创造自己的音乐 (Making your own music)

夏天时很想继续更新这个博客，可是由于工作的原因，所以没能把每个故事都写下来。现在已经回到耶鲁了，时差已经倒过来了，可是文化冲击（culture shock）实在太大了。到处都是消毒液和各种肤色的人。耶鲁本身也焕然一新了，每天在路上走路的时候可以听到改修建筑的那铿铿之声。

前几天跟久违的朋友们聊天的时候发现我个人的变化也相当明显。据一哥们儿说，我的思维和言行变得比他更“成熟”。确切地说，我变得比他更“老，”而我还没到21岁。

以后再说朋友所注意到了的变化——这篇博文的题目是“创造自己的音乐。”关注我的博客的网友们也许注意到，我的每一篇博文都有和音乐有关的题目，可以说，像古代诗歌里所描述的自然现象

代表诗人的某种心绪一样，我也会选些恰当的词来抓住并总结整篇博文的内容。这次，我之所以起这么一个题目，是因为我想讨论一下写博客的一个关键矛盾——我们不可能将生活中所有经历的每一个细节都志于纸中，只能把精髓与大家分享。这次，我会试图把我夏天所做的一切都解释清楚。

不过，这个博客毕竟是给不会看汉语的耶鲁同学们以及我的母亲看的，所以从此我会回到英语。

Sometimes we have to make the decision whether to write or live the blog. I apologize for not writing over the past few months, and will do my best to summarize.

Over the past year and a half, I have been traveling and studying in China as a Richard U. Light Fellow of Yale University. I learned of a nonprofit organization called Compassion for Migrant Children in late December 2008, and began working there in April of 2009 to develop its health initiatives. With the support of the Yale Global Health Leadership Institute, I have been able to establish a health awareness and education program and expand outreach and awareness on China's internal migration issues.

As those who do not have an identity under the current hukou (household registration) system, migrant children and their communities face many challenges, including substandard education, inadequate healthcare and unstable residency. A needs assessment survey conducted at the now-demolished Dawangjing village in late 2007 reveals that many migrant children and parents are not aware of many hygienic habits and health facts that could decrease the frequency of preventable illnesses such as diarrhea and dysentery. Negative images of migrant communities are reflected in media, even in community health stations, where doctors describe migrants to be poor and dirty, a stain on what were originally “pure” villages populated by Beijingers. Migrants realize this and simply go to unlicensed clinics in migrant neighborhoods. As one man I spoke to over a couple bowls of beef noodles related, “Any medicine that ease the aches sold without the (urbanite’s) discrimination is better than service provided with disdain.

After working with migrant teenagers, local organizations and fellow workers, I drafted the health program manual for CMC, outlining health curriculum development and implementation procedures for CMC’s core programs as well as procedures on developing healthcare projects with outside organizations.

I approached and negotiated with several organizations on providing preventative medicine workshops for migrant youth, including corporations such as SOS International, Vista Health and United Family (China’s only foreign-run hospital). However, I found my proposals heard by another Beijing-based NGO called Prevention through Education (PTE), an organization which seeks to spread HIV/AIDS prevention education throughout China. While the teachers’ primary topic of expertise was sexually transmitted infections with emphasis on HIV/AIDS, PTE’s medical representatives realized the value and importance of providing a comprehensive preventative health curriculum for migrant youth after understanding their major health concerns and needs. Today, PTE’s teachers have already developed classes to be taught to our young migrant trainees that will cover essential topics including personal hygiene, diet, drug/alcohol abuse and sex education. Because the migrant teenagers who lived at CMC’s community center were familiar with me as a teacher, I ran trial awareness seminars in Chinese on sample topics, including H1N1 flu awareness and human anatomy.

I also began discussing projects with United Family’s philanthropy director in early June to provide free immunization service for the migrant youth of the Dongba community. However, following the economic crisis, United Family’s board of directors fired the philanthropy director for engaging in projects “that do not comply with currently changing development plans (of the hospital).” The projects have not been discussed since the director’s dismissal. This was among the earliest of my several encounters in Beijing with corporate social responsibility (CSR). Though I accept the fact that many businesses today may never be socially responsible and comply with CSR for the sake of window-dressing, my work to provide health education at CMC’s community centers has taught me how to negotiate in order to leverage resources that benefit a greater social good.

Demolition mandated by district and city government officials constantly threatens CMC’s work in migrant communities. Government officials realize that migrant workers literally have built the physical infrastructure of major coastal cities and continue to create economic wealth for China. However, policymakers worry that unmanaged growth of migrant villages will result in formations of nonstate migrant power that threaten government rule. Therefore, the ultimate goal behind demolition acts is not to completely erase migrant communities, but to create regulated regimes of private capital. Without a doubt, restructuring both the physical landscape and social hierarchy in migrant communities has major consequences on the lives of migrant children and their families, but in the race for survival on urban territory, migrant workers sacrifice their health for socioeconomic security. A lack of healthcare awareness coupled with a biased healthcare system that serves only those with urban hukou discourages the typical migrant worker from investing time and money learning about local healthcare services. For the migrant worker, a couple pills of acetaminophen may mean comprehensive healthcare. To ameliorate the ill-effects of policy concerning internal migration, the nongovernmental sector in China must persevere in its efforts to provide evidence of successful alternative programs that respect the migrant individual as a human being. At the same time, players in the nongovernmental sector must learn how to rangbu, or make way, for government. Though the health program is far from complete, the foundations have been laid for greater and more meaningful projects to come. I hope to return to CMC next year to continue overseeing the development of the health program as CMC’s community centers expand, face new political obstacles and interact in new migrant communities.

Truth be told, I leave Beijing dissatisfied. I leave a program to which I dedicated the second half of my life in China, and wander around Yale from class to class, still wondering ways to alleviate China's internal migration problems. I left behind relationships in the migrant communities, friends my age who are braving the real world for less than minimum wage. For now, there are only two things that help me put this program into perspective.

The wise Charlie, the former Director of Operations at CMC (now studying at the London School of Economics), advised me, "You're not going to fix the world in five months. The program who design will guide the people who come after you - think about the work as a mission where you have allies there to support you. Interventions and short-term projects are great, but ask yourself - what is the point, and will it make a long-term irreversible positive impact?"

Second, I read a book recommended to me by the founder of CMC, Jonathan, called Pathologies of Power by Dr. Paul Farmer. In his book, Dr. Farmer says that the claim that some people are born unlucky is a fallacy - simply put, there are socioeconomic and political roots to health issues that have caused concentration of wealth and fortune in the hands of few. These problems must be addressed in order to maximize our current efforts in global health.

Indeed, after working at CMC, I realize that there are poisons in this world whose antidotes, though we possess them, are difficult to distribute. However, if we have the ability to imagine a future where, as Dr. Farmer incessantly says, Articles 25 and 27 of the Universal Declaration of Human Rights are observed, can't we also create it?

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