When it comes to comparing men and women in terms of potential, ability, capacity, prospects, intelligence and some other considerations, oftentimes, there is no consensus, and there is usually equal support on both sides of the divide.In many parts of the world, men are seen to be on the upper rung of the ladder when it comes to gender comparison, while women are (often) treated as being second in line, and in certain places, relegated to the background. This is further strengthened by certain religious, cultural and societal beliefs.But beyond these, there are reports by some experts that women are more intelligent than men, lending some support to the popular saying that what a man can do, a woman can do better.Some of the reasons why women are considered to be more intelligent include women having better memory than men, smarter, being able to handle stress better than men, having the ability to multi-task more, being better leaders, more careful drivers, better students by being more focused and being more frugal.In a study published in the British Medical Association’s Journal of Neurology, Neurosurgery and Psychiatry and reviewed on Mail Online, researchers found that women were more intelligent than men. In their examination of 600 Netherlanders through a standard intelligence quotient test, which is a measure of a person’s reasoning ability, they found that the female participants were quicker and smarter than the men.The study adds that the reason for the difference in their intelligence is not social but biological, noting that this could be the reason why girls now do better at school than boys.Apart from these, it was also gathered that 33 per cent of women, compared to 28 per cent of men, had good speed in their replies in the test, while four in ten women had a good memory compared to three in ten men.According to an American expert in intelligence research, Prof. James Flynn, women score higher than men when it comes to intelligence quotient. He noted that when the test was conducted in Europe, the United States, Canada, and New Zealand, women maintained higher scores than the men.Flynn, an emeritus professor known for his interest in matters relating to IQ, observed that even though the scores of both sexes in IQ test have been rising for a long time now, women’s scores have risen faster than men’s. He explained further that some of the responsibilities surrounding womanhood could have brought out the best in them.He said, “In the last 100 years the IQ scores of both men and women have risen, but women’s have risen faster; the demands of juggling family life and building a career have made women more intelligent.“This is a consequence of modernity. The complexity of the modern world is making our brains adapt and raising our IQ. This improvement is more marked for women than for men because they were disadvantaged in the past.”According to him, it is instructive to note that women’s higher intelligence is not due to the brain formation or some changes in the brain, but that it is largely dependent on how the two sexes approach the modern problems that confront the world per time.He added, “It is this that may give us a clue as to why women are not only catching up with men but, in some places, starting to overtake them. There may be something innate about the way women’s brains are put together or the demands placed upon them that allow them to cope with complexity and the need to systematise.”However, the factors identified by these experts are independent of heredity and some other external factors, like income, condition of living, etc.A professor of psychology at the University College, London and the Norwegian Business School, Adrian Furnham, told Psychology Today that the observable sex differences in both genders start to manifest from infancy, all of which he said might not be unconnected with their traits and what becomes of them later.He noted that while boys are more active, show narrow interests, spend more time awake, and are more interested in things, systems and vehicles, girls are well coordinated, have better hearing, show wider interest in things, more vocal, make more eye contact, more interested in social and emotional stimuli, more sensitive and acquire language earlier.He explained further that girls show more concern for others and are better at reading other people’s minds which make them to have more instinct.But, a neurologist, Dr. Adilkaibe Ezeala, said even though it is not ethical to do such comparison, it is not true that females are more intelligent than males, saying most of the studies that came out with such reports were flawed.“There is no study till date that showed that females are more intelligent than males. The same thing with brain size, there is no evidence to show that males have bigger brains than females; the size of the brain is proportionate to the body size of individuals,” he added.Ezeala explained that before making such conclusions, natural gifts of individuals and other confounding factors would have to be explored, “which makes it more difficult to measure intelligence and it is not even ethical to do such (gender) comparison.”He concluded that everybody, regardless of gender, has strengths and what they can do better than others.Also, a consultant endocrinologist, Dr. Olamoyegun Michael, said the reasons people adduce to such claims are more of environmental factors rather than biological factors. “There are no biological factors, because I’ve not come across any biological explanation for it, but maybe environmental factors. In the case of female students doing better than male students, it has to do with their comparative levels of commitment, focus and what the two sexes do with their time,” he added.However, in the view of Prof. Oni Fagboungbe, a consultant psychologist, individual’s intelligence level depends on the quality of the brain cells and not about the gender of the individual. He noted that women tend to be better than men in certain areas and men tend to be better than women in some other areas.He said, “IQ is determined by the quality of the brain cells of individuals. So, it is a function of the quality of those cells of individuals. That is why in some countries, they make sure their young ones do not lack nutritious food so that it can lead to qualitative brain cells and when the brain cells are of high quality, the possessor is bound to be intelligent.“There are certain areas of life that are very feminine in nature and a woman would seem to have an upper hand while men do better than women in some other things. So, the variation in intelligence is not due to the sex but the quality of the brain cells. So, in certain situations, you may see women displaying very high intelligence more than men and vice versa.“In fact, psychologists even have a problem with the universal definition of intelligence because there were many perspectives to it, but the consensus is that intelligence is people’s ability to solve a specific problem in a specific situation, and IQ is measured by mental age, divided by chronological age and then multiplied by 100. So, brain cell is what matters, not gender.”Source: PUNCH, 2016 扫码分享本页内容！
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大学英语精读第二册课文中英文对照学习 Intensive Reading Book 2
