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University of Miami Active Labor Susan Wong Case Study

University of Miami Active Labor Susan Wong Case Study.

Instructions: Read the following case study and answer the reflective questions.  Please provide  rationales for your answers.  Make sure to provide citations/references for your answers in APA format. 
CASE STUDY: Active Labor: Susan Wong
Mrs. Wong, a first-time mother, is admitted to the birthing suite in early labor after spontaneous rupture of membranes at home. She is at 38 weeks of gestation with a history of abnormal alpha-fetoprotein levels at 16 weeks of pregnancy.  
She was scheduled for ultrasonography to visualize the fetus to rule out an open spinal defect or Down syndrome, but never followed through. Mrs. Wong and her husband disagreed about what to do (keep or terminate the pregnancy) if the ultrasonography indicated a spinal problem, so they felt they did not want this information. 
Reflective Questions:
– As the nurse, what priority data would you collect from this couple to help define relevant interventions to meet their needs?
– How can you help this couple if they experience a negative outcome in the birthing suite? What are your personal views on terminating or continuing a pregnancy with a risk of a potential anomaly? What factors may influence your views?
-With the influence of the recent Human Genome Project and the possibility of predicting open spinal defects earlier in pregnancy, how will maternity care change in the future?
University of Miami Active Labor Susan Wong Case Study

HIST 32 SMC Week 3 Air Pollution Impact Human Beings in Urban Areas Essay.

I have an essay on the following prompt: “Week 3:Essay Question: How the air pollution could impact the lives of human beings in the urban areas in the world?My professor said to be sure to use all class materials and articles as information for this essay,Film: Feast or Famine- Water Management and Food Production in China_transcript[MUSIC PLAYING]Danger lurks behind this beauty. This is a land of extremes. Rivers can explode, driven by rainfall of 40 inches a week. Only the Sahara has a larger expanse of shifting sands. Mountains and deserts make 90% of the land mass useless for growing food. 1.3 billion people have to be fed off an area of land comparable with just two Californias.[SPEAKING CHINESE]We feed one fifth of the Earth’s population using only 7% of the world’s arable land. We’re feeling the pressure.Professor Zhou Yunning Ming is a top agricultural scientist, deeply concerned about how this country will feed itself. 640 cities are now spreading over the precious arable land. This bride is permitted only one child. Within a few decades, the population will still reach 1.6 billion. Failure to feed those millions could trigger a global crisis. And this is a land with a history of rapid lurches from feast to famine.China can rapidly boost food output. How else can the population growth of the last 50 years be explained, as it jumped from 500 million to 1.3 billion.[SPEAKING CHINESE]But newsreels do not tell the whole story. Historical records reveal 1,200 famines. When farming was thrown into chaos by Mao’s romantic dream, 30 million starved to death during his Great Leap Forward.[SPEAKING CHINESE]Things are done collectively in peoples’ communes. A lot of food was wasted in the fields. Some fields were deserted. All these mistakes stopped the farmers getting in the harvests.Sometimes hunger is man-made. Sometimes nature is the cause. Down the centuries, a fear of famine ran deep. [SPEAKING CHINESE]My parents were farmers. When I was young, my home area was hit by natural disasters. My mother and I left the land and we became beggars.People also fear chaos. A deep sense of history reminds them that this rapidly brings hunger. Travel anywhere in China and you hear personal memories, especially amongst the 850 million who live in the countryside [? Gai Jianxiang ?] farms in North China’s Shanxi Province.[SPEAKING CHINESE]I attended school in the cave dwelling over there. These ones as well. I attended school in both. They’re both very old caves.I came here because I suffered from hunger. In my hometown, we could not even afford steamed bread or call or sorghum. I almost starved to death. We didn’t have any rain for a year. It was disastrous.[SPEAKING CHINESE]When I was a child, there was no meat and no rice. We never even thought of them. We just managed to survive on maize and sweet potatoes.Zou Wengang farms in the southwest of China, in Sichuan Province. Now, food is sufficient. But how will farm output be boosted to feed a soaring population? The answer is water.To manage the country, we must first control the waters, is an ancient Chinese saying. Water control and farming are inseparable. Professors Gu Zhaoqi and [? Chun Chien Liang ?] have been building dams and canals across China for 50 years.Water is so important in China that famous water engineers of the past are worshipped. Li Bing created one of the wonders of ancient China, the Capital River Dike, Dujiangyan.[SPEAKING CHINESE]Over here, you get the best view of Dujiangyan. From here, it’s easy to see the water coming from the Min River and dividing into the canal down there.In 276 BC, here in the southwest, in Sichuan Province, provincial governor Li Bing started to divert the Min River. He dug a canal hugging this mountainside. He used fire and cold water to shatter the rock. He had to cut through this hill to reach the present city of Dujiangyan.In the city, the water divides and many canals fan out. The dry but fertile plain of Chengdu in Sichuan Province needed water. Li Bing’s scheme still operates as he designed it, irrigating over 1 and 1/2 million acres. What excites Professors Gu and [? Chien ?] is the science in the design. As water engineers, they know why it still works so well.