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Asthma

Socioeconomic and Environmental Factors in the High Incidence of Asthma in Brownsville

Nur 4010

June 19, 2017

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Introduction

As a general rule, respiratory issues have priority in terms of patient acuity. How important is it, then, to look at asthma, a chronic condition that requires lifestyle modification, yet can also have sudden onsets with fatal results. With proper management, the complications of asthma can largely be avoided. Nonetheless, its annual cost in the US exceeds $50 billion in medical treatment, with another $5.9 billion in economic losses stemming from 14.4 million missed days of school and 14.2 million work call outs. (Malcarney, Seiler, and Horton, 2013, p.402) Another issue is that certain groups are more affected than others due to social and economic factors that place them at greater risk. Thus, asthma can be assessed as a medical problem or as a political or socioeconomic one.

Asthma is unique in that it typically manifests in childhood. According to Malcarney, Seiler, and Horton (2013), it is the most common chronic condition among children in the US. (p.402) The early appearance has lifetime consequences. A child with even a mild case may have to alter living conditions and activity patterns. Davis (2008) points to the tendency for people to remain indoors during times of poor air quality. (p.39) This limits physical activity, or clients avoid certain streets, parks, or even homes of others, which in turn affects social and psychological development. Heikkinen, Quansah, Jaakkola, and Jaakkola (2012) state that “asthma patients often limit physical exercise to avoid respiratory symptoms… This may predispose asthma patients to severe long-term health risks and impair the prognosis of asthma.” (p.397) This strategy, though, has been found by Bake, Viklund, and Olin (2014) to be ineffectual- even indoors, there may be enough exposure to pollen to trigger an attack. (p.1281)

Population Profile

The Ocean Hill-Brownsville section of Brooklyn ranks as one of the borough’s lowest in terms of socioeconomic status. Tellingly, the neighborhood also has some of the city’s highest rates of health risks, including prevalence and emergency treatment of asthma. The issues plaguing Brownsville read like a list of asthma risk factors and triggers. According to King et. al (2015), only 18% of Brownsville residents have a college degree, compared with a 41% citywide rate. (p.6) As education level often dictates employment options and earning potential, this ensures a high poverty rate. With 37% of residents living below the poverty line, Brownsville is Brooklyn’s poorest area, among the poorest in the city, and the unemployment rate of 16% also outstrips the citywide rate of 11% (King, et. al, 2015 p.6). High poverty leads to illegal activity. Brownsville’s 180 hospitalizations due to assault was the highest of any neighborhood in the city, and Brownsville had an incarceration rate of 348/100,000 adults 16 and over, the second highest of any neighborhood and over three times the average for Brooklyn (96) and New York City as a whole (93) (King et. al, 2015 p.7).

The neighborhood also faces health risks. In 2011, 73% of all homes had at least one maintenance defect, including mice or other pests (King et. al, 2015 p.5). Lovasi et. al (2013) found in their study that 31% of participants were allergic to the cockroach, making it the most common asthma trigger. (p.496) Another contributor is tobacco. In Brownsville, 14% of residents smoke. (King, et. al, 2015 p.8). Brownsville had the 10th highest number of tobacco retailers per capita of all city districts in 2011 (King et. al, 2015 p.5). One other contributor to asthma is poor prenatal care. The preterm birth rate of 13.3% of all births is second highest of any neighborhood, while the neighborhood also has one of the city’s highest rates of teen pregnancy (King et. al, 2015 p.7).

With multiple risk factors it is not surprising Brownsville has one of New York City’s highest concentrations of asthma sufferers. Brownsville’s rate of childhood asthma hospitalizations, 61 per 10,000, was roughly double the rate for Brooklyn, 32/10,000 and the citywide rate of 36/10,000, while the rate of adult asthma hospitalizations, 621/100,000, was well above twice Brooklyn’s rate of 263/100,000 and the city’s overall rate of 249/100,000 (King et. al, 2015 p.12). Although asthma can be managed through medications, poverty removes that option for many residents of Brownsville. King et. al (2015) found that 18% of residents lacked health insurance, and 11% went without needed care. (p.11) 40% of Brownsville area children miss at least 20 days of school per year, the worst ranking of any city neighborhood for that category (King et. al, 2015 p.7). While not all absences are attributable to asthmatic episodes, some are. Repeated absences mean these children fall behind, contributing to the lower educational levels found in the neighborhood. Frank, Hong, Subramanian, and Wang (2013) suggest psychological stress is also a trigger. (p.38) Given Brownsville’s high crime, high unemployment, and low educational achievement, there is a correlation.

Barriers

A big challenge towards management of health is the ability of the client to take ownership. With asthma, the client has little control, because the triggers sometimes cannot be avoided. An asthmatic client may clean the home to remove dust or pests, not smoke, remove carpeting, and not keep pets. However, the client cannot control what goes on in other apartments in the building, nor can the client manipulate the weather or local traffic. If the home is located near a major roadway, there will be exhaust. Financially, the client may lack the means to relocate, and so must modify what risk factors he/she can control, and to learn coping methods with factors that are outside control. In short, as Frank, Hong, Subramanian, and Wang (2013) state, urban living and overcrowding increase exposure to triggers. (p.38) A second barrier to solving the asthma problem in Brownsville is the lack of a singular cause. Shmool, Kinnee, Sheffield, Clougherty (2016) assert that multiple factors, including PM2.5, NO2, and ozone, play a role in triggering an attack, and these can vary widely from one point in the city to another, and even vary by time of day, making it difficult to pinpoint a precise cause. (p.111) Kazuhiko et. al (2015) suggest that ozone and pollen likely have a synergistic relationship in triggering an asthma attack. (p.9)

Another challenge is the overall fiscal health of the neighborhood. Medications can help achieve long term stability and respond to acute flare ups. Working with a nurse or respiratory therapist can help the client develop stronger, more efficient breathing patterns. However, if the client is uninsured, this treatment is unavailable, and the client is forced to rely on emergency room visits. Indeed, Frank, Hong, Subramanian, and Wang (2013) point out that the high prevalence of emergency room asthma visits is not so much a reflection on severity but on the lack of adequate coverage. (p.11)

Another development that may adversely impact Brownsville’s asthmatics is gentrification. While this may bring the promise of economic prosperity, it also means further crowding and changing traffic patterns. A number of major roads cross Brownsville, including Atlantic Avenue, Kings Highway, Eastern Parkway, Jamaica Avenue, and Rockaway Avenue. Adjacent to Brownsville, the City Council recently approved on April 20, 2016 a rezoning plan for East New York, specifically calling for “medium-density, mixed-use development along key corridors.” (City of New York, 2016) This runs counter to the findings and recommendations of residences along major streets brought up by Barrett (2012), Perez, Lurmann, Wilson, Pastor, Brandt, Künzli, and McConnell (2012), and Price, Plante, Goudreau, Boldo, Perron, and Smargiassi (2012). Bushwick is another adjacent area undergoing gentrification. Some of Brownsville’s major roads are shared with these neighborhoods, so Brownsville’s residents have a stake. Chen and Whalley (2012) note that even with improvements to mass transit to reduce pollution in the long run, pollution increases in the short term as a result of construction and traffic diversions associated with it. (p.69) Brownsville, and New York City in general, is served with multiple subway and bus lines. Chen and Whalley (2012) conducted an analysis of air quality in the days prior to and after the opening of Taipei’s commuter rail system in 1996 and saw rapid drops in carbon monoxide levels. (p.60)

Literature Review

In an urban environment, a key trigger is exhaust from vehicles- cars, trucks, buses, construction equipment, and motorcycles- that ply the streets and highways and idle at traffic stops. Around the globe, studies have been conducted and have conclusively demonstrated a relationship with exposure to exhaust and asthma. In urban areas, dense housing tends to place large numbers of residents close to major streets. Barrett (2012) notes that a large proportion of children in Los Angeles was found to be living within 75 meters of a major roadway, contributing to tens of thousands of incidences of asthma and bronchitis. (p.436) Perez et. al (2012) also based their study on Los Angeles and warn that while denser housing can contain sprawl and reduce dependence on the automobile, reducing CO2 emissions by 20%, there is the countereffect of more housing in proximity to emissions, which raises asthma rates. (p.1619) Price et. al (2012) conducted a longitudinal study in Montreal, and found a correlation between living within 50 meters of a major road and the onset of asthma symptoms by age 2, and an even higher percentage of asthmatic children at age 6. (p.115)

An area that remains inconclusive is the role of trees. Lovasi et. al (2013) note the role in trees in curbing pollution, yet their findings do not support the hypothesis that increased tree coverage decreases asthma rates, although they also note that the presence of IgE to tree pollen does not confirm respiratory symptoms such as cough, wheeze, rhinitis, or asthmatic attack. (p.497) Kazuhiko et. al (2015) state that although pollen was shown conclusively to be a trigger, pollen counts only reach high levels for a short duration, compared to ozone and particulate matter. (p.8)

Researchers have also found connections between asthma and socioeconomic factors. Patel, Henderson, Jeffreys, Smith, and Galobardes (2012) conducted a study of college students and found higher rates of asthma among those of lower socioeconomic status. This conclusion was also reached by Frank, Hong, Subramanian, and Wang (2013). Lovasi et. al (2013) state that poverty and belonging to an ethnic or racial minority reflect higher rates of asthma. (p.494) Mitchell et. al (2012) state that asthma has an overall prevalence of 9.1%, with higher rates among lower economic classes and minorities. (1607) Frank, Hong, Subramanian, and Wang (2013) conducted a study connecting the asthma rate for a neighborhood to its incarceration rate. They found that of 466 participants, those with a history of incarceration had a significantly higher rate of asthma than persons with no prior incarcerations; formerly incarcerated persons with asthma also had more emergency room visits. (Frank, Hong, Subramanian, and Wang, 2013, p.40) It is not postulated that poverty in itself is a cause of asthma. Rather, Frank, Hong, Subramanian, and Wang (2013) suggest that impoverished and minority neighborhoods have disproportionately higher rates of incarcerated individuals, which places a burden on the households of those individuals, leading to stress and lifestyle behaviors such as smoking. (p.38) Lack of education is the topic of the study conducted by Malcarney, Seiler, and Horton (2013). As stated earlier, Brownsville has one of New York City’s highest rates of preterm labor, another general indicator of low socioeconomic level and low education. This becomes significant because Duijits (2012) has found links between low birth weight and preterm birth with the development of asthma. (p.6)

Interventions

Increasing Tree Cover

Several New York City developments have significance for asthma in Brownsville. Under Mayor Bloomberg, the city launched the Million Trees NYC initiative. This would lead to improvements as tree cover removes carbon dioxide, traps particulate matter, retains precipitate water, and provides shade to lower temperatures. (Lovasi et.al, 2013, p.494) The MillionTreesNYC site states that “one tree can remove 26 pounds of carbon dioxide from the atmosphere annually, the equivalent of 11,000 miles of car emissions.” (2015) The ability of trees to regulate temperature cannot be understated. Sheffield, Zhou, Shmool, and Clougherty (2015) state that due to rising temperatures, fluctuations in ozone levels are disappearing. (p.3) Without lulls in ozone production, asthmatics are susceptible to more frequent attacks. Most trees were planted in parks, though there were also a number planted along city streets.

The policy is not free from risk, as trees produce pollen, itself an asthmatic trigger. This is a potential issue, as a hallmark of public health is to encourage physical activity. Heikkinen, Quansah, Jaakkola, and Jaakkola (2012) demonstrated the connection between exercise and improved outcomes for asthmatics, yet it has also been shown that asthmatics may avoid exercise or going outdoors. Of 727 participants in their study on long term exposure to tree pollen and asthma rates, Lovasi et. al (2013) found an overall rate of 19% of participants allergic to tree pollen, 28% of children had asthma at age 5, and 36 % had asthma at age 7. (p.494) Yet the rates for both cohorts are greater than the number of children allergic to pollen, so it cannot be the only factor. Kazuhiko et. al (2015) echo this find by comparing pollen counts, OTC allergy relief sales, and emergency visits for asthma, concluding that a pattern of asthmatic flare ups in April occurred before pollen counts had risen, meaning that these asthma attacks were due to triggers other than pollen. (p.3) Kazuhiko et. al (2015) find that the pollen types most correlated with asthma are oak, birch, and maple, with beech, poplar, and elm having mild to low contribution. (p.11) The city can use that information when planning which species of tree to plant in the future, favoring species that are less reactive, or spreading trees with high reactivity further apart.

Traffic Regulations

Since ozone and other greenhouse gases are triggers for asthma, the issues of asthma reduction and pollution reduction overlap. One measure cities have implemented to combat both is to limit the number of vehicles in operation on certain days. Davis (2008) studies the efficacy of one program- Hoy No Circula began on November 20, 1989 to ban car use in Mexico City once a week based on license plate number. (p.39) It was hoped traffic would decrease and emissions would drop sharply, resulting in fewer respiratory episodes. Ultimately, the plan was a failure. According to Davis (2008), people drove at times the ban was not in effect, or purchased older, poorer quality secondary cars to drive on days they could not operate their primary vehicles. (p.63) The result was that pollution actually increased until 1993. (Davis, 2008, p.51) Nonetheless, other cities adopted similar measures. Launched in 2016, Delhi’s city government banned even numbered plates on odd days, and vice versa, from 8AM until 8PM, with a fine for violations. (Government of Delhi Transport Department, 2016, p.1) The plan was more successful in Delhi than Mexico City. In early November 2015, PM2.5 levels in India’s capital topped 600mcg; after implementation, levels dipped below 400. (Environment Pollution Authority, 2016, p.2) Other cities have implemented similar plans. In fact, Delhi looks not to Mexico City but to Paris as its inspiration. Delhi’s Environment Pollution Authority (2016) cites that Paris saw an 18% reduction in traffic and a 6% drop in pollution when it started a traffic program in 2014. (p.8) New York City has recently considered congestion pricing.

Stakeholders

The treatment of asthma in an area like Brownsville carries high responsibility for a number of stakeholders. For politicians and administrators, the need to address asthma in the communities, especially in a disadvantaged neighborhood like Brownsville, is challenging. Policymakers have to meet the demands of the sick in their jurisdictions to improve access to healthcare, but also face demands to improve economic opportunities. These two goals are not always compatible, and may well be antagonistic.

For providers, the question of asthma prevalence is crucial. With shifts in health care costs and reimbursement, there are greater calls for accountability. Since asthma rates hover near 10%, it becomes incumbent to look for ways to demonstrate better management, reduced exacerbations, and improved quality of life among those with asthma.

