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20 Questions: China Edition

By Jim Duffy
Illustrations by Ken Orvidas

China has long been a source of mystery and wonder to Westerners. That's as true today as it was in the time of Marco Polo — maybe even more so, given the speed of China's phenomenal emergence in recent decades out of the depths of the oppressive Cultural Revolution and into the role of emerging powerhouse.

What are we to make of this new China? What's at stake for its 1.3 billion people — and for billions more in nations around the world? What do we need to know about China? And what can we learn by getting to know its culture a little better?

The Johns Hopkins community is engaged in these questions across many different disciplines. We got in touch with 20 faculty members, alumni, and students and asked them to share a bit of their experiences, opinions, and expertise on what's under way in China and what it might mean for the world.

1. What's the single most important thing about the rise of China?

Academic types sometimes toss around words like "unprecedented" too easily. Not David Lampton: The director of the China Studies Program at the Johns Hopkins Nitze School of Advanced International Studies (SAIS) works his way up to it. "China has the most rapidly growing middle class in the world today," he says. "In fact, it's growing more rapidly than any middle class in modern times. It's probably growing more rapidly than any middle class ever has, anywhere. What's going on there today is unprecedented."

This is very good news, Lampton says. The World Bank estimates that 250 million to 300 million people have climbed out of poverty since China adopted economic reforms. That's a population roughly equal to the whole of the United States, moving from a subsistence existence to a measure of middle-class wealth within a single generation. Lampton is at work on a book about the rise of China's middle class, and he recognizes that the phenomenon is a tumultuous one. Will skyrocketing demand from China deplete the world's energy resources? What impact will China's growth have on global warming?

"There are lots of things that make this a painful and maybe even dangerous process," he says. "But it's hard for me to look at the rise of this middle class and not see it as extremely positive. I wonder sometimes if it might be one of the most positive developments in all of human history. Who knows? It might just be."

2. What's the secret ingredient to China's economic transformation?

As a doctoral candidate at Columbia University, Kellee Tsai set out to study the informal credit and savings associations operated by women entrepreneurs in rural China. She soon realized, however, that such innovative underground financing was actually driving much of China's business growth. "This is all a little counterintuitive," says the Hopkins assistant professor of political science. "China is still an authoritarian party state, nowhere near democratic. Yet people at the ground level are getting away with so much, often with help from local officials."

Tsai's forthcoming book, Capitalism Without Democracy: The Private Sector in Contemporary China, draws a portrait of China's entrepreneurial class and its complex relationship with the Communist government. "In some ways, this book is a response to the conventional wisdom of inside-the-beltway political circles that as the private sector develops and incomes rise, China is likely to evolve into a liberal democracy," Tsai says.

Many entrepreneurs seem quite content with the way the Communist state is serving their business needs, and the Chinese government is adept at recognizing what the underground economy is up to and incorporating it into the official way of doing business, she says. "What this means is, don't hold your breath. The leap to democracy, well, it's just too big a leap for China to make at this point."

3. Is it true that China's universities now graduate more engineers and scientists than do U.S. universities?

China's college-going rate has gone from next to nothing in the 1960s to 20 percent today. In the last decade alone, college enrollments jumped 500 percent to 23 million students — that's 6 million more than in the United States. Should U.S. colleges be worried?

Kathryn Mohrman, executive director of the Washington program office of the Hopkins-Nanjing Center, isn't ready to push the panic button. She points to studies showing that the engineers coming out of Chinese colleges today rank more as technicians than as well-rounded scientists. "But as with everything in China today, this is a very dynamic situation," she says. China has set a goal of reaching a 50 percent college-going rate by 2050 and is aiming to upgrade some 40 of its universities to world-class levels by spending billions of dollars on research infrastructure. "If I were a dean at a university here," Mohrman says, "I'd start thinking about the day when universities in China and India are able to undercut my research enterprise or affect my ability to get the best students and faculty. I think we know that intellectually, but we're not acting on it yet."