[SPEAKING CHINESE]This ancient design matches modern scientific thinking.Li Bing grasped how silt and clean water separate at bends in rivers. Put the division in the right place and silt never blocks the canal. And the weirs he built ensure an even flow all year round.2,000 years ago when Dujiangyan was built, 50 million people lived in China. Across the country, there are many ancient water schemes constructed to increase farm output. Li Bing was thoughtful enough to leave behind a design and maintenance manual for his scheme.[SPEAKING CHINESE]The words are [CHINESE]. He is advising that on straight stretches of the river, the center of the channel must be dug deep. This matches the modern theory of soil mechanics.In the winter, the whole canal network stretching out from Dujiangyan is shut down for 50 days’ maintenance. [? Zhou Wen Gang ?] is now one of thousands of farmers who do the work.[SPEAKING CHINESE]Every year for the past 10 years, I’ve been coming here to dig this canal. We have to keep up the maintenance of the canal so there’ll never be any shortage of water.Farmers first dug this canal over 2,000 years ago. Ancient records show that over 1 million people could be engaged on a single project.Canals for irrigation and transport have spanned China for centuries. In it’s 2,000 year history, the volume of water from Dujiangyan has not changed. Much less water is needed to produce hugely increased crop yields.Immense water savings come from lining the earth canals with concrete slabs or stone. The water saving means viaducts and canals reach further and further into the dry Sichuan plain. The area now irrigated is almost four times what it was in 1949. With water, two crops a year easily spring from the fertile land.[SPEAKING CHINESE]Zhou has lived on this farm all his life. He has two sons and a daughter. They were born before the introduction of the one child policy. [SPEAKING CHINESE] showed you shouldIn our area, nine out of 10 years, there was always a drought. Life was very difficult. Without water, how can rice grow? Crops are like fish, they cannot live without water. Our crops just died.Zhou is determined his grandchildren will never starve. [SPEAKING CHINESE]When we work on the canals, we get an allowance from the government. It’s not very much. But this does not bother us and we are laboring to ensure there is water and so make a better future for our children.Zhou helped build these canals, which ended the problem of drought. [SPEAKING CHINESE]I was only a teenager. I had just graduated from elementary school. I first worked on the canals near our town. Later, I went to build new canals linking Dujiangyan with three nearby counties.Water now flows to this farm, over 250 miles from Li Bing’s intake at Dujiangyan.Before the completion of the canals, we had to carry water. This was extremely hard work. It was too hard for women.Sometimes devices called pallet pumps were used. These could lift water a height of 15 feet. They were invented in China 1,900 years ago. [SPEAKING CHINESE]We no longer need to carry water to the fields. When we need water, we to just let the water flow. It’s as easy as that. When the canals were completed, we no longer needed men to help us do the farm work. Women can manage the farms on their own.The fishing is left to the men, when they’re at home. [SPEAKING CHINESE]With the irrigation system in place, a lot of manpower can be saved. You’ll not see many men in the villages around here. Most of them have gone to work in the cities.[SPEAKING CHINESE]Women take care of everything on the farms. We do things like building reservoirs, pile stations, canals and bridges.Zhou’s life shows how food output can switch rapidly from famine to feast. But it all depends on very careful water control. Without that, famine and disaster make a rapid return.600 miles away, water is threatening to get out of control. Flooding has always been a major threat to human lives in farming in China. If these dikes break, 7 million people in the city of Wuhan will be under as much as 15 feet of water.[SPEAKING CHINESE]The current situation is that rain is forecast for Sichuan and South Yangtze today and tomorrow. If the predictions of rainfall reaching 16 inches are correct, then this means we’ll face a real battle.The Yangtze River runs through the vast industrial city of Wuhan. Governor Wang Shengtie is heading for the worst crisis in his life. [SPEAKING CHINESE]Here is the news summary. The provincial flood control center held an emergency meeting today and issued a warning. The second peak of the Yangtze will reach Wuhan within 24 hours.The Yangtze River dominates Southern China as it flows the 800 miles across its flood plain to the sea at Shanghai. 1,200 stations measure levels that can rise many feet in just one hour. Governor Wang makes decisions that affect the lives of 400 million people living along the banks of the Yangtze River.Because of floodwater coming from several sources, the water levels here on the Yangtze will rise. The situation is very alarming. [SPEAKING CHINESE]Under the orders of the Central Military Committee, the armed forces, including the army, navy, air force, and the police are moving urgently to protect the dikes.Over 80,000 miles of dikes are manned every 300 feet, 24 hours a day. [SPEAKING CHINESE]We must be on full alert. The real danger is not caused by this part of the river, but by the water from the Han River. So you must watch out for any change in the water level. If we fail to protect this place, then all our previous achievements will be in vain.