Ginseng and aspirin

Written by Dr. Zibin Guo, the book Ginseng and Aspirin is a well researched and well documented account of both the history of Chinese immigration into the United States and the problems many of todays Chinese immigrant population encounter in dealing with health related issues, especially among the elderly. In this report, I will briefly explain two aspects of this phenomenon: the differences in the beliefs and behaviors of elderly immigrants from Mainland China and Taiwan and why those differences exist, and how these differences relate to the study of culture. THE DIFFERENCES In order to understand the differences between elderly immigrants from Mainland China and Taiwan, one must first look at their history to explain why these differences exist in the first place. Several major events occurred during the last century that shaped the nation of China and its people. Prior to 1949 when the major hostilities finally ended, there was the overthrow of the Qing dynasty in 1911, followed by more than 10 years of strife between the ruling Guomindang Party and the political warlords. Once this conflict was settled in 1927, there followed more fighting between that party and the Communists, which ended with an invasion by Japan and a subsequent war with that country lasting from 1937 to 1945. By the end of that war, there was already begun a civil war between the Guomindang and Communist ruling parties which lasted for another 5 years. This civil war ended in 1949 with the Communist Party victorious and the establishment of the Peoples Republic of China on the mainland. The remnants of the Guomindang were forced into exile on Taiwan (Guo 2000:60). This created a division of the peoples of China that allowed them to develop different cultural views on healthcare according

to each ones own set of circumstances and environment. Even though many cultural similarities remained, one of the most marked differences was in their attitudes toward and pursuit of healthcare. This difference was largely due to each governments stand on the issue of traditional Chinese medicine versus the more modernized Western style of medicine. Now that the reason for the differences is known, it can be better explained what these differences are and their significance. At first, the new government of Mainland China attempted to bring about a sweeping modernization movement into the country, including the area of healthcare practices. Despite their intention, this early movement failed because it was centered in the urban areas and ignored the rural areas which were predominant in the country at the time. Despite official disdain for the practice of Chinese medicine, over the next twenty years its practice prevailed, especially in the vast rural areas (Guo 2000:61). Realizing that traditional Chinese medicine was a strong institution and would not be easily replaced by modern Western medicine, and in many cases it was also better equipped to serve the large rural population, the government decided in 1950 to attempt to integrate the two disciplines and reap the benefits of both. This was a long and complicated process, but by the end of the twentieth century, most people in Mainland China viewed traditional Chinese medicine and modern Western medicine as equally viable options in their overall view of the healthcare system. As a result of these factors, and several more equally important reasons like the language barrier and complicated payment systems of American healthcare facilities, elderly immigrants to America from Mainland China are more apt to seek healthcare options that are more familiar and easier for them to understand. This usually means that they will seek out traditional Chinese healthcare practitioners before pursuing treatment from modern American healthcare services as a last resort because that is what they are more comfortable and experienced with and where their confidence lies.

In Taiwan, the situation was very different. Under the rule of the Chinese Nationalist Guomindang Party, that country evolved under the strict adherence to the capitalistic principles of the West. Even before then, the country was occupied and ruled by the Japanese, which encouraged modernization of the island, often at the expense of the traditional ways of the native Chinese. By 1949, when the Guomindang Party retreated to Taiwan from the mainland, the health care system was already Westernized, and the practice of Chinese medicine was severely suppressed (Guo 2000:68). Adding to the decline of practicing traditional Chinese medicine in Taiwan was the fact that the Guomindang were a defeated party upon their arrival in Taiwan. They felt that their only hope in restoring their prominence was through Western support. Part of their strategy for courting the favor of the West was through the introduction and promotion of a more modern Western style of medicine. Several other factors, such as the fact that most of the Guomindang party that came to Taiwan were either military or professional career oriented and were thus already more exposed to modern Western practices, combined to better equip the average Taiwanese to utilize the modern American style of Western healthcare available to them when they immigrated to the United States. That is why, in general, elderly immigrants from Taiwan to the United States are more apt to seek out Western medicine alternatives for their health problems before their counterparts from Mainland China. HOW THESE DIFFERENCES RELATE TO CULTURE Since culture can be defined as the set of beliefs, attitudes, and practices a person learns through societal and environmental influences, then the apparent differences between Chinese and Taiwan elderly immigrant attitudes towards Western medical practices could perhaps best be viewed as differences in their respective cultures. It is clear that the divergent paths taken by the governments of each country in regard to their relationship and attitude towards the West has

resulted in a marked difference in their respective populations desire and ability to deal with the complexities of a modern Western style of medicine such as the one they encounter when immigrating to the United States. The benefits and shortcomings of both the traditional Chinese healthcare system and its Western counterpart apply equitably to each population, yet the Taiwanese immigrants are more inclined to draw on their culturally adapted attitudes and choose Western medicine than the Mainlanders. It could be suggested that if the civil war had ended in 1949 with a Guomingdang Party victory instead of the Communist, then the situation might be just the opposite, with a more Western, capitalistic society prevalent on the Mainland and its immigrants more able to deal with the American style of Western healthcare. This is clearly then a case of cultural differences in the populations rather than a biological or hereditary inadequacy.