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Song Xi, a 24-year-old nurse, is planning her trip to Germany, but the preparations have been far from easy. She has only been abroad once before, to Vietnam, and this time her journey will not be a short sightseeing trip, but a working visit for three to five years. When it comes to hiring nurses, turning to Chinese recruits is nothing new. As many countries face the problem of an aging society and difficulties in hiring nurses - due to work stress and low wages - employing Chinese workers has become popular in some Asian countries including Singapore, Japan and South Korea. However, working in Western countries, including Britain and Canada, is an emerging trend. In Germany, the European Union's richest country, such an opportunity for nurses has been allowed only since July. Song is among the first group of nurses to benefit from the new policy in Germany. Under an agreement signed by China and Germany at the end of 2012, some 150 Chinese nurses will work in the European country from 2013, with the first 25 leaving in October. Traveling to Europe has been a dream for Song since childhood, as she views the continent as a place of fairy tales, ancient castles and a different culture. However, studying abroad is too expensive for her family of four from Jingzhou, a city in Hubei province. Although she couldn't afford to study overseas, Song never abandoned her dream. After studying foreign nursing care at Hubei University of Chinese Medicine for five years, she worked as an intern at a local hospital in 2012. "But it was hard to practice what I learned in college. For example, health education was not highly valued," she said. During this time, she heard of the nursing program between China and Germany, feeling the time was right to make a move. "I believe this working experience will give me a chance to be a real nurse," she said. The shortage of nurses has become a problem in Germany, which has had an aging society for decades. In July, 4,393 nurses in Germany were registered as unemployed, with 6,792 vacancies announced to the German Federal Employment Agency. For nurses caring for the elderly, there were 3,517 registered as unemployed, with 9,080 registered vacancies. "In Germany, employers are not obliged to announce their vacancies to the Federal Employment Agency, so the latter figure might be even higher," said Marcel Schmutzler, a press official with the agency's International Placement Services Department. Franz Wagner, chief executive officer of the German Nurses Association, said that in the past 10 years most of the foreign nurses in Germany came from Poland and Romania. He said there are cultural differences and differences between the roles of nurses from country to country. "A nurse from Europe probably finds it easier to adjust than somebody from Asia or Africa," he said. Huge population Although the number of Asian nurses has not risen significantly in the past year, Wagner said Asia has become interesting for German employers, because of its huge population - China and India, in particular. He said German employers have also found it difficult to find nurses in Europe who want to work in Germany, because working conditions for them there are not competitive when compared with those in Scandinavian countries, Britain or the United States. "In these countries, nurses find better conditions, such as a lower workload, better recognition and image, less overtime and better salaries," Wagner said. "In addition, German is a difficult language to learn." Although she has had German-language and culture training since September 2012 and has passed the language test, Song still lacks confidence in her upcoming trip. "I watched some German TV programs, but felt they were hard to understand because they speak fast and sometimes with dialects," she said. "And also the letter 'r' is very difficult to pronounce." Other questions about living in Germany are also on her mind. Are all shops and restaurants closed on Sundays? Can you still eat rice in a Western country? And do you have to buy boots in Germany, because of thick snow and extreme cold in winter? A win-win deal Compared with the average monthly salary of about 3,320 yuan ($540 or about 400 euros) for a nurse in China, working overseas represents a good deal. Wang Zhuwen, director of operations at Shandong International Nurse Training Center, which is responsible for training the 150 Chinese nurses who will work in Germany from this year, said: "Most overseas Chinese nurses earn more than they do in China. In Germany, the gross starting salary for nurses in public hospitals ranges from 2,190 to 2,365 euros ($2,957-$3,193) a month." Many Chinese nurses are passionate about going abroad, not only because of the higher salary, but also because they receive greater respect from patients, he said. Relations between medical staff and patients have been severely strained in China over the past years. Without competition from privately owned hospitals, public hospitals take almost all the responsibility for patients' medical services. Patients have not been happy with hospital services, while doctors have complained of low salaries. "In some other countries, nurses enjoy more respect and hospitals place greater value on their services. It is also the dream of many young people to see the outside world," Wang said. He added that some Chinese nurses have migrated after working overseas for several years, while others found better jobs after returning to China. The nurses' training center in Shandong province is owned by an overseas personnel-training company, formed in 1989. To date, more than 80,000 Chinese have been trained and sent overseas through the center. Previously, most of the workers were blue-collar employees, such as welders and farm workers. Now, demand has grown overseas for more skilled workers from China, including nurses. Since the training center was set up in 2005, more than 1,000 Chinese nurses have been sent abroad, mostly to Asian countries, including Singapore and Japan, which have a shortage of nurses along with an aging problem. "The consequences of this immigration will be mainly positive," said Schmutzler, the press official with the German Federal Employment Agency. He believes such immigration will increase, because the labor force in Germany will decline in coming decades as the number of elderly people increases. "Neither immigration from European Union countries, nor from non-EU countries, may be able to fill this gap alone. Only a mixture of both, plus domestic measures to activate hidden potentials in the German labor market, will help to meet this challenge successfully," he said. Wagner, from the German Nurses Association, said, "In the short term, we will be able to cover vacancies with German nurses if employers create better working conditions." He said thousands of German nurses have left the profession, unwilling to cope any longer with the workload and other factors. "If more nurses from abroad come to Germany, I assume many will move on to other countries in Europe where they will find better jobs," he added. Personal choice Working overseas is a personal choice for Song, of concern only to her family and boyfriend. "Many single girls might be encouraged to marry Germans, who are known for their good looks as well as an attitude centered on the family," she said. "But I've got a Chinese boyfriend. He will not come with me, but our relationship will be sustained by our trust and love." She has many images of Germany in her mind, including its dress sense, gentle attitude and numerous types of beer and sausages. Most of her impressions stem from books or TV programs, with Munich being Song's favorite city "because of local people's hospitality". Song said that with her hometown known for its spicy food, one essential item she must take with her to Germany is a large bottle of local chilies. Source: China Daily, 2013 扫码分享本页内容！