For the general public, the reason is not so clear. Employers gripe about high overhead due to the cost of providing coverage for employees. However, employers are neglecting the cost of an asthmatic worker, or the caregiver of an asthmatic child, needing to miss work on any given day due to an attack that may have been prevented with adequate coverage. The price of asthmatic medications is considerably less than the cost of several emergency room visits per year. There is much political debate about the Affordable Care Act stemming from the argument, appealing to many, that the covered and working public should not have to shoulder the financial burden of providing coverage for those without it. However, many fail to realize that emergency rooms still treat regardless of the ability to pay- in short, the public would still carry the fiscal obligation of providing care for the underprivileged, since the emergency room would remain their lone option. Malcarney, Seiler, and Horton (2013) state that under the Affordable Care Act, Medicaid allowed states to push more preventative strategies outside the formal clinical setting; among those was the Monroe Plan in New York, which targeted children and saw emergency room visits decline by 78% and asthma hospitalizations drop by 60%. (p.404)

Policy Recommendations

Since asthma is a chronic condition affecting children, education should not be limited to those afflicted or health care providers, but expanded to the public school system. The Department of Health and the Department of Education could collaborate on a program identifying schools with high prevalence of asthmatic students, and targeting those schools for programs such as pamphlets students could take home with tips on how to remove triggers from the home, or information for teachers on what to do in case of an asthmatic attack in the classroom; school nurses could provide the necessary teaching. The city currently runs the Open Airways program, which provides education for children and information for parents without charge in public schools. (New York City Department of Health and Mental Hygiene, 2016) In New Orleans, counselors collaborated with school nurses and providers to create individualized plans for children with asthma based on each participant’s specific triggers, coupled with education on improving home air quality. (Mitchell, et. al p.1608) This allowed afflicted households to have specific plans in place. Mitchell et. al (2012) followed up with participants and saw marked improvements in household conditions, resulting in more symptom free days. (p.1609-1610) Malcarney, Seiler, and Horton (2013) note that the National Asthma Education Prevention Program sponsors teaching sessions in schools and community centers, saving a range of $5.30 to $14.00 per dollar spent. (p.402-403) Malcarney, Seiler, and Horton (2013) note that several insurance companies, such as Optima, Priority Health, and Neighborhood Health Plan, have asthma education programs, and all have seen substantial returns and savings. (p.403) Bake, Viklund, and Olin (2014) assert that asthmatic symptoms lag several days after exposure. (p.1281) Kazuhiko et. al (2015) also note that there is a delay of several days between peak pollen counts and a subsequent spike in OTC allergy relief meds or emergency room visits. (p.6) With this in mind, another solution would be to publicize warnings on days following high pollen counts so that affected people can take precautionary measures.

Concerning traffic, Sheffield, Zhou, Shmool, and Clougherty (2015) find that ozone production follows a pattern, with low levels from 4-6 AM and peaks at 12-2 PM. (p.3) Since these times roughly correspond to both times of low and high traffic volume and low and high daily temperatures, the city can attempt to manipulate traffic patterns centered around peak times. Bike lanes and even jogging lanes can help. Heikkinen, Quansah, Jaakkola, and Jaakkola (2012) point to several random controlled trials in which asthmatics who exercised regularly had increases in oxygen consumption as well as improvement in FEV1 among the intervention group, along with a reduction in the average number of inhaler puffs of beta2-agonist meds from the first week of the exercise program to the last week. (p.402) Perez et. al (2012) also point out that denser housing would also increase physical activity because it would promote walking rather than driving. (p.1625)

Yet increased congestion and traffic mean more emissions. One policy recommendation would be to accompany a rezoning plan with another for reducing overall emissions. (Perez et. al, 2012, p.1624) A second would be to limit the number of new residences placed along major streets, since they will be the most trafficked. Major streets could be reserved for commercial developments, while residences are placed further away on side streets. In their study in Los Angeles, Perez et. al (2012) concluded that thousands of cases of asthma could have been averted if residences were placed further away from highways and major roads. (p.1622) The Delhi government instituted its alternate day ban on vehicle operation in large part “to protect public health in a city where every third child has impaired lungs.” (Environment Pollution Authority, 2016, p.1)

Summary

The urban landscape combines high density housing with vehicular traffic and its consequent greenhouse emissions. Combine this with the stresses of poverty- lack of coverage, homes in disrepair, poor gestational and neonatal care, and the recipe is set for asthma and other respiratory illness. New York City as a whole may have a smaller carbon footprint than other major US and world cities due to a credible mass transit system and relative walking distance to most amenities. Yet asthma still remains a major health concern for the city, especially in certain neighborhoods like Brownsville. Navigating an issue like asthma presents many challenges because there is no single treatment, and no cure, for asthma, while at the same time the necessities of continuing to foster growth and prosperity with housing and economic opportunity has to be balanced against the knowledge that these developments may actually worsen the current asthma epidemic. New York City is not alone in this struggle, and can look to both learn from the experiences of other cities and be a leader in innovating new strategies to improve asthma rates.

References

 

Bake, B., Viklund, E., Olin, A. (2014). Effects of pollen season on central and peripheral nitric

oxide production in subjects with pollen asthma. Respiratory Medicine, (108), 1277-

  1. doi: 10.1016/j.rmed.2014.06.007.

 

Barrett, J. (2012, November). Proximity Plus Pollution: Understanding Factors in Asthma among

Children Living near Major Roadways. Environmental Health Perspectives, 120(11),

A436 doi: 10.1289/ehp.120-a436b

 

Chen, Y., and Whalley, A. (2012, February). Green Infrastructure: The Effects of Urban Rail

Transit on Air Quality. American Economic Journal: Economic Policy, 4(1), 58-97.

doi:10.1257/pol.4.1.58

 

City of New York. (2016). East New York Neighborhood Plan. Retrieved from:

http://www1.nyc.gov/site/planning/plans/east-new-york/east-new-york-plan.page

 

Davis, L. (2008, February). The Effect of Driving Restrictions on Air Quality in Mexico City.

Journal of Political Economy, 116(1), 38-81. doi: 10.1086/529398

 

Duijts, L. (2012). Fetal and infant origins of asthma. European Journal of Epidemiology, 27(1),

5-14. Doi:1 0. 1 007/s 1 0654-0 1 2-9657-y

 

Environment Pollution (Prevention and Control) Authority for NCR. (2016, January 8). Air

quality benefits of odd-even vehicle rationing programme in Delhi: An analysis of week   1. Retrieved from:   http://delhi.gov.in/wps/wcm/connect/506517004b4432b5b8bdfab40ef8d347/EPCA+anal  ysis.pdf?MOD=AJPERES&lmod=770556182

 

Frank, J., Hong, C., Subramanian, S., and Wang, E. (2013, May). Neighborhood incarceration

rate and asthma prevalence in New York City: a multilevel approach. American Journal

of Public Health, 103(5), 38-44. doi: 10.2105/AJPH.2013.301255

 

Government of National Capital Territory of Delhi (Transport Department). (2016, April 11).

Retrieved from:             http://delhi.gov.in/wps/wcm/connect/faec83804c6322d1be53bea086717e58/odd_even.p

f?MOD=AJPERES&lmod=348624296

 

Heikkinen, S., Quansah, R., Jaakkola, J., and Jaakkola, M. (2012). Effects of regular exercise on

adult asthma. European Journal of Epidemiology, 27(6), 397-40.

Doi:10.1007/s 10654012-9684-8

 

Kazuhiko, I., Weinberger, K., Robinson, G., Sheffield, P., Lall, R., Mathes, R., …Matte, T.

(2015, August). The associations between daily spring pollen counts, over-the-counter

allergy medication sales, and asthma syndrome emergency department visits in New

York City, 2002-2012. Environmental Health. 27(14),71.

doi: 10.1186/s12940-015-0057-0.

 

King, L., Hinterland, K., Dragan, L., Driver, R., Harris, G., Gwynn, C., … Bassett, T. (2015)

Community Health Profiles 2015, Brooklyn Community District 16: Brownsville; 2015;   40(59), 1-16. Retrieved from:           http://www1.nyc.gov/assets/doh/downloads/pdf/data/2015chp-bk16.pdf

 

Lovasi, G., O’Neil-Dunne, J., Lu, J., Sheehan, D., Perzanowski, M., MacFaden, S., …Rundle, A.             (2013, April). Urban tree canopy and asthma, wheeze, rhinitis, and allergic sensitization   to tree pollen in a New York City birth cohort. Environmental Health Perspectives,          121(4), 494-500. doi: 10.1289/ehp.1205513.

 

Malcarney, M., Seiler, N., and Horton, K. (2013, September/October). Using Insurance Laws to Improve Access to Community-Based Asthma Prevention. Public Health Reports, 128(5),   402-406. doi: 10.1177/003335491312800512

 

MillionTreesNYC. (2015). NYC’s Urban Forest. Retrieved from:             http://www.milliontreesnyc.org/html/about/forest.shtml

 

Mitchell, H., Cohn, R., Wildfire, J., Thornton, E., Kennedy, S., El-Dahr, J., … Martin, W. (2012,             November). Implementation of Evidence-based Asthma Interventions in Post-Katrina       New Orleans: The Head-off Environmental Asthma in Louisiana (HEAL) Study.           Environmental Health Perspectives, 120(11), 1607-1612. doi: 10.1289/ehp.1104242.

 

New York City Department of Health and Mental Hygiene. (2016). Asthma Open Airways.         Retrieved from: http://www1.nyc.gov/site/doh/health/health-topics/asthma-open-       airways.page

 

Patel, S., Henderson, J., Jeffreys, M., Smith, G., and Galobardes, B. (2012). Associations between socioeconomic position and asthma: findings from a historical cohort. European    Journal of Epidemiology, 27(8), 623-631.  doi: 10.1007/s 10654-012-9703-9

 

Perez, L., Lurmann, F., Wilson, J., Pastor, M., Brandt, S., Künzli, N., and McConnell, R. (2012, November). Near-Roadway Pollution and Childhood Asthma: Implications for Developing “Win—Win” Compact Urban Development and Clean Vehicle Strategies. Environmental Health Perspectives, 120(11), 1619-1626. doi: 10.1289/ehp.1104785

 

Price, K., Plante, C., Goudreau, S., Boldo, E., Perron, S., and Smargiassi, A. (2012,           March/April). Risk of Childhood Asthma Prevalence Attributable to Residential           Proximity to Major Roads in Montreal, Canada. Canadian Journal of Public Health /             Revue Canadienne de Santé Publique, 103(2), 113-118.

 

Sheffield, P., Zhou, J., Shmool, J., and Clougherty, J. (2015, March). Ambient ozone exposure     and children’s acute asthma in New York City: a case-crossover analysis. Environmental         Health, 18(14):25. doi: 10.1186/s12940-015-0010-2.

 

Shmool, J., Kinnee, E., Sheffield, P., Clougherty, J. (2016, May). Spatio-temporal ozone variation in a case-crossover analysis of childhood asthma hospital visits in New York            City. Environmental Research, 147, 108–114. doi: 10.1016/j.envres.2016.01.020

 

Hepatitis

Introduction

As the body’s second largest organ, and the performer of dozens of metabolic tasks, the liver certainly lives up to its status as a vital organ. However, the liver is also a susceptible organ. Hepatitis is a blanket term defined as inflammation of the liver. It can be caused by any number of conditions; the focus here will be on viral hepatitis. Viral hepatitis itself is subdivided into several main categories, designated by letter, and those divisions are themselves subdivided into various genotypes- the result of natural genetic mutations. Depending on the type, the infection can be self limiting or a lifelong chronic condition, and the resultant damage to the liver can be fatal, including the development of cancer.

Our knowledge of viral hepatitis has come a long way since the disease was first identified. Blum (2016) notes that between 1963 and 1989, five different forms of viral hepatitis were identified. We now know of several subdivisions within those five, making treatment a challenge, because the forms behave differently. The various types of viral hepatitis have different pathways, specific to their genetic makeup and behavior. Tajiri and Shimizu (2016) identify hepatitis B as a DNA virus. Hepatitis C, by contrast, is an RNA virus containing 9600 nucleotides, per El-Guindi (2016). Hepatitis C was formally classified in 1989 after its isolation. El-Guindi (2016) points out that prior to being designated hepatitis C, the virus was simply referred to as non-A/non-B hepatitis. Lee, Yang, Yuan, L’Italien, and Chen (2014) indicate that there are six known subtypes of hepatitis C. El-Guindi (2016) also mentions that hepatitis C uses LDL (low density lipoprotein) receptors to gain entry to the liver. Hepatitis A has also been identified as an RNA virus (Hinkle and Cheever, 2014). Hepatitis E was first identified in the 1980’s; as stated by Dalton, Saunders, and Woolson (2015), hepatitis E was initially dismissed because it is similar to hepatitis A in that both are transmitted through the fecal oral route and both are seen as self limiting. We now know that hepatitis E can progress to a chronic condition, and chronic hepatitis E can occur in up to 60% of transplant recipients, according to Dalton, Saunders, and Woolson (2015). Chronic hepatitis E can progress to cirrhosis within two years, per Dalton, Saunders, and Woolson (2015), suggesting a progression even faster than hepatitis B or C. Hinkle and Cheever (2014) refer to yet another variant, hepatitis G, which appears in patients receiving blood transfusions.

Pathophysiology

One of the challenges of diagnosis is that many people infected with a form of viral hepatitis may be asymptomatic. Aebi-Popp, Duppenthaler, Rauch, De Gottardi, and Kahlert (2016) state that “it is very likely that more than half of HCV-infected newborns are not diagnosed as their mothers are not tested during pregnancy and their newborns are asymptomatic after delivery.” (p.52) El-Guindi (2016) states that “mild symptoms of fatigue and fever present in only 15% of children at the time of primary diagnosis.” (p.84) Paul et al., (2016) state that patients with hepatitis E show no signs of liver disease other than an elevated alanine aminotransferase (ALT) level. Even if a person is experiencing outward signs and symptoms, they may be like those of other illnesses.

Which of the major divisions of viral hepatitis, and even which subdivision, is also important to consider. For those infected with hepatitis C, for example, those with genotype 1B are three times more likely to develop liver cancer than those infected with other strains of hepatitis C virus, according to Lee, Yang, Yuan, L’Italien, and Chen, (2014). As for hepatitis E, per Dalton, Saunders, and Woolson (2015), genotypes 1 and 2 may be self limiting diseases, but can prove fatal in pregnant women. Dalton, Saunders, and Woolson (2015) indicate that hepatitis E genotype 3 poses little risk to pregnant women compared to genotype 1, although Paul et al., (2016) indicate that genotypes 3 and 4 can lead to liver failure and cirrhosis, especially in the immunocompromised.

Hepatitis B and C are both blood borne pathogens, although hepatitis B is present in all body fluids. Being present in blood, hepatitis B and C can be passed not only horizontally, but vertically during childbirth. Vertical transmission cannot be overlooked, as it is one of the most common methods of transmission globally. Aebi-Popp, Duppenthaler, Rauch, De Gottardi, and Kahlert (2016) point out that currently, there is no routine testing for pregnant women who may be infected with hepatitis C because there are inadequate methods to prevent vertical transmission. El-Guindi (2016) notes that children can gain hepatitis C antibodies passively in utero from their infected mothers, providing 12-15 months of protection.

Due to the modes of transmission, viral hepatitis is often a comorbidity with one or more other infectious diseases. A concern for the treatment of viral hepatitis is that people may already suffer from a condition at the time of their infection. Wong and Gish (2016) point to the already high and increasing rates of obesity, both in the United States and worldwide, which would already compromise liver function through the development of fatty liver, so that a disease like hepatitis C would progress to fulminant hepatic failure more quickly. Alcoholism can also weaken the liver and make treatment of hepatitis more difficult. Hepatitis B can be transmitted sexually, and so an infected individual may also have another STI such as syphilis, chlamydia, gonorrhea, or HIV. HIV is also a common comorbidity of hepatitis C, due to the sharing of needles for illicit or even medical drug use. According to El-Guindi (2016), a public campaign to vaccinate against schistosomiasis in Egypt between the 1960’s and 1980’s involved the sharing of needles between family members; after disposable and sanitary needles were used, rates of transmission of hepatitis C dropped significantly, although today rural Egypt has the highest prevalence of hepatitis C in the world. (figure E) As pointed out by Lee, Yang, Yuan, L’Italien, and Chen (2014), iv drug use accounts for 60% of hepatitis C infection in the US, and 80% in Australia, while the use of unsanitary needles in health care settings accounts for the majority of hepatitis C infections in the developing world. Hepatitis A and E are both transmitted through the ingestion of contaminated food and water, and so can be transmitted with any other bacterial, fungal, or parasitic agent likewise transmitted.

