NIGH's Beck in China Peoples' Daily

China People's Daily interviews Dr. Deva Marie-Beck, co-director, Nightingale Initiative for Global Health (NIGH).

“Like Norman Bethune, She Loves China”

Full interview: Deva-Marie Beck, PhD, RN, International Co-Director, Nightingale Initiative for Global Health (NIGH) based in Ottawa talks to  Li Wenzheng, Chief Canadian Correspondent, China People's Daily. Dr. Beck recently travelled in Beijing and Jinan during October, 2008 and met with Chinese nursing leaders and nurses to get a first-hand understanding on healthcare issues in the country. Excerpts of the interview were published in the China People's Daily on 10 December 2008.

Deva-Marie Beck, International Co-Director, Nightingale  Initiative for Global Health (left),  greets His Excellency, Mei Ping, Chinese Ambassador to Canada (1998-2005), now Senior  Fellow, Centre for International Governance Innovation (CIGI).  Louise Jiang Birch, China  Research Institute of Ottawa (CRIO) at the centre. photo credit: Yang Shilong, Xinhua News Agency

LI WENZHENG: Recently, you made a spontaneous and important contribution to the discussion “Re-Inventing Canada-China Relations — A Panel in Memory of Dr. Norman Bethune” — convened in Ottawa, Canada on October 29th. Can you please repeat what you shared at that meeting?

DEVA-MARIE BECK:: It was such an amazing coincidence that — just after I had returned from an extensive trip to China — I was able to attend that meeting in Ottawa. Upon learning of China's new vision for establishing better Chinese-Canadian relations, I felt that I must take the opportunity to speak, at the microphone, about my recent experience. I shared that I was recently honoured to attend and present at a WHO [WPRO] regional nursing leadership conference in Jinan, in China's Shandong Province, the birthplace of Confucius. At this conference, I learned that Chinese nurses have been commended for their excellent contributions, through the Red Cross Society of China, to the rescue efforts during the recent Sichuan earthquake.  I expressed my heartfelt condolences to China for their extensive, tragic losses from this earthquake and I acknowledged how important China's disaster "preparedness" had been, to minimizing the tragedy.

As well, I talked about my recent privilege to present at a major international nursing conference in Beijing, noting that this conference had an important Canadian connection. The Registered Nurses Association of Ontario (RNAO) had co-sponsored this conference with the Beijing Nightingale Community of Culture (BNCC) where many Canadian nurses joined Chinese nurses to meet and discuss the key nursing issues they have in common. This, I noted, was an excellent current example of new Chinese Canadian relationships already established between the citizens of our two nations.

I also proposed another way for the 300,000 nurses practicing in Canada to better understand China, suggesting that China should be very proud of the 2007 Chinese Peoples' Congress strong commitment to achieving health care for all Chinese people by the year 2020.  Because Canada has made such a commitment to all Canadians, I knew that Canadian nurses would be very pleased to learn of China's similar commitment.  To this end, I shared how I had recently been meeting with Chinese officials to discuss the possibility that China might be willing to collaborate on bringing two proposed Resolutions to the United Nations General Assembly in 2009. These proposed Resolutions are to commemorate the year 2010 as the UN International Year of the Nurse as the launching of a dedicated UN Decade for a Healthy World, from 2011 to 2020.  If China champions these proposals — in keeping with China's commitment to health for all Chinese people by 2020, Canadian nurses will certainly appreciate this further commitment of China to the world's nurses and to global health.

I also mentioned, in closing, how much I love the China I have visited. And, especially, I appreciate the warm, caring hospitality and strong sense of self-discipline I noticed in the Chinese people I met.       

LI WENZHENG: Based on what you have seen and read, what are your brief views on China's social and economic progress?

DEVA-MARIE BECK:: From my standpoint, China's economic progress has been truly remarkable and an awesome thing to behold. And, I admit, at first, this was very surprising to me.
 
Because I was raised in Southern California in the 1950s and 60s, my knowledge of China was limited to what I was taught by my parents and community. And, this perspective was, of course, factored by a "cold war" culture that was experienced throughout the west.  During that time, we did not learn very much about the good people of China or about China's struggles to do the best you could, given the severe hardships you have suffered, even for many decades, before and during World War II.

