China enacts draconian curbs on foreign healthcare NGOs

by MICHAEL WOODHEAD
When a Chinese minister says a new arrangement is a "win-win situation" you know have lost. And so it is with China's new NGO Management Law, which is in effect a piece of highly restrictive legislation that will drastically curtail the activities of foreign health and medical NGOs, put them under the direct control of relevant ministries and subject them to tight monitoring and suppression by the Public Security Bureau. 

In what seem to be a parallel with the widespread crackdown on civil and legal rights with the mass arrest of lawyers, Xi Jinping has launched an aggressive campaign to strike against the increasing activities of health NGOs. Many of the activities of groups such as Oxfam and Project Hope may seem relatively inocuous to westerners - but programs focused on poverty alleviation, disability awareness, environmental health and promoting reproductive health, and offering health services to minorities are a highly sensitive subject for China's supposedly Communist administration. You only have to look at the crackdown on HIV organisations to see how the authorities react to any imaginary threat to their authority or the questioning of it.

Perhaps the authorities fear the so called "Third Sector" groups will undermine their legitimacy by highlighting the failures of the government to provide basic services. Or perhaps they are just paranoid, with ministers already on record as saying that NGO claims about "Big Society" are an underhand way of bringing about social revolution - a kind of Velvet Revolution in scrubs.

Whatever the reasons, the new conditions are harsh. The new law for regulating NGOs specifies that

• At least 50% of staff must be local Chinese, 
• All NGOs must register and gain permission for all programs in advance, 
• NGOs must put themselves under the control of the relevant health ministry and departments.
• Programs will only be permitted if they are in line with Chinese government policies. 
• NGOs must also clear all their activities with the PSB and make all their documents and staff subject to instant inspection and ongoing monitoring.

Of course, this is not how the NGO Management Law has been reported in official media. On the contrary, it has been described as a measure that finally recognises the high value of NGO work and seeks to bolster the status of such efforts. The Chinese government said the new law it would provide better management "and strive to provide more convenience and service, better environment and security."

A meeting held to launch the new regulations was told that China "welcomed long-term friendly exchanges and cooperation, and that foreign NGOs brought China international capital, advanced technology and management experience, and their activities were conducive to the development of Chinese science and technology, people's livelihood, welfare and other aspects of business."

However, it was notable that the launch meeting was chaired by Minister of Public Security Guo Shengkun rather than ministers responsible health or development. Guo said that China placed great importance on the work of health NGOs and wanted to further encourage them.

Nevertheless, the security chief also warned that NGOs must strictly obey Chinese laws and regulations, and the new NGO regulation was needed to ensure that NGO programs were conducted according to their stated purpose and "in an orderly manner" - that's Chinese official speak for not doing anything that is vaguely beyond government control.

Another speaker more pointedly warned against NGO "trickery", using the Chinese idiom of "displaying a sheep's head but selling dog meat" (“挂羊头卖狗肉”)

However NGO representatives and diplomats especially from the EU have strongly criticised the wide ranging and oppressive conditions in the new law. They say health NGOs already find it difficult to operate in China and the new law will make it even harder. The law curtails almost all the rights and functions of NGOs and their staff, and makes them subject to vague but sweeping and draconian powers of the PSB and ministries.

An EU representative said the new laws will impose an excessively heavy burden in terms of administrative, financial and personnel requirements on NGOs and greatly increase operating costs of the organizations, making their China programs unviable.

The meeting heard that there were about 1000 NGOs with long term programs in China and as many as 7000 with short term or one off aid programs. How they will be affected by the new measures remains to be seen.