Each of the major types of viral hepatitis has its own method or methods of transmission, though the clinical signs and symptoms are similar, if numerous, as outlined by Hinkle and Cheever (2014). These symptoms are primarily related to the gastroenterological system, and include nausea, vomiting, or diarrhea. Systemic symptoms include fever with its associated characteristics of elevated temperature, malaise, weakness, and sweating. However, given the many functions of the liver, impairment of this organ can lead to even more severe problems. As the liver synthesizes clotting factors, chronic or extensive hepatic damage can interfere with the body’s clotting capacity. The liver also has the function of conjugating bilirubin, a byproduct of the breakdown of dead erythrocytes. As levels rise, bilirubin is deposited in the skin and sclera of the eyes, giving them a yellowish color referred to as jaundice. The liver also produces bile, necessary for the breakdown of fats. Alteration of hepatic function can impair bile secretion, leading to difficulty in digesting fat, which then is passed in the feces, a condition referred to as steatorrhea. El-Guindi (2016) notes that feces may turn a light color and urine a dark color, also due to altered bilirubin metabolism. Plasma proteins such as albumin and globulin, instrumental in creating an osmotic gradient to pull blood from tissues and back into venous circulation, and for transporting hormones, are produced in the liver, and if their levels decrease, blood pressure and fluid balance can be compromised. Fluid volume is also disrupted through the symptom of ascites, which occurs when blood flow is backed up through the scarred liver, engorging the spleen and abdominal vessels so that fluid enters the peritoneal cavity, leading to a swollen abdomen that is characteristic of liver dysfunction. The liver detoxifies harmful substances in the body; if the liver is injured, these toxins can build up, stressing the kidneys and other organs. Ammonia, one of these toxins, can lead to irreversible brain damage in large amounts. Lastly, impaired lipid metabolism can lead to higher LDL levels, contributing to atherosclerosis and potentially heart attack and stroke. Wong and Gish (2016) point out the link between hepatitis C and cardiovascular diseases because of increased insulin resistance due to chronic infection with the virus.

Data and Statistics

Viral hepatitis is among the most prevalent illnesses in the world. It is reported that between three and seven million people in the United States are infected with hepatitis C (Wong and Gish, 2016). Paul et al., (2016) report that hepatitis E virus (HEV) is a leading global cause of acute viral hepatitis, with 20 million estimated infections and 70,000 deaths per year. The story is far more grim for hepatitis B. Minuk, Bautista, and Klein (2016) point out that hepatitis B is most prevalent in Southeast Asia and Sub-Saharan Africa, and the worldwide incidence tops several hundred million. (see figure D) Bereket-Yucel (2007), states that hepatitis B is “more likely than HIV to be transmitted because it is present in higher concentrations in the blood and more stable in the environment.” Hepatitis D is unique in that, according to Hinkle and Cheever (2014), the virus essentially piggybacks hepatitis B, and uses hepatitis B surface antigen for its own replication, so that infection with hepatitis D is rare since it obligates a preexisting infection with hepatitis B. As much of the world lives in areas with poor sanitation and inadequate clean water supply, hepatitis A is a frequent occurrence. This is important because as people from developed countries travel to these areas, they are at risk for contracting the virus. Hepatitis E is also transmitted through consumption of contaminated products, especially pork, although fruit or shellfish can also be reservoirs, according to Dalton, Saunders, and Woolson (2015). As per Aebi-Popp, Duppenthaler, Rauch, De Gottardi, and Kahlert (2016), “the worldwide prevalence of HCV in pregnant women varies: 8.6% in Egypt, 3.6% in Benin, 1.5% in Nigeria and 1.5% In France. The estimated number of people in Europe who are HCV antibody positive varies by country from 0.4% to 5.2%.” (p.52)

Age, gender, any other present comorbidities, and the level of the host’s immune response all play major roles in limiting or eliminating the threat posed by viral hepatitis. As viral hepatitis progresses, inflammation of liver cells leads to constriction of portal vessels, followed by the death of damaged cells and their replacement with scar tissue. El-Guindi (2016) looks at a study of Italian children with hepatitis C, in which the infected children developed portal hypertension, with resultant ascites and esophageal varices. As Wu and Chang (2015) show, there is clearly a relationship between gender and progression among those with hepatitis B after puberty, as males are far more likely to progress into more severe manifestations and final stages than females, due to the tendency of testosterone to increase hepatitis B transcription and estradiol to inhibit it. As stated by Tajiri and Shimizu (2016), while the majority of those infected with hepatitis B can move into an asymptomatic carrier state through immune surveillance and medical treatment, those who do not- ten to fifteen percent of all cases- continue on a progressive course leading to cirrhosis, fulminant hepatic failure, or liver cancer. Dalton, Saunders, and Woolson (2015) point out that acute hepatitis E infection occurs more often in males, and commonly at an older average age, 63.5 years. Hepatitis A, in contrast, does not lead to a chronic or carrier state and typically does not progress to a state where liver function is severely hampered, according to Hinkle and Cheever (2014).

Increased immigration from the developing world is leading to higher incidences of viral hepatitis in developed countries, placing strain on medical and financial resources. Ng, Myers, Manuel, and Sanmartin, (2016) refer to a demographic study that showed that while the overall prevalence of hepatitis B in Canada was 0.5%, there was a 3% prevalence among immigrants. Ng, Myers, Manuel, and Sanmartin, (2016) state that although liver cancer accounts for only about 1% of all cancer cases in Canada, its incidence has risen sharply in recent decades due to a high number of immigrants from countries where hepatitis B and C are more common. Hepatitis C is the leading cause of liver cancer and the single most likely reason for a liver transplant, despite the fact that transplantation does not cure the virus (Wong and Gish, 2016). According to Ng, Myers, Manuel, and Sanmartin, (2016), 80% of all cases of liver cancer worldwide can be attributed to infection with hepatitis B or hepatitis C. Minuk, Bautista, and Klein (2016) raise the question of whether viral hepatitis infects healthy hepatocytes and causes cancerous mutations, or if hepatitis infects infects cancerous stem cells which attack the liver once activated and matured. This is very significant data considering that worldwide, according to Minuk, Bautista, and Klein, (2016), liver cancer is the third most fatal and fifth most common cancer overall.

Treatment and Future Developments

Currently, the trend in treating viral hepatitis is to move away from the use of interferons and antivirals. Hepatitis B exhibits a similar behavior to HIV in that the virus can move into a latent or dormant phase, maintaining a reserve stock to reemerge at an opportunistic time, so that while “current HBV antiviral drugs are highly effective in suppressing viral replication, they cannot cure.” (Ebert and Pellegrini, 2016, p.1) Ebert and Pellegrini (2016) point out that hepatitis B integrates its own genetic material into that of the host, making complete eradication difficult; hepatitis C does not. Because of this integration into the host DNA, even if the initial immune response is able to curtail viral replication and alleviate symptoms, hepatitis B DNA will still be present in the host, as stated by Tajiri and Shimizu (2016). Per Tajiri and Shimizu (2016), the rate of viral replication can be held in check by CD8 T cells specific for hepatitis B, although the levels of circulating T cells was the same in those with low levels of hepatitis B and those with high levels of viral activity. Behrooz, Khodadoostan, Pouria, and Adibi, (2016) state that “the goals of treatments are consistent suppression of the virus replication and prevention of progression of the disease to cirrhosis, liver failure, and hepatocellular carcinoma,” (p.167) and show the results of one study where after treatment with tenofovir, nine of seventeen patients had undetectable levels of hepatitis B DNA, and fifteen of seventeen tested negative for hepatitis B antigen. Tajiri and Shimizu (2016) state that up to 90% of persons with hepatitis B enter this latent phase. With this in mind, one of the strategies in treating hepatitis B is to develop medications that will trigger the release of latent virus, and effect a cure by eliminating the reserve pool. (Ebert and Pellegrini, 2016) Another possible pathway, according to Wu and Chang (2015), is interferon- ɤ, which inhibits the production of furin, a protein in the endoplasmic reticulum used by hepatitis B in replication. Since hepatitis A and E are considered self limiting, treatment often is rest and fluid replacement, with an antipyretic or antidiarrheal if needed.

Hepatitis C remains a difficult virus to eliminate. The virus’ rapid mutation rate, similar to HIV, makes finding a permanent curative medication unlikely, and aids in the virus’ own defense against the host’s immune system, as stated by El- Guindi (2016). One of the other challenges of hepatitis C management is that the virus colonizes other organs besides the liver, such as lymphatic tissue, and about 3% of the viral load is outside the liver, according to El-Guindi (2016). Aebi-Popp, Duppenthaler, Rauch, De Gottardi, and Kahlert, (2016) point out that using newer DAA (direct action antiviral) drugs may safely eliminate hepatitis C in pregnant women and prevent vertical transmission. These newer drugs are encouraged not only for their therapeutic value, but also because of the lower incidence of adverse effects. The impact of side and adverse effects on a patient cannot be underestimated, as they may lead to noncompliance. Rosenthal and Graham (2016) discuss the shortcoming of interferon-alfa in treating viral hepatitis due to toxicity. El-Guindi (2016) points to problems with the use of Ribavirin in the treatment of children with chronic hepatitis C, which included thyroid dysfunction, fever, hemolysis, and slowed growth by as much as 1.6 cm less than average. There is also a push to improve education about modes of transmission and ways to improve sanitation and hygiene. A study of wrestlers in Iran by Kordi, Neal, Pourfathollah, Mansournia, and Wallace (2011) found that among the participants, 12% shared razors and 2% shared syringes for drugs, even though these items are relatively cheap and easily accessible. El-Guindi (2016) mentions simple measures that can go a long way towards prevention, such as hand washing, wearing gloves when coming into contact with body fluids, proper use of needles, and screening of blood products. A hindrance to successful treatment of viral hepatitis, as with any disease, is cost and availability of resources. Rosenthal and Graham (2016) state that when the Medicare Modernization Act was passed, the US government lost its ability to negotiate prices for drugs, at a current loss of $15–16 billion annually; using sofosbuvir as their example, they show that while the regimental cost in the US is $84,000, it is $54,000 in the UK, and $25,000 in Spain.

Relevance and Concluding Remarks

Much attention is given to transmission through sexual contact, poor sanitation, or healthcare acquisition; viral hepatitis is shed through body fluids. But one other realm goes largely unnoticed. Contact sports, by definition, involve sustained interaction and contact with an opponent, and often includes contact with one or more fluids, such as sweat, blood, or saliva. The threat of rampant hepatitis infection in sports is not novel. According to Bereket-Yucel (2007), there was a hepatitis B outbreak in the 1960’s in Swedish athletes that numbered hundreds of cases, a 1980 outbreak of hepatitis B among high school Japanese sumo wrestlers, and it was found that 20% of the American football team at Okayama University tested positive for hepatitis B, while the campus wide rate was under 2%. For any lifelong fan of professional wrestling, Abdullah the Butcher needs no introduction, nor does his use of weapons during his matches. This provides entertainment for fans, but also danger to his opponents- some of whom Abdullah infected with hepatitis C. Egan (2014) reported on the ensuing trial that brought to light some of the very real risks taken in what is considered a fake sport, and states that the most compelling piece of evidence in the trial was that the plaintiff, Devon Nicholson, who previously tested negative for hepatitis C, was found to be infected with the same strain of the virus as Abdullah (Lawrence Shreve), a strain found in only 10% of all hepatitis C cases. Gray (2013) conducted an interview with another popular wrestler, Nigel McGuiness (Steven Haworth), who was forced to retire after being infected with hepatitis B in 2012, stating:

I will never know for sure. 30% of people that test positive for hepatitis-B never know, because it’s so contagious. It’s a hundred times more contagious than HIV, so I will never know. All I do know is how I didn’t get it. I never used needles, I never had unprotected sex, which is how a lot of people get hepatitis-B. However, I was around a lot of blood. So you know as much as I know. There were dangers that were inherent being around blood. Whether I got it from them or whether I didn’t, the danger was certainly there. It was certainly there after the fact that I did have it, because if I had bled around anybody, they could have got it from me.

According to Bereket-Yucel (2007), as late as 2007, the International Federation of Associated Wrestling Styles and the International Boxing Federation did not require hepatitis B testing, even though such testing was required for HIV, while neither the International Federation of Sports Medicine nor the World Health Organization recommended hepatitis B vaccination for athletes. Despite the emphasis on blood in the above cases, Bereket-Yucel (2007) points to a study of 70 wrestlers of the Turkish national team to assess the possibility of transmission through sweat, finding that 9 of the 70 tested positive for hepatitis B- among those 9, 8 had detectable hepatitis B in a 200 microgram sample of sweat. Just something to consider the next time someone casually refers to professional wrestling, or sports in general, as childish nonsense.

 

 

Figure A:

http://2.bp.blogspot.com/-lttm1_s5Ldc/UaGSYOoiTiI/AAAAAAAADDA/wzZXw0eg-VU/s1600/hepatitis.jpg

 

 

 

 

 

Figure B: Jaundice

http://www.hispanichepatitisday.org/wp-content/uploads/2012/04/hepatitis-s2-person-with-jaundice.jpg

 

 

Figure C: Ascites

http://clinicalgate.com/wp-content/uploads/2015/03/B9781437713671000975_f097-001-97814377136712.jpg

Figure D: Prevalence of Hepatitis B

https://vdsstream.wikispaces.com/file/view/Population%20infected%20be%20chronic%20HBV.png/490077842/675×318/Population%20infected%20be%20chronic%20HBV.png

 

Figure E:

http://www.info.gov.hk/hepatitis/images/hep_c_eng_l.gif

 

 

 

 

 

Abdullah the Butcher

Figure F:                                                           Figure G:

http://img.bleacherreport.net/img/slides/photos/001/998/740/abbypondo1.redpac.com_original_crop_north.jpg?w=433&h=420&q=75

http://scontent-fbkk5-5.us-fbcdn.net/v1/t.1-48/1426l78O9684I4108ZPH0J4S8_842023153_K1DlXQOI5DHP/dskvvc.qpjhg.xmwo/w/data/848/848708-topic-1422606159-14p.jpg

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Figure H:

https://i.ytimg.com/vi/elPoBEmm_RY/maxresdefault.jpg

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

Aebi-Popp, K., Duppenthaler, A., Rauch, A., De Gottardi, A., & Kahlert, C., (2016, Jan).

Vertical transmission of hepatitis C: towards universal antenatal screening in the

era of new direct acting antivirals (DAAs)? Short review and analysis of the situation in Switzerland. Journal of virus eradication, 2(1): 52–54. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946698/

 

Behrooz, A., Khodadoostan, M., Pouria, B., and Adibi, P. (2016, Jul-Sep). Tenofovir in

treatment of Iranian patients with chronic hepatitis B virus infection: An open-

label case series. Journal of research in pharmacy practice, 5(3)166–170.

doi:  10.4103/2279-042X.185714

 

Bereket-Yucel, S., (2007, May). Risk of hepatitis B infections in Olympic wrestling.