4. How easy is it to land a role in a Chinese film?

Second-year SAIS Conflict Management graduate student Joseph Bubman traveled to China last winter on a fellowship. He and five fellow students chronicled their adventures on a blog, where Bubman's entries focused on his relationship with his host family in the Beijing neighborhood of Erlizhuang.

"My cultural immersion is coming in the form of a home stay with a retired couple — 'Shushu' (uncle) and 'Ayi' (aunt) — who do not speak any English. . . . I have generated no shortage of entertainment by unwittingly saying things like 'I am going to eat the television.' Not one to be deterred by my endless state of confusion, Shushu goes to great lengths to demonstrate and act out the meaning of words. . . . He has become so enamored of our teacher-student sessions that he recruited a friend to make a video capturing the educational experience. My Chinese movie première was highlighted by a shower scene in which I stand wrapped in a towel beneath the showerhead while pretending to gingerly touch the water. I yell leng (cold) and then tang (painfully hot) before banging on the door to be let out."

Read more such anecdotes, including one about Ayi's efforts to arrange a marriage for Bubman, at www.saisin

5. How do you start a nursing doctoral program in a country with virtually no nursing PhDs?

Starting a new degree program is challenging enough; imagine doing it in a country that has only a handful of candidates qualified to teach the subject at hand. That's the situation Peking Union Medical College (PUMC) faced when it set out to create the first Chinese doctoral program in nursing. "This country, this gigantic country, has just four or five doctorally prepared nurses," says Marie T. Nolan, an associate professor and director of the doctoral program in the Johns Hopkins School of Nursing. "That's why we had to think through so many different things to create a program that was sustainable and productive."

That groundbreaking initiative involves both sending Hopkins faculty to Peking and bringing PUMC students to Hopkins. The first cohort of five Chinese students arrived in Baltimore in fall 2006.

China's medical community is already reaping the benefits. One PUMC doctoral candidate is working on a thesis that examines whether nutrition screenings of hospital patients can improve health outcomes in Chinese hospitals. Another is looking to build China's first database of injuries to children. But it goes both ways, Nolan says. "This program has already had impacts on our faculty and students that are going to last a lifetime."

6. Has the status of Chinese women changed?

Veronica Li, SAIS '80, spent 13 years at the World Bank before becoming a journalist. Her new book, Journey Across the Four Seas: A Chinese Woman's Search for Home, is a memoir based on the life of her mother, who was born in 1918, just after the last emperor was overthrown. In a presentation at SAIS in February, Li noted:

"I would like to label my mother's [generation] as the 'Big Foot' generation. [Women] had been one of the most oppressed people in China. Polygamy was rampant, and women were treated as chattel for men to show off their wealth. Then there was foot binding. Can you imagine breaking the toes of little girls and binding their feet so tightly that they can't grow? Some died of infection, and they all suffered unspeakable pain.

"My mother represents the first generation of Chinese women to be free from this practice. And they've gone very far with their big feet. Some got themselves educated, held jobs, and became mistresses of their own fate. The turbulence of the first half of the 20th century brought out the strength in Chinese women. They took timid steps at first, until monumental crises forced them to take a giant leap.

"Today you can see Chinese women in any profession, and some have attained the highest levels. This progress from bound feet to unlimited possibilities took place in less than a hundred years. This remarkable story should be told, so that we can all draw inspiration from it."

7. How big a threat is AIDS in China?

The social and economic isolation that China's government embraced for so many decades may have left much of the nation mired in poverty, but it also helped stem the onset of the world's worst epidemic disease: AIDS.

Scientists have tracked the earliest case in China to the late date of 1983, but the virus now seems to be making up for lost time. In coastal areas where trade and travel are expanding, AIDS is linked with rising intravenous drug use and prostitution. In the rural heartland, it took root through bungled blood transfusions and now spreads through heterosexual contact. "The most recent estimates are more serious even than we expected — 800,000 to 1 million infected people," says Xiao-Fang Yu, a professor of molecular microbiology and immunology at the Bloomberg School of Public Health. "That makes it not as bad as it is in Africa, perhaps, but there's no doubt it's quickly getting worse."