[SPEAKING CHINESE]It has now rained nonstop for 40 hours. The weather bureau reports that Wuhan has had one third of its average annual rainfall in just two days. We now have the worst flooding on the Yangtze since 1954. xxIn the flood control center, the governor hears the latest reports. [SPEAKING CHINESE]In summary, the flood control situation on the middle reaches of the Yangtze will be very, very serious. From the beginning of July until now, the upper reaches of the Yangtze have had continuous rain.[SPEAKING CHINESE]As usual, the armed forces are in the front line fighting the floods. In this year’s battle, many officers and men are risking their lives. [SPEAKING CHINESE]We are well prepared for the battle of the floods. We have 300,000 soldiers permanently guarding the dikes, with 30,000 in reserve. [SPEAKING CHINESE]At 11:00 hours, on the 19th of July, the water level at Jiangxi will reach 120 feet. That is 9 inches over the emerging sea level.[SPEAKING CHINESE]If this does happen, then there’ll be an intense battle for us to fight.[SPEAKING CHINESE]In the eastern part of Dujiangyan dike, evacuation is now underway. Flood diversions are being prepared.Diversion means flooding in many areas designed as basins to hold the excess floodwater. The level of the Yangtze has to be lowered to save cities like Wuhan. It is a horrible decision to have to take. Hundreds of thousands of farms inside the flood diversion basins will be sacrificed to save millions in the cities.Alongside the Yangtze River, in many flood diversion basins, the life’s work of millions of farmers has been drowned. This one, near Jiangxi, 130 square miles. 20,000 homes are destroyed. 110,000 people have fled.In 1998, the cost of flood damage across China was 4,150 deaths and damage of $31 billion US. People were never meant to live in these flood diversion ocean basins. Many of them were built over 1,000 years ago. But more than doubling the population of China in 50 years left no choice.Ouyang Xuewen is one of those whose dreams have been shattered. His father built this house. Ouyang has lost everything. [SPEAKING CHINESE]The flooding was an order from the top. We had to accept it. It meant that the city of Wuhan was saved. But we got flooded. At first we were very unhappy about the decision to flood our homes. But then the officials came and explained the situation to us. They persuaded and convinced us. But all of us cried.I’d invested over $3,000 into 16 acres that I’d planted with rice. All this investment has been wiped out by the flood. Our house is collapsing and all our furniture is under water.Many have built temporary camps on top of the dikes. Ouyang, with his wife and two children, have been living like this for over a month [SPEAKING CHINESE]We live on government handouts. There’s nothing to do but just watch the flood water or stay in this tent. I didn’t fix this tent up very well. It leaks when it’s wet and windy. There’s nothing I can do about it.My children have fun playing in the water. But one day they cut their feet. I didn’t know what to do. Fortunately, the medical team was here. [SPEAKING CHINESE]Up until now, we have been spared from any serious diseases that could cause an epidemic. Most of the cases here are just colds, sore throats, and stomach upsets.The Yangtze and the Yellow Rivers dominate Chinese farming. The water is crucial for the feeding of 1.3 billion people. Even the most ancient rag rolls show how worried people are about how heavily and where it rains.Much of China has to get by on just three months of torrential summer rain. The Yellow River is called “China’s Sorrow.” It is the most dangerous, as it is unpredictable. Historical records show the Yellow River has changed its course 20 times. The last time was in 1947, 900,000 died.Those that survive know they have to quickly rebuild their lives and grow food. Within days, school starts in a tent. [SPEAKING CHINESE]These children are schooled to act as one. They learn the need for communal action, to fight the floods and so prevent famine that has struck so many times in China’s history.[SPEAKING CHINESE]If I get a government loan, I would definitely keep on farming like before. If not, I will try and borrow from family or friends. We simply cannot give up farming because as we’d lose even more by having no food or the means to pay back the loans.There is a different battle in North China. [SPEAKING CHINESE]Our explosive population growth means people have been chopping down trees indiscriminately.Shanxi provincial governor [? Wang Wen Shui ?] and Professor Zhou are fighting the destruction of forests. Like battling floods, this is an ancient war. 500 years ago, a Ming scholar wrote, wood was cut from the Southern Mountains. The result was that if the heavens sent down rain, there is nothing to obstruct the flow of water.[SPEAKING CHINESE]In ancient times, Shanxi Province was a beautiful place with a lot of trees and clear rivers. Later, in the Ming dynasty, with the population growth, more and more land was cultivated and more and more forests disappeared. The loss of forests brings serious soil erosion. There is no future that way.Every year, billions of tons of earth are washed away by the torrential summer rains. Land without trees cannot retain moisture and turns to desert. But some, like Professor Zhou, are fighting back with tree planting.