British Journal of sports medicine, 41(5): 306–310. doi: 10.1136/bjsm.2006.032847

 

Blum, H. (2016, May). History and Global Burden of Viral Hepatitis. Digestive Diseases,

34 (4) DOI: 10.1159/000444466

 

Dalton, H., Saunders, M., & Woolson, K., (2015, Jan.) Hepatitis E virus in developed

countries: one of the most successful zoonotic viral diseases in human history? Journal of virus eradication, 1(1): 23–29. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946667/

 

Ebert, G. & Pellegrini, M. (2016). Hepatitis B virus and inhibitor of apoptosis proteins –

a vulnerable liaison. Cell Death Discovery, 2: 16014 doi:  10.1038/cddiscovery.2016.14

 

Egan, K., (2014, June 2). Judge delivers piledriver, awards bloody wrestler $2M decision.

The Ottawa Citizen. Retrieved from http://ottawacitizen.com/news/local-

news/judge-delivers-piledriver-awards-bloody-wrestler-2m-decision

 

El-Guindi, M. (2016, Jun) Hepatitis C Viral Infection in Children: Updated Review.

Pediatric gastroenterology, hepatology, and nutrition, 19(2) 83–95. doi: 10.5223/pghn.2016.19.2.83

 

Gray, R., (2013, May 22). Nigel McGuinness on losing his push in TNA, chances of an

in-ring return, ROH’s top guy. Wrestling News World.com Retrieved from

http://www.wrestlingnewsworld.com/nigel-mcguiness-on-being-buried-released-from-tna-chances-of-an-in-ring-return-rohs-top-guy

 

Hinkle, J., and Cheever, K. (2014). Brunner and Suddarth’s textbook of medical-surgical

nursing. 13th edition. Philadelphia: Wolters Kluwer Health Lippincott Williams

& Wilkins.

 

Kordi, R., Neal, K., Pourfathollah, A., Mansournia, M., & Wallace, W., (2011 Jul-Aug).

Risk of Hepatitis B and C Infections in Tehranian Wrestlers. Journal of athletic

training, 46(4): 445–450. Retrieved from

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3419158/

 

Kudo, M. (2016 Jul) Risk of Hepatocellular Carcinoma in Patients with Hepatitis C Virus

Who Achieved Sustained Virological Response. Liver Cancer, 5(3): 155–161. doi:  10.1159/000443563

 

Lee, M., Yang, H., Yuan, Y., L’Italien, G., & Chen, C., (2014 Jul 28). Epidemiology and

natural history of hepatitis C virus infection. World Journal of Gastroenterology,

20(28): 9270–9280. doi: 10.3748/wjg.v20.i28.9270

 

Minuk, G., Bautista, W., and Klein, J. (2016, Mar. 29). Evidence of Hepatitis B Virus

Infection in Cancer and Noncancer Stem Cells Associated with Human

Hepatocellular Carcinoma. Canadian journal of infectious diseases and medical

microbiology, v2016; 2016 doi: 10.1155/2016/8931591

 

Ng, E., Myers, R., Manuel, D., & Sanmartin, C. (2016, Apr-Jun). Hospital stays for

hepatitis B or C virus infection or primary liver cancer among immigrants: a

census-linked population-based cohort study. Canadian Medical Association

Journal Open, 4(2): E162–E168. doi: 10.9778/cmajo.20150117

 

Paul, S., Pisanic, N., Heaney, C., Forman, M., Valsamakis, A., Jackson, A., …

Karnsakul, W. (2016, Jan.). Hepatitis E Virus Infection Among Solid Organ

Transplant Recipients at a North American Transplant Center. Open forum infectious diseases, 3(1) doi: 10.1093/ofid/ofw006

 

Rosenthal, E., & Graham, C., (2016). Price and affordability of direct-acting antiviral

regimens for hepatitis C virus in the United States. Infectious agents and cancer,

11: 24 doi: 10.1186/s13027-016-0071-z

 

Tajiri, K., and Shimizu, Y. (2016, July 28). New horizon for radical cure of chronic

hepatitis B virus infection. World journal of hepatology, 8(21): 863–873.

doi:  10.4254/wjh.v8.i21.863

 

Wong, R., & Gish, R. (2016, May). Metabolic Manifestations and Complications

Associated With Chronic Hepatitis C Virus Infection. Gastroenterology and

Hepatology,12(5), 293-299. Retrieved from

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4973560/

 

Wu, J., & Chang, M., (2015). Natural history of chronic hepatitis B virus infection from

infancy to adult life -the mechanism of inflammation triggering and long-term

impacts. Journal of Biomedical Science, 22, 92. doi: 10.1186/s12929-015-0199-y

 

 

 

 

Slavery in ancient China

China geographically is a large place, and historically is easily as large. Since the beginnings of its

civilization along the Huang He, a number of kingdoms have risen and fallen, some of them attaining a

great enough size, power, and durability to call themselves dynasties. Each dynasty brought unique aspects

to the face of Chinese civilization, among other variations such as shifting geographic boundaries and

capitals. But some constants remain, one being that agriculture remains the backbone of the economy and

the predominant lifestyle of the people. Another is servitude among the multitude of the people towards

members of the elite. Among these servants, some remained as serfs, but a number entered slavery. Slavery

in China was a multi-layered system. There were slaves owned by private citizens and those whose services

were retained by the government. These is also a contrast between secular slavery and slaves who perform

religious functions or work in a religious setting. Some became slaves due to debt, while others were war

captives or were forced into slavery as punishment for crimes. The reasons why a slave was a slave bore

upon what types of treatment the slave received, as well as what, if any, legal protection and rights the

slave was afforded. The existence of, or absence of, extensive slave labor, coupled with the question of

what types of tasks did slaves perform, raises the question of whether China can be labeled as a slave

society or a society with slaves. The answer depends on what dynasty one discusses, as each dynasty had

its own peculiarities, and also on whether the slavery was secular or religious in nature. In addressing these

issues, a problem arises over what the best possible approach is. One can take a secular against a religious

approach, a private against government slave approach, though these may not be consistent with the proper

chronology, or to take a dynasty by dynasty chronological approach. A study that surveys several dynasties

spanning several thousand years might best be served by the chronological approach.

Chronologically, the Shang is China’s earliest substantiated dynasty. Situated around what is

present day Anyang in Henan province, the Shang lasted from 1760 BC until its demise in 1045 BC.

Without great agricultural technology, the people of Shang were less sedentary. The capital was fixed,

though the people were more mobile, curbing growth. For this reason, mobility, families did not own land

for very long, and if they did not remain in any one place for too long, then they did not own slaves on that

land for an extended period, so that while society did not develop, neither did slavery as an institution. For

the agriculture that was practiced, there was the jing tian system. A plot of land was divided into nine

squares. The center square was the home of the landlord and his family. The surrounding eight squares

were rented to peasants or worked by slaves. Since the economy was society was dominated by the

landholding elite, it can be argued that there really was no difference between the serfs and the slaves. The

slave was not considered the property of any on individual. Rather, the slave was commonly held by the

landlord family, perhaps suggesting that the notion of individual rights and individual property had not

arisen.

As the aristocratic landlords held slaves, the Shang king held the aristocratic families as his slaves.

In addition, the Shang led numbers of military expeditions against bordering states, bringing thousands of

war captives home as servants or sacrifices. Among the targeted peoples for captivity, the Jiang peoples

who lived in what is now eastern Tibet appear to have been the favorite. Shang religion was based on the

idea that the supreme being, Di, and the spirits of the ancestors of the royal family in association with Di,

required constant sacrifice and veneration in exchange for good fortune. The wishes of Di and the ancestral

spirits were ascertained by reading the cracks in plastrons and scapulas made through prodding such

substances with heated sticks. Records of the questions asked the spirits and the conclusions reached

sometimes indicate that any number of Jiang would have to be sacrificed. In addition, upon the death of the

Shang king, any number of people would be sacrificed in order to ensure the king protection. Those who

were sacrificed with the king were from all levels of society, from common slaves to members of the elite

classes. Likewise, kings were not the only members of Shang society to take servants with them to their

graves. Some elates also had slaves sacrificed in their tombs. Unearthing Shang tombs, one can determine

the social status of the sacrificed victims according to adornment and according to treatment of the body.

An intact body, carrying weapons and adorned with jewels, would be indicative of a high ranking member

of society, while a beheaded and sometimes mutilated corpse whose headless body is not adorned would

indicate the person was a slave, with intermediate levels of adornment suggesting corresponding social
strata.

Shang fell to Zhou, and Zhou itself fragmented into seven feudal states until one of them, Qin,

conquered the rest and unified China in 221 BC Its capital was Xianyang, near present Xi’an, in central

China. It was during Qin that it was put forth by Li Si that governmental status should be based more on

merit than by birth. By the same token, if high position was to be given on the basis of merit, then

punishments would be allotted similarly. Qin had a strict and rigid penal code, and while execution was

quite common, governmental slavery and penal labor were alternative measures of penalization. The Qin

penal code called for a combination of mutilation and labor, with tattooing and amputation of limbs or the

nose common forms of punishment depending on the severity of the crime. Slaves who committed crimes

were also tattooed and mutilated accordingly, and after completing their allotted time of labor, were

returned to their masters, while at the same time, a slave could be forced to undergo punishment even if he

or she did not commit the crime, as the Qin code stated “when commoners need to pay fines, commutation

fees, or debts, they may have their male or female slave, horse, or ox work it off for them.”

The practice of sacrificial interment continued through that time. One can view the ballad “Yellow

Bird” for a depiction of the sacrifice of three men on the occasion of the death of Duke Mu. First was Yan

Xi, who “was the finest of a hundred, but standing by the pit, he trembled in his dread.” He was followed

by Zhong Hang and Qian Hu, who could respectively “hold” and “ward against a hundred, but standing by

the pit, he trembled in his dread.”

In 206 BC, Qin was overthrown by the Liu family, and the Han began. Han would last until 220

AD, with its capital at Chang’an, also present day Xi’an. During the first few years, Han was in shambles,

recovering from the civil war that was fought to remove Shang and from some natural disaster. Overall,

however, by the time of the founding of Han, agriculture and society had progressed enough to be stable

and sedentary. China was also more established politically. Nonetheless, despite the greater stability, the

war had strained the nation so much that a huge famine lurked over the shoulders of the peasants. The

famine and the cost of the war created a financial crisis. While the lot of the poor peasant class was dim,
elite landlords remained in comfort. Many people sought the stability the elite had, and were willing to do

anything to attain it, even if that meant slavery. Many sold either themselves into slavery to social elites or

sold over their wives and children. Selling family members removed some financial responsibility, or

served to remove members from the household to facilitate relocation. Government edicts had little choice

but to assent to this practice of self enslavement, but then abolished it and freed all self- made slaves quite

quickly as the economy recovered. Selling people into slavery was illegal, but thus allowed in times of

emergency. The celerity on the part of the government to erase self induced slavery reveals that the Han

court perhaps did not wish to see the majority of the population enslaved, and took steps to ensure some

freedom of social and economic mobility.

Further evidence that the Han sought to go away from general enslavement of the people can be

found in the acquisition and treatment of war captives. Han did take in war captives, to be sure, but there

are no records indicating long term usage. Then again, Han did employ at its court a number of slaves.

Han government slaves were employed in a number of tasks. Males were employed as artisans, scribes, and

announcers, while females served as concubines and nurses. Han government slaves might also serve in a

number of penal labor projects. There was a greater shift towards penal slavery over execution during the

Han. However, Han resurrected a Qin law that placed culpability not only on the individual who committed

the crime, but also on that person’s family members, and also neighboring families, such that the penalty

for one person committing a crime might be that 3-5 separations of that person would all be enslaved.

The female slave was afforded some special recognition. The female slave, the concubine, was

exclusively the property of her master. A record from the Qian Han Shu (Book of the Early Han) dated 115

BC tells of a man named Po, who married into high status, but was arrested and tried for having had

relations with his father’s concubine. If another man had relations with a man’s concubine, even a male
member of the master’s family, then that person faced severe legal consequences. Concubinage was

definitely an exclusive master- slave relationship that could not be violated. Likewise, there were various

guidelines for determining the status of a slave’s offspring.

A peculiar aspect of Han government slavery is the blurring of gender roles. The blurring is done

primarily through the clothing worn by the slaves. Han government slaves wore mainly green colored

clothing, as indicated by a note by Han Jiu Yi in the Qian Han Shu, where it is written that male slaves

wear green turbans (hence the reason “green head” was a common slang expression for slave) and Palace

Women wear green robes. But one other Qian Han Shu record tells of times when the clothing worn by

slaves became a perverse reversal of both society and gender. The record comes in the form of complaint

about the opulence afforded government slaves while the masses remain impoverished, but nonetheless

describes a unique scene. The writer states that the slaves, who were in holding pens, were wearing elite

garb. The male slaves were dressed in embroidered clothes with tapered silk shoes, the clothing worn by

ancestral temple empresses, while female slaves were wearing braided white gauze and silk, the traditional

garb of ancient emperors. Perhaps the reason for switching clothing types was a means of reinforcing

social position- wearing incorrect clothing created the idea that the slave was below social status. A female

dressed in male attire may be reminded that she must work while elite women remained indoors and were

waited upon. A male in female garb might feel debased.

It seems quite clear that government slaves were in a better position than slaves owned by private

persons. It can even be inferred that the governmental slave was in a better position than a free commoner.

It can be asked, then, what was the public’s reaction towards government slaves. In times of economic

hardship, when many commoners were struggling or starving without aid from the court, while at the court

there were numbers of slaves enjoying luxuries and comforts, there was indeed negative sentiment towards

the governmental slave. There appears to exist a decided jealousy that a free person toils all their life while

a slave lives in luxury at the court. The significance of the protest concerning clothing may be its

description of gender reversal, but the writer’s chief concern was protest that slaves were dressed in royal

garb. Other similar complaints were voiced. A commentary in the Qian Han Shu from 74 BC refers to Liu,

who presented a ceremonial cap to a male slave. The commentary states that, “A ceremonial cap is
honorable clothing; a male slave is a mean person. He enjoyed conferring uncustomary ceremonial clothing

without reason, a symbol of disregarding honor. Ceremonially capping a male slave is equivalent to making

the height of honor fall down to the extreme of meanness.” Another complaint to the emperor stated that

“male slaves regard wine as soup and meat as beans. That the green heads and hut dwellers shall all be

employed and become rich is not heaven’’ intention.” In 44 BC, Kong Yu, the Grand Secretary, noted that

the government held upwards of 100,000 male and female slaves who did little or no work, at the annual

expense of millions in tax money collected from the people, so that the best course of action would be to

either free them or to employ them as soldiers. Lastly, the Yan Tie Lun (Commentaries on Salt and Iron)

by Huan Kuan recounts an 81BC statement that the “government accumulates male and female slaves who

sit and are stipended with clothes and food. Privately they create estates and make evil profits. Their

strength and labor are not exhausted; the government is losing. The people have no grain, yet government

male slaves gather 100 gold. The people from dawn to dusk are not free from affairs though male and

female slaves idle about.”

