lnterndtiond Affdirs Health
Promotion-A
T
HIRTEEN years ago I was invited to participate in a Health Tour of the Peoples Republic of China (PRC ). The United States had not at that time negotiated “normalization” for economic trade and visitor entry between our two countries, so after a great deal of scrutiny, for a visitor’s visa, some colleagues and I entered the previously isolated country and post-Maoist era of the PRC. My friend and colleague, Em Bevis, arranged the tour for us as a “medical” group because this was the only way US citizens could enter the country. My curiosity was high, having studied and read a great deal about this land of over one billion people and their heritage from the many dynasties to the postrevolutionary society at the time of my visit in 1978. However, my curiosity was even higher about the health care system, the health of the public, the government’s use of health maintenance within their postCultural Revolution period, as well as the beliefs, attitudes, and behavior of the general population regarding health and illness. I believe that two most unexpected findings I made through trial and error are worth reporting: (1) Health promotion and health maintenance, I found, was a way of life and nothing in the Mandarin language quite articulated this phenomenon, and (2) gerontology did not at that time exist as an entity in China, thus I could not get a translation to express the meaning of the study of elderly people and subsequently had no language to pursue this topic. I believe now that the PRC was practicing primary health care (albeit as one aspect of an early version of primary health care before the Alma Ata Declaration made manifest in 1978) through the use of “the barefoot doctor” and other indigenous, untrained community workers teaching health promotive actions at specified times throughout each workday. I saw this as a health orientation and propaganda time that was taken in lieu of our western coffee break. Loudspeakers barked across fields, machine shops, and other industries of the communes espousing health-sustaining ac-
JOAN E. UHL, PHD, RN Associate Dean for Academic Affairs Director of Graduate Studies School of Nursing University of North Carolina at Chapel Hill Chapel Hill, NC 27599-7460
Copyright 0 1991 by W.B. Saunders Company 8755-7223/91/0705-0005$03.00/O
Journal of Professional Nursing,
Vol 7, No
Cultural
Affair
tions interspersed with political messages of that current regime. No wonder I was looked at with blank faces when I tried over and over to explain what I meant by health promotion and health maintenance. Very early morning made this culture’s health behavior most relevant and at the same time breathtakingly beautiful. It was most awesome to see dozens of strong, healthy people barefoot, as if one with the earth, making the soft rhythmic body, arm, and leg movements of tai chi. Just what is it that this American nurse persists she must find the language to translate? Could this be so natural that no question or answer exist? Finally, my ethnocentric language and beliefs were becoming conscious. Of course! My problem was trying to find a relatively contemporary term for a very old practice that was soundly integrated into a life-style. Perhaps also no explicit study of elderly people was necessary as the extension of a life-style over a lifetime was explicit within each community group. Regardless of the political agreement or disagreement we may have with this country, it was apparent, at least to me, that the postrevolutionary culture of this China was dominated by health promotive beliefs and actions of the people. Every song, every dance, and every event carried a message promoting a healthy environment as well as the belief of a physical and mental oneness with earth. The political propaganda was the price one had to pay to glean the wisdom of centuries of oriental philosophy that carries meaning to life. Nothing is perfect, but at that time and in that place I felt closer to an ideal community than ever before. If our American cultures included a belief in the need for a reflective, quiet time to express man’s and woman’s oneness with earth each day, could we possibly create a sense of wonderment of nature, the meaning of life, and the pursuit of goodness? The fact that the United States is an industrialized country can not exempt a culture being cultivated to include at least a daily ritual like this. I saw similar group activities by employees in an urban setting in Tokyo, Japan. Might we study the oriental culture to search for fundamental behaviors that promote both physical and mental health? If an activity such as this cannot be nurtured within each family or individual, then why not in schools, employment settings, and other community gatherings? Then, this American nurse would not have to search for a common language to seek a response to an established lifestyle that may lead to furthering health promotion. She would have no question, only hope, for health promotion as a cultural affair within our culture.
