My first visit to China and finding the Chinese people

Excerpted from Memories that linger: My journey in the world of disability by Padmani Mendis)

“Today I found China,” is what I wrote to Nalin on Friday, three days after I arrived in Guangzhou, which at school I had known as the city of Canton. Let me explain why I wrote this. I arrived in Guangzhou, a port city at the mouth of the Pearl River on Tuesday and had been met at the airport by Mr. Hu. He turned out to be my constant guide and my interpreter throughout the 24 days that I spent on this my first visit to China in July 1986.

Mr. Hu loaded my luggage and me into a black limousine, sat with me in the back seat and had me driven to the Garden Hotel to check in. The first part of the route from the airport was all tree-lined highways. Turning off the highway, the second part leading to the hotel was roadways lined all the way with colourful flowerbeds. The whole forming a post-card pretty landscape. A couple of black limousines, rather like the one I was riding in, were to be seen on the highways and on the roadways, a few cyclists on the pathways for cycles but hardly any pedestrians on the pavements.

Over the next few weeks, Mr. Hu came to the hotel every morning at an appointed time and took me to the Sun Yat Sen University for Medical Sciences, the location of my assignment. He came for me at an appointed time to take me back to the hotel. Every day I saw the same kind of scenery on the routes we took. Lots of trees and flowers but few people. I was bewildered. It would be rude to ask Mr. Hu about where the people were.

Mr. Hu had indicated to me that it would be best if I did not go out on my own. He had told me just to let him know and he would take me in the limousine. But on the third day my curiosity got the better of me. I decided to do a little investigating on my own. I said to myself, what does it matter? I am only going for a walk. On an old map that I had seen, I could tell roughly in which direction the Pearl River lay in relation to the Garden Hotel. So I set out in that direction. I knew that where the river was, so would the people be.

I thought I would keep to the straight road. As I walked the architecture and scenery changed somewhat. After a particular junction, not far away new buildings gave way to the old; still trees to provide shade, but no flower beds. Large buildings for housing that had seen better days. Clothes hanging out to dry. People on the small crowded balconies. Children playing on the streets. Safe, no vehicles.

And then, not much later, after crossing another junction and may be about half an hour since starting off from the hotel, there it was and there they were. Narrow streets and narrower byways. Crowded apartment blocks. The Chinese people. In their thousands. Seemingly hundreds of thousands. Rushing hither and thither as Chinese people would do. Rather like ants,speeding on their way, but always time to greet one another. Always politely, often with time for a brief conversation. There they were, all the way down to the river.

This was the China I was expecting to see and was looking for. I had found that China and its people. Thereafter, an evening walk down to the river was on my itinerary. The Chinese people left me and my saree alone. No stares, no remarks. They had their lives to lead. The children had their games to play. I was just someone else moving among them.

The Sun Yat Sen University of Medical Sciences and Prof. Zhou Dahong

My counterpart on this assignment in China was Prof. Zhou Dahong, Head of the Department of Rehabilitation. As I arrived at the main entrance to the university on the first morning of my assignment, Prof. Zhou, pronounced Jo, and his senior staff were waiting for me at the top of the steps. Someone was there to open the car door for me.

I still recall the special saree that I wore that morning. It was a printed Kashmiri silk in a light purplish colour, a gift from my mother-in-law. I wore also an amethyst pendant which had belonged to my mother. It is remarkable how little things like this come flooding back to one’s memory when writing about one’s journey. As I climbed up the steps Prof. Zhou reached down to welcome me.

He kind of helped me up with a warm gesture and introduced me to his senior staff. Everything was very formal. I was then led to the Department of Rehabilitation and introduced to the other staff. Prof. Zhou, now warm and friendly, did all the talking. He spoke English like an Englishman – with hardly a Chinese accent.

I had two tasks to complete with Prof. Zhou during the next three weeks. The first was to plan two CBR development projects, one rural and one urban. The second was to prepare a work plan and teaching material for a National Workshop on CBR to be held in October that year. I would be back for the workshop. It was to be held here at this university. It would be a significant occasion for Prof. Zhou. That the Chinese government had selected Prof. Zhou to initiate collaboration in rehabilitation with WHO was itself an indication of the high regard that Prof. Zhou was held in by the Government in Beijing. It increased Prof. Zhou’s standing in the university.

But first things first. Before we settled down to work, Prof. Zhou told me he was taking me out to lunch with the staff of his department. We could all meet informally and get to know each other. Which we did. There were about ten of us seated round the table.

The food was served in small bowls, each round as a separate course with rice served last. Waiters served each course. This was one way a meal was served in a restaurant, and the number of courses varied. Today there were twenty courses. Later when we were entertained in Xian our meal with the choicest food of the North-Western area of the country was served as 36 courses.

When I returned to Guangzhou in October the food was served as a banquet. In Xian too it was served as a banquet.

The meal was called a banquet because everyone served themselves from common dishes placed on a rotating tray in the centre of the table. The tray was called a “Lazy Susan” in other countries. I sat next to Prof. Zhou and he kept serving food on to my dish. As the chief guest, it was customary for me to wait until he did so. The banquet was enjoyable, the food was interesting.

On the first occasion in July Prof. Zhou told me that Cantonese food was special, different from the rest of China. He said to me, “In Canton we eat everything that crawls except their tails, and everything that flies except the planes.” In other words, he told me that in Canton they eat everything, That Was Everything. I learned this from the specialty restaurants I saw after that. From bats and rats to snakes and well, you name it. I ate it that day. And, determined not to know what I was eating, enjoyed it too.