Chinese calligraphy adds another element to gender. The word for a female slave is bei. As might

be expected, it contains the female character. Bei, the pictograph that offers pronunciation, has a meaning

of baseness, such that the word can be interpreted as a base female. However, the word for male slave, nu,

also has the female character. Granted, the female character is what provides the word with its

pronunciation. However, the fact that a female pictograph is being used to represent a male cannot be

ignored. The way the female radical is coupled with the word for baseness to represent the word for female

slavery, the presence of the female character in the word for male slave delivers the psychological blow, the

indication that this male is lower than other men.

Private citizens also held slaves during the Han Dynasty. But unlike Shang, Han private slaves

were not employed in the fields. Rather, slaves served as artisans, producing goods for sale, or, more

commonly, as guards. A master who employed artisan slaves would be able to keep the profits the slave

made, and could become quite wealthy. Female slaves were trained as entertainers, then later hired out to
parties and events as singers, dancers, jugglers, acrobats, or musicians. Government slaves also carried on

private business, allowing them to get “100 gold.” However, there is something else at play. The

aristocracy wished to maintain as much power as possible, and this meant minimizing the amount of

imperial intervention into affairs. Peasants had to offer payments to both, rent to the aristocracy for land,

and taxes to the capital. Members of the elite, though, were able to house large numbers of slaves to build

local power. Slaves belonging to aristocrats thus became private police and private gangs. Nobles used their

slaves to bully not only the commoners for more rents, but also to bully the local government officials to

keep out of the business of the aristocratic class. Numerous cases exist where nobles and even some

government officials ordered their slaves to kill local or political rivals, extort more taxes, or for theft and

plunder. Slaves served the purpose of maintaining the local clout of the elite, as well as a status builder.

The wealthier one was, the more attendants and slaves that person could have on his estate. For this reason,

the court imposed a limit on the amount of land and slaves a person could possess. The limit was based

upon social rank, with higher officials allowed to hold larger estates.

One other key aspect of Han slavery, both in the private and governmental spheres, is that of legal

protection. The Han slave had few legal rights, but was not, however, viewed as sub human chattel. There

were penalties for excessive abuse, and although there were differences in penalty for crimes committed

against a free citizen as opposed to the slave, there were later edicts that reduced the discrepancies.

Particularly in the later Han, slaves were being given more and more protection. In 100 BC, Liu Shun was

tried for the murder of men and slaves. When Huo Wang killed a slave, his father commanded him to

commit suicide. In 18 BC, an official was tried and stripped of his post for kidnapping a former female

slave of his who had purchased her freedom and forcing her to resume her duties as a slave. The greatest

lack of legal recognition of the slave was the inability for a slave to testify in court against a free person,

especially if the free person was the slave’s master. In the Qian Han Shu, there is the recount of a slave who

reported the rape of his sister, a government slave. Chang An Shi, Superintendent of Palace Gentlemen,

ordered the slave to be punished for bringing “seedy” accusation against a gentleman.

These are individual cases. The Han court itself became more involved in guaranteeing slave

rights, gradually reducing differences in punishment given to free and slave persons committing like

crimes. In the year 14, when Han expansion into the western frontier was causing the frontiersmen to

become slaves, the court issued a decree that “Those officials or plebeians who dare traffic in frontier

people shall be publicly executed.” The Hou Han Shu, chronicling the dynasty’s later years, lists two

major enactments geared towards improving the lot of the slave. On March 6,35, the court declared that

anyone who killed a slave would receive no reduction in punishment, while another decree issued on

October 16 of the same year stated that if a master branded his slave, then the master would be tried, and

the slave would be freed.

A good example of the rights of a slave can be found in the record of Wang Bao, dated 59 BC .

Wang, while visiting a widow, asks the widow’s slave, Bian, to fetch some wine. Bian refuses, stating that

his contract requires only that he guard the grave of his dead master. Infuriated, Wang purchases Bian from

the widow. Bian calmly tells Wang that he will perform only those tasks that Wang indicates in the

contract. The contract is completed, the sale is completed, and Wang reads off an enormous slew of tasks

Bian will have to daily perform for his new master. Bian, after hearing the abundance of jobs he now has,

groans and complains, stating he should have just gone and fetched the wine. This document illustrates the

importance and validity of the slave contract. Were slaves complete chattel, Bian could have been forced

to run the errand. But due to the presence of the contract, Wang could not force Bian, nor could he beat

him. His only recourse was to purchase Bian and redefine Bian’s responsibilities as a slave. Bian does not

protest his transfer, recognizing his status as a slave, but does remind Wang that he will be bound only to

perform whatever tasks are included in the bill. Slaves, then, did have rights whenever a contract was
involved, and this contract presumably would stand in court.

The “Romance of the Three Kingdoms” led to Han’s collapse, followed by the eventual

emergence of Wei. As Han showed more progress towards recognizing personal freedoms of slaves and

even freedoms of commoners, the Wei appears to regress back into more rigid social stratification and poor

treatment of peasants and slaves. Wei was a far smaller nation than Han geographically, and was more

vulnerable to attack, having to relocate the capital at times in the face of invading armies from the north.

Wei was thus far more financially strained than Han. Without the presence of a strong, stable court, the

aristocracy had more of a free hand, and took advantage of it. Elites continued to extend their estates

through a number of means- purchase, claims made on vacant lots, grants, since some members of elite

families were also officials, and by outright seizure, since elite families possessed large numbers of slaves

who could act as a private army. As the wealthy landowners continued to accumulate land, more and

more peasants had no choice but to rent from those estates, or sell themselves into the estates as slaves,

thereby becoming exempt from paying taxes , making elites more powerful, in turn allowing the cycle to

continue. And as the estates grew, the government could do less and less to curb the estates. The court was

pressed in defense, and could not afford uprisings by nobles, and thus even though the court may not have

approved of the expansion of noble estates, it had to use caution and allow the noble families a degree of

autonomy. The Han was able to impose limits on the size of estates. But Wei was not as strong and could

not do so. Thus, Wei became more and more an almost two tiered government, with the imperial court at

top, but then the aristocratic class constituting another level, as both levied and collected taxes. Thus, the

wealthy accumulated more wealth, and the impoverished became poorer still.

There appears to have been a regression into more strict, less humanitarian views regarding slaves.

Once again, people were selling family members and children into slavery to avoid extra per head taxes, or

to cut the number of their dependents, or to move away; on a more grim perspective, people sold their

relatives in the hope that sale to a wealthy family would better ensure survival, or lead to a better life as a

noble’s slave than as a free peasant. A literary version, entitled “The Grain Barge Wife,” tells of a man

agreeing to sell his wife for three years due to financial difficulty, and the wife commits suicide. Practices

that the Han had outlawed crept their way back into society-namely the kidnapping of free persons for sale

and enslavement, and the tattooing of slaves for identification purposes. Thus, while the late Han was

progressive, under the Wei, a slave was chattel, “their safety was not guaranteed, and their lives were

unprotected by the law.”

The court had lots of expenditure, exacerbated by taxation difficulties. Some landlords withheld

taxes. In addition, Wei carried out many military campaigns against bordering minorities, such as the

Uighurs, Mongols, and Manchus, both as pre-emptive strikes and also for captives, the men to be used as

soldiers, and the women to be retained as concubines or given as “gifts.” So while Wei was engaged in

war, and elites shrunk the tax base, Wei also assimilated thousands of war captives, adding to its fiscal

problems. Wei’s money problems were such that there was a shortage of labor at the court, since servant

salaries could not be met. Some provinces were wealthy, some poor, and some had little to offer in terms of

produce, since taxes were collected in terms of agricultural produce, not only money. In these areas, a

special kind of tax arose. Rather than paying cash or produce, some families would be able to pay taxes in

the form of services, serving as musicians, herdsmen, soldiers, various artisan trades, silk cultivators,

palace attendants, and caretakers at Buddhist temples, to fill the shortages at court. These services were

hereditary. A family would become commissioned to these service agreements, learn and specialize in a

trade, and each generation would send a member to the court to perform that trade function.

These service taxpayers were essentially government slaves. Since they were skilled artisans and

tradesmen, these slaves and their specialized families were also able to have private enterprises and could

build wealth. This type of arrangement might seem beneficial to both parties. The government gets the

services it needs, and the family is exempt from monetary taxation while learning and excelling a particular

trade. However, there were stipulations. The status of the family was frozen. They were government slaves,

however wealthy and however skilled. Other conditions were that the family could not move, nor could it

change the trade or service it was commissioned for. In addition, family members could not marry outside

the class of service households. Some officials and very wealthy elites set up, in addition to the

governmental service households, a private system, whereby families would provide special service

laborers to the estate of the private commissioner. One example of private establishment of family

commission was Cao Cao. An advantage of a private system would be to build alliances with other clans

and to cement local influence.

In that case, it would appear that the special agreement taxes were far more advantageous than

outright taxation. It allowed these families to build wealth through artisan work but also established

themselves as an elite class of government slaves, keeping in mind that a government slave, as during the

Han, was in a socially and economically better position than a free peasant, and certainly better off than a

slave working on an elite estate. The Wei, then, represented a time when private slaves and citizens were in

an increasingly more dire position. Government slavery, though, became more advanced and more

specialized. As the society became more rigid and more worse off, the government slave was very arguably

a good social position because it was perhaps the most stable position, even if there were strings attached.

In 618, Wei, Liao, and even Sui had come and gone, and China was now entering its golden age,

the renaissance that was the Tang Dynasty. The capital was once again at Chang’an. The Tang Code

differentiated between “Good” and “Not Good” persons. It is not that Tang society erased social

distinction. During Han and Wei, there was a far more blurred line between slave and peasant. Tang in fact

clearly marked that line, and made social classes more distinctly defined and rigid. Despite the enhanced

liberalism, it can then be asked if the slave was in a better position. The Tanglu Shuyi (Book of the Tang)

stated that “male and female slaves, like money and goods, are for their owner to dispose of.” The Tang

also expanded well westward and incorporated aspects of many Inner Asian peoples, such as the Sogdians.

In 750, protesting the emperor’s absconding of duties in favor of his mistress Yang Guefei, a part Sogdian,

An Lushan launched a rebellion. Perhaps reeling from the rebellion’s effects, perhaps voicing anti-Sogdian

sentiment, or perhaps complaining over the importation of foreign slaves to the capital while there were

many impoverished residents, one wrote of the Sogdian Palace Women who acted as dancers, “in vain did

you labor to come east… officials and concubines all learned how to circle and turn.”

Similar to the Han, a slave could not being testimony against a free person. Under Tang custom, if

a slave accused his or her master of a crime, whether the accusation was true or false, the slave was

executed, and if a slave brought testimony against a relative of the master, whether true or false, the slave

was banished. The reason for these caveats was not due to the inferior position of the slave, but rather to

the Confucian code of ethics that had emerged as the backbone of Chinese society. A slave was to be

entirely loyal to the master, as the master was in a position of authority. Testifying against the master

violated that code of loyalty and order. At that, a slave’s testimony against a free person was only

admissible if the free person was already on trial, as the testimony of a slave could not initiate a case

against a free person.

Emphasis on slave or free status was extended into childbirth. Slavery was not necessarily a

permanent institution. People moved into and out of slavery all throughout the Han and Wei depending on

economic position. The Tang Code solidified these positions however, so that slavery was emerging as a

hereditary, permanent position, slaves were a static class. It was possible to be freed through purchase or

amnesty, but at the same time slave status was no longer something one can easily be demoted into for a

fixed period of time. A contract from the year 731 tells of an 11 year old girl being sold for 40 bolts of silk.

Witnesses had to be present not necessarily to witness the contract, but rather to attest that the girl was

already a slave, as a free commoner could not be sold into slavery. A short poem entitled “Ballad of

Selling a Child” speaks of a woman selling a five year old child for four and a half measures of grain, after

selling her other child to care for cattle. The ballad ends as a petition against slavery, exclaiming:

“Alas! The wild tiger does not eat its cub, and the old ox will lick the calf. Please realize:
the rich grow crueler as their fields increase, and they buy servants and slaves with their
wealth. Then, one day, they curse them in anger, whipping them unfeelingly until their
blood flows! Don’t they know that all flesh and bone comes from the same womb, that
another’s son and my son are of one form? Alas! Will the four seas and nine continents
ever share the same spring time, so there will be no more people who must sell their
daughters and sons?”

Likewise, since the slave class was more static, the question arose as to the status of slave children. It

would appear that status was determined through the father. A free woman could not marry a slave, or she

would be listed as “Not Good,” and presumably the children would be slaves. The child of a slave woman

whose father was not the mother’s master was a slave, but the child was free is the father was the mother’s

master , further evidence that status of slave progeny was based on the status of the father. Tang would

eventually fall in 907, and after a period of instability, the Song Dynasty began in 960.

To the west of Tang, and nearly simultaneously with its founding, Songtsen Gampo was finalizing

his unification campaigns among the various peoples of Tibet, becoming the first sovereign of the Tubo

Kingdom. Almost immediately after consolidating the kingdom, Gampo demanded brides from both Nepal

and Tang China. After the Tang’s refusal, and Gampo’s military response that sacked Chang’an and forced

the capital to retreat to Luoyang, Wen Cheng was given to Gampo. It was these brides who brought

Buddhism to the Land of the Snows, Wen Cheng bringing a gold statue of the Buddha, and Nepal yielding

a princess only after Gampo promised to construct 108 temples. Gampo led other military exploits into both

Tang China and into what is now Xinjiang, taking over a key stretch of the Silk Route that included the

major cities of Dunhuang and Gaochang, near present Turfan.

Monasteries were recognized tax free establishments. Some attention must be paid to the Tibetan

landscape. At its high altitude, there is little arable land, and only a small, select amount of crops can be

cultivated. Monasteries thus occupy areas of usable land. Peasants thus are dependent on the monasteries

for use of that land for sustenance, especially as the monastery expands and accumulates more territory,

causing more peasants to live on and rent lands from the monks, and as poor peasants cannot meet tax

requirements and so enter monastery grounds to get exemption. Those who remained outside the

monasteries were not well off unless wealthy and independent. The environs were not kind, and masterless

people, runaways from monasteries, or debtors were collectively referred to as “black people.” The

monasteries themselves, by turn, are dependent on the peasants to work the lands around the monastery. It
is also important to note that while the monastery existed tax free, it nonetheless taxed the peasants who

lived and worked on its land. These taxes were paid in the form of produce, labor, and in the form of

donations to the monastery in exchange for prayers and religious services. In this case, the Tibetan

monastery is seen like the landlord aristocrat in the jing tian system. The serfs who rented these lands were

similar to slaves, as there was little alternative, given the dearth of arable land. In fact, some were outright

slaves owned by either the monastery or by the individual monks. It is important to note that serfs

provided services to the monastery such as cooking, cleaning, music, or patrol guarding, or goods such as

silk and produce, things that can be considered donation rather than payment as a means of circumventing

governmental taxes and also of circumventing the Buddhist principles of earthly desire- wealth being one

of those desires.

With the population converted to Buddhism, there was little difference between church and state.

The line between religion and politics was further blurred by the fact that a large portion of the population

rented and worked monastery owned land. Each monastery was expected to have a certain number of

laypeople on hand as servants to the monks, and abbots were given some power over not only religious but

also legal and penal decision making. A shining example of the way Buddhism came to dominate Tibetan

politics is the decrees of King Repalchen. Repalchen declared

“he who shows finger to a monk shall have his finger cut off; he who speaks ill of the
monks and the king’s Buddhist policy shall have his lips cut off; he who looks askance at
them shall have his eye put out; he who robs them shall pay according to the rule of
restitution of eighty times…if anyone does not act as though bound by my Religious Law,
he will be punished without fail by the Royal Law.”