5 (September-October),
1991: p 267
267
Promotion-A
T
HIRTEEN years ago I was invited to participate in a Health Tour of the Peoples Republic of China (PRC ). The United States had not at that time negotiated “normalization” for economic trade and visitor entry between our two countries, so after a great deal of scrutiny, for a visitor’s visa, some colleagues and I entered the previously isolated country and post-Maoist era of the PRC. My friend and colleague, Em Bevis, arranged the tour for us as a “medical” group because this was the only way US citizens could enter the country. My curiosity was high, having studied and read a great deal about this land of over one billion people and their heritage from the many dynasties to the postrevolutionary society at the time of my visit in 1978. However, my curiosity was even higher about the health care system, the health of the public, the government’s use of health maintenance within their postCultural Revolution period, as well as the beliefs, attitudes, and behavior of the general population regarding health and illness. I believe that two most unexpected findings I made through trial and error are worth reporting: (1) Health promotion and health maintenance, I found, was a way of life and nothing in the Mandarin language quite articulated this phenomenon, and (2) gerontology did not at that time exist as an entity in China, thus I could not get a translation to express the meaning of the study of elderly people and subsequently had no language to pursue this topic. I believe now that the PRC was practicing primary health care (albeit as one aspect of an early version of primary health care before the Alma Ata Declaration made manifest in 1978) through the use of “the barefoot doctor” and other indigenous, untrained community workers teaching health promotive actions at specified times throughout each workday. I saw this as a health orientation and propaganda time that was taken in lieu of our western coffee break. Loudspeakers barked across fields, machine shops, and other industries of the communes espousing health-sustaining ac-
JOAN E. UHL, PHD, RN Associate Dean for Academic Affairs Director of Graduate Studies School of Nursing University of North Carolina at Chapel Hill Chapel Hill, NC 27599-7460
Copyright 0 1991 by W.B. Saunders Company 8755-7223/91/0705-0005$03.00/O
Journal of Professional Nursing,
Vol 7, No
Cultural
Affair
tions interspersed with political messages of that current regime. No wonder I was looked at with blank faces when I tried over and over to explain what I meant by health promotion and health maintenance. Very early morning made this culture’s health behavior most relevant and at the same time breathtakingly beautiful. It was most awesome to see dozens of strong, healthy people barefoot, as if one with the earth, making the soft rhythmic body, arm, and leg movements of tai chi. Just what is it that this American nurse persists she must find the language to translate? Could this be so natural that no question or answer exist? Finally, my ethnocentric language and beliefs were becoming conscious. Of course! My problem was trying to find a relatively contemporary term for a very old practice that was soundly integrated into a life-style. Perhaps also no explicit study of elderly people was necessary as the extension of a life-style over a lifetime was explicit within each community group. Regardless of the political agreement or disagreement we may have with this country, it was apparent, at least to me, that the postrevolutionary culture of this China was dominated by health promotive beliefs and actions of the people. Every song, every dance, and every event carried a message promoting a healthy environment as well as the belief of a physical and mental oneness with earth. The political propaganda was the price one had to pay to glean the wisdom of centuries of oriental philosophy that carries meaning to life. Nothing is perfect, but at that time and in that place I felt closer to an ideal community than ever before. If our American cultures included a belief in the need for a reflective, quiet time to express man’s and woman’s oneness with earth each day, could we possibly create a sense of wonderment of nature, the meaning of life, and the pursuit of goodness? The fact that the United States is an industrialized country can not exempt a culture being cultivated to include at least a daily ritual like this. I saw similar group activities by employees in an urban setting in Tokyo, Japan. Might we study the oriental culture to search for fundamental behaviors that promote both physical and mental health? If an activity such as this cannot be nurtured within each family or individual, then why not in schools, employment settings, and other community gatherings? Then, this American nurse would not have to search for a common language to seek a response to an established lifestyle that may lead to furthering health promotion. She would have no question, only hope, for health promotion as a cultural affair within our culture.
5 (September-October),
1991: p 267
267