Many give up their careers in China because of low pay and few benefits Nurse Song Yan would have sought a job in another country if not for her family and child. "I work at least nine hours a day and overtime from time to time, and get meager pay," said the veteran nurse who has practiced the profession for at least 20 years. "The working environment here is noisy, crowded and sometimes even chaotic," said Song, a senior nurse at the chest surgery department of Xuanwu Hospital Capital Medical University in Beijing. For young nurses, the work is even tougher. "They usually have to work extra to gain patients' trust," she noted. Many simply give up. In some big departments with about 100 nurses, about 10 quit each year because the job is so physically and mentally demanding. Some, usually younger ones, who have good command of a foreign language, have begun to go abroad for a decently paid nursing job, she said. "I have a family and a child to take care of, otherwise I'd also like to go." Countries like Singapore, Japan and Saudi Arabia have begun to tap other countries for competent nurses because they cannot produce enough of their own to meet needs. Singapore's healthcare system is expected to recruit about 1,000 to 2,000 foreign nurses annually to meet rising demand for healthcare prompted by a rapidly ageing population and China has become an outsourcing site of rising importance. According to Lou Qinghong, manager of the Sino-US International Nurse Training Company, Chinese nurses are "newcomers" compared with nurses from English speaking countries such as the Philippines, Malaysia and India, which have been the first choices for international employers. The agency based in Beijing helps train Chinese nurses for employers in other countries. "Finding jobs abroad is becoming popular among Chinese nurses. Many nursing schools have opened English nursing courses, and many training agencies like us are promoting programs for Chinese nurses to work abroad," he said. "Back when we started the business in 2005, we saw US employers come to Beijing to interview nurses and promise to help them and their family members get green cards as long as the nurse meets the qualifications to work there," Lou noted. The frenzy declined after 2009, when the United States stopped issuing employment visas for foreign nurses whose academic qualifications were lower than a bachelor's degree, but Lou emphasized his agency's business is "stable" since the demand by hospitals in other countries such as Singapore and Saudi Arabia remains strong. According to him, some Chinese nurses used working abroad as a "springboard" to finally settle down there. Judy Duan, 33, said that when she was as a contract worker in a public hospital in Wuhan, Hubei province, from 2004 to 2007, her salary was less than 3,000 yuan ($490) a month, and her bonus and healthcare reimbursements were much lower than for "officially employed" colleagues. In 2007, she passed the examination to become a registered nurse in Singapore and began to work there. She worked in the long-term care unit in two hospitals and earned more than S$1,680 ($1,370) a month. But challenges such as language accompanied the higher salary. "Chinese nurses are very proficient in nursing skills. But Singaporeans speak English with a heavy accent. I also needed to communicate with co-workers from the Philippines, India and Myanmar," she said. "Instead of Mandarin, many Chinese in Singapore speak Cantonese and Teochew dialects, which I found hard to understand," she noted. In May 2010, she applied to immigrate to Canada, moved there with her family in March 2012, and is now applying to take an exam to become a registered nurse. "Unlike in China and Singapore, a registered nurse here (in Canada) is a respected occupation and pays much more," she said. Duan, who now lives in Ontario, considers herself lucky. "I and my husband got permanent residency in Singapore in January 2008, whereas it got harder for my friends who later went to work there to obtain the status," she said. "People came to Canada to work as nurses from around the world. Doctors and teachers emigrating from China are also willing to get a nursing degree and work as a nurse there if they don't find a job that suits them." Stephanie Gu, 29, who is taking a nursing course in Melbourne, Australia, also finds herself accompanied by other aspiring Chinese students. Upon graduating from medical school in Hebei province in 2006, she was chosen by a nursing agency in Beijing to work in a private hospital in Saudi Arabia for three years. At the end of 2009, she began to work in Singapore. Last year, she finally went to Australia to take a one-year nursing course at Deakin University, achieving her dream to work and live in a developed country. Gu said she will become a registered nurse in Australia if she finishes the course and gets enough points at the IELTS exam, but finding a job as a nurse there is harder than before. "Many Chinese nursing students came here to take the nursing course, for example from Peking University and the Capital Medical University," she said. "We all would like to settle here. But we have to compete with each other and many local would-be nurses, who may not be as proficient in clinical practice but speak much better English. I have seen so many cases of failure." But she still wants to fight for the chance to stay. "I work as a personal care assistant in a nursing home three times a week, each time for about five hours. My job is to take care of the daily lives of people living there. It's a lot of physical work and sometimes dirty, but I get A$19 ($19) an hour. It's a lot of money," she said. "You can certainly make a living as a nurse in China, but not earn much money. It's harder if you want to buy a house and have children. Maybe I'll have to return, but I'll try to settle here," she said. In recent years, Japan has been another country where Chinese agencies find booming business opportunities. "Many agencies are introducing nurses to Japanese hospitals and other medical facilities," said a woman identified as Liu at the Sichuan Tianfu agency in Chengdu, Sichuan province. Liu, who is in charge of the agency's program that introduces Chinese nurses to Japan, said this year it has introduced 15 nurses to the country, and it is planning to send at least another 15 there within the year. "After going to Japan, nurses need to have language training courses and get the nurse certification there before officially working in a hospital. But they do part-time jobs in local hospitals to support themselves," she said. The agency's website listed programs recruiting nurses for hospitals in Japanese cities and prefectures such as Nagoya, Osaka, Nara and Saitama. The introduction says "Japan now lacks 40,000 nurses" and nurses in Japan make "3 million to 4.2 million yen ($41,300) a year". China had more than 2.49 million registered nurses last year, up 1.15 million over 2005, statistics from the National Health and Family Planning Commission showed. Currently, China's doctor-nurse ratio stands at 1:1.5, far lower than the international average of 1:4. The demand for nursing services is expected to increase as China's ongoing healthcare reform makes medical care services accessible to more people via an almost universal healthcare policy, according to Guo Yanhong, deputy director of the ministry's medical administration department. "Thereafter, making the team stable is highly important," she said. Besides the pay increase and favorable policies for nurses, more incentives like advanced training programs should be introduced to encourage good nurses and improve their working environment, she said. Source: China Daily 05/13/2013 page1 新形态2020 扫码分享本页内容！
