Treating China's Lost Generation

By Claire Vail, Senior Web Content Specialist

This story originally ran on Nov. 13, 2006

BOSTON - Boston's Chinatown is home to 5,000 first-generation immigrants, many of whom fled China during the country's Cultural Revolution -- an effort by communist party chairman Mao Zedong to throw off his country's "elitist past" during the late 1960s and early 1970s. Zedong uprooted and permanently derailed the lives of millions of China's urban residents, creating what is often called the "Lost Generation." College students were forced into manual labor, families were separated, and thousands were killed. Many of the survivors now live -- and seek health care -- in Chinatown.

According to Yoshie Ng, an Asian language interpreter at Tufts Medical Center, the revolution robbed a generation of more than time.

"A lot of our patients can't read their native language," says Ng. "During China's communist cultural revolution, when libraries were being destroyed, it was better to be illiterate. You might be punished for being educated."

At Boston's South Cove Community Health Center, Executive Director Eugene Welch oversees a dedicated staff of Chinese-speaking clinicians who treat 19,000 patients a year -- many of them children of the revolution who are now in their 50s and 60s.

According to Welch, poverty and lack of education in rural China continue to create difficulties for those who choose to leave the country, especially for older men and women. For those who come to Boston, the poverty rate floats around 28 percent, with an average combined household income of $9,500 in one of the nation's most expensive cities.

Once they arrive, financial barriers, complex insurance regulations and fear of the unknown discourage immigrants from seeking out preventative health care. Not surprisingly, many of the people are already ill by the time they see doctors.

"We find that we're dealing with so many people who have had very little care where they come from. Some of them come to the U.S. at a much older age, and some are very sick. We see a lot of diabetes, hypertension, hepatitis and tuberculosis," says Welch.

Welch sympathizes with many of his patients who have to struggle to understand the scope and seriousness of their illnesses. Despite the challenge that illiteracy can sometimes pose, he points out that SPIRAL -- an online database that offers health information in six Asian languages -- does make a difference.

"People don't realize how hard it is to access the health care system without help when you're an immigrant," he explains. But SPIRAL, which was created by staff at Tufts School of Medicine's Hirsh Health Sciences Library and the South Cove Community Health Center, can help, according to Welch. Even if patients can't read, he says, the database is a great resource for providers, nurses or aids who are trying to look up information.

SPIRAL, a free online resource for patient information in Asian languages, can be found at http://spiral.tufts.edu

Photos by University Photographer Melody Ko