[SPEAKING CHINESE]The hills all around us have been flattened by mechanic diggers to create terraces. Trees will soon grow on the hilltops.In Tianzhen County in Shanxi Province, Dai Jinxiang is no longer hungry. But as his village celebrates Chinese New Year, drought haunts their lives. So the battle in half of China is not too much water, but too little. The doubling of population in 50 years only fuels the crisis.Dai is helped with the farming by his family. As they had a girl first, they were permitted a second child. The lack of water they face is typical in North China. Water has to be carried to homes from the only well in the village.Shortage of water is at crisis levels. Per head, Chinese get by on a quarter of what Americans have. [SPEAKING CHINESE]For five months, we have no rain. Now, we need to hire pumps for irrigation. And it costs over $1 an hour.That may not sound a lot. Although they grow much of their own food, the family income is still under $1,000 US a year and Dai has no savings. This is typical for farming families in China.So with the water shortage, how can these farmers help grow yet more food? The first step is motivation. Political disruption in the Mao years destroyed motivation and the careful water control needed for intensive farming.After Mao’s death came the reforms and open door policies. In the cities the impact is obvious. But changes in the countryside have been just as dramatic. Market policies swept away Mao’s planning dictatorship and motivated farmers.Like millions of others, Dai signed a contract for land, which gives him rights to farm as he wishes for 30 years. [SPEAKING CHINESE]Now, we farmers are able to lease our land with contracts. It gives us an opportunity to make long-term plans. We can improve our farms. Motivation is being harnessed to science in the battle to boost food output and beat drought. But solutions must be simple and low cost.In this part of the plant, in Taiyuan, the capital of Shanxi Province, Professor Zhou thinks his scientists have come up with a winner. [SPEAKING CHINESE]Did you make the additive? [SPEAKING CHINESE]Yes, we make it. We also have the patent for it. It costs about the same as ordinary plastic. But the output of cotton has increased by 330 pounds per acre and the yield from maize has increased by 30%.Osmotic plastic has tiny holes. So when it rains, the water is able to pass through the plastic. But when the Sun comes out, the heat expands the plastic and blocks the holes. So this seals the moisture in the earth.The plastic boosts Dai’s maize yields. In China, science is the great hope to meet the growing food demands. [SPEAKING CHINESE]In the past, the maize cobs were not used. But now, we use them as culture for mushrooms. They’re ground to a power and mixed with wheat chafe.As the head of the leading agricultural research institute, Professor Zhou is brimming with ideas. [SPEAKING CHINESE]In this way, over a million tons of waste cobs can be used. After sterilization, we put in the spores and grow the mushrooms. After all this preparation, we can make $3 for every $1 of costs. You know we get a pound of mushrooms from every pound of ingredients. This is sustainable agriculture at it’s best. Nothing is wasted.Innovation in China is nothing new. Professor Zhou keeps this machine to demonstrate ancient technology. It was invented in China in the 2nd century BC.Seeds slide down three tubes into three even rows. This permits weeding and gives huge productivity gains. Until 150 years ago, Europeans wastefully scattered seeds by hand. Half the seeds did not germinate and weeds choked crops.Professor Zhou can show many other inventions and innovations that fed the expanding population in the past. But it is the future that really concerns him.[SPEAKING CHINESE]These seedlings are going to be used for genetic modification of cotton crops. These are the newly bred cotton seedlings. [SPEAKING CHINESE]In order to achieve high yields and good quality crops, seeds play an extremely important role. With the right seeds, we can save on both pesticides and water.Many laboratories focus on seeds. In the last 50 years, coupled with the use of artificial fertilizers, yields have more than doubled in the key crops of rice, wheat, maize, cotton, and soy. By 2015, predictions say 40% of seeds will be genetically modified.Science is a powerful weapon. But it may not be enough. Demand for food is bound to race ahead of population growth, as people want a better diet. 20 years ago, practically no one ate meat. Prosperity has radically changed that. So now, a vast amount of grain feeds livestock to satisfy increasing demand for meat.There are fears that China will become a huge grain importer, sending world prices sky high. But there is a glimmer of hope in one of Professor Zhou’s experiments.[SPEAKING CHINESE]Yeah, it smells good. It must be very tasty.Professor Zhou thinks there is a way to feed cattle without grain. [SPEAKING CHINESE]The governor works, so we must work. In this case, you don’t need any grain to feed the cattle, do you?Microorganisms have been used to break down waste maize stocks. Mixed with wheat chaff and mineral additives, Professor Zhou claims it creates more than enough protein to feed cattle. It is sustainable. The farmer gets free maize stalks in exchange for the manure from the cattle.In the south, with a mixture of dogged determination and innovation, Ouyang is rebuilding his life. Nine months after the floods, friends and family have rallied to help. His home is almost rebuilt.[SPEAKING CHINESE]Last year when the flood came, all the houses were destroyed. I saw them collapsing and it broke my heart. All the houses were flooded and they all collapsed.When the water levels dropped, I came back to the village and everything was in ruins. Later, my friends and family came to my rescue. We recovered the bricks that could be used and found some builders to help me.When there is stability and no floods, this land has always been exceptionally fertile. Food yields have always been huge. In Europe, until reforms 200 years ago, farmers had to hold back nearly a quarter of their wheat crop for seed. For over 2,000 years in rice growing China, only a tiny percentage has been needed. This is one reason why China can move so fast from famine to feast, and so trigger rapid population growth.