I am now for fact that (as I did a paper on it couple of years back) China has been involved in medical work in Sudan for years now. I guess it is true for most other places although I am not sure the degree of involvement and investment.
For one thing, unlike the US, China opts not to securitize/militarize its relationship with Africa.
China-Africa Medical Cooperation: Another Form of Humanitarian Aid
Doctors Without Borders, by Li Anshan
China has its own way of thinking and acting regarding aid and cooperation in Africa. Like MSF, China has provided humanitarian assistance to Africa for a long time.
However, China’s medical cooperation with Africa covers a broad range of services, rather than focusing only on the provision of emergency medical aid.
The medical cooperation between China and Africa started in 1963 when the first Chinese medical team (CMT) was sent to Algeria. In the CMT system, a Chinese province is responsible for one or more African countries and provides CMTs there. At the beginning of 2009, 45 CMTs had worked in 44 African countries, and about 900 members are now working in about 100 hospitals or health centers. In addition to CMTs, the China-African cooperation also includes provisions for medication, facilities or hospitals, training of African medical specialists in China or Africa, humanitarian medical aid, peace keeping with medical care, and more. China also set up anti-malaria centers in African countries after the 2006 Summit.
The China-Africa relationship is one between equals, which is quite unique considering that equality in international relations is often neglected, although the concept has been an aim in almost all the social movements in the history of any country. China has never used the term “donor-recipient” (a philanthropic idea) to describe China-African relations, using “partner” instead. China believes that assistance is not unilateral, but mutual. Both China and Africa appreciate each other and cooperate with each other. The principles guiding China-African relations include equality and mutual respect, bilateralism and co-development, no-political-strings-attached and non-interference with domestic affairs, and stress on the capability of self-reliance.
China views Africa as a promising, rather than “hopeless,” continent. Modern nation-building is a very difficult process for every country. With many assets such as human resources, natural resources, and cultural heritage, why should Africa be poor and hopeless? No-political-strings–attached and noninterference with domestic affairs is a particularly important principle for China. China and Africa have had similar colonial experiences, and China and many African countries both place great emphasis on national sovereignty. Regarding African issues, China always defers to United Nations (UN) and African Union positions. What’s more, international affairs show clearly that external interference rarely settles problems and often worsens the situation.
[2] China’s assistance policy also put a stress on self-reliance, an experience from China’s own development. With help from China, Sudan has gone from being a net oil importer to an oil exporter.
As far as medical cooperation is concerned, CMTs have contributed a great deal of service to Africans, improved health systems, and raised the standard of local medical service.
To Serve Africans in the Chinese Way
To serve the people is the fundamental aim of public heath systems, which Chinese doctors try their best to contribute to. In Algeria, for example, in 45 years, CMT expanded its 16 treatment stations to 21 provinces and cities, covering more than 10 medical specialties, and this program became the biggest and most influential of all CMTs in Africa. The greatest advantage of CMTs is Chinese traditional medical treatment, especially acupuncture. The reputation of CMT has spread to neighboring countries as well. In Mali, where the climate and living conditions cause many cases of rheumatism, arthritis, and sciatic strain, acupuncture is the most effective cure for the cases. CMTs in Niger treated 57,330 patients—5,120 with acupuncture—and several ministers were treated by Chinese medicine and acupuncture as well. The same thing occurred in Tunisia, Cameroon, Benin, Serra Leone, Tanzania, Mozambique, etc.
To Improve the Local Medical System
In order to help improve local public health systems, China has cooperated with African countries in various ways, such as building hospitals and medical facilities, providing free medications, and transferring Chinese medical techniques. In the Republic of Congo, the hospital for gynecology and obstetrics was a small one in the 1960s. Now, it is the third biggest comprehensive hospital in Brazzaville, with 23 Chinese doctors who play a significant role in the hospital’s work. The department or specialty of acupuncture has appeared in Tunisia, Cameroon, Lesotho, Namibia, and Madagascar. This cooperation has also promoted institutional innovation in African medical systems. The establishment of the Center of Acupuncture and department of acupuncture in Biserta Hospital in Tunisia is an example. Courses on acupuncture have started at universities in various countries, such as Conakry University in Guinea, Universidade Eduardo Mondlane in Mozambique, and Madagascar State Public Health School, among others.
Helping to raise Local Medical Standards
Chinese doctors have also tried to transfer medical techniques to local doctors. When Prime Minister Zhou Enlai visited Zanzibar in 1965, he told the CMT there, “the CMT would sooner or later return back home. We should train Zanzibar doctors and help them to work independently. Therefore to leave a medical team which would never go away. . . . Our assistance is to make the country able to stand up. Just like to build a bridge, so you can cross the river, and without a staff. That would be good.”
[3]
CMTs usually help local doctors by offering free lectures, training courses, and operation teaching. In Tanzania, in order to train local medical staff to learn acupuncture, CMT members used their own bodies for the local doctors to practice, directly teaching them to grasp the technique. In this way they trained a large number of medical specialists. CMTs also made the best use of local media to publicize medical knowledge. In Algeria, the CMT held more than 20 training courses, more than 30 lectures, and trained more than 300 personnel who have become the backbone of local medical institutions. Liberia suffered from war for a long time, resulting in many patients. CMT’s service was noticed by David Shinn, the former US Ambassador to Ethiopia and Burkina Faso. He said, “China received praise in Liberia for its medical teams because they prioritize the transfer of knowledge and technology. They sent specialists and general practitioners, who upgraded and built the professional skills of local heath workers. In the case of war-torn Liberia, this is a critical medical need.”