Program taps Chinese nurses to plug staffing shortages in the West A young Chinese nurse boarded a flight on Aug 3 to start living her dream. The 25-year-old, who specializes in foreign nursing care, flew with seven other Chinese nurses to Stuttgart, Germany, to work at a residential care center for at least three years. Xie Yanxi is one of the nurses benefiting from a program signed by China and Germany at the end of 2012. The program aimed to recruit 150 Chinese nurses in the following three years to work in Germany. Faced with an aging society and a shortage of nurses, countries including Australia, Japan, Canada, Singapore and New Zealand have turned to Chinese healthcare professionals to help plug the gap. The program marked the first time Germany recruited Chinese nurses, providing precious opportunities and possibly opening more of these for Chinese healthcare professionals who want to work in Europe. "It has always been my dream to work as a nurse in the West. I'm finally realizing it," says Xie, who worked at a hospital in Guangdong province for two years after earning a bachelor's degree from Nanchang University. Xie received the job offer last August. She then took an eight-month German-language course at the International Nurse Training Center run by Weihai International Economic and Technological Cooperative Co. Xie paid 8,800 yuan ($1,408) for the language course, which will be reimbursed by the German organization she works for. She also paid the Weihai company 25,000 yuan to help with employment matters such as arranging interview opportunities with German organizations and applying for visas. Chinese nurses have to pass the German B1 level examination before applying for the relevant visas. That is also why Wang Hao, a 24-year-old male nurse, is spending eight hours a day studying German at the Weihai training center. Wang received an offer to work at a care center in Stuttgart in January. He started the language course in February. "I value this opportunity. No matter how hard it is, I will try my best to master the language," Wang says. He is also learning German culture and lifestyle. Wang worked at a public hospital in Handan, Hebei province, after graduating from Hebei University last year. He says the three-year overseas experience will give him better career opportunities. "When I am back in China, I might get a chance to work in joint-venture hospitals where the salary is higher and the relationship between patients and medical staff is better," Wang says. Wang says the deteriorating relationship between Chinese patients and nurses and the prejudice against nurses, especially male nurses, are some of the reasons why he wants to work in the West and learn from the experience. Once in Germany, both Xie and Wang will first work as auxiliary staff for about half a year before taking the German nursing examinations. During this period, they will get a monthly salary of 1,900 euros ($2,545). After passing the exams, they would work as fully qualified nurses for at least three years, drawing a monthly salary of 2,300 euros each. Xie says the German organization has helped her rent a house, which will cost her 240 euros a month. The first five nurses who left for Germany in January passed the nurses' examination held by German authorities in June, which means they can work as registered nurses in Germany, says Wang Zhuwen, operations director of the Weihai training center. About 50 nurses are taking the German-language course at the Weihai training center. Most of them already have job offers. Filling the void Chinese nurses working overseas received positive feedback from their employers, says Marcel Schmutzler, a press officer with the German Federal Employment Agency's International Placement Services Department. "They show high professionalism and ability in their interactions with patients," says Schmutzler The nurses' grasp of German is similarly competent, as their patients said they can be understood by the nurses when they speak slowly, Schmutzler says. According to the agency, there were 597,016 people working as nurses, first-aid personnel and midwives, and 470,301 people as healthcare workers in nursing homes in Germany by September 2013. But demand for qualified nurses remains high. By May 2014, there were at least 9,179 vacancies for nurses, first-aid personnel and midwives in Germany. There were at least 8,990 vacancies for healthcare workers in nursing homes. Shandong province, where the Weihai training center is located, sends about 50,000 workers overseas a year, most of whom work at overseas construction sites, garment factories and food-processing, farming and forestation projects. "Over the years, we are upgrading our labor strategy by shifting from labor-intensive workers to skilled people like nurses," says Wu Jianguo, deputy director of the division of economic cooperation at Shandong's commerce department. The Weihai company alone has sent more than 1,500 nurses overseas since 2005, Wang says. But Australia has almost closed its doors to Chinese nurses, as the country requires a high level of language ability, which is difficult for Chinese nurses to achieve, Wang says. "It's a win-win strategy to encourage nurses to work overseas. Many students are happy to have overseas experience, considering it a good way to broaden their horizons and become more competitive," Wang says. Cao Huali has become a permanent resident in Australia, where she trains students majoring in nursing care at the University of Technology, Sydney. "My two years working as a nurse in Saudi Arabia not only enriched my overseas experience but also enhanced my English-speaking ability, which laid a solid foundation for getting the chance to work in Australia," says the 36-year-old, who went to Saudi Arabia through the Weihai company in 1998. Cao now earns about A$60 ($56) an hour and she has bought a house in Sydney. Reflecting on her 16-year career overseas, Cao encouraged Chinese nurses to work overseas. "In Australia, nurses focus on caring. Only when you focus on caring can you do the job well. Then you will be respected," Cao says. Source: China Daily European Weekly 08/08/2014 page24 新形态2020 扫码分享本页内容！
China is planning to open more Confucius Institutes to teach traditional Chinese medicine (TCM) overseas in order to promote this age-old medical science, deemed the essence of Chinese culture, said Vice Minister of Health Wang Guoqiang. Wang, who is also director of the State Administration of TCM, said Monday: "We are working closely with the Ministry of Education and the Confucius Institute headquarters to open more TCM Confucius Institutes and add TCM courses to the syllabus of existing Confucius Institutes," "TCM is very well received abroad, regardless of nationality or ideology," Wang said. However, he added, China lacks talented practitioners who have both a good command of TCM and speak a foreign language. The Confucius Institutes, named after the ancient Chinese philosopher, are non-profit public institutions for promoting Chinese language and culture in foreign countries. To date, there are more than 350 Confucius Institutes and 500 Confucius Classrooms in 101 countries and regions. Two are TCM Confucius Institutes based respectively in Royal Melbourne Institute of Technology (RMIT) in Melbourne, Australia, and in London South Bank University (LSBU). Source: China Daily, 2019 新形态2020 扫码分享本页内容！
Philippines hails China's Belt and Road Initiative
The Philippines welcomes China's Belt and Road Initiative policy, an ambitious effort to link Asia, Europe and Africa through the construction of massive infrastructure such as railways and ports, government officials and analysts have said. Philippine Trade Undersecretary Ceferino Rodolfo said on Tuesday that the Belt and Road Initiative would help in advancing the socioeconomic programs of the administration of Philippine President Rodrigo Duterte. "We welcome all international initiatives that would be consistent with (Duterte's) socio-economic agenda," Rodolfo told a news conference after the 28th Philippines-Chinese Joint Commission on Economic and Trade Cooperation. "Big parts of what we have been discussing here are in terms of how do we align the socio-economic strategies of (the Philippines and China)," Rodolfo said. The "belt" roughly with the historic Silk Road crossing Eurasia, while the "road" refers to the "maritime silk road" -- the sea routes along which Southeast Asia, South Asia, Arabia and Africa traded with ancient China. Over the next 10 years, China aspires to achieve 2.5 trillion U.S. dollars in annual trade with the nations involved in the two areas. Not wanting to be left out, the Philippines said it