East or West — Which is best?
Feng Jianhua

Zhang Gongyao, a professor at Central South University, recently launched an online petition calling for the removal of traditional Chinese medicine (TCM) from the country’s healthcare system. This provoked a big public outcry.
Some Internet users signed their names in support of the move, but things did not end there. When some well-known public figures joined the side of removing TCM from the healthcare system, the debate went wider and deeper.
Zhang, who researches the history of scientific thought, is not an influential figure in the traditional medicine community but his supporters, according to some media reports, come mostly from the health and medical fields.
A battle to defend traditional medicine broke out. An outraged doctor at the hospital affiliated to the Hunan Academy of Traditional Chinese Medicine decided to sue Zhang for libel after legal consultation.
To calm the heated situation, Mao Qun’an, a Ministry of Health official, said at a recent press conference that people who denied the historical achievements, current function and scientific basis of traditional Chinese medicine were clearly ignorant of history.
“The online petition to repudiate traditional Chinese medicine is a farce,” said a spokesman for the State Administration of Traditional Chinese Medicine.
A ‘pseudoscience’?
The key to the debate is whether TCM is a science or not.
He Zuoxiu, a theoretical physicist and academician of the Chinese Academy of Sciences and a reputed “fighter of pseudoscience,” said, “Traditional Chinese medicine theory, being all at sea, is a typical pseudoscience, which represents a ‘backward productivity’.”
According to those who advocate abolishing TCM, modern medical disciplines (i.e., Western medicine) is based on such sciences as physics, chemistry, biology and statistics. The curative effects and side effects of Western medicine can be explained and proven by its theories and clinical experiments.
By contrast, the yin and yang and five-element theories of TCM seem to be too abstract and metaphysical, and difficult to explain through science. What’s more, uncertainties often occur during the clinical application of TCM. For instance, in TCM, there may be 10 different treatment methods for just one disease. Besides, the performance and side effects of each TCM material hasn’t been proven through strict clinical experiments. Therefore, TCM is viewed as no more than an accumulation of experience, not a science, though it has some effective medicines and therapies.
Recent negative reports on TCM also have put extra pressure on it, resulting in a lessening of public trust. The most recent one happened in August, when the UK’s Medicines and Healthcare Products Regulatory Agency found that one traditional medicine, Fufang Luhui Jiaonang, contained toxic levels of mercury.
“The problem with TCM is its effectiveness and side effects. It will benefit the country’s medical situation to get TCM out of China’s healthcare system,” said Zhang.
Traditional medicine, which dates back several thousand years, used to be the quintessence of the country, and Western medicines were not popular until 1949, when the People’s Republic of China was established. Before that, TCM was predominant in the Chinese medical system. It’s no surprise then that the debasing of TCM has encountered much opposition.
“I’m a little suspicious of traditional Chinese medicine, but what I’m pretty certain is that it has such a long history and an irreplaceable position in human medical history,” said Chen Dazhi, Deputy Director of the Organ Transplant Center at Chaoyang Hospital in Beijing.
Chen said that while TCM theories can’t be explained by modern science, it doesn’t necessarily mean that TCM is unscientific. It’s just a matter of time before TCM can be interpreted by current science, just as many other phenomena that used to be considered unexplainable were later proven scientifically. Even within the Western medical field there are some things that cannot be explained by modern medical theory. In addition, TCM does have good curative effects for many diseases that can’t be cured by Western medicine.
Song Aizhu, a doctor at the Beijing Hospital of Traditional Chinese Medicine, is keenly aware of the special curative properties of TCM. Her institution has received patients from around the world, and the cupboard in her office is stuffed with gifts sent by the many healed patients.
Miyuri Makabe, a 50-something Japanese woman who was badly injured in a boating accident, came to China for help after two years of Western medical treatment failed to work. “When I landed in this hospital I was like a robot with steel struts tied to my body and crutches under my armpits. I couldn’t walk without support,” she recalled.
After careful examination, a panel of experts decided to put her through acupuncture treatment, supplemented by some herbal remedies. The next day she showed improvement. On the third day she needed only one crutch and a week later she could go shopping. In a month she was totally cured and headed back home. Half a year later, when she returned to the hospital for follow-up treatment, she could even scamper about.