Part of the reason I was surprised — and perhaps many others were, as well — was that I did not know much about how China's ancient civilized and caring culture remains available to Chinese society, even today.  What you endured — from the early 20th century, even into the 1970s and 80s — was like a long wintertime for your people. Now, with your 'open policy,' seeded in the 1970s and bearing fruit, 30 years later, your progress is like a new springtime — blooming from ancient Chinese roots — for China to enjoy and for the world to witness.

You have come a long way and I know you acknowledge that much more progress needs to be made.  I think you can be justly proud of your economic success.  Much of this has been accomplished — I believe — because of the remarkable discipline and creativity of the Chinese people, who have been encouraged to be so by China's 'openings."  With the current global economic crises — and a related lack of fiscal responsibility — now more apparent to all of us worldwide, China's careful approach to financial progress can also be more widely appreciated. 

As to social progress, this too is remarkable and needs to be better understood by the rest of the world.  While you still struggle with issues that the world is quick to criticize, I see that you are also aware of these concerns and making efforts to improve the “human rights" of individuals by first making wider investments in what all Chinese people need. Your 2007 Peoples’ Congress commitment — to health for all Chinese people by 2020 — is an excellent example. 

From a western perspective, the approaches of the east still seem mysterious to us. As we come to understand the definitions of what social progress means in the 21st century, a better understanding — "of the east by the west" — and "of the west by the east" —  can contribute to significant social progress by and for all peoples. We all have much to teach each other about the best of our respective cultures. While we can still be critical of each other — and perhaps we need to be — we should also all remember to be critical of our own faults. This, so that we can all change — to make a better world in the near and distant future. As China seeks to change for the better — as I believe you are sincerely attempting to do — your changes might well become models for the rest of us.

LI WENZHENG: You were a practicing nurse for many years?

DEVA-MARIE BECK:: From the early 1970s through 2003, I practiced in a wide variety of clinical areas, mostly in critical care settings, in California, Virginia, Maryland and Washington DC.  Overall, my favorite hospital assignments, throughout the 1990s, was on a series of civilian nursing contracts at the Walter Reed Army Medical Center in Washington DC. I liked these assignments for many reasons. First, it was a privilege to be sharing my nursing knowledge and skills with retired and active-duty soldiers and their families. As well, American military hospitals are the closest model I could find for "universal health care" within the United States.  Because the government provides the funding, this means that the nurses, doctors and hospital administrators can focus on giving good patient care instead of worrying about finding enough cash flow and investors to maintain the "business" of health care. And, I also appreciated that the US military promotes nurses to high-ranking officers, colonels and even generals. This means that the priorities of nursing — to promote health and recovery, while also supporting the treatment of disease — can be brought to all health care decisions, from individual bedside care to major policy implementation. 

LI WENZHENG: You were also learning and teaching about holistic health?

DEVA-MARIE BECK:: Throughout the late 1970s and 1980s, even while I was nursing in clinical settings, I was also learning to practice what is often called "holistic health" which refers to caring for people's spirits, emotions and minds, as well as their bodies.  After several years of studying and practicing this, I began to teach these ideas myself, co-authoring a book and developing workshops for nurses in California, where I lived at that time.  This also helped me to better understand why ancient healing practices were similar to my studies. These included traditional Chinese and Asian healing practices, such acupuncture, proper diet, herbal remedies, meditation and "energy" exercises like Qigong.  I was very impressed to learn that, in traditional Asian cultures, healers were paid to keep people healthy, instead of being rewarded for treating people after they became sick. This notion — very different from what we mostly practice in the west — has since been very important to me.

LI WENZHENG: Beyond your clinical work, you’re nursing practice is as a global activist for health.  How did you start on this unusual mix?