Yu is at the forefront of efforts to identify the molecular and genetic patterns unique to strains of AIDS in China. His lab has developed a prototype vaccine, now in testing, that aims to boost the body's immune response to local strains of the virus.

"The good news here is that the government is trying to put more resources and effort into prevention," Yu says. "Each country is unique. Some have been successful, but many of the countries that have done prevention programs still have a big problem. We just don't know yet how effective an effort like that will be in China."

8. What works of Chinese art should we see at least once?

Standing before Guo Xi's Early Spring Taiwan is an experience that the Krieger School of Arts & Sciences' Tobie Meyer-Fong will never forget. Painted during the Northern Song Dynasty in the year 1072, the hanging scroll depicts in ink on silk an intricate nature scene measuring more than 5 by 3.5 feet. Meyer-Fong is a historian, not an art historian, but she didn't feel that she needed any extra expertise to appreciate the work when she saw it at the National Palace Museum in Taipei, Taiwan. "It's such a huge painting," she says. "You just know it's a masterpiece. It's so incredibly dynamic, with such a sense of movement in the clouds and tree forms." Early Spring speaks volumes about the Chinese way of looking at the world — and how it differs from Western ways, Meyer-Fong says. It eschews a single-point perspective in favor of an approach Guo termed the "angle of totality" that strives to portray a single scene in a single flat work from multiple visual perspectives.

Out of concern for its preservation, the painting is rarely on display, so Westerners likely will have a better chance to see Meyer-Fong's second recommendation, the tusk-holding man of Sanxingdui. This figure is part of a magnificent archaeological haul discovered in the 1920s when a farmer in Sichuan Province uncovered some pieces of jade while digging a well. Researchers called to the scene were astonished to see works done in an artistic style unknown in Chinese art. "Monumental figural representations are really unusual in China," Meyer-Fong says. "That's the thing with the tusk man. He's so mysterious. He represents a civilization that we never knew about, and he forces us to think again about what we think we know and about the multicentric origins of this thing we call Chinese culture." The tusk man is part of the permanent collection at the Sanxingdui Museum near Guanghan.

9. What's it like to conduct medical research in China?

The Bloomberg School's Thomas Kensler has been doing just that for more than two decades. His focus is liver cancer, a disease that takes nearly 400,000 lives a year in China. A key risk factor is exposure to aflatoxin, a substance produced by a mold that grows on crops in humid climates. Kensler, a professor in the Division of Toxicological Sciences, is aiming to develop a chemoprotective agent that changes the way the body metabolizes aflatoxin and prevents the onset of the disease.

U.S. scientists at work on domestic experiments often complain about paperwork and regulatory burdens, but they've got it easy compared to Kensler. In addition to getting his study protocol approved by reviewers at Hopkins, the National Institutes of Health, and the Food and Drug Administration, he had to submit it to the U.S. State Department and to different authorities in China. "All seven parties had to agree on every single word that would appear in the consent forms," Kensler says. "I can't even begin to tell you how arduous a process that was."

Working in China does have its advantages, however. "My Chinese colleagues are just supremely good at all the critical organizational activities that go into something like this," Kensler says. "The other great thing in my experience in Jiangsu is that once people make an agreement to take part in the study as a subject, they feel honor-bound to keep to that agreement."

10. What does China's rise mean for the U.S. economy and its workers?

Just 25 years ago, no one regarded China as a potential economic force. Pieter Bottelier, senior adjunct professor of China studies at SAIS, can think of only one historical precedent for what's happened since: the boom in the U.S. economy in the latter part of the 19th century. "But this is even more dramatic," he says. "This is a country that is still relatively poor on average. It's just an unbelievable turn of events that it could have such an impact in such a short time — completely unpredictable."