The Tubo kingdom effectually ended in 842, when the Tibetan king, after leading a persecution and
suppression campaign against Buddhism, was assassinated.
The Tibetan Empire swept all of what is now Western China. A number of documents, some

accidentally preserved, was discovered in 1900 near Dunhuang. Some of these documents pertain to sales

and purchases of slaves for many reasons, and reveal something of the nature of slaves. At 28, Jiansheng

appears to be the oldest slave sold among the slave contracts collected by Yamamoto and Dohi. In one

document, dated 509, Zhai Shaoyuan purchased a 25 year old female named Shao Nu. In 661, Zuo

Chongxi, an official, purchased 15 year old Shen De from another official, Zhang QingZhu, in Gaochang.

A 916 contract states that “with nobody to provide food due to the early death of her husband, Wang Zai

Ying, the widow Wu has fallen deep into debt. Her naturally born son, Qing De, aged 7, is contractually

offered to commoner Ling ZhuaXinTong. The price is due today in full with no part owed. After the price

is paid, and the deal completed, Shen De will forever be owned by the Ling family.”

People were not always sold into abject slavery. At times people were merely mortgaged or sold

into indenture. In 921, commoner He TongZi, “suffering because his family lost everything” mortgaged his

son Shan Si. A November 3, 925 contract stated that Xiao SengZi was mortgaging his son, Guo Zi, to Li

Qianding, for some agricultural products. The contract included a provision in case Guo Zi became ill or

died, and had a limit of 6 years, and included, among other witness signatures, a signature from Monk

Yuantong. In 943, a commoner Wu Qingshen, because his family was poor and owed a debt, mortgaged

himself to the family of Longxing Temple Monk Suo. One other contract reported that Guo Nuzi was

giving his daughter, BenZi, to the temple to be made a nun. The fact that many of these documents have

the signatures of monks as witnesses, and the last two actually involve monks and temples reinforces the

view that the monastery was more than a religious institution in the Tubo Kingdom and the Tibetan

Empire. The monks and the faith pervaded all aspects of culture and acted as economic and political

stations as well.

Overall then, it can be said that from 1750 BC until 1000 AD, several conclusions could be made.

One, in cases where the slavery was based on religion, in Shang and Tubo, the slave performed his or her

tasks in an all pervasive setting. Slaves performed tasks that were needed for them to survive economically,

politically, and spiritually. A large number of the masses were involved in the servitude, and were vital to

the function and survival of the ruling class. In Shang, slaves were the sacrifices used to bribe the ancestors.

In Tubo, they performed the menial labor needed for the maintenance and sustenance of the monastery, the

lifeline of Buddhism. These states, then, must be considered as slave societies. Were the people to rebel

against the monasteries in Tubo, the political and religious, and therefore economic and social structure of

the civilization would crumble. In Shang, the plastromancy practice evolved into corruption, people did

rebel, and Shang was overthrown, as it was believed the spirit world lost favor with the Shang kings.

Han, Wei, and Tang civilization, including the initial years of Song, culture and society was not

based upon any religious ideology. Ancestral worship, Buddhism, and Daoism were practiced, but did not

dominate the society. Rather, the Confucian code of ethics was the moral determinant. There was far more

sophistication of the slave, as the slave performed a wide variety of functions to both the private sector and

the bureaucracy. Slaves were employed by the government to perform daily functions. Slaves were used by

private individuals for manufacturing, for commercialism, and for extortion. However, the government had

other agents. There were salaried officials and salaried soldiers. Were the government slaves to be

removed, the political engine would continue. In the private sector, China was, and is, an agricultural

society. The majority of people are peasants. Undoubtedly, some slaves were employed in the fields. Most

were used as status emblems. So if the private slaves were all manumitted, the aristocracy may have less

cash, but society would not halt, because the economic backbone, agriculture, would be unaffected. Slaves

then were only one aspect of the economy, a for profit sector rather than a sustenance sector, and so the

Han, Wei, and Tang Dynasties were societies with slaves.

Regardless of the dynasty, one was decidedly better off a slave of the government over being a

private slave. A private slave received whatever treatment his or her master wished to dole out, often the

minimum. The private slave owned little property, as the possessions of the slave belonged to the master.

government slaves, though, lived in the palace or the residence of the local official. Government slaves

carried on private enterprises. Many government slaves ended as soldiers, especially if they were captives,

and criminals were also government slaves. But these were enemies of the state. The ethnically Han

government slave, especially the special arrangement slave of the Wei, had a position many commoners

would want. In addition, any question that the private slave was superior could easily be refuted by the

observation that government slaves sometimes got to wear royal clothing.

Overall, it would appear that the general condition of the slave began bleak. There was almost no

difference between slave and peasant. Gradually, though, slavery as a class became more defined, and

refined, as the slave became specialized into various tasks. It seems that the late Han was the peak of slave

conditions for private slaves. Government slavery continued to evolve and specialize throughout. but

private slavery devolved after the fall of Han, so that the Tubo almost resembled Shang, with the

monasteries replacing the extended family members of the Shang monarch. It appears that because the

slave was so similar to the peasant, there could be no legal and social distinction. but as status and class

became more rigid, the slave was placed at the bottom of society, the free peasant was elevated to a

superior social strata. Nonetheless, the increasing ethic code implemented by Tang showed that as slavery

as a distinct and fixed social class matured, the condition of the slave did not necessarily worsen.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BIBLIOGRAPHY

 

Carrasco, Pedro. Land and Polity in Tibet. Seattle: University of Washington Press, 1959.

Ebrey, Patricia. Trans. “Penal Servitude in Qin Law” in Chinese Civilization: A Sourcebook Second Ed..
Ed. Patricia Ebrey New York: the Free Press, 1993.

Ebrey, Patricia and Clara Yu trans. “Deed of Sale of a Slave” in Chinese Civilization: A Sourcebook
Second Ed. .Ed. Patricia Ebrey New York: the Free Press, 1993.

Fu, Zhufu. The Economic History of China: Some Special Problems. In Modern China vol.7 no.1 Jan.,
1981.

Giles, Lionel. Dated Chinese Manuscripts in the Stein Collection VI Tenth Century (AD 947-995). In
The Bulletin of the School of Oriental and African Studies, University of London vol.11 no.1,
1943.

Hansen, Valerie. Negotiating daily life in traditional China : how ordinary people used contracts, 600-1400.
New Haven : Yale University Press, c1995.

Owen, Stephen. Trans “Classic of Poetry 131: Yellow Bird” in An Anthology of Chinese Literature: From
Beginnings to 1911. Ed. Stephen Owen New York: WW Norton and Co., 1996.

Pearce, Scott. Status, Law, and Labor: Special Service Households Under the Northern Dynasties. In
The Harvard Journal of Asiatic Studies vol. 51 no.1, 1991.

Po, Chu-yi and Yuan Chen. “Iranian Whirling Girls” in the Shorter Columbia Anthology of Chinese
Literature. Ed. And Trans. Victor Mair New York: Columbia University Press, 1999.

Stein, RA. Tibetan Civilization. Trans. JE Driver Stanford: Stanford University Press, 1972.

Wang, Jiu-si. “Ballad of Selling A Child” trans. Jonathan Chaves in The Shorter Columbia Anthology of
Chinese Literature. Ed. Victor Mair New York: Columbia University Press, 1999.

Wang, Yi-Tung. Slaves and Other Comparable Social Groups During the Northern Dynasties, 386-618. In
The Harvard Journal of Asiatic Studies vol. 16 no.3/4 Dec., 1953.

Wilbur, Martin. Industrial Slavery During the Former Han Dynasty, 206 BC-25 AD. In The Journal of
Economic History, 1943.

Wilbur, Martin. Slavery in China During the Former Han Dynasty, 206 BC-25 AD. Chicago: Field
Museum Of Natural History Press, 1943.

Wu, Jia-ji. “The Grain Barge Wife” trans. Jonathan Chaves in The Shorter Columbia Anthology of Chinese
Literature. Ed. Victor Mair New York: Columbia University Press, 1999.

Yamamoto, Tatsuro and Yoshikazu Dohi trans. “Fan Huan Jin Buys a Slave” in Tun-Huang and Turfan
Documents Concerning Social and Economic History vol.3A. ed. Tatsuro Yamamoto and
Yoshikazu Dohi Tokyo: Toyo Bunko, 1985.

Yamamoto, Tatsuro and Yoshikazu Dohi trans. “Guo Nuzi Makes His Daughter a Nun” in Tun-Huang and
Turfan Documents Concerning Social and Economic History vol.3A. ed. Tatsuro Yamamoto and
Yoshikazu Dohi Tokyo: Toyo Bunko, 1985.

Yamamoto, Tatsuro and Yoshikazu Dohi trans. “He Tongzi of Hongchi Mortgages His Son” in Tun-Huang
and Turfan Documents Concerning Social and Economic History vol.3A. ed. Tatsuro Yamamoto
and Yoshikazu Dohi Tokyo: Toyo Bunko, 1985.

Yamamoto, Tatsuro and Yoshikazu Dohi trans. “Mi Lushan Sells a Female Sogdian Slave” in Tun-Huang
and Turfan Documents Concerning Social and Economic History vol.3A. ed. Tatsuro Yamamoto
and Yoshikazu Dohi Tokyo: Toyo Bunko, 1985.

Yamamoto, Tatsuro and Yoshikazu Dohi trans. “Unknown Person Buys a Slave” in Tun-Huang and
Turfan Documents Concerning Social and Economic History vol.3A. ed. Tatsuro Yamamoto and
Yoshikazu Dohi Tokyo: Toyo Bunko, 1985.

Yamamoto, Tatsuro and Yoshikazu Dohi trans. “Wang Xiuzhi, a Long Distance Trader, Sells a Sogdian
Slave” in Tun-Huang and Turfan Documents Concerning Social and Economic History vol.3A.
ed. Tatsuro Yamamoto and Yoshikazu Dohi Tokyo: Toyo Bunko, 1985.

Yamamoto, Tatsuro and Yoshikazu Dohi trans. “Widow Wu Sells Her Son” in Tun-Huang and Turfan
Documents Concerning Social and Economic History vol.3A. ed. Tatsuro Yamamoto and
Yoshikazu Dohi Tokyo: Toyo Bunko, 1985.

Yamamoto, Tatsuro and Yoshikazu Dohi trans. “Wu Qingshun Mortgages Himself” in Tun-Huang and
Turfan Documents Concerning Social and Economic History vol.3A. ed. Tatsuro Yamamoto and
Yoshikazu Dohi Tokyo: Toyo Bunko, 1985.

Yamamoto, Tatsuro and Yoshikazu Dohi trans. “Xiao Sengzi Mortgages His Son” in Tun-Huang and
Turfan Documents Concerning Social and Economic History vol.3A. ed. Tatsuro Yamamoto and
Yoshikazu Dohi Tokyo: Toyo Bunko, 1985.

Yamamoto, Tatsuro and Yoshikazu Dohi trans. “Yaya Official Han Yuanding Sells a Female Slave” in
Tun-Huang and Turfan Documents Concerning Social and Economic History vol.3A. ed. Tatsuro
Yamamoto and Yoshikazu Dohi Tokyo: Toyo Bunko, 1985.

Yamamoto, Tatsuro and Yoshikazu Dohi trans. “Zhai Shao Yuan Buys a Female Slave” in Tun-Huang and
Turfan Documents Concerning Social and Economic History vol.3A. ed. Tatsuro Yamamoto and
Yoshikazu Dohi Tokyo: Toyo Bunko, 1985.

Yamamoto, Tatsuro and Yoshikazu Dohi trans. “Zuo Chongxi Buys a Slave” in Tun-Huang and Turfan
Documents Concerning Social and Economic History vol.3A. ed. Tatsuro Yamamoto and
Yoshikazu Dohi Tokyo: Toyo Bunko, 1985.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

THE CHANGING FACE OF SLAVERY IN CHINA TO 1000

 

 

 

 

 

 

 

 

 

 

