Cone Hospital review [September, 1982]

              r evi ew ®
THE MOSES H. CONE MEMORIAL HOSPITAL
GREENSBORO, NORTH CAROLINA
20 Days in July: Nursing Director On4'People To People" Mission To China f
Landing in Beijing (Peking), China on
July 14, 22 doctors, nurses and county
health directors from North Carolina,
although tired from many hours of
traveling, were anxious to begin
exploring the great land of China. Their
mission was to meet the Chinese people
and absorb information about their social
mores, their government, economy,
religious practices, and medical
community. They would be living
among the Chinese people for 20 days.
Gene Tranbarger, Director of Nursing
at Moses Cone Hospital was one of the
group comprising North Carolina's
"People to People" cultural exchange to
China. He soon realized that the Chinese
people were just as anxious to observe
the group of Americans and hear what
they had to say. "Wherever we went,
we were surrounded by throngs of
Chinese people. Once, while shopping in
a department store, I was surrounded by
40 or 50 people who followed me about
the store. I stopped to make a purchase
and they all stopped with me. As I
opened my wallet, multiple voices
gasped. 'What's wrong?' I asked the
person accompanying me. 'Oh, they've
ever seen so much money in one
billfold' was the reply. I soon learned
that most Chinese either speak or are
learning to speak English." Mr.
Tranbarger said, "and they were
following us wherever we went to hear
the conversational English. The TV
program with the highest rating in China
is a series of English lessons called
'Follow Me.'
The North Carolina delegation visited
five cities: Beijing (formerly known as
Peking), Hohhot (in Inner Mongolia),
Chengdu, Xian and Shanghai. They
toured Buddhist temples, imperial
palaces, communes'and hospitals. They
traveled by bus, plane, train and camel.
They attended Chinese opera,
symphony, an acrobatic show, a horse
exhibit and the zoo.
Mr. Tranbarger talked about one
commune he visited called the "Red
Flag." The commune was occupied by
more than 6,000 families who operated
more than 15 schools and several
factories. They also farmed several
thousand acres of land. "Theoretically,
the commune governs itself, but actually
it is closely regulated by the federal
government," he said.
"Although housing is continuously
under construction, the Chinese have not
been able to meet the housing needs of
the one billion population. The average
waiting period for a young couple to get
their own apartment is about five years.
It is not uncommon for newlyweds to
continue living in their respective
parents' homes after their marriage until
an apartment is available.
"Most housing there is primitive. A
number of people still live in caves and
many houses have dirt floors. Flushing
toilets and running water are virtually
unheard of in rural areas. Many people
cook outside in the courtyards, using the
internal space for sleeping. Around six
o'clock in the evening, people begin
moving  out onto  the  streets (not just
Chinese workers in the Sew Shop of a
denim factory in Hohhot.
sidewalks) setting up card tables and
chairs. People sit outside and read by the
light from the street lamps and enjoy the
cooler air outside. The Chinese can't
relate to the space Americans have in
their homes. The typical Chinese
apartment is about the size of my office
and houses five people.
"Full headlights on vehicles are not
permitted in the streets. The drivers may
use parking lights and blink the
headlights periodically as a warning to
pedestrians and bicyclists. You can
imagine how hazardous driving is with
people sitting about in the streets!
However, we didn't see more than 25
privately owned automobiles while we
were there. Most private citizens ride
bicycles."
According to Mr. Tranbarger. only the
males in China can decide to get
married; the females cannot make this
decision. However, the decision to
divorce is strictly the woman's choice.
"If a couple is having marital difficulties, they are heard by a reconciliation
committee at the place of employment.
After sufficient counseling, the wife may
decide that divorce is necessary. The
committee gets deeply involved in
marital affairs. If the committee feels it
is necessary in order to save the
marriage, they tell the couple what they
must do and threaten demotion of
position, loss of job or loss of home
(housing is owned by the employer) to
bring him or her back into line. The
leading cause of divorce in China is the
unwillingness of the husband to share
household responsibilities.
"Household responsibilities usually
are shared by the husband and wife in
China, and there is clearly a great deal of
REVIEW
SEPTEMBER, 1982
INSIDE:
®
Main Entrance W ill Move   4
Department Spotlight   2
Educational Assistance —
Loan Program  4
male involvement in child rearing. I saw
men cleaning house, and young fathers
were obviously spending their day off
from work with the children. On the
other hand, we saw women working at
hard labor and we saw female soldiers.
"I got the impression that Chinese
males still dominate. Whenever we
visited hospitals, the male doctors and
male administrators usually spoke for the
female nurses.
"Everyone in China speaks of the
serious nursing shortage there. China has
530,000 nurses with a total population of
one billion. (Total population of the
United States is 220 million with
1,300,000 nurses.) China has no licensed
practical nurses or nursing assistants -
only registered nurses. The more serious
problems facing hospitals there include
staffing shortages, nurse/physician/
patient relationships and problems of the
new nurse. Shortage of nurses was
further compounded by absenteeism,
childbearing and dissatisfaction of the
new graduate with nursing practice.
Mr. Tranbarger (front row, right) and
three other visitors from North
Carolina pose with Chinese nurses at
the Evergreen Commune Hospital.
"Nurses in China do procedures, such
as lumbar punctures and accupuncture,
which would be done by physicians in
the U.S. Nurses there also go into the
countryside and practice 'barefoot
doctoring.' Nursing licensure regulations
are less stringent than in the U.S., and
although it is mandatory that nurses in
China belong to the national professional
society, the Nursing Association of
China lacks the strength of its counterpart in the United States. China does,
however, place a great deal of emphasis
-=  •£
Street scene in Hohhot.
on continuing education for the barefoot
practitioners, nurses and physicians.
"We were able to observe samples of
every level of health care available in
China ranging from the barefoot doctor
to the large university hospitals. The
barefoot doctor is a paraprofessional who
is responsible for the care of
approximately 900 people, usually in the
rural areas. We saw community
hospitals, which were about 150 beds;
the county hospitals are slightly larger
than the community hospitals, and the
university hospitals averaged about 1200
beds in service.
"The hospital equipment was
generally 1920 to 1930s vintage with the
surprising exception of an occasional
very modern piece of equipment such as
a CT Scanner or a small laboratory
computer.
"The hospital patients and their
families are expected to assume more
responsibility for the patients' care in
China than in the U.S. For example, in
China the patient's family will stay with
a hospitalized family member; they
select from a supply of raw food
furnished by the hospital and actually
prepare the patient's meals.
"Every hospital has two pharmacies,
located back-to-back, with two
dispensing windows. One pharmacy
dispenses traditional Chinese
medications and the other dispenses
western medicines. The patient decides
which medication to take. Any type of
Chinese medication that is for sale may
be purchased without a doctor's
prescription in China.
"The average salary for a nurse in
China is approximately 50 yaun per
month and doctors make about 90 yaun
monthly." (One yaun is the approximate
equivalent of 50 cents in U.S. currency.)
"The cost of public transportation in
China is equivalent to one penny in U.S.
Continued on page 2 . . .
REVIEW
Moses Cone Hospital
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Greensboro, North Carolina 27401- 1020
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Carolyn Beard, Editor