To many Americans, it's a frightening prospect. Competition from China entails real costs to the U.S. economy, especially in manufacturing. But the benefits don't get as much attention. Bottelier points to a new study that credits the China factor with creating 500,000 new jobs in U.S. service sector industries such as distribution operations and financial institutions. Overall, the study commissioned by the U.S.-China Business Council concludes that trade with China delivers a net boost of 0.7 percent to U.S. GDP and creates lower consumer prices of 0.8 percent. That combination adds up to an extra $1,000 in disposable income per U.S. household.

11. Has Chinese cuisine survived six tumultuous decades of Communist rule?

Over his distinguished career, Sidney Mintz, a Hopkins professor emeritus of anthropology, has chronicled cultures and their foodways with the rigor of a scientist and the passion of a gourmet. His deepest expertise may lie in the Caribbean, but he's spent his share of time in Hong Kong and China. Asked via e-mail to share his impressions, Mintz replied with a crisp 981-word essay. It includes the following:

"Among the joys of eating food in China is the variety of restaurants, and the role of family in how the Chinese eat. It is at table that children learn to become adults; at table that babies meet their grandparents; at table that people display their civilization and communicate it. To watch the giver of a restaurant banquet — some paterfamilias welcoming the family of a son's fiancée, celebrating a grandchild's birth, or just treating friends — is to get a sober lesson in etiquette, self-discipline, and joy....

"Maoist excesses nearly destroyed completely the glories of Chinese cuisine, and there was fear that when they ended, there would be nothing left of what had been. But in characteristically Chinese fashion, once those excesses did come to an end, the marvelous food was soon back. Part of it, of course, was that the Chinese have been around a very long time."

You can read Mintz's complete essay in the online edition of this issue here.

12. What is the "nutrition transition," and what does it mean for China's future?

As countries move from poor toward rich, people tend to change the way they eat. Urbanization moves millions out of the countryside and away from traditional diets, introducing them to fast foods, processed snacks, and a more sedentary lifestyle. "The shift from a plant-based diet to a more mixed diet usually involves foods that are linked to the risk of cardiovascular disease, for example, and colon cancer," says Benjamin Caballero, a professor of international health at the Bloomberg School and the director of its Center for Human Nutrition.

Obesity and diabetes are already on the rise in China, but the situation is more complex. In many rural areas, traditional diets deliver just 4-5 percent of protein from meat. Experts estimate that 10-12 percent would be healthier. (Americans get an over-the-top 60 percent of their protein from meat.) Finding the right balance is especially important for China because its public health and medical expertise lies in issues that its poor have traditionally faced, like infectious disease and maternal health, not heart disease and diabetes.

"I believe that the Chinese authorities, at least in the scientific establishment, are truly concerned about the emergence of these chronic diseases," Caballero says. "With the experience they have in communicable diseases, they really might be able to focus on the non-communicable diseases in ways that could be a model for the rest of the world."

13. Is the U.S. doing the correct things to promote democracy and human rights in China?

Chinese citizens can't choose their own leaders. They can't criticize government policies or engage in peaceful protest without risking imprisonment. Their government even attempts to sanitize what's available to them on the Internet. In a new book, The China Fantasy: How Our Leaders Explain Away Chinese Repression, James Mann questions the wisdom of U.S. policy toward human freedoms in China.

The author-in-residence at SAIS's Foreign Policy Institute lays out three scenarios for China's future and argues that U.S. politicians and diplomats are failing to consider which one may be the likeliest. In the "Soothing Scenario," a freer economy sparks a peaceful, orderly transition to a freer society. This is the foundation of policies geared to promoting China's economic growth. These policies help China steer clear of a nightmarish "Upheaval Scenario" in which the country's internal conflicts and contradictions — between rich and poor, urban and rural, economic freedom and Leninist repression — explode into chaos and violence. "The Soothing Scenario is the one all the policymakers in Washington keep talking about," Mann says. "It's the one that also happens to be the path of least resistance. It puts a premium on good relations with China, on not causing trouble."

