Health in China: Another Angle

I’m back after being offline for several days while cruising down the Yangtze on a riverboat (more on that in a few days). Meanwhile, a few observations on some things the Chinese are really doing right, healthcare-wise.

Sometimes, when I’m in restaurants at home, I wonder if the food prep workers resent having to wear gloves while they work. I often wear them when on ambulance calls, of course, and even though I work in a cool, low-humidity area, I’m irritated by how the sweat builds up on my hands. I can’t imagine having to wear them for hours at a time.

Classic Asian face mask.
I bought some of the face masks to bring home.

Food workers generally wear them here, too (not counting individual street food vendors), but many also wear face masks. So for any U.S. food workers that hate the gloves: just wait. That’s probably just the start.

In fact, it’s not at all unusual to see people walking in the streets wearing face masks. Sure, some are hoping to avoid breathing in smog and vehicle exhaust (and, in Tibet, I was told that many wear them to help capture humidity so they’re not always breathing such dry air.)

I was so taken by the concept that I just had to have one — they were easy to find in the markets, and I was even able to find one that matched my eyes (which were so strained by the harsh Tibetan sun that I grabbed a hat, too).

Not Shy About Using Them

But here’s where the Chinese are a step ahead of the west: have a cold or flu, but you “have to” go out? Many wouldn’t dream of exposing others to their germs, so they wear a mask to protect others.

Do that in the U.S. and people think you’re a freak. That needs to stop. People should do what they can to help keep others from getting sick; they’re doing it for you!

Such behavior is encouraged by the government here, too. I spotted this sign in the airport as we left Hong Kong:

Avian Flu Poster

If you’ve heard of the 1917-1918 “Spanish” flu epidemic that killed hundreds of thousands in the U.S. well before air travel made mobility easy, you know what can happen again. Now millions of lives are at stake, and with the population density of Asia (and the love for very fresh poultry), it’s a real danger here. Here’s an example of what I mean by fresh poultry:

Ducks at market, waiting to be taken home for dinner.
These ducks are just patiently watching shoppers go by in the market, waiting for someone to take them home. I guess that’s the sort of calm behavior that led to the idiom, “sitting duck.” We watched as one woman chose one and headed home.

Fresh Food

Taking the duck home — alive.It never even occurred to me to wonder how you carry a live duck home to kill it just before you throw it into the oven, still warm. For this woman, it’s a routine matter. No, the duck didn’t thrash about; it was still quite calm, perhaps even enjoying the ride.

But back to flu pandemics: once one starts, it will be hard to stop. Thus, there’s even a “health check” at the airport.

First, there’s a questionnaire: do you have sniffles? A fever? Other symptoms? If so, they check you out.

In Hong Kong (and, I understand, in many other airports and high-traffic areas), they have infrared scanners, looking for people who stand out, thermally, from others — indicating a fever. In any sort of epidemic situation, such people are whisked away to hospitals for more thorough exams, and kept there if they’re contagious. And they’ll keep them there until they’re sure there’s no danger of spreading it.

Even foreigners? Absolutely, said one of our guides. See “millions of lives at stake” above. That’s what they did when SARS was an issue, he said; they closed the borders to tourists, costing the economy dearly, but it’s probably what kept SARS from becoming a bigger problem than it was.

And good for them. Because in all likelihood, when the next strain of bird flu crosses over into the human population (that is, human-to-human transmission), it’ll probably happen in Asia. I appreciate that they’re aware, and actually doing something about it now, rather than waiting until it’s too late.

6 Comments on “Health in China: Another Angle

  1. Randy said;
    But here’s where the Chinese are a step ahead of the west: have a cold or flu, but you “have to” go out? Many wouldn’t dream of exposing others to their germs, so they wear a mask to protect others.

    These have been a longtime common sight in Japan too, but it has always been the subject of debate as to which direction the germs are being prevented from traveling – infecting others or being infected BY others.

    Tony, Japan, who actually wore one once at the height of the SARS crisis only because I was traveling home to my wedding and I did not want to risk cancellation.