“Chinese medicine is so magical, I will introduce it to more people,” she said in simple Chinese.
Several patients at the hospital from Switzerland and Romania were randomly asked their reaction to the issue of removing TCM from China’s healthcare system. All looked surprised and shook their heads as if to say, “Why? I don’t get it.”
Hou Manzhen, a veteran practitioner of TCM, has his own point of view on the issue. Chinese medicine theory is built on macro philosophy while its Western counterpart is based on micro philosophy, he said. Take the common cold for example. Western medicine views it as the result of a viral infection while Chinese medicine sees it as the result of a weakening of the immune system. Thus the treatments differ. A Western doctor might suggest medicine to ease the symptoms, while his Chinese counterpart would suggest a therapy to improve the functioning of the whole body.
“TCM and Western medicine are actually two complementary things,” said Hou. “It’s not proper to say which one is better. TCM does have some defects, but it makes no sense to exclude it on the basis of Western medicine, and it’s unfair to traditional Chinese medicine.”
Facing a predicament
Leaving aside the argument about the removal of traditional Chinese medicine from the Chinese healthcare system, what is clear is that TCM is now in difficulty in its place of origin—China.
Sina.com, one of China’s largest Internet portals, conducted a survey involving 20,046 respondents. When asked the question “What do you think of TCM,” 74 percent voiced their support while only 17 percent opposed it. However, when asked “Would you choose to go to a traditional medicine or Western doctor when you are sick,” about 58 percent chose Western doctors, 16 percentage points higher than the rate of those choosing TCM.
What’s more frustrating for TCM was another survey conducted by Wang Li, the leading surgeon at the People’s Hospital of Peking University. The survey showed that 90 percent of the respondents don’t believe in TCM any more. The reasons include TCM’s long period of treatment, complicated therapy methods and the exaggerated publicity of some TCM hospitals, she said.
“Pushed by the economic benefits, a few small TCM hospitals and private clinics boast they can heal any disease, which is of course impossible. This has brought a bad influence on traditional Chinese medicine,” said Song, the traditional medicine doctor.
“Traditional Chinese medicine is something extensive and profound, and many herbal medicines or treatment methods take the form of secret recipes, which gives an opportunity to a few designing people,” said Hou.
According to the certified physician law of China, one is required to have at least four years of medical school education to take the test to become a certified physician and two fifths of the test is about Western medicine.
Many of the most experienced TCM practitioners don’t know Western medicine or foreign languages, although they are good at curing diseases, and thus they cannot obtain the certification, which will lead to the disappearance of traditional medical wisdom when they die.
The present medical law enforcement and supervision system hampers the normal private practice of TCM. Even if a person dies a natural death under a private TCM practice, the practitioner will be punished if someone sues him, since he does not have certification. Another unreasonable point is that a medical accident occurring in TCM practice must be examined by Western medical technology even though the two belong to different medical systems. As a result, TCM treatments are too cautious and conservative in innovation.
Statistics show that the number of TCM practitioners stood at 800,000 in 1912, 500,000 in 1949 and is now below 300,000. The number of Chinese veteran TCM practitioners has dropped to the present 500 from 5,000 in the 1980s, with most of them above the age of 88.
Therefore, some warn that Chinese medicine is facing the loss of its legacy. But Zhang Bing, a professor at the Beijing University of Chinese Medicine, said the crisis is a “problem in progress,” and people should not be so worried about it because it will be eased with the advancement of higher education in TCM.
TCM has been gradually marginalized. TCM hospitals are facing a declining business, and local financial support is insufficient. In Hunan Province, the provincial fiscal revenue stood at 73.9 billion yuan in 2005 but only 5 million yuan was allocated to TCM, and the spending hasn’t seen any increase over the past 10 years.
“Many TCM hospitals would rather adopt Western medical treatments instead of prescribing cheap Chinese herbal medicines to survive in the business,” said Bai Zhengping, Deputy Dean of a hospital affiliated with the Hunan Academy of Traditional Chinese Medicine. It costs only 60 yuan to cure a fracture through traditional treatment but the cost for having surgery is 1,600 yuan. To earn more money, hospitals would rather put fracture patients through surgery.
“Most of the current TCM hospitals don’t live up to their names,” said Lu Bingkui, the former Director of the Chinese Medicine Bureau of the Ministry of Health. “They are mixed hospitals with both traditional Chinese and Western medicines.”