[SPEAKING CHINESE]Throwing the rice seedlings is a new planting method we are using. It gives us a better yield and saves a lot of work. Rice planting used to involve many people and days of back breaking labor.[SPEAKING CHINESE]The yield used to be about 3,300 pounds per acre. Now, it’s double that amount.Ouyang will try anything if it saves time and makes money. But like millions of farmers, he struggles to make a living growing basic crops like rice. So Ouyang looks for other ways to make money.[SPEAKING CHINESE]If I stick to just farming, my life will never get better. I just cannot make any money from planting rice.The problem is fixed government prices for grains such as rice and maize. So Ouyang has borrowed money to build a pit for snakes he will breed and sell.[SPEAKING CHINESE]We can’t depend on government handouts. We know we have to make a living with our own efforts.But what if all farmers followed Ouyang? [SPEAKING CHINESE]People now have different ways of making a living. We are free to do whatever we like. Some still farm. But others go to the cities and become carpenters and builders. Some even start their own businesses.The frustration of farmers is serious. But in the drive to grow food, the main battlefront is water. Miyun Reservoir was built in one year in 1958. It’s part of a nationwide program that has expanded irrigated areas by over 250% in 50 years.Close by Beijing, this is the largest reservoir in North China. The dam and waterworks were designed by professors Gu and [? Chien. ?] [SPEAKING CHINESE]Many people were involved in the project, over 200,000 farmers, over 10,000 soldiers, 700 barbers, 3,000 seamstresses, and 10,000 cooks. It was very exciting.The professors have lost count of the water projects they’ve built. But clearly, far from enough. [SPEAKING CHINESE]In North China, we just don’t have enough water. Even if we economize, that won’t solve the problem.Throughout North China, the challenges mount. Water levels keep falling. Across China, forest cover has been reduced to under 14%. Ancient rivers are drying up. Logging bans made in 1998 may have come too late.Spurred on by overgrazing, deserts advance almost 800 square miles, about the size of Rhode Island, every year. Millions have left the land to work in new industries. More industry demands more water. Urban growth eats into the best farming land. But this man thinks he has the strategy to win China’s water wars.[SPEAKING CHINESE]The quality of the project and the safety of the workers are of equal importance. I think that’s it’s just enough to be wearing a safety helmet. Li Antian has great responsibilities. He masterminds the development of the Yangtze River from Tibet to the sea at Shanghai. [SPEAKING CHINESE]Today, the rain is light. When it’s heavy, you can’t see your fingers in the rain. So the problem is very much one of having too much water or too little.This earth dike at Jingjiang in Hubei Province is 1,000 years old. Sustained floods make it soft like a sponge. A wall of steel is the latest strengthening solution, but there are thousands of miles. The cost will be huge.This project is an integral part of the Yangtze River flood control program. It will make a great contribution to controlling floods in the future.Fighting the floods has obsessed China’s rulers for centuries. A famous poem by Mao reads, I dream of a great reservoir in the Three Gorges and it will amaze the world.Li Antian is responsible for realizing the dream. The dam will generate electricity and hold back floodwaters of the Yangtze River in the mountains of the Three Gorges, before it crosses the flat plains that are so threatened by floods. Li Antian supervises the design and construction of what is now the largest water engineering project in the world.But the Three Gorges dam is dwarfed by beating the water shortage in northern China He thinks he can divert the excess flood water of the Yangtze river into the Yellow River.[SPEAKING CHINESE]We can build a canal and direct surplus water from the Yangtze River across to the Yellow River. And the additional water in the Yellow River can be used to irrigate a huge area.Water will make the desert bloom. But this is not new. In the far Northwest of China. glacier water has been fed by canal to irrigate crops for centuries. What is new is the scale. 115,000 square miles can be irrigated. That’s the size of Arizona.[SPEAKING CHINESE]We have the capability and the technology. It is predicted that the population of China will reach 1.6 billion. We are sure that this area will be sufficient for feeding our future generations.But such giant schemes are costly and controversial. The environmental impact is uncertain. Some feel much could still be done to reduce the demand for water and perhaps avoid the need for such vast projects.[SPEAKING CHINESE]We have a saying, water the fields. What I urge is water the plants. We cannot afford to flood whole fields.70% less water is used on these fruit trees in Shanxi Province. But saving water like this is rare, even though it is easy and cheap. [SPEAKING CHINESE]Chinese agriculture is now at a crossroads. We are facing two choices. One is blind development that destroys the environment. The other is sustainable agriculture.Voices calling for more sustainable development are getting louder. But the giant water schemes seem unstoppable. When the reservoir created by the Three Gorges Dam fills, over 1 million people will have had to leave their homes.The purpose of the Three Gorges Dam has been misinterpreted as a project to generate more electricity, with deliberate mass migration. But the bottom line of this project is to ensure the safety of people living along the Yangtze River. 