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China death taboo on its way out

With the advent of hospice care, many Chinese are changing attitudes about death.

China Health Aging Hospice Care Culture
An elderly Chinese man watches tourists walk by in the historical Shi Cha Hai area, Aug. 21, 2008, in Beijing. (Paula Bronstein/Getty Images)

BEIJING, China — Death in China isn't what it used to be.

In 1993, when Dr. Li Songtang drove patients to his brand new hospice care facility in Beijing, a place for terminally ill patients to receive necessary care, dozens of protesters gathered to block his way.

Anything associated with death is believed to bring misfortune in China, and the protesters blamed Li for bringing a curse on the whole neighborhood. They smashed the clinic's windows, and eventually forced him — not to mention nearly a hundred dying patients — out in the middle of the night.

But just 10 years later, when Li again brought patients into a new hospice care facility in Beijing, it was an entirely different scene: Hundreds of volunteers came out to help. Taxis stood in line offering free rides. And the local police cleared traffic for them.

This colossal change in behavior mirrors a radical shift in the general attitude toward death in China. With the arrival and proliferation of hospice care — something that happened in the West in the mid-1970s — an increasingly informed and worldy public is starting to change its mind about death and dying. A centuries-old taboo has started to give way.

“Modern education influenced by the West has been eradicating China’s blind faith in death taboo,” said Jin Fenglin, author of "Observing the Line Between Death and Life," a book on the subject of death in Chinese culture. “Hospice clinics have provided another great way to educate Chinese [in terms of their attitudes on death],” he added.

According to Li, who founded Songtang Hospice, the country's first hospice clinic, in 1987, it was as simple as letting patients and their families experience the service and having the results speak for themselves.

Ren Shufen is case in point.

Last year, after Ren's mother, Su, was hit by a severe stroke, she had no place to go. The hospital was reluctant to keep her on since medical measures could no longer help her. Nursing homes that are not qualified to treat terminally ill patients turned her down. And although Ren wanted her mother to stay at home, she couldn't find a caregiver.

Then she heard about Li’s clinic. She was hesitant to give it a try, but since it was the only place available, Ren didn't have much choice.

“I felt so sad when my mother just moved into Songtang Hospice,” Ren said. “I couldn’t fall asleep at night, thinking of her staying in a place where patients are gone [die] everyday.”

But, to Ren's surprise, Songtang Hospice was anything but dreary. In addition to palliative treatments like pain control, doctors there encourage terminally ill patients to spend their days as if they were healthy.

They sing together, watch movies and listen to music. They play wheelchair sports in the garden. Su, who was told a year ago that she had but one month to live, is still alive today.

Although Su's health condition prevented the 96-year-old Su from chatting and being interviewed for this article, it doesn’t stop her from having fun. Half an hour before the clinic’s wheelchair sports began, she was already in a hurry to go so that she wouldn't miss the action. Su's family asked that she be referred to only by her surname.

“Hospice care brings fun. That’s what my mother needs most,” Ren said, adding that she no longer believes strictly in a taboo against death. “I don’t mind being around dying people now. I enjoy watching my mother play with them.”

Since Songtang Hospice was established, families have been spreading the word about positive experiences they have had with hospice care.

Dong Wei, 28, read an article about Songtang Hospice in 2000, and traveled hundreds of miles from eastern China’s Shandong province shortly thereafter to see the little-known operation with her own eyes.

When she first got there, she said she was “afraid to sleep because I always felt as if there were ghosts behind me" — which she now recalls with a laugh.

Even then, the fear did not deter her. She decided, mainly because of the clinic's "warm atmosphere" to stay and become Li's assistant. Today, she says she derives a tremendous amount of satisfaction from bringing happiness to people in their final stage.

One of Dong's patients, Zhang, liked fashion. "So I asked the doctor to allow her out and went shopping with her," said Dong. "Whenever we met, I always called her Miss Beauty.” With tears in her eyes, Dong recalls how her efforts helped a middle-aged cancer patient fulfill her dying wish.

Along with its 180 employees, Songtang Hospice has also seen an increasing number of volunteers, with more than 10,000 people offering their services last year.

Nurse Han Liqing goes about her rounds with the daily dosages of medicine for the elderly patients at the Songtang Hospice in Beijing. (AFP/Getty Images)

Zhang Danuo, a 38-year-old volunteer, has been blogging about his experiences since 2007. His posts detail practical methods that help comfort terminally ill patients, including children, elderly and cancer patients.

Still, there is a long way for China to go. The latest twist of its social prejudice on death came from the country’s heartland. Since October, Beijing’s traffic authority has stopped issuing car plates with number “four” because its pronunciation in Mandarin sounds similar to the word for "death." 

Because of years of ignorance, hospice care remains largely unknown in China. Even in the country’s medical circles, many have never heard of such service, according to a July report from Economist Intelligence Unit, a research firm in London.

To bring hospice care to more Chinese, other NGOs such as Li Ka Shing Foundation have also taken action. Backed by the richest man in Hong Kong, the foundation provides free, at-home hospice care to poor cancer patients across the country.

While, for China’s veteran hospice advocate Li, the mission isn’t yet over. The 61-year-old says he plans to open one hospice clinic in each province of China by 2015, adding that “it’s a wish hidden in my heart for 20 years.”

http://www.globalpost.com/dispatch/china/101108/hospice-care-health-aging-culture