Frank Cavitolo
History 705

Human sacrifice in ancient China

Frank Cavitolo

Thousands of oracle bones remain from Shang dynasty divinations, revealing the kings fear of, and diligence to please the spirits and ancestors. The tombs of the kings reveal that more than turtle plastrons and cattle scapulas were cracked and poked in order to accommodate the wishes of Shang kings. Found within the tombs excavated at Anyang are found hundreds of sacrificial human remains, in addition to animals, mainly dogs. Human sacrifice in the Shang was not confined to only burial ceremonies, and evidence suggests that the sacrifices were not willing participants. Shang divinations were performed by posing the question to the gods whether they wished a sacrificial offering of humans, animals, or even both. Further evidence that many of the sacrificial offerings were not volunteers is seen by the fact that many of the skeletal remains show the hands bound behind the back. Granted, it is possible this was the way the ceremony was performed. But it is more likely that the hands were bound as a means to prevent resistance. Within the tombs, there are varying numbers of skeletal remains, and in varying levels of adornment and damage. Robert Bagley suggests that perhaps the purpose of the victims was not to appease the ancestors, or even to accompany the dead king, but rather to scare away any demons or grave robbers that might disturb the body of the king.
The purpose of human sacrifice can be closely compared to that of the oracle bone divinations themselves- there were political as well as religious significance. Sacrifices were absolutely essential as they were a means of appeasing the gods and ancestors and thereby deterring any hostile actions on their part against the kingdom. At the same time, the sacrifices served as a reinforcement of the social hierarchy. One oracle inquiry, asking, “Should the king make a you- yu- shui sacrifice to those from Ta- Yi downward at the Hsiao-tung” maintains that the purpose of sacrifice was that only the king could perform it and only to his ancestors. And as only the kings were permitted to perform oracle charges, only the Shang kings were worthy enough to not only command sacrifices but to have sacrifices performed to and for them as part of their funerary rites. KC Chang states that the Shang human sacrifices “best symbolize the relationship, or rather the social distance, between the king and the pit- housedwellers.” Since the gods required much attention and sacrifice, Shang kings made offerings on the belief that, according to Vassili Kryukov, that the greater the number of victims, the more extensive the libation, the greater Shang Di’s satisfaction would be and the more protection Shang kings would have against calamity. “If he offers Qiang, ten men, the king will receive assistance.” It is important to note, though, that while the divinations really were inscribed and set, albeit in bone rather than stone, sometimes circumstances were simply beyond control. “On the coming yihai, we will you cut to Xia Yi fifteen dismembered victims and will split open ten penned sheep. Verification: On the twenty- first day, yihai, we did not you- cut the victims because it rained.” This is an example of how not all divinations were eventually followed.
The Jiang people were the most common victims used for human sacrifice. Shang divinations frequently refer to the Jiang in questions as to how many Jiang are needed for the sacrifice, or should Jiang captives be used. “On the chia- wu day, divined. Inquired: The following day, yi- wei, perform the yu ritual to Tsu Yi and sacrifice Ch’iang, fifteen persons?” “Should we sacrifice three sheep, five Ch’iang… to Mu Kwei?” and “Should the king make a you- yin sacrifice to those from Pao- Chia downward at the ta- tsung and kill Ch’iang as well as ten sheep?” are examples of how Jiang were considered lowly and the way the Shang freely disposed of them. That the Shang used captives from the Jiang, an outside people, indicates that the sacrifices were not regarded as a necessarily glorious ceremony. The Jiang were seen by the Shang as a barbarian people, decidedly inferior. Yet they served this important function in Shang society. When Jiang first arrived at the capital, it was asked, “Should the king receive the Ch’iang at the temple gate?” It is also pointed out from divination records and by Herrlee Creel that a number of Shang wars were conducted for the sole purpose of procuring captives to be used in human sacrifices. Other oracle bone divinations express the concerns of the king as to the potential number of Jiang that could be taken in as sacrificial candidates. “In Pei- shih have we captured the Ch’iang people?” while another states that a mission “…required 30 cavalry. Will they seize the Ch’iang people?”
When Jiang were sacrificed, it was often in number. Several examples include “Inquired: Perform ritual and sacrifice Ch’iang, four hundred, to Tsu X?” “Perform the yu ritual to Tsu Yi and sacrifice ten Ch’iang? Twenty Ch’iang? Thirty Ch’iang?” and “Should the king make a yu sacrifice to Tang, Ta Chia, Ta- Ting, and Tsu- Yi with one hundred Ch’iang and one hundred sheep?” Not all Jiang captured were reserved for sacrifice. In some cases, the Jiang captives were used as slaves. “The king to order the many Ch’iang to clear new field?” shows that some Jiang were kept for their labor. A select few were even retained for court service.
It is possible that the victims were chosen from all levels of society, and even perhaps from other ethnicities besides the Jiang. Reasons for this can be seen in what items, if any, the sacrificial victims carry. Bagley and Chang both offer extensive descriptions of the various skeletal remains found in the unearthed Shang tombs. According to practice, the victim was usually beheaded, and the skulls were stored in a different part of the tomb than the rest of the body. However, some skeletons were whole. Many of the headless skeletons had weaponry, while the complete skeletons often hold other grave goods such as vessels, musical instruments, and pottery, and are more likely to be adorned by decorative dress and jewels. On that note, it is likely that the complete skeletons were people of higher social status, while the headless victims were likely Jiang or lower members of society. Some propose that the skeletons may have been damaged by grave looters. But it can be proven that victims were intentionally decapitated in two ways. One, Shang axes bare inscriptions depicting decapitations, while on the skulls themselves, some of the vertebrae are still attached to the base.
Further evidence of the importance of selecting a proper sacrificial victim to protect or appease the ancestors can be found in Hsi- pei- kang, the royal cemetery, where many of the sacrificial victims were members of the aristocracy, not slaves. Another oracle divination suggests that not even the highest of the Jiang were considered beyond sacrifice, asking, “The chiefs of the two Ch’iang states, would they be used as offerings to Tsu- ting?”
In addition to including victims from all social strata of society, the victims also span the variety of age and gender of the population. Chang notes that the typical age for a female sacrificial victim was between 20 and 35, while male victims were between the ages of 15 and 25, while Bagley also mentions that in the tombs there were some females and even some infants sacrificed, but that the most common victim found is a teenage male. It is also important to note that decapitation was not the only means of killing the victim. Bagley points out that some other methods employed included dismemberment, dividing the body in two at the waist, and also to inter the victims alive. Excavations of bone working factories at Zhengzhou reveal that human bones were used, although not as commonly as animal bones, to form tools and implements, most notably hairpins and arrowheads, while one human skull was used to perform an oracle divination.
Positioning was important in the tombs, with respect given to the five directions. Examining tomb HPKM 1001, Li Chi notes that underneath the tomb complex were 9 pits containing victims, one pit at the center, and two at each corner, while in addition stating that the purpose of these victims almost surely was to ward off evil subterranean spirits, given that the pits were located underneath the floor of the tomb. Shang diviners were so concerned with proper positioning that they even performed charges to determine what position the decapitated should face. Such emphasis was placed on direction in Shang planning and beliefs that the directions themselves were sacrificed to, in great numbers. “We should perform a beheading sacrifice to the south,” and “Diviner Lu asked: Should the king make a sacrifice at the tseung of Pi- Keng?” cite only two of many oracle bones calling for such sacrifices to be made.
Some sacrifices were performed not as a means of consummating the burial, or to the dead king. Victims were used not only as burial sacrifices, but as offerings to the Yellow River or to the God of the Four Quarters. Other sacrifices were performed to appease the sun. Two oracle bone inscriptions describe offerings to the sun, divined as “We call upon Qiao to perform a beheading sacrifice to the rising sun, and to the setting sun offer a penned animal.” and “We will split open victims to the setting sun and chop up four bovines. To Shang Jia, two bovines.” In some cases, the king would offer himself to the sun.
Some other sacrifices were made to the tomb itself. Cheng Tekun describes how the construction of the tomb was divided into stages, and sacrifices would be made at the conclusion of each stage, as a means of sanctifying the tomb. Cheng identifies two types of tombs, those with a single sacrificial pit and those with multiple pits. Where only one pit is present, all victims were beheaded and buried around the building at the same time. Multiple pit tombs had a more complex system. Initially, following the laying of the foundation of the tomb, a pit was dug in the center and received either an animal or an infant sacrifice. Then holes were dug to receive three additional animals and sometimes one kneeling human, skeleton complete. Following these sacrifices, the next stage of construction was set to begin. Pits were dug both inside and outside the door to the main burial chamber. Human victims placed in these pits were in tact and prostrate, and held weaponry and shields. Thus the second stage of construction was complete. Lastly, following the burial itself and the completion of the tomb, many human victims were buried at the front of the building where, according to Cheng, “those victims were indeed the spiritual guardians of these important buildings.”
Burial was not, however, the only form of sacrifice that took place, nor were the people sacrificed captives or aristocrats. Sarah Allen and Edward Schafer both explore another type of sacrifice that had nothing to do with the death of a king. Sacrifices were also needed in times of natural disaster. Shang oracle divinations frequently search to identify certain ancestors, ancestors who could perhaps be causing the disturbance, most notably drought. In an agricultural economy, drought represents the greatest potential catastrophe, and so in times of drought, sacrifices were used to placate the spirits. Sacrifice in drought times did not require death, however. The importance of this type of sacrifice was not the death of the victim, but rather the willingness of the victim to die if necessary. This is a stark contrast to the burial sacrifices, that did require a violent death from an unwilling victim. The greater the selflessness, the greater the relief from the drought.
The deity sacrificed to in the case of drought was Hanpo, the drought deity. For the sacrifice, either a deformed man or a shamaness was chosen to be exposed for a period of time. Hanpo was depicted as being deformed, hence the selection of a deformed man for the exposure sacrifice, while the shamaness was viewed as a symbol of rain and fertility. Allen notes that the shamaness, since more often a shamaness was chosen rather than a deformed individual, first went through a ritual before the exposure that involved bathing and cutting of hair. It is important to keep in mind that the shamaness played an important role in society, in the religious structure of a government that very much utilized religious practice for policy making. The selection of a shamaness for the sacrifice, then, is representative of the importance placed on the sacrifice. The exposed person would remain exposed outdoors until the rains came, but in severe circumstances, death would be required, as when exposure failed, burning was turned to. The fire based exposure would involve the sacrificial victim being placed in the center of a ring of fire in an attempt to mimic the sun.
Shang calligraphy offers yet another avenue to explore sacrifice. Creel offers a depiction of a character showing a man, as written on the oracle inscriptions, hanging, with something through the neck, the character fa, to sacrifice. Cheng Tekun offers a wide display of Shang characters pertaining to sacrifice. The character His suggests a person with a rope around the neck, the word for a war captive. In addition, there is the character hsiao, a decapitated person with an ax above. Another character depicts a large person with an ax in the left hand, and a small person upside down in the right hand.
Shang society was not built on the practice of sacrifice, but sacrifice most certainly played a role in maintaining that society. The sacrificial victims were the ransom paid to the ancestors for protection, and also a means of genocide of the barbarian neighboring peoples. The Jiang eventually had revenge by helping the Zhou overthrow the Shang. Perhaps the excess of sacrifice helped facilitate the public turning on the government.

 

 

 

 

 

 

 

Allen, Sarah. Drought, Human Sacrifice, and the Mandate of Heaven in a Lost Text From the
“Shang Shu.” In The Bulletin of the School of Oriental and African Studies, University of
London vol.47 no.3 1984.
Allen, Sarah. Sons of Suns: Myth and Totemism in Early China. In The Bulletin of the School of
Oriental and African Studies, University of London vol.44 no.2 1981.
An, Chin-Huai. “The Shang City at Cheng-Chou” In Studies in Shang Archaeology. Ed. KC
Chang. New Haven: Yale University Press, 1986.
Bagley, Robert. Shang Archaeology. In The Cambridge History of Ancient China. ed., Michael
Lowe and Edward Shaughnessy Cambridge: Cambridge University Press, 1999.
Chang, Cheng-Lang. “A Brief Discussion of Fu Tzu” In Studies in Shang Archaeology. Ed. KC
Chang. New Haven: Yale University Press, 1986.
Chang, KC. Early Chinese Civilization: Early Anthropological Perspectives. Cambridge: Harvard
University Press, 1976.
Chang, Kwang-chih. Shang Civilization. New Haven: Yale University Press, 1980.
Chao, Lin. The Socio-Political Systems of the Shang Dynasty. Taipei: Institute of the Three
Principles of the People Sep., 1982.
Cheng, Chen-Hsiang. “Bronzes of the “Ssu T’u Mu” Inscriptions” In Studies in Shang
Archaeology. Ed. KC Chang. New Haven: Yale University Press, 1986.
Cheng, Tekun. Archaeology in China. Vol.II Shang Archaeology. Cambridge: W. Heffer and
Sons, Ltd., 1960.
Creel, Herrlee. The Birth of China. New York: Frederick Ungar Publishing Co., 1937.
Creel, Herrlee. Soldier and Scholar in Ancient China. in Pacific Affairs vol. 8 no.3 Sep., 1935.
Keightley, David. The Ancestral Landscape: Time, Space, and Community in Late Shang China.
Berkeley: Institute of East Asian Studies, University of California, 2000.
Keightley, David. Sources of Shang History: The Oracle-Bone Inscriptions of Bronze Age China.
Berkeley: University of California Press, 1978.
Kryukov, Vassili. Symbols of Power and Communication in Pre- Confucian China. In The
Harvard Journal of Asiatic Studies vol.58 no.2 June, 1995.
Li, Chi. Anyang. Kent: University of Washington Press, 1977.
Schafer, Edward. Ritual Exposure in Ancient China. In The Harvard Journal of Asiatic Studies
vol.14 no.112 June, 1951.
Yang, His-Chang. “The Shang Dynasty Cemetery System” In Studies in Shang Archaeology. Ed.
KC Chang. New Haven: Yale University Press, 1986.

