Episode: "A Long Way From Home"

Name: Edward N. Chai
Nationality: USA
Profession: Neuropsychiatrist
Birthplace: Chester, PA
Hobbies, if any: Running, reading
How many years with MSF? 1 year
MSF missions? China

What brought you to MSF / sparked your interest in humanitarian work?

Contributing to the common good, sense of adventure, finding "life defining" actions, interest in travel

Most memorable moment with MSF?

Taking a boat twenty minutes, hiking for over an hour, making a house call to see a man who was paralyzed from a spinal chord tumor but was now walking after I made the diagnosis and MSF supported the surgery...knowing how much my expertise and consultation services are worth monetarily in New York, and getting "paid" with only a homemade meal…

Where was your MSF mission and how did MSF come to open a project there?

We were in Guang Shi, which is the province just west of Gong Dong. We were in the northwest portion of the province in a very, very mountainous region. MSF had been there for about five or six years. In about 1996 there was flooding there (it rains a lot there particularly in the summertime) so initially MSF went in for acute disaster relief and decided to set up a mission there.

What is Gong Dong like?

So we were about five hours away from a major city with an airport, and six hours away from Nam Ling, which is the capital. All the farming was terrace farming there because it’s very mountainous. Access to villages was difficult—it would frequently take an hour and a half to two hours driving on dirt roads to get there, but once you got there, you found a lot of people. I mean you would drive an hour-and-a-half and you would constantly see people walking on the road.

It’s always been very poor. My father who was born in China, when I told him where I was he would say that the whole area has always been poor. There’s a Chinese saying that said that it was “the rule of twos” of the area. He says you can’t go two days without rain—which is true—you can’t go two feet without a hill—which you can see is true—and you can’t find two pockets with two cents, meaning that it’s always been very, very poor.

Was physical access to villages ever a problem in such a remote area?

One village was accessible by about a twenty-minute car ride and then a thirty to forty minute walk up a dirt road. As the buildings are built along an incline, and it rains a lot, there’s a lot of mud. You have to be pretty careful on foot. The interesting thing is that my first response was, you know, when you see access this poor, my first response was why don’t they do something about it? You know, how are we supposed to access this? And then it dawned upon me that this is not poor access for the locals, because they’ve grown up like this. So this is, I mean, when it takes us like ten or fifteen minutes to get down the hill, they just kind of dash down with anywhere between 50 and 100 kilos of stuff on a yoke. So, it’s not a problem for them, it’s my problem [laughs].

In retrospect, what was your overall impression of your mission in China?

China is a corrupt mess, worse than I thought. The role of MSF in quantitative terms is minimal but it is important in that we should be an example to the Chinese so they might expect better from their government and their own authorities.

How is access to medical care and basic services?

Since the so-called economic boom and the opening up of economics, there’s nothing that’s free. Medical care all costs money – I mean it’s not as expensive as it is here, but if you’re only making, you know, 20 or 30 American dollars a year, medical care becomes very, very expensive.

School also costs money. It’s not a lot, but like I said, primary school costs money, middle school costs money, high school costs money, if you’re only making a very small amount… to put some of this in perspective, a semester in primary school is about 140 Quai. A lot of families are lucky if they make two or three hundred Quai a year. Now that doesn’t include food, because they grow their own food, but 200 or 300 hundred Quai to cover anything else that can’t be grown – clothing, etc. Universities cost anywhere from 6,000 to 12,000 a semester. So, you can do the math.

The gap between the “haves” and the “have-nots” in China is enormous… it’s immense. There’s certainly a small population in the big cities right now that is very, very wealthy. And if you go to Beijing or Shanghai they have Mercedes dealerships and Rolls Royce and Ferrari dealerships and there are clearly people who have the money to buy them. But we’re also talking about a population that doesn’t have access to basic education or even basic health care.
Medical care has to be self-sustained, meaning that for a medical institution to stay afloat, they have to bring in enough money financially to stay afloat.

What did the mission mean to you as a professional or personal learning experience?

It made me appreciate the affluence and high standards of our society.

What are your hopes for the population you were serving in China?

I would hope that with MSF's continued presence there, the people of China might demand more accountability from the authorities, both medical and governmental.