20 million people will directly benefit, with another 90 million along the middle and lower reaches of the Yangtze who will also benefit.Ouyang is one of those who will benefit. The snake enterprise did not work out. But friends have lent another $600. Ouyang now owns a bus. [SPEAKING CHINESE]It’s more profitable than farming. A farmer plants seeds in the springtime and has to wait until the autumn to be paid for his efforts. But as a bus owner, I make money every day, well, more or less.Operating rules are strict. A timetable means he has to set off with or without passengers. But Ouyang has it fixed, even though the competition looks stiff.[SPEAKING CHINESE]Nine buses are licensed to operate from here. But we nine owners pool all the fares. And at the end of the day, we divide up all the money.Today, China is winning the battle to feed its millions. It succeeds with the same formula of invention and water engineering it has used for over 2,000 years. But what of the future?With a population expansion from 1.3 billion to 1.6 billion expected within two decades, China must not fail to feed its people. Stability will be critical. The fallout from failure will be global and catastrophic.[PLAYING MUSIC]———————————————————————————–Article: Lora-Wainwright_ Doom to SufferAnna Lora-WainwrightDoomed to Suffer in Silence? Living with Pollution in Industrialized Rural ChinaChina’s rapid emergence as an economic power over the past quarter century has been accompanied by growing concerns over environmental impacts, particularly in terms of pollution. Food safety scandals, large-scale pollution accidents, and widespread, persis- tent, and routine pollution feature regularly in the media, both within China and beyond it. Clusters of cancer, infertility, birth defects, and other pollution-related health prob- lems are a major matter of concern for China’s citizens, who are increasingly taking action through civil litigation, environmental NGOs, the media, complaints and petitions to state institutions, and mass protests. Largely middle-class protests against anticipated pollution took place in 2012 in Qidong, Shifang, and Ningbo and were covered widely by international media. Academic studies have drawn attention to the role of the media, environmental NGOs, and civil litigation in potentially helping implement environmental protection measures.Most environmental suffering, however, takes place far from the purview of journalists, courts, and NGOs. Equally, much citizen action is small in scale, relatively unorganized, and premised rather differently from the language of the media, courts, and NGOs. The everyday struggles of people living with pollution are hugely diverse (see Lora-Wainwright 2013b). The vast majority of Chinese people suffer in silence, are unsuccessful in their at- tempts to put an end to pollution, or are co-opted by polluting enterprises into seeing it as inevitable. This is especially the case when not only the local (and central) governments depend on industry but people themselves rely on it for employment. Such reliance is at its starkest in areas that have traditionally been poor and have few other sources of income. There, local governments face hard trade-offs between long-term sustainability and short- term needs to provide employment and public services. In this context, environmental regulations are largely overlooked because polluting firms provide employment and pay taxes. This happens largely with the acquiescence of locals, raising troubling questions over their potential for aiding environmental protection.If we are to truly make sense of citizens’ potential for championing sustainable devel- opment, we need to look at the intricate processes through which citizens themselvesapproach environmental health threats, whether they accept them, and why. For the past decade, I have been interested in experiences of illness and healing in the Chinese countryside (Lora-Wainwright 2013a) and since 2007 I have focused on the extent to which pollution is regarded as a cause of illness and with what consequences (2009, 2010). This has involved in-depth fieldwork on how villagers understand and respond to pollution-related health risks in sites engaged in intensive resource extraction and processing in Yunnan, Hunan, and Guangdong provinces. It is typically assumed when villagers do not demand an end to pollution that this is due to their ignorance of the risks it poses. To the contrary, my fieldwork has shown that those living with pollution have a sophisticated awareness of the risks they face. Yet over time they learned that they can- not demand an end to pollution and that concerns with health effects are not a produc- tive focus for their demands. The case of a severely polluted Yunnan village I call Baocun will serve as an example of how and why this happens and with what consequences.Baocun is a large administrative village that depends heavily on phosphorous extraction and processing. The main employers are a large phosphorous fertilizer plant, Linchang (a pseudonym), several smaller plants, and local mines. Living in a symbiotic relation- ship with phosphorous mining and processing on a large scale, locals are alarmed by what they call “poison air” emitted by local industries. They blame it for air and water pollution, crop failures, and deaths of livestock. They also venture complex accounts of how pollution may be causing locals to experience frequent inflammations of the respi- ratory tract, painful joints, and gallbladder and kidney stones— all of which are common local ailments and are epidemiologically correlated to forms of pollution present locally. Comparisons with the past and with other places, and direct observation and experi- ence