  2. Is that you with the hat, Randy? It doesn’t even closely resemble your photo at the top of the page!

    Where did you find a cowboy hat in China? Of course, the ones they sell in the Rocky Mountains of Colorado are probably made in China, silly me! 😉 Glad to hear Kit is feeling better!

    It’s definitely not a Texas-style hat; closer to a fedora. And yes, indeed it was made in China. -rc

  3. Such an interesting trip, so many adventures. Thanks for keeping us in the loop, vicariously traveling with you.

    The worst smog we experienced on our trip in 1988 was in Bangkok, Thailand. Glad Kit is feeling better. Looking forward to more of your posts.

  4. My brother lives in HK (along with his Chinese wife) and each time I have visited them, I have gone through the temp scanners at both ends of the trip. We also have signs up at our International airports re: bird flu and when SARS was a concern. Funny, I just assumed all (major) international airports had the same policies – obviously not. My US trip is still on the agenda….maybe I’ll make it to the Alaskan True trip 🙂

  5. The problem with your idea as I see it….

    Yes, to prevent the spread of deadly new diseases, I can see perhaps wearing a mask. Also for keeping out smog.

    However… With the way that advertising is going these days, it would be no time at all before everybody was required to wear masks before they left the house.

    Anti-bacterial kleenex.
    Spray your compost and garbage cans.
    lysol everything in sight and all surfaces.
    Germicidal carpet shampoo.
    anti-bacterial dish soap.
    etc. etc.

    This is all a helluva long way from “Don’t put money in your mouth. You don’t know where it’s been.”

    If you live in a sterile environment, you’re going to get sick every time you stick your nose out of the door.

    Remember all the “Bubble Boy” stories? That’s where we’re heading, it seems to me.

    Great excuse to have people wear a mask at all times.

    I wonder if there’s any statistics on Burkha wearers health VS “open face” ?

  6. Two of your China topics are very close to home for me: first, I work at Emory University in Atlanta where the 14th Dalai Lama has accepted a Professorship for the first time at a US school. I attended one of his lectures on Oct 21 and was there for his installation as Professor on Oct 22. He is truly an amazing individual and we are honored to have him here at Emory. There is actually a new curriculum for Buddhist monks to study science here at Emory and it’s awesome to see the monks walking around campus in their colorful robes. You can watch videos of his visit here:

    Second, the topic of avian flu is one I deal with every day. Emory has been funded through the NIH for a Center of Excellence for Influenza Research and Surveillance. I am the project manager for our Center. We have four research groups who are looking at the pathogenesis of influenza (especially, why was the 1918 pandemic so deadly), and studying immunity to flu.

    A quick word on the relation between “pandemic” flu and bird flu: A pandemic is started when a new strain of flu (i.e. bird flu) is added to the existing flu strain currently in circulation in humans. This causes the strain to mutate and become resistant to any current vaccines – and that’s a pandemic. The bird flu is thought to be one of those variables that could possibly enter the existing flu strains.

    Bird flu is common – all types of flu that affect humans come from birds. Most poultry flocks get common strains of flu – but this one called H5N1 is especially virulent AND has infected humans who killed and cleaned the infected birds (mostly in Indonesia). I get updates from the feds each day and so far there is no confirmed case of H5N1 being transmitted from human to human. Our biggest concern is that wild birds will carry it to North America and it will either enter our poultry population or mutate the current human flu strains – thus causing a new strain that no one is immune to and we don’t have a vaccine for. That’s a pandemic.

    The good news: the “surveillance” part of the Centers is literally people going out and capturing wild birds in key areas and testing them for H5N1. AND the feds have a pretty impressive plan in place in case this does happen.

    The way that China dealt with SARS was ideal, and is the reason why SARS did not become a bigger issue. It was so well contained because citizens were told to wear masks and they did. Unfortunately, this level of compliance would be nearly impossible in the U.S. and Europe!

    OK, this is probably more than anyone wanted to know about influenza but it’s my thang! For more info see our website at:

    If anyone has a question for me, click on Contact. (Yes, my last name is Cassingham, Randy and my husband are distantly related.)

    One more thing: get a flu shot. Even if you’re one of those who “never gets it” you could unknowingly spread it to others who are more susceptible.


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