intends to hit the road with China in pursuing this economic strategy that is hoped to re-establish the so-called "Silk Road Economic Belt" and "21st Century Maritime Silk Road" which Chinese President Xi Jinping first introduced in the fall of 2013. The initiatives are part of China's 13th Five-Year Plan, which will run from 2016 to 2020 and guide national investment strategy throughout that period. Philippine President Rodrigo Duterte has reportedly agreed to attend the Belt and Road Summit scheduled in China in May. A spokesman for the Philippine Department of Finance, Paula Alvarez, has told Xinhua in a written interview that the Philippines looks forward to the May summit, voicing hope that the Philippines and China could identify mutual areas of cooperation to facilitate trade and investment. The Belt and Road Initiative, which seeks to bring back the glory of the ancient Silk Road, hopes to integrate Asia, Africa and Europe through closer diplomatic, commercial and financial cooperation, in an unprecedented effort that will bring together up to 65 countries. Duterte, who took office in June last year, visited China in October in a bid to rekindle Sino-Philippines diplomatic relations that soured under the previous administration of President Benigno Aquino. Philippine academics and analysts said that improvement of relations with China has made the Philippines a promising participant in the initiative. "The important thing is for the Philippines to be part of the international market," political analyst Benito Lim said in a telephone interview. Lim added that Duterte's decision to attend the May summit is a wise decision. "It's best to find out (what the Belt and Road Initiative is about) and not be left out." Analyst Victor Corpuz, a retired Army general, told a recent forum that re-establishing close diplomatic ties with China "brings the Philippines a special seat on the gigantic 21st Century Belt and Road Initiative project," adding it could make the Philippines the "eastern hub to circumnavigate the globe through the Pacific." George Siy of the Integrated Development Studies Institute stressed the importance of the Philippines to be part of the new Silk Road. "To be part of the plan means to be part of a highway of trade with infrastructure, with harmonized customs, with financing, with technology to allow the infrastructure," he said, adding that the initiative would allow products and services, and investments to flow freely. Siy added, "Tourism will flow, and people to people relations will grow. Cultures will pollinate and you can adopt the portions you want." Source: Xinhua, 2017 新形态2020 扫码分享本页内容！
- Member profile Health Volunteers Overseas (HVO) is a private non-profit organization based in Washington D.C. committed to improving healthcare in developing countries through training and education. By emphasizing teaching, HVO aims to create an indigenous group of trained health workers who can teach others. This builds an ongoing capability that will benefit the population long after the volunteer has departed. It has projects in Africa, Asia, Latin America, Eastern Europe, and the Caribbean. Currently, HVO supports over 60 projects in more than 25 countries. Each project is different depending on the technological capacity of the country. - Main activities HVO is a teaching and training organization. Volunteers lecture, conduct ward rounds and demonstrate various techniques in classrooms, clinics, and operating rooms. They may be involved in teacher training, curriculum development, and mentoring of students. These providers can be in the following specialties: anesthesia, dermatology, internal medicine, oral and maxillofacial surgery, orthopaedics, pediatrics, hand surgeons. These highly skilled and experienced volunteers come from both private practice and university settings, with a significant number of retirees as well. - Links to the health workforce crisis HVO develops and implements clinical training programs in various developing countries. These training programs are staffed by highly-skilled health care professionals in the US and Canada who volunteer their time and expertise to provide training and education to local health care providers to make a difference in their communities. HVO's overall mission is to improve the availability and quality of health care in developing countries through training and education. Source: WHO, 2019 新形态2020 扫码分享本页内容！
My Life as a Doctor in the World Health Organization
Editor's Note: Over the course of time, I have come to see how easy it is to believe that what we believe and what we do medically in the United States must generally be the way medicine is viewed and practiced in most countries. We hope, therefore, that the readers of The Permanente Journal will be interested every so often to hear physicians around the world describe their medical practices, so that we all may better understand the wide range of what physicians do. This issue's contribution is from Einer Helander, MD, PhD, a distinguished Swedish physician, trained as a cardiologist and biochemist, who has spent much of his professional life as Chief Physician for the World Health Organization, visiting countries most of us would not consider going to, and spending his time there among the destitute and the disabled. Dr Helander is the author of The World of the Defenseless a soon-to-be-published medical book about disability and abuse around the world, including some eye-opening stories from the United States. — Vincent J Felitti, MD At the end of one's life, one often reviews one's life decisions. At the age of determination, when I had finished my specialty training, I had three choices: I could remain at the fabulous and well-equipped National Institutes of Health in Bethesda, MD to continue working with one of the most fascinating basic problems of physiology and biochemistry—the molecular mechanisms of muscle contraction; or I could return to Sweden with an academic career in rehabilitation and social medicine, as the government's consultant. But, I also had an offer to work at the World Health Organization (WHO); I accepted it and I have had no regrets. I was to work in developing countries … I was totally unprepared for such field work. I am a Swede and my initial background is totally academic: biochemistry in the laboratory of Arne Tiselius, internal medicine, and medical rehabilitation. My life changed after becoming involved in 1967 with a cardiac rehabilitation program at the WHO regional office in Copenhagen. In 1974, I left for Geneva and became a staff member of WHO at headquarters. I was to work in developing countries where I would focus on persons with disabilities: the poorest among the poor and the most underserved of all. I was totally unprepared for such field work. WHO was set up in 1948 as a specialized agency of the newly founded United Nations (UN). WHO's objective, set out in its Constitution, is “… the attainment by all peoples of the highest possible level of health.”1 Health is defined in WHO's Constitution as “…a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”1 Prior to the development of WHO, and even the UN, the Pan American Health Organization (PAHO) was developed in 1902 (as the Pan American Sanitary Bureau) to combat disease, lengthen life, and promote physical and mental health in the Americas. With the development of the League of Nations and its Health Programme, incorporating PAHO became important because the United States was not a League member. The advent of World War II and the development of the UN, in 1945, and WHO, in 1948, made the incorporation of PAHO even more significant if WHO was to be truly universal. PAHO's desire to maintain independence led to the decision to create regional networks for WHO with offices in Washington, DC, Copenhagen, Alexandria/Cairo, Brazzaville, New Delhi, and Manila. Although this added a layer of bureaucracy, all