of its effects have convinced villagers that pollution causes an increase in “strange illnesses,” illnesses that were unseen in the past and grew concomitantly with industry. They believe living there results in a shorter lifespan. They talk of a putrid smell (“like dead mice”), irritated eyes, and teeth dropping out among those working in close con- tact with raw material.All these examples point to locals’ acute concerns for the potential dangers presented by industry. However, they also readily doubted their own ability to attribute specific ill- nesses to pollution. If asked directly whether their symptoms could be linked to pollution, they pervasively commented “I am not sure.” Environmental health justice movements typically materialize when those affected move from individual illness experiences to theIndustrialization in rural China, 2009. (Courtesy of the author.)social discovery of a disease (the awareness that others are affected) and the politicization of the disease (Brown 2007). This did not happen in Baocun. Villagers had a sense that a number of ailments were common locally, but hesitated in linking them to pollution. They raised several other possibilities, such as physically demanding work, individual vulner- ability (for women, children, and the elderly), genes, and a weak immune system (see Lora-Wainwright 2013c).Their uncertainty surrounding illness causation is reinforced by experiences over the past few decades. When industry (and pollution) first started, they presented a petition de- manding it should stop and staged several blockades. The basis for their collective action was a concern for the environment (damages to crops and livestock) and for their own health. However, their attempts either failed or resulted in a tweaking of the distribution of benefits. This allowed some locals to draw income and opportunities from industry and made them complicit with its presence. Consequently, villagers learned to protect themselves from pollution in largely individualized ways rather than engaging in collective action against presumed health damages. Their collective complaints are targeted at dam- aged crops rather than harm to health or demanding a decrease in pollution.This shift is due to the embedding of industry in the locality. The local government main- tains a very close relationship with local industry, taking the lead in securing compensa- tion deals and controlling the employment of unskilled workers in Linchang. Local in- dustry and mining attracts a large number of migrants to Baocun, most of whom engage in low-paid and hazardous work. Locally registered residents also benefit from industry through employment opportunities, a growing service sector, and a range of land rental fees and pollution fees, which only they (not migrants) are entitled to. Locals’ life experi- ence and opportunities (as well as dangers) have become inextricable from industry (Lora- Wainwright et al. 2012). Industry has created an increasingly stratified community, divid- ed between those registered locally (and entitled to compensation) and migrant workers. Locally registered residents in turn are a diverse group: some have become managers of private mines and industries, others have opened thriving local businesses, and yet others rely on unskilled labor in the industry for income. With such diverse structural positions and uneven benefits, the local community has little sense of cohesion or shared interests, and they approach pollution largely as an individual or family matter.The Baocun case brings to light very powerfully the intertwining of (1) uncertainty; (2) local perceptions of industry, pollution, and illness; and (3) power relations and social, political, and economic configurations (see Auyero and Swistun 2009). The local politi- cal and economic context is central to maintaining citizens’ uncertainty about pollution’s effects on their health. The fact that protests initially involved demands for better pol- lution control and better health shows that the present subsiding of these demands is not merely due to a lack of awareness or uncertainty. Rather, uncertainty is reinforced by the current social and political economic setting. Through years of living with in- dustrialization, pollution has also become routinized and normalized. It is experienced as an inevitable fact of life. Reactions to pollution cannot be separated from the many other challenges locals face—such as finding work, paying for healthcare, and improv- ing their family homes. For those with a Baocun hukou (registration), job opportunities and compensation rates have tied them to the locality while failing to provide enough wealth to enable them to move elsewhere unless relocated by the industry. They are trapped between having a strong sense of the harm of pollution and yet feeling that they can do little to stop it.In this context, complaints focus on elements for which individual households can more easily gain compensation (damage to crops), and which have proven more successfulin obtaining redress so far. The more visible, positive, and quantifiable outcomes of industry (work opportunities and compensation) overshadow the much more elusive and potentially contestable effects of pollution on the body, which remain the object of suspicion rather than certainty. Local power relations, opportunity structures, and inter- actions with the industry and the local government have disciplined villagers into mak- ing demands that comply with the economistic and materialistic approach to welfare put forth by the industry. Conversely, harm to bodies came to be constructed as difficult to prove not only scientifically, but also socially, politically, and economically. The result is that industry is asked to compensate