BUILDING THE NATION THROUGH WOMEN'S HEALTH: MODERN ...

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minor venereal illnesses (qing xing jibing 轻性疾病), promote maternal and child health (fuying weisheng 妇婴卫生), train old-style midwives (chanpo jiesheng 产婆接生), give preventive injections (inoculations, yufang zhushe 预防注射), promote public health, supervise and help in the work of rural relief workers and old-style midwives, and gather the cun’s birth and death reports. The budgets for the district dispensaries and hospitals were small and depended upon the provincial and county financial situations at the time. The budgeted start-up costs for each 25-bed county hospital totaled 3,275 yuan, and operating expenses were allowed 1,430 yuan per month, give or take depending upon the county’s size and financial situation. District dispensaries were budgeted 850 yuan for start-up costs and operating expenses of 253 yuan per month, also depending on the district’s size and financial conditions. Experimental counties like Dingxian (定县) and Jiangningxian (Jiangning zizhi shiyan xian 江宁自治实验县) incorporated rural health centers staffed with midwives and nurses whose duties included pre- and postnatal care and submitting birth and death reports. By 1933 Jiangning had a “health demonstration area” (weisheng shiyan qu) and a public health clinic (weishengyuan) five miles outside of Nanjing that was established to test the medical education policy of creating model xian (county)-level rural health centers. Eventually every rural xian was to have a public health clinic with a 30-50 bed hospital, a diagnostic laboratory, and a health administration office. The hospital should staff five to seven nurses and two zhuchanshi, along with a head doctor, laboratory and public health workers, and administrative personnel. The monthly budget was 2,000 yuan. 238 Below the xian, “health stations” (weishengsuo 卫生所) 238 Neizhengbu, Neizheng nianjian, 218-19. 91
were established for each 50,000 people, and subordinate “health substations” (weisheng fensuo 卫生分所) in each xian or administrative village. This plan was organized by LON-HO’s Dr. Berislav Borçic and was based on the Yugoslavian model. The first Three-Year Plan for the Chinese National Health Administration (1931-34) called for local and national governments to pay for all medical services in these xian until local cooperative health insurance plans were established. Each xian health station was staffed by one physician, two nurses, and one midwife, with a monthly budget of 200-300 yuan. Part of its mission was to carry out maternal and child health and midwifery work, oversee school health, and propagate and disseminate public health methods and information. The substations each had a nurse trained in public health and with midwifery experience who could handle “routine maternity and health problems, school hygiene, vaccination, and general first-aid emergencies.” 239 The monthly budget of 50-70 yuan was to cover outpatient treatment; smallpox and other vaccinations; school health programs; maternal and child health work and midwifery; reporting births, deaths, moves, and marriages; and propagating public health. 240 Each cun was to have a local “village health assistant” (xiezhu yishi 协助医师). 241 In 1933, the Public Health Department under the Division of Internal Affairs (neizhengbu weishengshu 内政部卫生署) and the Public Health Experimental Station of the National Economic Association (quanguo jingji weiyuanhui weisheng shiyan chu 全国经济委员会卫生实验处) helped to fund one head nurse (hushi chang 护士长) and one midwife instructor in Jiangningxian “for experimental rural health work and to train qualified personnel” (wei shiyan xiangcun weisheng gongzuo ji xunlian rencai qijian 为实验乡村卫生工作及训练人才起见). They also paid part of the salary of one assistant 239 Lucas, Chinese Medical Modernization, 72-73. 240 Ibid., 72, Neizhengbu, Neizheng Nianjian, 218. 241 Lucas, Chinese Medical Modernization, 72-74. 92
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BUILDING THE NATION THROUGH WOMEN
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Copyright © by Tina Phillips 2006
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family and community. This research
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LIST OF TABLES 3.1 Curriculum for t
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PREFACE This work would have not be
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healthy, intelligent, male offsprin
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New midwives (zhuchanshi 助产士,
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traditional Chinese medical profess
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Republican and Nationalist eras (19
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the Rockefeller Foundation, one of
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unscientific jumble of superstition
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maternal and child health care cent
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uilding efforts after the fall of t
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ways, imports, Chinese medical univ
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IMPERIALISM Some have argued that W
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modern medicine as soon as it was a
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In addition to the culturally imper
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(1927-1937), the Nationalist govern
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irths were attended by untrained mi
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Communist Party’s “barefoot doc
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more important in making government
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CHAPTER ONE. LAYING THE FOUNDATION:
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Well into the twentieth century, mo
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pamphlets like Infant Care and Pren
Page 49 and 50: This ideal of aseptic births to dec
Page 51 and 52: medical beliefs. 73 Furthermore, so
Page 53 and 54: y the Rockefeller Foundation’s Ch
Page 55 and 56: named the Turner Training School fo
Page 57 and 58: Cochrane subsequently convinced Cix
Page 59 and 60: Medical Missionary Society. Dr. Mai
Page 61 and 62: Hongzhang to help his struggling ho
Page 63 and 64: clinic at the temple, I presume for
Page 65 and 66: It later became the Beiyang Naval M
Page 67 and 68: and college continued jointly by th
Page 69 and 70: sent her sons to the mission school
Page 71 and 72: nationalist reforms. A group of Nan
Page 73 and 74: College for Women in Peking (establ
Page 75 and 76: medical colleges with a national st
Page 77 and 78: critical of the quality of the Chin
Page 79 and 80: Boxer indemnity money that the Unit
Page 81 and 82: CHAPTER TWO. MIDWIFERY EDUCATION AN
Page 83 and 84: authority that had previously been
Page 85 and 86: After the start of the Nationalist
Page 87 and 88: schools. The 28 medical schools in
Page 89 and 90: crisis in maternal and child health
Page 91 and 92: the only course for China to take i
Page 93 and 94: The maternity ward practice grouped
Page 95 and 96: was established for nurses to recei
Page 97 and 98: Department of Education in 1931. Du
Page 99: Furthermore, it was hard to get qua
Page 103 and 104: Health Administration offered a gra
Page 105 and 106: Chen did institute successful progr
