from experts, local cadres and villagers of those provinces, we can now illustrate the huge diversity of everyday interactions and the diverse aspects of support, accommodation, and resistance. By analyzing local implementations and personal testimonies against statistical analysis and political rhetoric, we can better understand the many complexities involved in the implementation of large-scale public health initiatives. While my analysis of these cases provides immediate lessons for those seeking to strengthen health systems, it also generates background information for future research.
Project Blog: https://wordpress.com/view/betweenstateandcommunity.wordpress.com