Differences of Opinions - Public Health in China

Since I last wrote my relationship with my one-on-one Chinese public health teacher has improved. She has started to share with me more nuanced information, and a slightly deeper analysis of some of the situations in China. For instance yesterday we talked about the affect of the one child one family policy on the use of condoms which also protect against sexually transmitted sexual disease. The name of the policy is a bit contentious because it assumes that children are only born within wedlock - I’m still not clear about how children are classified if they are born outside of wedlock i.e. whether this counts as a child for both the father and the mother, or whether they are forced to marry(by society, family or government) etc. These are things I’ll have to ask her to speak more clearly about. However, the policy has had devastating affects on the use of condoms because it stresses childbearing as the most important event to prevent. Not disease. The cheapest and most effective way to prevent childbearing is not condoms and therefore they are not commonly a first choice among sexually active adults. Additionally, rural married peasants receive subsidized IUDs (Intrauterine Devices) from their local family planning center. They do not receive condoms. This would not be a problem if all families were completely faithful. But like many societies undergoing economic change, husbands are migrant workers and work half of the year (the warm half) in the cities, and some (fathers and mothers) are tempted by other interests. I have not yet seen any stats on extramarital affairs, so I’m not sure how often this occurs.
My time spent with this professor has been more and more useful and interesting, and I’ve enjoyed hearing her analysis. This analysis has not been without an occasional generalization/stereotype, or what I see as oversimplification of the issue. For instance, last week I gave an oral summary of a report published in the Journal of Infectious Disease (one way that I’ve been able to gain her trust and support is by sharing information with her that she would otherwise not have much access to i.e journals written in English). The article was on internet sites that target homosexual men and are used to find friends, partners, and sex partners. It linked the use of these sites to a heightened risk of HIV infection. While there many reasons why this may or may not be true and why it is popular among homosexual men to use websites as a primary social/sexual network (the least among them the secrecy that is required to be homosexual in China), the reason my professor gave for homosexual men having a heightened risk of infection was an inability to control their sexual desires, and an inability to care or listen to advice about how to protect oneself and others from harmful sexually transmitted diseases. Now, I write this in translation so I don’t think her viewpoint is as harshly critical of homosexual men as it sounds in English, but this viewpoint I did disagree with. She did admit that a large problem is that they don’t think they’re at risk (which I think is common in America as well), but she didn’t think more information would necessary help, or that they would listen to advice from health experts. I don’t know much about the HIV epidemic that hit largely gay men in America but I know that the homosexual population organized and responded very effectively to the situation with the popularization of how to protect one-self and others. It makes me think that things are not as hopeless as she puts it here in china.
This is one area where we have disagreed; another is the usefulness of different types of research and information. Her bias is towards statistical information. This bias is understandable because she is an epidemiologist and statistician so her work deals largely with the use and production of statistics. While I agree that stats are important and can reveal useful information about a population, it fails to show the intricacies of the lives represented by numbers. Furthermore statistics in China can (not always) be used to control or to advance a national interest or stereotype. When stats are steeped in prejudice and stigma they only serve to reinforce those stigmas in the mind of a larger public. For instance surveys used to monitor populations would see the gay men in the paper above as first in foremost gay men. This determines their risk of infection and little else matters. However, the survey cannot uncover the daily economic toils, or psychological encounters that may or may not be more important in determining access to health information and the use of that information. My point is, is that I think you need both.
Although everything I have written so far about this professor seem terribly critical, she is actually quite wise and I’ve enjoyed our discussions. Her viewpoints also have there underlying reasons too, which I’m slowly uncovering.

-----
I’m sorry for talking so much about access to health, etc. But it’s been on my mind. Not much else has been happening here. It feels like fall (which it basically is) and I’m enjoying myself for the most part. Also, my dad is volunteering for the Obama campaign which I think is cool and I’m currently wearing my Obama/WhiteSox T-shirt… and the white sox beat the Yankees today 6-2. All is well.