DEVA-MARIE BECK:: I was born in Los Angeles and have always been interested in the wider world. As a child, I loved to study maps and read stories about peoples from different lands and cultures. When I was 12, my parents adopted my sister, who is a beautiful Eurasian, an orphan from the Korean War. I longed to travel abroad myself and started doing so in my late 20s. By now, I have traveled and volunteered in more than 30 countries and I plan to do much more. In the late 1980s, I began to think about how ordinary citizens can become global citizens, activists who work on global problems with their time and energy.  At the time, the environmental movement was gathering momentum with the Rio Earth Summit in 1992 and I wanted to learn more about how to join the world of global activism.  Throughout the 1990s, I attended many meetings, conferences and trainings, including at the United Nations in New York, at the World Bank in Washington, DC and at meetings convened beside the 1995 G-7 Summit in Halifax. From these, I learned from people and networks who were advocating for human rights, women's and children's rights, as well as for environmental concerns and sustainable development. In 1996, I had the honour to contribute, myself, by co-facilitating a two-week series of International NGO Forum sessions at the UN Habitat II Summit in Istanbul. This series, titled, "Wellness Dynamics" looked at the key connections between health and economics, conflict resolution, cultural and social issues, urban planning, education and, of course, the environment. 

LI WENZHENG: This connected you with Florence Nightingale?

DEVA-MARIE BECK:: Actually, yes, although I didn't plan it that way. During these explorations to learn about global activism, I funded myself by doing nursing shifts. But I thought I was walking away from nursing.  Then, unexpectedly — during the planning stages for the UN Habitat Summit in Istanbul — I learned that Florence Nightingale had actually begun her famous nursing career in Istanbul [then Constantinople]. With this knowledge, I looked for the first time at Nightingale's life and work in-depth. I was flabbergasted to learn that Nightingale had, herself, been both a nurse and a global activist in her own time. As a nurse who was concerned with promoting the health of peoples, she, too, had worked on similar issues, the connections between health and environmental, economic, social and cultural challenges. While in Istanbul at the 1996 Summit, I co-chaired a "United Nations Tribute to Florence Nightingale" convened at the "Scutari" Barracks — which still stand on the Asian side of Istanbul — where Nightingale actually looked after wounded and dying soldiers during the Crimean War in the 1850s.  This opportunity to understand Nightingale's deeper and broader legacy for nursing was pivotal in my own life insights and career direction. This initial experience led to my own primary Nightingale research and my doctoral and post-doctoral work. 

And by the way, it has been very gratifying to learn that Florence Nightingale is much appreciated in China. She is remembered every year, at a national Red Cross Society of China awards ceremony where China's President personally honours leading Chinese nurses with prestigious Nightingale Medals. It would be wonderful if all countries could follow China's example on this — to nationally honour all leading nurses, around the world, in Nightingale's name. 

LI WENZHENG: So, recently, you have been interested in China and have now traveled there, twice. What else have you learned from this?  

DEVA-MARIE BECK:: While in China I noticed, again, what I had learned earlier, that China's traditional lifestyle includes many longevity factors. These include staying active, eating vegetables and fruits and not so many fatty foods. As well, in Chinese culture, there is a strong emphasis on emotional family and community support and on reverence for elders, for moderation in all things and spiritual traditions that develop kindness and caring. All of these lifestyles are to be actively practiced in society. 

As China looks at how to provide health for all its peoples, today, I believe that all these positive "health determinants" should be emphasized and invested in — as important ways for each Chinese citizen to stay as healthy as they can. This is, of course, back to the notion of investing in ways to keep people healthy in the first place. While China must also invest in the best doctors and the best-possible disease treatment facilities, a focus on keeping people healthy could well make an important difference in keeping their promise to provide health for all Chinese by 2020. 

I also appreciated the opportunity to being several key discussions about how Chinese nurses can further contribute to the health of the Chinese people.  One such discussion developed an idea for convening, in Beijing, a "small meeting with a big idea" to build upon China's current focus on the needs of its 600 million rural peoples.  This idea focuses on bringing leading nursing experts — particularly from rural areas of Canada and the United States — to advise Chinese leaders about how Chinese nurses can gain in similar capacities to be strong health leaders throughout China's countrysides.  