But what if Mann's "Third Scenario" comes to pass? In that case, China will simply continue to grow and prosper as an economic force — and remain authoritarian. Mann's contention is that the failure to consider this possibility in crafting policy is something the U.S. may come to regret. "Obviously, it would be best for the Chinese people if they had some say in how their country was governed," he says. "And that kind of reform would likely help promote the long-term stability of the country."

14. How does an American teen get so interested in China?

Tracy Whelan, a Seattle ninth-grader, has a yen to go to China that traces back to a sixth-grade social studies teacher who devoted large chunks of class time to ancient China. Soon thereafter, Whelan signed up for a school program that brings language teachers from China to teach American students. "I'm not sure I can say there's sort of one thing that got me interested," she says. "I just find the culture of the country quite interesting."

She's been saving pennies to help pay her way to China. Twice, her school trips fell through. At last, she's headed to the Hopkins-Nanjing Center this July on a three-week-long study trip organized by the Johns Hopkins Center for Talented Youth, which offers educational programs to students who demonstrate exceptional academic abilities. Students choose from seven different classes, from mathematical game theory to Chinese philosophy. Whelan chose a course that will explore traditional Chinese healing practices and what they may have to offer Western societies.

"The whole idea that other people always bring up — how learning Chinese and learning about China might be useful to me sometime in the future — is something that hasn't really occurred to me," Whelan says. "To me, this is just a great opportunity to learn."

15. Can the blogosphere help China find its way to a more open society?

Alexander Brenner, SAIS '03, is writing a book about contemporary Chinese society. Asked via e-mail if he'd describe a particularly striking aspect of youth culture in the new China, the Beijing resident, who earned his master's in China studies, replied with this:

"Over the past two years, blogging has exploded among China's urban youth. The total number of blogs in China — estimates vary, but at least 30 million have been created — is now second only to the United States....

"Is blogging in China just another youth trend? Some observers think the development of the blogosphere is potentially much more significant. . . . Liu Jin of the China Youth University of Political Science, one of the first scholars conducting research on the Chinese blogosphere, believes that blogs elicit self-expression that is 'more rational, mature, and honest,' and asserts that for the first time they are creating in China a true 'public sphere.' Naturally, this public sphere is circumscribed by government control; blogs that address sensitive topics can be censored or shut down. However, Liu and others suggest that by vastly expanding the space for discourse, the blogosphere can be seen as a kind of training ground for the public discussion necessary for democratic politics."

16. Should Western medical students study at least some Chinese medicine?

Marta Hanson doesn't have to convince her students at the School of Medicine that they should know about acupuncture and herbal remedies from China. They all seem quite eager to dive into the topics, and that's just how the assistant professor of history of medicine thinks it should be.

"First of all, they need to know about these therapies because their patients are using them," Hanson says. Acupuncture is on the rise as a pain treatment in dentists' offices and medical clinics, as well as with practitioners devoted to the more holistic approach that targets "patterns of disharmony" in the body. Dietary supplements based on Chinese remedies are big sellers at health food stores and even traditional pharmacies. "There are safety issues here," Hanson says. "And there are efficacy issues, including the fact that there's evidence that some of these things are efficacious. It's a topic that needs much more research.

"This line of study is important for students in another way, too," Hanson adds. "It forces you to really examine the ways you've been taught to think about the body and how it works. To me, history is like a ship that you can take to another land, where you see things in a new way. It gives you a sense that there are other ways outside of our biomedical model of seeing and knowing the human body. That's important."

17. How are China's factory workers and farmers faring under economic reform?

Joel Andreas' specialty is not the new China, but an old one. A Krieger School assistant professor of sociology, Andreas studies working-class life back in the Mao Zedong era, when the government assigned families to a decidedly un-capitalistic collective enterprise for all their daily activities. "Each of the work units had its own health clinic," Andreas says. "The units often had elementary schools for kids, as well as adult schools for the workers."

This system collapsed in the 1990s under the economic reforms that lifted hundreds of millions of people out of poverty. But China is a country of 1.3 billion people, and hundreds of millions more remain quite poor. Many formerly state-run enterprises "now do their hiring on short-term contracts," Andreas says. "Their permanent employees have been replaced by rural migrants and peasant workers. For most of these workers, it's meant a degradation in their social status and their social welfare."