countries in the world joined WHO. They are able to belong to whichever regional office they choose and the headquarters (HQ) remain in Geneva. When I arrived at WHO, there was a remarkable and charismatic Director-General, Halfdan Mahler, MD, (1973–1988). He initiated a complete change of WHO's policies, placing emphasis on programs for primary health care: everyone in the world was to have access to at least the basic and most-needed health services, near where they lived. In 1978, when the final preparations for change were ready, WHO and UNICEF held a conference in Alma-Ata, (Soviet Union at that time; now Kazakhstan). All countries adopted the “Health for All by the Year 2000” policy. This program had four components, of which one was rehabilitation. I was put in charge of developing the practical program for this; nothing existed before. My director at WHO was Kenneth Newell, MD, a great innovator and the person behind the primary health care program and the introduction of appropriate technology. The first thing I asked for when I arrived in 1974 was to be sent to a developing country to get some experience: that happened to be Iraq. Saddam Hussein, then Vice President, was the de facto ruler. Following several years of drought, Saddam had twice imported large amounts of grain for Iraqi farmers to use as seeds. The grain had been routinely pre-treated with a pesticide, alkyl mercury. Unfortunately, because of the lack of other food, in 1972, about one million farmers and their families had made bread from the poisoned grain and eaten it. The aftermath was a widespread epidemic of alkyl mercury poisoning that killed thousands. Among the survivors, there were an estimated 100,000–200,000 persons with blindness, tunnel vision, ataxia, or paralysis. Two years later, the Iraqi government requested funds from WHO for two expatriate physiotherapists to deal with this problem. I went to evaluate the situation. Providing two physiotherapists clearly was an ineffective solution in a country where the farmers lived far from each other in places that not even jeeps could access. To get to a small settlement of an extended family with some 40 people, we walked for an hour in 50° C (122° F) temperatures. By the time we were through, however, I had learned three important lessons. My first lesson was about spontaneous family-based rehabilitation. During the two years following the disaster, many in this extended family had died and about one third of its surviving members had persisting sequelae of mercury poisoning. With no help, family members themselves had trained many of the disabled individuals at home. They trained blind people, mobilizing them so they now walked alone, using canes. They had trained paralyzed children successively to sit up, to move their arms and legs, to stand up, to walk, to dress, to feed themselves, and other activities of daily living. Mothers and grandmothers, without any schooling, had played key roles in achieving these results; in fact, the results often were identical in quality to those one would have expected had professionals been involved. There was no need to send Western therapists to provide rehabilitation; given the numbers of victims involved, the original request was pure window-dressing. The lesson was that dedicated family members—even when totally uneducated—can find ways of providing effective rehabilitation. This was again confirmed during continued field work in Africa, Asia, and Latin America carried out from 1974 to 1979. These experiences resulted in the new official WHO strategy and program of Community-Based Rehabilitation (CBR). Thirty years later, this program functions in about 90 countries. The second lesson from my visit to Iraq was equally unexpected. There were no statistics available on the extent of the poisoning, but a Swedish organization later provided statistical analysis. My conclusion from their data is that over a million people were affected. In an effort to discover something about the mortality, I visited the local pathologist in a small town south of Baghdad. Yes, he said, there had been many deaths but, because of “government security rules” he was explicitly forbidden to tell anybody how many. I wondered whether Saddam perhaps was embarrassed by publicity about his “government-organized” poisoning, most likely the largest ever in the world. … these phenomena have a very high incidence in developing countries but, because the subject is taboo, nobody speaks spontaneously about them … An important side observation came as I was waiting for the pathologist to receive me. I saw three women, all in black and with covered faces, leaving his office. I casually asked why they had come to see a pathologist. It appeared that he was also the police doctor and these women were a mother with her two daughters. They had been sent by the police to him because the father had raped the girls when he was drunk on locally brewed alcohol. There was nothing the pathologist could do because the women refused all examinations. He added that incest was not uncommon; any infants resulting from incest disappeared soon after birth. This event—in my early days at WHO—spurred me to continue asking questions for 30 years about family violence, child abuse, and other maltreatment. I discovered that these phenomena have a very high incidence in developing countries but, because the subject is taboo, nobody speaks spontaneously about them and almost nothing gets published. One of the most abused groups are children with developmental disabilities. The results of this research appear in an upcoming book, The World of the Defenseless.2 My third lesson came a year later, when I visited Indonesia. I had opportunities to stay there several times while a major disability survey was being set up and an Indonesian organization invited me to study several of their projects in Central Java. We traveled for some weeks to small villages and stayed in tiny guesthouses; tropical rains and an active volcano in the neighborhood somewhat impeded our transportation. I was shown local rural development programs built on community mobilization. In one such village, the community leader had for the last ten years mobilized the entire community in many projects. All men worked every Saturday on these projects without any pay. The rich families, instead of working, provided money for the equipment and building materials. Other funds came from local taxes on land, rice harvests, buildings, weddings, and much more. There were 16 different taxes when I visited; these taxes were raised and spent locally. Decisions were made and accepted in a democratic way. The village leader told me that it took just three months to eradicate malnutrition. The first of this village's projects was to build an irrigation system for their rice fields. When this was ready, there were three rice harvests a year, an important increase from the prior rate of one harvest per year. The increase in rice production gave jobs to everyone; it also increased the local taxes so that more projects could be financed. Building latrines and eliminating the open sewers that cause infectious diseases especially among children followed; also collecting and disposing of garbage. Next, was a primary health care program: three women were chosen to become health workers and were sent to a course in a nearby town. When they returned, they introduced immunizations, a maternal and child health program, and a nutrition program. At that time, malnutrition was widespread in Indonesia. The village leader told me that it took just three months to eradicate malnutrition. All newborn babies were regularly examined and weighed by the health workers and, when there were any signs of impaired growth, the family was visited. The health worker gave lessons at home in nutrition and how to give the baby supplementary foods; she showed how vegetables could be added to the polished