Eradicating curse of child labour
Nabeel Ahmed Sheikh

Child labor is not a new phenomenon in the developing countries of the world. However, its state is worsening with time, mainly attributable to an ever increasing population, and the fact that the number of poor households is constantly on the rise in the country. It is indeed a threat to human resource management (HRM). It is one of the most serious issues faced by HRM in the current scenario and is becoming even more complex as the population continues to grow. Child labour is almost slavery. Toiling children can often be seen at such as roadside restaurants, services stations and shops where welding work is done. Some of the jobs done by these children, such as welding, are potential hazardous for children and young people. Child labour is a cause and a consequence of the socio-economic and political reality. This problem is closely interlinked with various other socio-economic and political problems of this continent. Landless, poor access to resources and production, gender inequity, inequitable distribution of land, unemployment programmes and environmental degradation are the underlying factors for this curse.
The International Labour Organization (ILO) has estimated that 250 million children between the ages of five and fourteen work in developing countries, at least 120 million on a full time basis. Although legally child labour is forbidden in Pakistan, no previous government has ever enforced these laws. The present statistical profile is that almost 3.3 million children are involved in child labour in Pakistan. The children working as labourers get low wages but are over worked. Majority of the child workers is concentrated in the invisible sector of the economy and thus remain hidden from the statistical and planning procedures. The children working on agricultural farms have never been given any consideration for their welfare. The child workers do not enjoy basic amenities of life and are exposed to lasting physical and psychological harm
The government is committed to vigorously combating and eliminating child labour. A series of steps taken by the government have helped curtail the problem of child labour. Pakistan Baitul Mal in collaboration with the ministry of child labour has established 83 national centers in different parts of the country for rehabilitation of children. These centers are imparting non-formal education free of cost upto primary level. At present 6,240 students are studying at the centers. Around 4,484 have already completed courses and have been admitted to government primary and middle level schools. A private owned institute with the name of Child Care Foundation has opened 283 non-formal education centers for children involved in carpet-weaving and about 9,449 have been enrolled. The Ministry of Education is pursuing vigorously the goal of universal primary education. On the other hand, Pakistan Literacy Commission is pursuing a program through establishment of non-formal education centres across the country. The Frontier Education Foundation (FEF), a public-NGO partnership, is also working for the expansion of educational facilities. As a result of FEF initiative most villages in NWFP now have a school within their reach. The government of Punjab has announced free education up to matric level and it is providing free text books. Under different projects launched with the assistance of International Program for Elimination of Child Labour more than 25,000 children have been withdrawn from workshops and are being imparted formal and non-formal education.
The National Policy and the Plan of Action to Combat Child Labor was approved by the Federal Cabinet on May 10, 2000. National Action Plan for Elimination of Child Labour is based on an integrated approach and will be implemented by actions at the federal, provincial, district and local levels. The Plan aims at reaching the target children in phased manner through various short and long term strategies. The short-term strategies include awareness raising, development and dissemination of information, community mobilization, situation analysis, establishment of monitoring and evaluation system, withdrawal of children from exploitative labour on priority basis; and special protection to the most vulnerable groups of child labour. The measures that would take a long run to achieve the inherent objectives include universalization of primary education, full implementation of the law, empowerment of families/poverty alleviation, expansion of social safety net, etc. Education and skill development of working children, institutional capacity building, and strengthening of inspection services are among some of the medium-term strategies. Some of the on-going Projects are: i) Pakistan Bait-ul-Mal Schools for Rehabilitation of Child Labour. ii) Elimination of Child Labour in Soccer Ball Industry in Sailkot. iii) Elimination of Child Labour in Surgical Industry in Sailkot. Combating Child Labour in Carpet Industry in Pakistan. iv) Combating Child Labour through Education and Training. v) Rehabilitation and Prevention Programme working in Leather Tanneries, Kasur. vi) Non-Formal Education and Occupational Safety and Health Project Children working in the Automobile Workshops. vii) Non-Formal Education and Awareness Programme for Children, working in Textile, Garments and Leather Sectors. And viii) Child Labour Education Programme (CLEP) in Sindh.
Child labour is a complex problem which demands a range of solution and sensitive treatment. The international community must take greater responsibility for funding local programs that will tackle the root causes of child labour. The matter of the truth is that the lack of social concern has been the biggest problem behind it. In conclusion, a society can be judged by the way it treats its future generation. Our prestigious asset is our future generation. The legal framework is there, the laws are there, the institutional framework is there; all we need is to scale up the efforts to at least achieve elimination of half of the child workers. If we reach the target of 50 per cent by 2010, we will be successful. It is for all of us to develop a quantitative mechanism as to how the numbers are increasing or decreasing, to see our progress.


Our climate is changing. Can we?
Kofi Annan

IF THERE was any remaining doubt about the urgent need to combat climate change, two reports issued last week should make the world sit up and take notice. First, according to the latest data submitted to the United Nations, the greenhouse-gas emissions of the major industrialised countries continue to increase. Second, a study by the former chief economist of the World Bank, Sir Nicholas Stern of the United Kingdom, called climate change “the greatest and widest-ranging market failure ever seen”, with the potential to shrink the global economy by 20 per cent and to cause economic and social disruption on a par with the two World Wars and Great Depression.
The scientific consensus, already clear and incontrovertible, is today moving towards the more alarmed end of the spectrum. Many scientists long known for their caution are now saying that warming has reached dire levels, generating feedback loops that will take us perilously close to a point of no return. A similar shift may also be taking place among economists, with some formerly circumspect analysts now saying it will cost far less to cut emissions now than to adapt to the consequences later. Insurers, meanwhile, have been paying out more and more each year to compensate for extreme weather events. And growing numbers of corporate and industry leaders have been voicing concern about climate change as a business risk. The few skeptics who continue trying to sow doubt should be seen for what they are: out of step, out of arguments and just about out of time.
A major UN climate change conference opened last week in Nairobi. The stakes are high indeed. Climate change has profound implications for virtually all aspects of human well-being, from jobs and health to food security and peace within and among nations. Yet too often, climate change is seen as an environmental problem when it should be part of the broader development and economic agenda. Until we acknowledge the all-encompassing nature of the threat, our response will fall short.
Environment ministers have been striving valiantly to mobilise international action. But too many of their counterparts — energy, finance, transport and industry ministers, even defence and foreign secretaries — have been missing from the debate. Climate change should be their concern as well. The barriers that have kept them apart must be broken down, so that they can, in an integrated way, think about how to “green” the massive investments in energy supply that will be needed to meet burgeoning global demand over the next 30 years.