Page 107 and 108: February 1936, they surveyed 1,000
Page 109 and 110: as “Maternity and Child Health He
Page 111 and 112: 卫生模范区) was begun in 1927
Page 113 and 114: 1930s, the following schools were e
Page 115 and 116: midwife or physician in attendance,
Page 117 and 118: in a “foreign style” and funded
Page 119 and 120: and controlled by the state. As soo
Page 121 and 122: standards or else shut them down. A
Page 123 and 124: 6. If, after a birth, there is bloo
Page 125 and 126: CHAPTER THREE. THE JIESHENGPO MEET
Page 127 and 128: physicians. Thus, Marion Yang’s m
Page 129 and 130: Hopkins served as the model for med
Page 131 and 132: third wife and came from a rich fam
Page 133 and 134: However, Yang was drawn to the plig
Page 135 and 136: During the next section (January to
Page 137 and 138: addition, Beiping would be the muni
Page 139 and 140: $67,608, of which $38,080 was suppl
Page 141 and 142: course schools” throughout China.
Page 143 and 144: Table 3.1: Curriculum for the Two-Y
Page 145 and 146: Table 3.2: Curriculum for the Six-M
Page 147 and 148: The first class opened in July 1931
Page 149 and 150: “poor theoretical instruction.”
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sessions given by an obstetrician o
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Buddhist” contributed $1,000 to t
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school wished to train them in fill
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in the city, undertaking periodical
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efresher courses each for local mod
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conditions.” 382 Furthermore, the
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educational visits to instruct moth
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section. They accompanied the atten
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of discharge from the hospital, one
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Midwifery School and a key player i
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November 25-December 8), Zhangzhou
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Suiyuan 3 Hebei 50 Shaanxi 3 Shando
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deaths. At the hospital that year,
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New Cases Return Visits Table 3.6:
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However, the largest number of wome
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Marion Yang and the First National
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egistration of births. In this way,
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In his book on professionals in Rep
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three-quarters of the profession, b
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MEDICAL PROFESSIONALIZATION IN CHIN
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applied their organizational struct
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participate in any scheme which pre
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THE CHINA MEDICAL BOARD AND PEKING
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health policy. In fact, in the 1930
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future, since one-third of present
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Local midwifery organizations could
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supported career woman. Several con
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Bethel trained nurse-evangelists to
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Mission Hospital of Nanjing. She ta
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Field Health Station and the FNMS,
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pharmaceutics. According to Peabody
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social standing in their community.
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leaders penned treatises on the imp
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traditional Chinese and/or scientif
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the rate was probably higher in urb
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Ono Kazuko’s translation reads,
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therefore they had less life- and s
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to oneself could be passed on to on
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give the fetus favorable emotional
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weak nations of the East, but we ca
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Figure 5.1: Advertisement for Dr. W
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Figure 5.2: Advertisement for Japan
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major impact on health policy and a
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and hat. She has the images and doc
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Figure 5.5: Monthly position of pre
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we can see in Figure 5.6 a clothesl
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A similar organization in Changsha,
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Articles about these clubs in Weste
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we can see a struggle not just over
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Figure 5.8: Tuqiang Advanced Midwif
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Along with images of people, these
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Figure 5.10: Guangzhou Municipal Ho
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MODERN CURRICULA The curricula that
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- Simpson’s straight perforator -
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wonders how a jieshengpo could have
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elieve pregnancy discomfort. Furthe
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CONCLUSION Childbirth in China unde
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often moved around for jobs or took
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My research ends in 1937 at the Jap
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1941, she helped to establish Sichu
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centers that included maternal and
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those trained were midwives or “y
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all women go to hospitals to have t
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examinations, supine position, and
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APPENDIX A RULES GOVERNING THE ADMI
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d. Make investigation into existing
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BIBLIOGRAPHY Abbot, Andrew. The Sys
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"Bulletin of the Hackett Medical Co
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Franklin, Sarah. "Postmodern Procre
Page 289 and 290:
Ingram, Ruth. "Midwifery Training,"
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Maxwell, J. Preston. “Scheme for
Page 293 and 294:
Rogaski, Ruth. "Hygenic Modernity i
Page 295 and 296:
Verdery, Katherine. "From Parent-St
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