02 April 2015

Facing up to demographic change in China

LUZHOU, Sichuan Province, China—Luzhou City has the same population as my native Scotland: 5 million people. The UK could be dropped into Sichuan Province, and it would take a major expedition to find it. The size and scale of everything in China is impressive, but its growing population is presenting problems.

The one-child policy was misguided. It failed to curb population growth and led to asymmetric growth whereby China has a surplus of men. The policy also led to another demographic change. By 2050, if the trend continues, the proportion of the population that is younger and economically active will be outweighed by the older and more dependent proportion. This change in the dependency ratio means that an increasingly older population will require care when fewer people are available to look after them.

While in Luzhou, I participated in a conference at Affiliated Hospital of Luzhou Medical University on elder health promotion and nursing care. The session I presented was titled “Preparing nurses to work with older people.” This was my second visit, and they honoured me with a three-year visiting professorship and signed a memorandum of understanding with my university.

It was good to see old friends. Not the least was my translator, Daniel Kuwei Liu, an extraordinary young man fluent in English and French. Formerly located in Luzhou, he now works in Beijing. When the opportunity arose to translate for me, he made himself available. Much frustrates me about working in China, but the sincere loyalty of many Chinese people to old friends is salutary. 

With Daniel Kuwei Liu and conference delegates.
Another loyal friend who has featured in blogs passim, Sally Chan, PhD, RN, FAAN, now head of nursing and midwifery at The University of Newcastle, New South Wales, Australia, also addressed the conference. Chan made a previous appearance in this blog when she was head of nursing at National University of Singapore. In addition to addressing the conference, Chan and I met with senior staff members of the hospital affiliated with the university, and we also gave short speeches to nursing students. We were asked many questions about ourselves and how nursing could be developed.

Sally Chan and Yours Truly.
Nursing is considered a relatively low-status occupation in China, and the image of the profession is poor. I hope the opportunity that the students had to hear from a global nursing academic like Chan and the editor-in-chief of a major nursing journal lifted their vision. Men are particularly lacking in nursing here, and the few men present were interested to see someone who had spent his career in the profession. However, above all else, everyone was astonished to hear I had eight children and only one wife.

The mighty Yangtze
Luzhou is situated on the banks of the Yangtze River, which runs from the Himalayas to Shanghai. On my previous visit, pollution was such that I could not see the river. This time, I managed two three-mile runs along the riverbanks in the early morning. Air quality was good, and the temperature and humidity were bearable. On the first day, I shared the banks with assorted joggers, dancers, martial artists, and fishers. On the second day, it was raining, and the few people I saw looked at me as if I was crazy.

Sichuan Province is famous for the pandas near the capital city, Chengdu, and also for the cuisine which is—famously—spicy. I was rendered speechless at least twice when I swallowed a chili. There is a particular seed here that makes your mouth go numb. For a few minutes, you speak as if you have just left a dental surgery. This passes, though, and my best advice is not to speak until the effect wears off.

“Hot pot” cooking is also very common, although not unique to Sichuan Province. This is a process of cooking your own food in a steaming pot into which a rich variety of ingredients can be added. Frankly, it is not my favourite way to eat, as it is hard work. That and the constant way of toasting, common in Sichuan, whereby everyone leaves their place and goes round the table offering thanks and clinking glasses. You barely consume one uninterrupted mouthful and are exhausted by the end of the evening.

I go home for Easter Sunday and a few days of leisure but will address the PhD Experience Conference at the University of Hull, slated for 7-8 April. At the end of the week, I go to the Middle East, to Saudi Arabia. I fly to Riyadh, which I have visited before, but will also visit Jeddah for the first time. This will be another reunion with old friends and former PhD students. It’s not all hard work!

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

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