rice that was the staple diet. Families started growing vegetables in their own backyards. These preventive health services were paid by a small insurance fee raised from the entire population. It included a weekly visit by a doctor. Essential medications were dispensed at the health center. Because the villagers deemed insufficient the education provided by the government, the community built an additional school and hired their own teachers. The old curriculum was improved by adding new subjects: health, how to cultivate additional foods and set up fish dams, community work, and childcare. There was an active child-to-parent information component that was initiated by the school. When I told my colleagues at WHO HQ, many were very upset and told me that children should not teach the parents; I replied, “But it works and it has reduced mortality and malnutrition!” I asked the community leader about his contacts with the authorities, and he told me that that they were informed about all projects. Although some were illegal or not officially approved, they did not interfere. In the following year, I went to the Republic of Korea (South) and visited a government-initiated, countrywide, rural development project (Saemaul Undong) that was based on community mobilization. Reports showed that, between 1971 and 1975, villagers built 24,645 miles of village roads, 25,761 miles of farm roads, 50,952 small bridges, 83,023 irrigation ponds, 11,301 dykes, 1570 water channels, 27,051 village halls, 13,258 village warehouses, 372 village factories, and 11,235 water-supply systems. They carried out reforestation projects of 3,965,500 acres of land and installed 10,429 village telephones. They accumulated US$456,875,000 in agricultural cooperative savings, US$46,666,000 in fisheries cooperative savings, and US$55,416,000 in village credit union savings. The government invested about US$579 million on these Saemaul projects, but the value of completed projects is estimated at 2.5 times the government spending.3 I concluded that development programs using community mobilization work well both locally and nationally. They are excellent models and it is surprising that they have not been copied more. One of the main obstacles is the reluctance of governments to allow local populations to raise and keep local taxes for their own projects. One notable exception has been India, where this system was introduced ten years ago. Work continued at WHO; Dr Mahler went on decentralizing the control and use of funds from HQ to the regional offices and to the field. WHO obtains its income from contributions paid by the Member States, generally in proportion to their national incomes. In addition, some countries supplement WHO's budget with voluntary contributions. WHO spends annually an average of between US$1 and 2 billion, excluding some special programs that have their own funds. This is not enough to meet more than a small part of the health needs of the developing countries. Therefore, program officers at HQ try to raise funds from outside donors. This was not easy for a new program like the CBR even though its regular annual budget for field programs was just US$20,000. The CBR program mainly developed because of voluntary extra-budgetary funds from the government of Sweden, my home country. In 1979, one year after the Alma-Ata Conference, we had developed with Swedish economic assistance an 800 page technical manual, Training in the Community for People with Disabilities. This was composed of 30 instructional packages for family training; these are simple texts using only 1300 different words but with 2200 drawings to illustrate how to home rehabilitate polio victims, the blind or deaf, children and adults who are mentally disabled, and people with mental illness, epilepsy, and leprosy. All these training packages were based on our direct observations of “spontaneous rehabilitation” of the type first observed in Iraq and then in nine additional countries; the manuals encouraged community mobilization for their implementation. In addition, advice was given about schooling, job training, and economic activities. We had well-developed evaluation and reporting procedures from the start. The manual went through extensive field testing and peer review, is translated into 54 languages and is now widely used. Later, we added several managerial components: surveying, planning, service delivery development, personnel training, and a computerized evaluation system for quality, cost, efficiency, and effectiveness. Special management courses are held for participants from 90 countries. We had no problems inside WHO to get the new CBR strategy and program fully accepted. Outside, however, there was great resistance for several years in many developing countries where there were small, mostly residential rehabilitation centers that had been set up by overseas nongovernmental organizations (NGOs); they felt criticized and perhaps economically threatened by the new and radical change that was taking place. The professionals felt that, by transferring skills and knowledge to the families, almost all of whom were living in extreme poverty, they would lose their jobs. This was of course totally unfounded, but some 150 highly critical articles were written against the WHO strategy, accusing, among other things, the CBR program of bribing personnel in the test countries to report good results. Finally, after about ten years, resistance came to an end. The CBR program is still the disability and rehabilitation unit's main input to the WHO's regular program. … development programs using community mobilization work well both locally and nationally. They are excellent models and it is surprising that they have not been copied more. All components of the Primary Health Care program, including rehabilitation, were meant to be set up and managed by national governments, but during the 1980s and 1990s the International Monetary Fund (IMF) and the World Bank (WB) were in full swing introducing “structural adjustment.” These international organizations virtually controlled the political and economic decisions of many poor countries. Health and social programs were cut in a large number of countries. What happened is accurately described by the United Nations Research Institute for Social Development (UNRISD) in a publication in 2002: the WB and IMF “… prided themselves in not wasting their time on ‘soft’ things like social policy in designing their ‘structural adjustment’ programs .… Diverting resources to social policy, which softens the blow of adjustment on the weaker sections of the society, was regarded as a way to slow down the necessary adjustments .… This was pursued to the point of producing a widely spread international counter-reaction in the form of a call for ‘adjustment with human face’ by those who … were deeply concerned by what they saw as unnecessary human suffering caused by such programs in their unadulterated forms.”4 Although the IMF and WB stated that they were engaged in eradicating poverty, in reality they advised the governments of a very large number of developing countries to cut social personnel, social services, and safety nets aimed at the destitute, thereby causing poverty among the poorest to increase. As a result, governments were constrained from introducing CBR and other social programs; this made the situation very difficult for WHO's CBR initiative. Joseph Stiglitz, a 2003 Nobel Laureate in Economics and a former WB Senior Vice President and Chief Economist, later wrote they have “… implemented a set of standard economic theories that have sometimes failed, caused havoc, riots, and substantial destruction of economic and institutional assets.”5 Stiglitz resigned from the WB and is now one of its biggest critics, becoming one of several well-reputed economists speaking openly against the incompetence of the aid industry. Although the WB sounds