[4]
African governments awarded about 600 CMT members with various medals for their service to the humanitarian cause.
Fighting Malaria in Africa
China adopted several measures such as CMT training programs, anti-malaria projects, free facilities and drugs, and anti-malaria centers. Fighting malaria is a major task for CMTs, who usually distribute free medications to patients. Cotecxin, the most effective anti-malaria drug produced in China, and acupuncture have won a great reputation in Africa. In certain areas, life habits and the abuse of medication cause serious disease. In Mali, malaria is very common and people have to take Quinine for treatment and many people suffer from limb hemiplegia caused by overuse of Quinine. Chinese acupuncture experts cured cases by using silver needles. CMTs also compiled booklets for training of local medical workers.
China holds training programs at home and in Africa to provide anti-malaria training for African specialists and officials. In 2002, the Jiangsu Center for Verminosis Control and Prevention (JCVCP) was designated as a base for international assistance. Since then, the center has run six programs for African medical staff and officials, offering training to 169 officials and special technicians from 43 countries. In 2003, two anti-malaria programs ran in Madagascar, Kenya, and Cameroon to train medical staff from 35 African countries. In Moheli Island, Comoros, villages are seriously affected by malaria. In 2007, a joint project started between Moheli Island and Guangzhou University of Traditional Chinese Medicine (GUTCM) in China.
To combat malaria, drugs are of vital importance. When a delegation of senior African government officials visited a Shanghai-based pharmaceutical company in 2005, they called on Chinese companies to set up branches in Africa for medicine production. DihydroArtemisinin, or “Cotecxin,” was first developed by Beijing Holley-Cotec in 1993. It was approved by the World Health Organization (WHO) as an effective anti-malaria drug. In 1996, China’s Ministry of Health designated Cotecxin as the required medicine for CMTs. It is also chosen many times as aid materials to Africa, either by governments or pharmaceutical companies. Another important measure is the set-up of anti-malaria centers in Africa, a direct result of 2006 Summit.
There are obstacles in the bilateral cooperation, such as the lack of a comprehensive system of aid and the difficulty of selection of a CMT. What’s more, with the effective use of Cotexin, the abuse of Chinese traditional medicine in Africa has appeared as a problem. On the African side, CMTs should be used more effectively. At present, CMTs mostly serve as practitioners doing simple service in remote regions where local doctors are unwilling to go. In some countries, CMTs are not recognized as doctors, so that they cannot serve at hospitals. Future medical cooperation needs a joint effort of China and Africa to find more effective methods, establish law enforcement and quality control systems to supervise the medical sector, and guarantee a healthy working condition for future cooperation.
Some remarks on MSF
MSF as an organization, is doing a great job, and saving people’s lives is a great cause. But it should not interfere with other countries’ internal affairs since standards are different and the understanding of local things is usually different from outsiders. MSF has made great progress and expanded all over the world. If MSF believes its own deeds are correct, then it should keep doing its work. But if MSF’s purpose is to save people’s lives in emergency situations, it should keep in mind that it should not meddle with others’ business in a country it knows very little about.
The Chinese perspective on humanitarian action is not much different from MSF’s. China regards humanitarian action as a great cause since it includes either releasing other people from their suffering, or curing their disease or saving their lives. It is a selfless deed and should be praised in whatever situation.
Humanitarian aid and development aid are both for the benefit of people. The difference is that humanitarian aid is delivered in emergency, for a temporary purpose, while development aid should be linked to strategic planning and a long-term goal.
Although MSF claims to be a humanitarian organization, and most of its deeds are related to that, it cannot change the fact that it is an organization initiated in a colonial master country and that its headquarters and most administrators are based in the West. Since the development stages are different and the values and cultures are different, MSF can’t judge situations from its own point of view, which usually is that of the West or developed countries. MSF’s working area is in most cases in developing countries that are very sensitive to their colonial heritage, especially the negative parts. If MSF meddles with others’ internal business, no doubt it will make more trouble than it solves.
Many INGOs have a bad name in the South simply because they are so interested in meddling with others’ affairs based on the presumption that they are the saviors. It’s important to differentiate between help and interference.
Footnotes
- China-African Summit, November 2006
- “Where the West regularly changes its development advice, programs, and approach in Africa . . . China does not claim it knows what Africa must do to develop. China has argued that it was wrong to impose political and economic conditionality in exchange for aid, and that countries should be free to find their own pathway out of poverty. Mainstream economists in the West today are also questioning the value of many of the conditions imposed on aid over the past few decades.” Deborah Brautigam, Dragon’s Gift, The real story of China in Africa, (Oxford U.P., 2009), p 308.
- Jiangsu Provincial Health Burea ed. Glorious Footprint, In Memory of Fortieth Anniversary of Jiangsu Province to Dispatch Medical Team Abroad (Nanjing: Jiangsu Science and Technology Press, 2004) p 3.
- David H. Shinn, “Africa, China and Health Care,” Inside AISA, no. 3 and 4 (October/December, 2006): p 15.