The cardiologist behind Project Hope is honoured in Shanghai

Dr John Howe collects his Magnolia Award

 A small-town boy from Maine who once rushed to the library to read the latest National Geographic has been honored with Shanghai's highest award to foreigners for the work of international medical charity Project Hope.
Dr John P Howe III, internist and cardiologist, has seen a lot of the world and helped a lot of people since becoming president and CEO of US-based Project Hope (Health Opportunities for People Everywhere) in 2001.
In September, Howe received the city's prestigious Magnolia Award for his contributions through the Shanghai Children's Medical Center (SCMC). It opened in 1998 with US$37 million in medical equipment from Project Hope.
Today the center is one of China's leading pediatric hospitals and one of the world's premier pediatric heart centers. Hope continues to donate equipment and sponsor SCMC doctors for overseas training.
Project Hope, founded in 1958, has programs and offices in 35 countries. Its most visible symbol at one time was the US Hope, a converted US Navy hospital ship that sailed the world, delivering badly needed medical treatment, training and health education. Today, its operations are land-based.
In 1983, Project Hope became the first international non-governmental organization to partner with China's Ministry of Health to improve the healthcare system. Today it has 13 programs in China and is involved in children's health and cardiac surgery, diabetes, HIV/AIDS and training of doctors, nurses and health professionals.
"As a doctor, you save people one by one, but in Project Hope, you can save a lot of patients," Howe said of the difference between being a doctor and being a CEO. He was interviewed by Shanghai Daily after receiving the Magnolia Award, given annually to a number of expatriates and foreigners.
"Of course, working for Project Hope is a tougher job," he said. "The hardest part is matching our resources with the needs of the world. Every day I am involved in fundraising."
Howe praised the work of Chinese and American healthcare professionals who contributed to the success of the Shanghai Children's Medical Center.
"The highly specialized, excellent care of young patients at SCMC is an indication of how Project Hope's mission of training local doctors, nurses and health professionals can help build stronger communities for generations to come," he said.
The hospital also shows how cooperation between US groups and Chinese leaders can create expertise and enhance public health in a rapidly emerging country, he added. "Before 1998, the hospital didn't exist. When the city decided to create a world-class children's hospital to meet its commitment to children's health, Project Hope decided to become the partner."
The children's medical center is one of Project Hope's biggest programs and every year it donates around US$1.5 million for equipment, training and academic exchange. It supports 16 training programs in diabetes, children's nutrition, child development, critical care medicine, cancer care and other areas. Project Hope also sends rural healthcare workers and professionals for training at SCMC.
Every year more than 3,500 children receive surgery at the hospital for congenital heart defects. That's more than any other hospital performs, said Dr Liu Jinfen, president of the medical center, which also specializes in leukemia treatment.
In 2011 the hospital was accredited by the Joint Commission International (formerly the Joint Commission on Accreditation of Healthcare Organizations) - the first Chinese pediatric hospital to receive such accreditation.
Project Hope also works in rural areas, training healthcare professionals and donating equipment to hospitals.
Read more: Shanghai Daily

Ma Zhengzhou: An AIDS Relief Practitioner on the Frontlines

As part of her series on NGOs in Anhui, CDB Senior Staff Writer, Guo Ting, tells the bittersweet story of an AIDS relief practitioner’s ultimately successful efforts to set up a Chi Heng Foundation office in Anhui province, register it as a NGO and deliver financial assistance to HIV-infected families in the area. Ma Zhengzhou’s story reveals the difficulties faced by NGO practitioners in China yet also illustrates how they can overcome those difficulties by persisting through adversity and rejection, and building good relations with local GONGOs.
At the end of 2011, I received an anonymous reader’s letter.  The letter in fact consisted of only a single line, "please pay attention to the tragic fate of rural HIV-infected people," while the body was completely empty, without a name or contact details.  Curious, I wrote back to seek an understanding of the writer: He was Xiao Dai, a young man from rural northern Anhui, whose parents contracted HIV through blood transfusions in the 1990’s, bringing further hardship to this already poor family.  He had to study hard to secure a place at a university, and yet he arrived  carrying his bedroll, unable to pay his tuition, and prepared to be rejected and head south to do manual work.  He avoided this fate thanks to the generosity of the Chi Heng Foundation (智行基金会), an organization that provides financial aid to children affected by AIDS and which, having learned of his situation, provided tuition fees and living expenses.  Today Xiao Dai has graduated and is married with children.
Read more: China Development Brief