like a giant, it is small, lending out each year about US$18 billion. By contrast, there are ten banks, mainly in USA and Japan, that have over US$1 trillion in assets. Fortunately, bilateral cooperation organizations, particularly the Nordic countries, Canada, and the Netherlands, along with some large international NGOs actively supported local NGOs to set up CBR. In 2000, a major publication, The Declaration of the Millennium Development Program,6 described activities related to the eradication of poverty. It was the outcome of the world's largest summit, supported by all governments and all large international organizations. Unfortunately, it contains nothing specific about how to solve the problems of the poorest: persons with disabilities, widows (each of these two groups constitutes 5% to 7% of the world's population), the landless, families without a breadwinner, single parents, and those who must send their children to work instead of school. It provides no information about what to do about alcohol and illegal drug abuse, about family planning, about the pervasive violence in the world, and how to solve the corruption of judicial systems in which few poor people feel that they can trust the police and the courts. After I left WHO, I stayed another eight years with the UN Development Program. During the last seven years of these years, I have worked with country projects and management. All of these were jobs inside large bureaucracies, WHO being the most complex with rules and procedures that cover several thousand of pages. During my time, there were still some loopholes, if you could find them; but every year more rules were introduced. Working with international organizations can be rewarding if you are encouraged and allowed to present and carry out innovative strategic ideas. You have to create a free space for yourself, and it helps if you can raise the necessary funds outside the organization. In the area of disability and rehabilitation no strategy existed; the temptation to take on this job was for me the irresistible attraction of the impossible. Other colleagues with less courage preferred to make no waves. WHO is an intergovernmental organization, and all 190 Member Countries have the right to a proportion of the professional posts. Many people in higher posts are political appointments, who have approval power over all projects. As in all bureaucracies, power plays are common. You have to create a free space for yourself, and it helps if you can raise the necessary funds outside the organization. Once you have endured the initiation time and learned about the constraints, you will go out to the field and discover the real problems. Over the course of 30 years I have traveled to over 100 countries, and worked in 88 of them. When your medical practice is there, you can forget about most laboratory tests, x-ray equipment, medications except a few essential ones, blood transfusions, or surgical equipment beyond the most simple. You will buy a good pair of shoes so you can walk to roadless villages. It is most useful to have good training in physical examination using your own senses, and practical knowledge of diagnoses—although you will quickly find a large number of health conditions you never have heard of. You will need to communicate with the local village and slum dwellers; you need to stay with them, sleep in their guesthouses, and eat their food. You will soon find a number of very intelligent persons—some illiterate—who are able to contribute to community development and carry out simple components of a health program. A good beginning is often to clean up the dirt and garbage that surrounds everybody. But what finally overwhelms you is the sheer number of people in need of help, literally billions. For that reason, we realized that we would reach more people if we had simple, practical books with instructions. We produced nine such manuals for the CBR program. The most striking problem in the world is poverty; it took me some time to realize that the poor are sacrificed routinely. The population of the developing countries is now well over five billion; three billion are under the poverty level. The overseas aid they receive, after deduction of administrative and other overhead costs, is a pittance that varies from US$1-5 per poor person per year. The combined income of the 25 million wealthiest people in the USA equals the combined income of the two billion poorest in the developing world, a one hundred to one ratio. Fifty years of international development aid has left few traces.7,8 Health care quality has developed with WHO's technical work, but 750 million people still lack primary health care. Anyone doing this work learns there is no place for romantic ideas; the world is run by the citadels of economic power: the IMF, the WB, the WTO, and the finance ministers of those rich countries who operate these organizations. So far, there has been more talk and declaration than impact on poverty levels; sometimes programs have increased poverty, caused havoc, riots, popular uprisings, widespread and costly destruction of assets, and mass killings. The solution—as I see it—is that the developing countries should start to mobilize their own resources. They must make it a policy that everyone will work for the collective good—their own community—and undertake action programs in the interest of all. I have seen this function well in about a dozen countries. What I saw in Iraq, Indonesia, and South Korea some 30 years ago, and then in many other countries, is effective. Mobilization works much better than any development program directed from afar using international donor money, or from far above directed by the ineffective bureaucracies of national governments. Let the people decide what is important for them, plan for what is needed, and then do the job. Motivate them to do it, which is easy if they know that the benefits are for them. What rich countries can do is to set up national and regional courses for community management training, employing those local leaders who have had success. Further developments needed relate to secondary education, to the availability of uncorrupted local judicial systems, and to government performance. Being a doctor in developing countries has many unfamiliar aspects for a clinician. You try to help with what you know; you try to transfer knowledge and skills to local populations to make them more independent. When I was 15, I heard a visitor asking my mother “What is Einar going to do?” My mother replied, “Einar will do something for the poor.” Never did she or I at that time realize that doing something for the poor is ultimately politics. But even so, there is also room for the individual doctor to contribute and to be the voice of the defenseless. … we realized that we would reach more people if we had simple, practical books with instructions. References Constitution of the World Health Organization [monograph on the Internet]. Geneva: The World Health Organization; 1946. [cited 2006 May 24]. Available from: www.opbw.org/int_inst/health_docs/WHO-CONSTITUTION.pdf. Helander E. The world of the defenseless. Geneva: Defense for Children International; 2004. Helander E. Prejudice and Dignity. 2nd ed. New York: United Nations Development Program; 1999. Chang HJ. The roles of social policy in economic development [monograph on the Internet]. Geneva: UNRISD; 2002. [cited 2006 May 24]. Available from: www.ohchr.org/english/law/millennium.htm. Stiglitz J. Globalization and its discontents. London: Penguin Books; 2002. United Nations millennium declaration [monograph on the Internet]. Geneva: United National; 2000. Burnside C, Dollar D. Aid Policies and Growth. The American Economic Review. 2000;90(4):847. Easterly W, Levine R, Roodman D. Aid Policies and growth: Comment. The American Economic Review. 2004;94(3):774. Source: Einar Helander, MD, PhD, 2006. 新形态2020 扫码分享本页内容！