In the countryside, it's more of the same. In a market economy, farmers can't predict how much their crops will be worth. Many are reduced to subsistence farming and must migrate to cities on a seasonal basis to take low-paying, temporary jobs. "The country has really perfected a means of organizing labor in the most efficient fashion," Andreas says. "So some people are more wealthy in some ways, but people are very insecure in others."

18. Is China up to the environmental challenges arising from its phenomenal growth?

In her class, Domestic Challenges of China's Development, Carla Freeman, associate director of the China Studies Program at SAIS, tackled a broad array of problems arising from China's shift from a command economy to a market economy and its transition from an agricultural to an urban society. "The whole world is talking about China's rise, and the Chinese people themselves are excited about the return of global prestige to their country," Freeman says. "But all of that could be compromised by incredible environmental problems." Some of China's key water supplies are already heavily polluted. Desertification is spreading rapidly. Air pollution, mining issues, waste management, habitat destruction — the list goes on.

The risks aren't just to human health and economic progress. The government's reputation could falter in the face of social and political unrest, Freeman believes. Lately, the government has been working to increase its environmental initiatives and explore new green technologies. "The Chinese government is aware of what's at stake here," she says. "Making improvements will be an uphill battle, but China has some powerful incentives and the capabilities that could enable it to emerge as a global leader in sustainable development."

19. Can China's economic rise make a difference for the world's poorest continent?

China and Africa aren't exactly strangers. Chinese vessels visited the east coast of Africa as far back as the early 15th century. But never before has China had as much potential as it does today in shaping the future of a continent that remains too marginal a player in the global economy.

"Africa accounts for less than 2 percent of world trade," says Peter Lewis, director of the African Studies Program at SAIS. "That's why the prospect of trading opportunities with and investments by a large economy like China's is something many African countries see as very, very significant." China's growing economic and diplomatic overtures to African nations are not without risks, however. China's overriding economic interest in the continent is gaining access to energy supplies and raw materials, Lewis says. Africa has traded such resources away before, to Western nations, without finding much in the way of lasting economic benefits.

On the political side, the risks may be even greater. China has shown no qualms about trading with some of Africa's most authoritarian and repressive regimes. "The concern is that the Chinese government will take pressure off of these countries," Lewis says. "It'll give them access to trade and investment that's not tied at all to whether they're improving human rights or reducing corruption."

But Lewis cautions against jumping to pessimistic predictions. "It's still the early days in this relationship, and that involves a kind of learning curve. The Chinese may well come to a growing appreciation that governance issues and security concerns need to be part of their perspective."

20. What makes classical music so thrilling in China these days?

Cellist Sam Matthews, Peab '02, '05 (MM), performed recently with an ensemble that included the former concertmaster of the Shanghai Symphony Orchestra. The two musicians came from very different places on their way to that stage in Shanghai. Matthews, after earning bachelor's and master's degrees from Peabody, headed off to a teaching job at the Shanghai American School. The former concertmaster had grown up in China at the height of the anti-Western Cultural Revolution. He never had classes or teachers; everything he knows about playing the violin, he taught himself.

"Pretty amazing to think about, right?" Matthews says. "That's how it's been for many of the people here."

But Western-style classical music is building momentum in China. The New York Times reported recently that the country now has 30 million piano students, 10 million violin students, and more than 140 instrument-making factories. At roughly $25 apiece, symphony tickets remain too expensive for most Chinese. But Matthews recently played solo on a double bill with a chamber ensemble at the Shanghai Concert Hall that was specially priced at $3. "It was completely sold out," he says. "They put extra seats up on the stage so more people could watch. That's what's exciting for me about being here — this growing interest and enthusiasm for the art form I've learned."

Freelancer Jim Duffy wrote about Johns Hopkins' Center for Alternatives to Animal Testing for the November Johns Hopkins Magazine.

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