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What We Use in China


Section II: Living in China continued

Personal and Public Hygiene

Chinese Public Hygiene Posters
Public Hygiene Posters from the 1980s

Sun Yatsen (1866-1925), considered the founding father of modern China, was convinced that "competent governance of the body's natural functions" was a "necessary condition for competent government" (Fitzgerald, 2006, p. 153). As long as Chinese were "lacking in personal culture," he wrote, they would not be respected. Sun and his contemporaries called for an end to the practice of growing fingernails to an unseemly length (for the purpose of indicating that they were men of leisure or, at the very least, not manual laborers), advocated the regular brushing of teeth and criticized the practice of passing gas, burping, hawking and spitting at will. Keeping oneself tidy became part of a new style of personal self-management that was considered essential to show the world that the Chinese people had awakened. For any foreigner who has spent any length of time in China, it would appear that Sun's message was lost on a few. Certainly, public hygiene is not in China what most of us had grown accustomed to in our native countries.

Most Chinese believe that expelling bodily gases and fluids is essential for good health and, related, that a failure to clear the throat of sputum can result in respiratory illness. For this reason, it will not be unusual for you to witness many instances of public spitting and urination, the blowing of the nose without the use of tissue paper (expelling mucous by pressing against one of the nostrils and blowing hard through the one open nostril), as well as coughing and sneezing without covering one's mouth and face. Although these practices have fallen into general disfavor with most educated and middle-class Chinese, they are certainly not limited only to poor, uneducated farmers and workers.

Related to the philosophy of ridding oneself of bodily waste when the need arises, Chinese babies are not diapered the way Western infants and toddlers are: They are dressed in crotchless pants and are eventually taught to squat where they stand when they need to urinate or defecate (and, in fact, Chinese toilets—in all public areas and in very old apartment buildings—are simply composed of porcelain covered holes in the ground that one squats over).All relatively new apartment buildings in China are now supplied with Western-style toilets. It is not unheard of to witness a mother hurrying her baby out of a restaurant with stretched arms while the infant leaves a trail of urine behind.

Recently, while I was buying some fruit at a local street market, a little girl—who was about four-years old—smiled at me as she lowered her pants, squatted and urinated, and then grinned widely and innocently as the trail of her urine trickled down past me, just inches from my feet as well as the street vendor's boxes of produce. I personally felt there was something very endearing about that, in a sweet and innocent sort of way, but I can easily imagine how others might be put off by such an occurrence.

Anti-Spitting Poster
Anti-Spitting Poster, Shanghai 2004

In preparation for the 2008 Olympic Games, Beijing made a concerted effort to eliminate many of these behaviors via numerous public service announcements on television and on billboards admonishing citizens not to spit or queue-jump. The 11th of each month was officially designated as "Queuing Day" and passengers were told to stand in line while they waited for buses. Related, all banks in China have now implemented a customer service number system (first-come, first-served) to prevent their customers from pushing ahead of one another and it seems to have worked well—not just in preventing queue-jumping in the banks but, in a more general sense, by conveying that waiting your turn should be practiced in all such situations regardless of what one's social position is relative to others. From February through August 2008, the city had distributed 2.8 million pamphlets to local households addressing numerous issues related to daily etiquette and public hygiene, and social etiquette courses were offered to all civil servants as well as 870,000 people working in the service sector, such as cab drivers, wait staff, and bus conductors (, 2008a). By all accounts, these efforts were quite successful.

Nevertheless, and particularly in the aftermath of the 2008 Olympic Games, China still has some improvements to make in regard to public hygiene. With the exception of Western food chains, most public bathrooms in China lack hot water, soap, a functioning hand-dryer (or paper toweling), and even toilet paper. Foreigners are well-advised to carry several packs of tissue paper on their person in the event they need to use a public toilet in China (although most Westerners never do get used to squatting over Chinese toilets and will do whatever they can to wait until they return to their own apartments). And although there are numerous laws on the books governing public health and safety, they are difficult to enforce with a population of 1.3 billion people. Consequently, eating at small, family-owned and streetside restaurants is ill-advised.

In addition, it is an excellent idea to get into the habit of thoroughly washing your hands upon returning to your apartment, especially if you have handled money or ridden inside any public transportation. Bank notes are ideal breeding grounds for bacteria, especially older bills that are worn and torn in that they provide various nooks and crannies for germs to hide, including fecal matter. A 2003 study reported by CNN revealed that old bank notes from China had 178,000 different types of bacteria and were home to 9,500 organisms from the e-coli family (Brown, 2003). Handling money is like shaking hands with everyone who has ever handled that note. Finally, aside from its cultural significance, there is a sound health reason that the Chinese remove their shoes upon entering their apartments and that is custom you will probably want to adopt as well.

Oral hygiene had never historically been much of a priority in China (because when you are starving, the condition of your teeth is not foremost in your mind), but one can now see more and more Chinese children with braces on their teeth and the number of store front dental clinics is growing.


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