for damages rather than prevent them from taking place again in the future.This fragile balance is probably typical for much of industrialized rural China, and it has worrying implications. First of all, development is accompanied by staggering hu- man costs and a deeply uneven distribution of costs and benefits. Industry has created a stratified community where “each cares for their own.” Collective resistance is seen as unfeasible since entitlements are not the same across the social spectrum. Migrant workers—who constitute much of the labor force essential to the running of these fac- tories—are paid menial wages, suffer much of the burden of pollution, have poor to non-existent welfare insurance, and are not entitled to compensation for pollution, for this is reserved for locally registered residents. This divide-and-rule strategy, however, is unstable. While local residents may get benefits denied to migrants, many work along- side migrants doing the same menial and dangerous jobs. If a growing part of the popu- lation begins to feel that the distribution of benefits is unfair, discontent might grow. This is particularly the case when, as in a site I studied in Hunan province, pollution remains but resource extraction ceases to benefit locals. Even if this dire situation does not result in violent protests, it produces disillusioned, self-abnegating people subject to environmental health threats whose effects they are painfully aware of but which they feel powerless to stop.This brings me to my second point. Any talk of a search for an “adequate life,” let alone a good life, in these settings is profoundly euphemistic (Zhang 2011). As this case shows, those living with pollution have learned to regard it as an unavoidable part of their natural surroundings. Likewise, their parameters of what constitutes a good life have been adjusted to what they conceive as possible. A clean environment is not on their list of possibilities. This is surely the deepest manifestation of environmental injustice: notonly do they live with pollution, but they do not feel entitled to demand any better. Un- like in the post-materialist model where an increase in wealth leads to greater care for the environment, here partial (and uneven) benefits from industry shift concerns away from demanding an end to pollution and instead requesting compensation for damages incurred. This highlights the difficult compromises that those who live in the shadow of industry have to make. Whether and how they mount complaints against pollution is not only an economic decision but also a deeply moral one.This status quo is inherently unsustainable. Nobody can predict to what extent this unre- lenting, uneven, and unfair environmental suffering will result in protests that challenge the government. My research has shown that the underlying (and growing) awareness of pollution’s harm may escalate into violent protests when particular episodes (acid leaks, explosions, or other severe events) bring it to the fore. At the same time, it has also suggested that the longer pollution continues, the more the community sees it as inevitable, especially when their attempts to oppose it have been unsuccessful. That people do not protest, that cries for help remain unheard or silenced as they stop think- ing they can demand a healthier environment, is in many ways an even bigger tragedy than when they try to resist it, as in the cases we repeatedly hear about in the media. While so many feel resigned to live in an unhealthy environment, it does not mean they are content with it. They are all too aware that there are others further up the ladder benefiting more and suffering less. In this context, citizens could play a crucial role in stopping pollution, but we first need to understand how powerless some of them have come to feel in its shadow.Acknowledgement: The author is grateful to the Rockefeller Brothers Fund and the So- cial Science Research Council for fieldwork funding (RBF/SSRC-CEHI/2008-01-07) and to a Leverhulme Trust Research Fellowship (RF-2012-260) and a Writing Residency at the Rockefeller Foundation Bellagio Center for supporting writing on this project.ReferencesAuyero, Javier, and Débora Alejandra Swistun. 2009. Flammable: Environmental Suffering in an Argentine Shantytown. Oxford: Oxford University Press.Brown, Phil. 2007. Toxic Exposures: Contested Illnesses and the Environmental Health Move- ment. New York: Columbia University Press.Lora-Wainwright, Anna. 2009. “Of Farming Chemicals and Cancer Deaths: the Politics of Health in Contemporary Rural China.” Social Anthropology 17 (1): 56–73.———. 2010. “An Anthropology of Cancer Villages: Villagers’ Perspectives and the Politics of Responsibility.” Special issue, The Journal of Contemporary China. 19 (63): 79–99.———. 2013a. Fighting for Breath: Living Morally and Dying of Cancer in a Chinese Village.Honolulu: University of Hawai’i.———, ed. 2013b. “Dying for Development: Pollution, Illness and the Limits of Citizens’ Agency in China.” Edited collection, The China Quarterly 214 (June): 243–393.———. 2013c. “The Inadequate Life: Rural Industrial Pollution and Lay Epidemiology in China.” In “Dying for Development: Illness and the Limits of Citizens’ Agency in China.” Edited collec- tion, The China Quarterly 214 (June): 243–54.Lora-Wainwright, Anna, Yiyun Zhang, Yunmei Wu, and Benjamin Van Rooij. 2012. “Learning to Live with Pollution: How Environmental Protesters Redefine Their Interests in a Chinese Vil- lage.” The China Journal 68: 106–24.Zhang, Everett. 2011. “Introduction: Governmentality in China.” In Governance of Life in Chinese Moral Experience, edited by Everett Zhang, Arthur Kleinman, and Weiming Tu. London: Rout- ledge.
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