Many people think of nurses as people who only follow doctors' orders.  But this is a tiny fraction of what nursing education and practice is all about.  Like traditional Asian healers, nurses are focused on the promotion of health and a positive recovery process. Nurses are teachers of healthy practices and counselors who encourage emotional support systems, from families and communities.  Nurses are aware of the connections between culture and health. And, while we know that spiritual beliefs can very important factors in healing, we are also taught to respect the spiritual beliefs of everyone. We are constantly reminded not to impose our own beliefs on others, but, instead, to encourage the people we work with to honour and trust in their own beliefs.  As well, nurses realize that there are important connections between the health of people and their environments, including any financial stress people may be facing.

And this brings me to urging all Chinese people to be particularly proud of China's highest-ranking United Nations official, Dr. Margaret Chan, the Director General of the World Health Organization.  Dr. Chan's view of health is very innovative and comprehensive.  She is keen to let the world know that health is much more than the absence of disease.  Dr. Chan sees that an investment in health must now be seen as a critical investment in overall human progress.  She defines "health as is the driver" of all sustainable development, including economic, social and cultural development. Further, she believes that humanity's health can no longer be addressed by Health Ministers alone. "They need help," Dr. Chan notes, from Finance Ministers, Education Ministers, Cultural Ministers and Foreign Ministers, as well as from ordinary citizens, themselves.

In this, Dr. Chan is a champion for returning to a global focus on "primary health care" in which health care is practiced at grassroots levels — where health outcomes can be addressed and measured in individual, family and community terms.  This, of course, brings me back to appreciating the connection between nursing practice and primary health care.  Nurses and midwives are at the core of primary health care delivery.  When I briefly met Dr. Chan, recently, at a global health conference — and she learned that I was a nurse — she smiled and acknowledged that she, herself, had learned a great deal from the nurses at the hospital where she trained, as an intern and resident, at her medical school in Canada — an education that she is still applying today.  

LI WENZHENG: And lastly, can tell us more about your current global work?

DEVA-MARIE BECK:: I am also privileged to be developing the Nightingale Initiative for Global Health (NIGH) with many colleagues — both nurses and concerned citizens —  from around the world.  We see NIGH as a global movement — a global awareness campaign that keeps the priority of health in the public eye and empowers nurses and all health care workers to bring voice to this priority — as well to be strengthened in all that they do.  We are developing this in several key ways. First, we have initiated an opportunity for the peoples of the world to sign their own commitment to the Nightingale Declaration for a Healthy World. This commitment is available online at www.NightingaleDeclaration.net. This online Declaration is currently available in English and Spanish and, now, most recently, in Mandarin. On this website, readers can also keep up with weekly updates on Global News about nurses and leading health issues.  In the near future, we will be featuring how nurses are helping to achieve, on the ground, many of the UN Millennium Development Goals (MDGs).

We are also developing large and small education modules that focus on health and healing factors that Nightingale also identified. These factors include personal wellness, renewal and stress reduction; healthy home and work environments, cross cultural understanding and health diplomacy and the many key environmental and social determinants of health. 

As well, we are proud to be collaborating with Dr. Jean Yan, Chief Nursing Scientist at the World Health Organization, on a recent WHO / NIGH video project which featuring historic, archival WHO photos of nurses and midwives.  This video is titled "Nurses and Midwives: Now More Than Ever for a Healthy World."  During my recent presentations in Jinan, it was thrilling to premiere this video in both English and Mandarin versions.  I am told that the Mandarin version is already highly regarded and will be enthusiastically distributed, across China and wherever Mandarin is used, to share the value of nursing practice with nurses and nursing students, as well as with everyone who is keen for advancing the health of the Chinese people.

Using all of these tools and themes, we — who are working through NIGH's activities — see ourselves as catalysts to call for the above UN Resolutions for the 2010 UN International Year of the Nurse as a launching of the 2011-2020 UN Decade for a Healthy World.  As I work beside my colleagues to move this agenda forward, it is very rewarding to be sharing these possibilities with Chinese and other national leaders and concerned citizens.

And, as I shared earlier, I am so impressed with how far China has come, in the last 30 years, since "opening" its windows and doors to the rest of the world. I believe that the Chinese people and their ancient cultures are key to China's continued success.  It is truly a wonderful opportunity for me to be in discussions, large and small, to encourage China's commitment to healthy people.

And, I think Florence Nightingale would be very proud of all of us.