I learned that Cantonese cuisine retains the natural flavours of the food by using mild seasoning and marinades in modest quantities. The methods they use the most are steaming, braising and boiling, sometimes for a very long time. Also stir-frying. Even though food is sometimes deep fried, it is never greasy.

Being at the mouth of the Pearl River, both sea fish and river fish was popular – lots of my favourite shrimp and prawns. I realised how special Cantonese food was only after I had been to Beijing. There I tasted the hot and spicy food from the northern Szechuan province more suited to the Sri Lanka palate. In Canton the staple was rice as in other parts of southern China. In the north people consume wheat products like noodles.

Information about Rehabilitation in Guangzhou

Prof. Zhou had arranged for me to visit a few rehabilitation institutions. Also for certain people to meet us at the university to explain to me what services were available for disabled people. Besides these, I had an extensive meeting with the Deputy Chief in the City’s Bureau of Civil Administration and his staff. What he told me was interesting. Attractive tax incentives approved in Beijing encourage industries to employ disabled people.

He told me that in Guangzhou 86% of adults who can work are gainfully employed. In the rural areas however, the employment of disabled people remained a problem. He also described to me the social development programmes the Bureau was putting in place with the participation of the street communities. He was telling me how these would be useful in urban CBR.

I was impressed with the tax incentives he described and often held these up as an example in other countries. China’s tax incentives included – any enterprise which had more than 35% disabled people in the workforce was free of profit tax; proportion 10 – 35% allowed profit tax to be halved; proportion of disabled people exceeding 50% was free of all taxes including municipal taxes etc.

He went on to explain that the basis of the incentives was not charity. They were designed to enable authorities to compensate for the lower productivity of certain disabled people and compete effectively in the market. Later, many an employer in Sri Lanka told me that disabled employees, particular those with hearing impairment showed higher productivity than non-disabled workers.

Prof. Zhou also took me to see a Rehabilitation Hospital that was being built in Guangzhou. Only the lower floors were as yet complete. Most patients had paraplegia and hemiplegia with a few who had tetraplegia. There were also a few children with cerebral palsy. The hospital was quite unusual. Treatment was by Traditional Chinese Medicine. Patients apparently took full responsibility for their rehabilitation.

As well as in the treatment areas, I saw them training by themselves by their bedside and in the corridors. In some instances, relatives were acting as helpers. One could see simple technical aids being used. I was told that the hospital was aiming at keeping the cost of rehabilitation per head low so that they could reach more people. One wondered whether a staff shortage was also a possibility. Or what was this about?

The Rural CBR Project

The Rural CBR project was to be managed by the WHO Collaborating Centre for Primary Health Care located in Conghua County, Guangdong Province. Sun Yat Sen University’s Rehabilitation Department, two hours away, would provide required technical support. This project would give the province and the country experience in integrating CBR within Primary Health Care. The country already had such a PHC system in the villages and community participation was part of that system.

Villages will be encouraged to participate in a similar way in CBR. The project will start with discussions in the villages. Village doctors within health stations would include CBR as one of their tasks. With time the Public Health Assistants of the collaborating centre will be trained to provide mid-level support for CBR enabling project expansion and sustainability.

The project would provide opportunities to assess personnel needs for CBR; assess the effectiveness of the project on disabled people, their families and the village; the effectiveness of the technology in the WHO Manual and changes necessary, and develop a monitoring and reporting system within that used in Primary Health Care. The Bureau also wished that costs of the project be determined to allow plans for expansion.

During my stay in Guangzhou, details of this process were worked out between the Collaborating Centre and the Rehabilitation Department, with my help. It struck me that the Chinese were very thorough about making detailed plans. This was really valuable. The development project was ready to take off when I left.

A CBR Development Project in an Urban Area

Because it was a stated assignment activity, an urban CBR project was also planned in as much detail as the rural project while I was at the university with Prof. Zhou. It was to be located in Jinhua Street within the municipality of Guangzhou. This time I will tell my story a little differently.

In 1988, that is two years later, I heard Prof. Zhou talk about this urban project at the 16th World Congress of Rehabilitation International held in Tokyo, Japan. I will share now how the project we planned was implemented as he described it.

The urban project has been ongoing since March 1986, pioneered under the guidance of the Department of Rehabilitation Medicine of the Sun Yat Sen University of Medical Sciences as a Resource Centre. The Jinhua Street community lives within an area of 0.44 sq. kms. with 146 short and narrow lanes spread irregularly like a maze.

The Street Community Administration set up a CBR Supervisory Committee. Members included local health workers, civil welfare workers, disabled people and Red Cross society members. This committee managed the project with technical support from the university. A local school physician was selected as a mid-level supervisor. It is interesting that he had participated in the National Workshop we held in 1986 to introduce CBR.

Thirty-two community workers were also selected. These were volunteers of the Street Red Cross Society. They were all given training by the university. A house-to-house survey was carried out among the street population of about 30,000. Three hundred and forty-four disabled individuals were located, amounting to 1.15% of the population.

Disabilities people had were in the areas of mobility, vision, communication, learning and mental and psychiatric disability. One hundred and five of these people had home training programmes. He listed features of the project as the following: use of traditional medicine for functional recovery, the setting up of a small community-run rehabilitation station to provide basic rehabilitation to those who could visit, 152 people with mobility disability included for employment in community-run factories, 22 individuals with mental handicap employed in a sheltered workshop, and inclusive recreational, sports and social activities organised by the street community.

China was developing her own urban CBR model using existing resources.