Borderwar

China traditionally has been an imperialist nation, perhaps the earliest predatory nation. The broad belt of countries that rings it had, for centuries, sent tribute to the larger, stronger, imperial court at Beijing. China’s imperial status fell, however, with the arrival of European imperialists, and later on, the Confucian system itself fell in favor of the eventual establishment of the People’s Republic. But once the other powers had left, several of China’s former tribute states became wary of the newly revitalized China, fearing that the new regime under the CCP would now attempt to reclaim its former glory and reassert itself as the dominant power of the east, using the historical observation that “a strong China has always been an expansionist China.” (Menon 6)
Indeed, shortly after the creation of communist China, the nation became actively involved in the revolutions of Korea and Vietnam, though China claimed it had done so simply to protect its own borders, and Burma was forced to cede territory in a border dispute. The question of exactly what the borders of China were was to become a hotly contested one in the second half of the twentieth century. Aside from Burma, and also the agreements with Pakistan, within thirty years of the founding of the People’s Republic, China would engage in armed conflict over territorial disputes with its three largest neighbors- India, the Soviet Union, and Vietnam.
The conflicts with India and Vietnam are complex in that they are not simple border disputes. In each case, three additional circumstances existed beside the disputed territory. In both cases, the events leading to the war were fueled by the presence and involvement of a third party, Tibet between China and India, and Cambodia between China and Vietnam. Also in both cases, the border disputes were, in part, the result of inadequate and incomplete negotiations between imperialists. India and Vietnam had the British and French on their side of the table to negotiate with the ethnically non- Chinese Manchus. The treaties that came out of these talks left the borders unresolved, and the task of the new, independent nations to resolve them. The third factor is the role played by the Soviet Union, and how the Sino- Soviet split affected relations between China, Russia, and the other nations of the Orient.
As the nineteenth century wound to a close, the British were in competition with the expanding Russian Empire. Moscow was moving not only east, but also south, prompting the British to look to seal off India’s northern borders and put an end to the Great Game. But in order to secure India’s border, the British would also have to negotiate with China, and more specifically, the province of Tibet. Tibet itself had long been the object of China’s western expansion, finally becoming incorporated under Qianlong after several other unsuccessful attempts. But, being a far distance from Beijing, and with the Qing having a slew of internal and external conflicts, such as the Taiping Rebellion, the imperial court could not do much to fully exercise authority over the region. Tibet then, was allowed to assume some mantle of autonomy. But even this was not without its difficulties, as Ladakh was annexed by Kashmir. (Maxwell 26) This annexation did not create too much difficulty, since China had claimed in 1847 that the border between Tibet and Ladakh was a solid one and needed no renegotiation.
There were other small areas that were also disputed, such as Hunza, a small kingdom adjacent to Kashmir that sent tribute both to India and China. The British later annexed this territory for India, though this also was seemingly not a huge problem since according to the Journal de St. Petersburg, the ruler of Hunza had ended the dispute by “placing himself under the dominion of the Empress of India and expelling a Chinese envoy.” (Lall 7) However, the Hunza region became a key to the British northern expansion, pushing India up into the Karakoram and Kuenlun passes, that had previously served as buffer areas. (Lall 51) In addition, the newly acquired territory would give the British more leverage against the Russians, and so the British claimed that they “cannot recognize Chinese rights” (Lall 11) in Hunza. Beijing, in a statement issued by the Zongli Yamen, simply said, ‘the Government of India ought not to have invaded the country without previously communicating with the Chinese government.’ (Lall 15)
Britain’s continuing expansion northward into the Himalayas went relatively unchecked until the 1890’s. The British followed a policy of encroaching on the buffer zone, annexing it to expand the territory of India, all while, under the policy of imperialism, applauding such action as “taking advantage of the absence of Chinese control south of the Kuenlun.” (Lall 70) By this time, the Chinese had seen enough and realized the importance of becoming actively involved in the abutting regions between India and Tibet. China had prior been left out of the talks between the British and the Russians. Neither empire had considered the weight of Peking might have in the dispute. China laid claim to the Aksai Chin area as part of Tibet. In addition, China refused to recognize British claims to Shahidula and the Karakesh River. The British admitted they had little to refute China’s claims to the area, because “though China never directly occupied it, they had taxed nomads.” (Lall 68) A further admission on the part of the British that China did indeed have a legitimate claim to the area was made by Macartney, who said that even though the Aksai Chin region would be better administered by the British, it was nonetheless Chinese territory. (Maxwell 31)
It was not until 1914 that the British attempted a meeting with the Chinese to delineate a permanent and concrete border between China and India. Tibet, with its semi-autonomous status, was the third party to negotiate at the Simla Convention. At this conference, British maps placed Aksai Chin in Tibet, and therefore China, as following an agreement with the Russians that the two imperial nations would cede the region to neutral China, and though China probably would not have objected, they were not involved in this agreement. (Maxwell 34) The inherent and glaring flaw on the part of the British at the Simla Conference was that the British negotiated with Tibet on an equal level, as though it were an independent nation, severely over- estimating its semi-autonomous status. The British failed to realize that Tibet is part of China, “with greater powers and functions than a province as laid down in the constitution and by law; but it is definitely not a protectorate- neither a Chinese protectorate, nor an Indian protectorate, nor a joint Chinese- Indian protectorate, nor a so- called buffer state between China and India.” (Vertzberger 155)
In addition, it would appear that the British had made covert arrangements with the Tibetans. Not only had the governments of India and Tibet already agreed on the proposals beforehand, but the Chinese delegate, Ivan Chen, was not even shown a complete map with all demarcations. (Hoffman 19) Chen made it clear that his initialing of the preliminary map he was shown was not to be taken as a sign of Chinese approval of the conference, but only an indication that he had seen the initial proposal, and the government in Beijing chastised him even for this. In addition, China made it clear it would not ratify the treaty. The initialing by Chen was to be his only function at the Simla Convention, as Chen was not present at follow up meetings where the maps he had initialed were revised and used as the final versions, thus concluding the three party conference between India, Tibet, and China with signatures from England and Tibet, and without an official Chinese signature. (Maxwell 48)
Thus, the Simla Convention had, in theory, laid out the border in the west between Tibet and Kashmir. In the east, the border between Assam and Tibet was still to be drawn. For this convention, no delegate from Beijing was present. The creation of the McMahon Line was seeped in blind British imperialism and complete disregard for the Chinese central government. When the line was drawn hastily, secretly, and agreed on by the British and Tibet, the British had violated treaties it had signed with both China and Russia that required communication between the nations in such affairs as safeguards during the Great Game. (Maxwell 50) Still, to the British, the conference had successfully created a working border between China and India. However, apart from negotiating an international border with a province of China, and not the central government, there were several loose ends to the treaty. For one, the line was drawn, for the most part, arbitrarily, without consideration for natural geographical features. Second, Tibet would still be allowed to levy and collect taxes in the areas south of the line that now became part of India. (Maxwell 52) Third, the position of the line went above the line of direct administration the British had used in India. It would appear the British were in competition with the Chinese for control of the peoples of this area for one, and to expand the territory of India further north, for the line gave India the noticeable acquisition of the city of Tawang. (Maxwell 61)
With the conclusion of the McMahon Line, the boundaries were now set for India and Tibet, and though the boundary had many problems that needed to be worked out, those problems would not be dealt with until roughly forty years later, since both India and China would spend the next several decades struggling to oust unpopular regimes and establishing new governments. It was not until several years after the British had departed India and Chiang Kai- Shek had fled to Taiwan that tensions began to flare over Tibet and its border with India. Right away, in 1950, did Beijing look to assert its authority over Lhasa. India, concerned over what it understood as its border, began to take its own actions to assert itself.
Newly independent India quickly picked up where the British had left off, entering and having Sikkim, Nepal, and Bhutan all sign treaties that left them economically and politically dependent on India. (Maxwell 68) In addition, Indian troops in 1951 moved, for the first time, all the way up to the McMahon Line and reclaimed the city of Tawang from Tibet, since for the remainder of British control and even the first several years of independence, the government of India still limited its direct authority south of the line, even though the line was the supposed border. (Maxwell 73) Indeed, the fact that India did not control up to the line, and that exactly what the line was was still an unresolved question, can be further evidenced by the fact that to better enter Tibet, the Chinese had entered and crossed Aksai Chin. The Chinese entertained no problem in this because they saw Aksai Chin as Chinese territory. India, though it claimed Aksai Chin as its own, did not notice the Chinese had used Aksai Chin as an entry into Tibet, meaning that India had not been patrolling or using the area. (Rowland 52)
What was noticed by India, though, was that by occupying and reaffirming control of Tibet, Chinese authority was becoming too close for Indian comfort. Demonstrations were held in India that were critical of Beijing’s actions in Tibet. Indians were concerned with two problems the “liberation of Tibet” would cause- one being the potential loss of trade for Indian goods, and secondly, the encroachment of communism. The Chinese opposed discussions in India’s parliament concerning the affairs of China. The Chinese also viewed India’s reaction towards the retaking of Tibet as a far cry from India’s non- alignment stance. Beijing claimed that by supporting Tibet, and denouncing China, India was also supporting the west, and therefore imperialistic. Mao Zedong questioned India’s policy, stating ‘one either leans to the side of imperialism or to the side of socialism. Neutrality is mere camouflage and the third way does not exist.’ (Kini 83) The Indian argument seemed clearly to agree with Mao’s view, for Krishna Menon had said that, ‘the British government of India had undertaken to support the independence of Tibet subject to the suzerainty of China. Independent India had, in a sense, inherited this commitment.’ (Vertzberger 332)
It was not until the middle of the 1950’s that the governments of India and China brought up the question of discussing the borders. By this time, it should be noted that the border between India and China had still not been officially marked. Both sides still had claims to the territory, and the Simla Convention had not laid out a permanent agreement. For one, the British had provided at the conference that the lines would be open for reinterpretation at a later date, (Maxwell 52) and this can serve as a British admission that the line was a poorly done one and would need more work. In addition, a map showing the McMahon Line published in 1935 in a collection of treaties included a note that the Chinese had not ratified the treaty. The unofficial state of the McMahon Line was further illustrated by the fact that the maps used in Nehru’s own book did not even show the line. (Maxwell 210) Even as late as 1954 did Indian maps show the McMahon Line as unfinalized, and, even more curiously, not only were Nepal, Sikkim, and Bhutan all included in India, no border at all between India and China was marked west of Nepal, and the map noted that the border was undefined. (Maxwell 83) Another flaw in the state of affairs after the Simla Convention was allowing Tibet to continue to exercise control in Tawang well into the 1940’s. (Hoffman 20)
India, however, complained that maps published in China placed the border south of the McMahon Line in the east, as far down in some places as the Bhramaputra River, and in the west included areas that India claimed, notably Aksai Chin. Nehru advised Indians not to be too concerned, as India was full sure of its claim and possession of the territory, and Chou Enlai answered that the Chinese maps were based on older maps, such as the nineteenth century British maps that did indeed recognize the western areas as Chinese territory. (Maxwell 96) Apparently, when the Chinese refused to answer the British proposal in 1899 to divide Aksai Chin, the government of India must have assumed that China had agreed to the plan. (Maxwell 34) The Chinese did make a proposal, however. In their dispute with Burma, the Chinese had accepted the McMahon Line as the border. Similar agreements were made with Nepal. Chou Enlai insisted that if China had agreed to the line with other nations, it would be willing to do so with India also. China would recognize the McMahon Line in NEFA, but in exchange would want India to accede to Chinese claims in Aksai Chin. (Hoffman 87) India refused, calling China’s placement of the disputed territory in China as imperialistic and expansionist. Shortly afterward, though, Indian maps began to appear that clearly defined the borders they had once listed as undefined, and the Indians began claiming that the borders were well known and had existed for a long time, though even on the Indian side there was still some uncertainty about what exactly those borders were. (Vertzberger 106) Perhaps in an effort to promote national support, India issued the statement that it was well known that ancient Sanskrit texts and epics had all described India as the land south of the Himalaya. (Paul Borders 10) China could have refuted this using the argument that Chinese texts referred to China as the middle kingdom and had sovereignty over the entire world. Instead, China pointed to the maps, the treaties, and the statements from India, and said that India had no real proof, or claim, “apart from citing ancient epics and legends which cannot serve as bases.” (Report of Chinese and Indian Officials 73) It was obvious at this point that there was a legitimate border question. India fully supported the denouement of the Simla Convention, though China had not.
China rejected the Simla Convention as a product of western imperialism. However, the Chinese were able to buttress their argument with the simple fact that they had never ratified the treaty, and therefore were not obligated to honor it. Chou Enlai reiterated, ‘No treaty or agreement on the Sino- Indian boundary has ever been concluded between the Chinese central government and the Indian government.’ (Lall 240) China’s main and most thorough argument was that Tibet is a province of China and not an independent state, regardless of any special privileges Tibet may have through treaties with the Qing. As a province, then, Tibet simply did not have any authority to negotiate with another nation as though independent.
According to India, a Chinese ratification of the Simla Convention was never required anyway, as “the boundary expressed the political and geographic realities of the situation between the two actual neighbors, India and Tibet.” (Lall 217) India also turned to the historical argument to denounce China as being imperialistic. “Peking’s main reason for rejecting the Simla Convention stems from China’s basic and traditional unwillingness to relinquish rights to territory which it considers to be eternally part of the ‘celestial’ realm. The idea of negotiating on equal terms with a country it considered to be vassal prejudiced China against any reasonable solution from the start.” (Rowland 49)
The two governments were able to agree on Panchsheel, five principles of non-violence, non- involvement, and peaceful cooperation. However, with the border not also resolved through peaceful negotiation, it would now have to be decided through violence. Twice, first at Niti and later at Shipki La, the Chinese entered the disputed territory and then withdrew, and “it may be surmised that these were probing actions to test Indian reactions.” (Lall 240)
But by far, the most controversial action, and the one with the most severe ramifications, was the construction of a road into Tibet by the Chinese over Aksai Chin. The road was built to facilitate transport of supplies and equipment into Tibet, and became widely used during the Tibetan uprising of the late 1950’s. Using this road, the Chinese were able to enter Tibet easily, forcing the Dalai Lama to flee. There was another wave of anti- Chinese sentiment in India, and this was escalated even further when India granted asylum to the Dalai Lama. China did not protest the asylum, especially when Nehru made it clear that India was only giving the Dalai Lama asylum, not providing a platform to further criticize China. The Dalai Lama was expected to remain in India in a state of political silence. (Hoffman 66) Yet once safely in India, the Dalai Lama soon resumed his political agenda. Chinese protest to this fell on deaf ears, prompting the Chinese accusation that the uprising in Tibet was being “instigated and abetted” (Renmin Ribao 3) by India. China also used the argument that Indian involvement in Tibet was in violation of the Panchsheel agreements. (Chaudhuri 11)
India viewed the construction and use of the road on what Indians considered their territory as an invasion. China argued that India’s refusal to allow the Chinese to use the road, and also refusal to debate whether or not it really was Indian land, was also a violation of the mutual advancement goal of the Panchsheel agreement. (Maxwell 268) Minor skirmishes began to occur between Chinese and Indian border patrol parties. On one such exchange, at Kongka Pass, Indian soldiers reported that they had been captured and tortured by the Chinese and were forced to sign a confession that they recognized the territory as Chinese. (Rowland 132) With an open conflict now, India proposed that each side withdraw to the borderline as claimed by the other. However, this arrangement would require India to draw back only a small area, while China would have to abandon thousands of square miles of territory. (Maxwell 142) Another Indian proposal called for each country to simply withdraw to their own side of the line. The problem with that proposal was that the line to be used was the Indian claim line. (Maxwell 129) If China were to accept either deal, then it would be recognizing India’s claims and dismissing its own. Chou Enlai’s proposal was each side to remain where they were at present and to maintain that status quo until proper negotiations could take place and limn an official border. (Maxwell 136) India rejected this idea, claiming that China had unlawfully entered Indian territory, occupied it, and now were trying to bargain for it.
China’s main claim was Aksai Chin, and that because of the road into Tibet. But soon, the border dispute expanded to include the smaller Himalayan states. India accused China of infiltrating into these countries, inciting unrest, and attempting to wrest control of them. China countered by pointing out the unfair treaties India had signed with the Himalayan states at the beginning of the decade as a measure to limit Chinese influence. Indians rebutted by saying that, “India was accused of crimes of aggression and expansion communist China itself intended to commit.” (Rowland 52) Nehru insisted on being firm on the status of Nepal, Bhutan, and Sikkim, as well as protecting Indian sovereignty over Ladakh. India recognized the competition for influence in these areas and explained that, “Just as Imperial Britain believed that it needed Tibet as a buffer zone for India, China believes it needs the Himalayan border states as buffers for Tibet.” (Rowland 183) Chinese propaganda reverberated the sentiment, averring that, “Tibet is China’s palm. Nepal, Bhutan, Sikkim, Ladakh, and the Northeast Frontier Agency of Assam are the five fingers. Now that the palm has been restored to China, the fingers should go with it.” (Rowland 144)
But in order to acquire its “fingers,” China would have to compete not only with India, but also with the Soviet Union. Nehru had reassured that India need not worry about China because Russia was the leader of the communist world, and as far as the communist bloc was concerned, Russia would put China in place, as India had a good relationship with the Soviet Union. (Vertzberger 88) As the skirmishes escalated, the Chinese realized that from their Indian adversaries “a neutral attitude was impossible,” since Indians were attacking using Soviet weapons and claiming neutrality. (Renmin Ribao 6) But the largest role played by the Russians was to come in 1960. In that year, the Russians abruptly ceased to supply weapons to the Chinese when, after making inquisition as to why the weapons were being stored in the undeveloped and unused areas of western China, the Russians were shown detailed plans for an invasion of Kashmir with intentions of reclaiming Ladakh, and in turn quickly warned the Indians of Chinese designs. (Sinha 48) This information confirmed the Indian belief that China had signed the Panchsheel agreement only as a measure of buying time to plan for a large- scale invasion later on. (Chaudhuri 43) Soviet support of India throughout the border dispute would factor into the cleft between China and the Soviet Union later on.
Communism played another key role in the Sino- Indian border question. Many Indians saw China’s occupation of the disputed areas as an attempt to spread communism into India, arguing that, “It is clear that the leaders of Red China are pinning their faith blindly in the doctrine of exporting communism.” (Das 80) India had recently seen Kerala elect a communist government, and Beijing’s decisive action in Tibet helped raise Indian concerns over communism. The border war then also became a struggle to preserve Indian democracy. “What we are facing today is not merely a violation of the country’s territorial integrity but a ruthless and unscrupulous on our freedom, our democratic values and our way of life.” (Mohammad 78) There was also concern as to what would be the reaction of the Communist Party of India. However, the party put to rest any doubts before long, announcing that their national patriotism was greater than their doctrinal loyalty. The Communist Party of India denounced China, and claimed to do so, “even at the risk of isolation from the international communism.” (External Publicity Division 6) The party went further in supporting the effort against China in its statement made by Ajoy Ghosh, who said that in defending against China, ‘the Government of India would be justified in taking all measures to repel the Chinese forces. In such a situation, the Communist Party of India would support all the measures taken by the Government of India.” (CPI India-China 56)
By 1962, still no agreement had been reached. Nehru stated that India “shall always favor peace provided that peace is a honorable one, one that leaves our territory in our hands,” (Nehru 65) yet India had rejected all Chinese proposals for peace, and would be satisfied with nothing less that a complete Chinese withdrawal from all disputed areas. China had pointed out that it had actually been using Aksai Chin for over a decade without any complaint from India until 1958, and that this free use of the land is what prompted the construction of the road. If Indians were so concerned over the sanctity of their lands, the Chinese argued, why had nothing been said sooner? (Chinese Foreign Ministry 19) In May of 1962, India offered to allow the Chinese use of the Aksai Chin road in exchange for an evacuation of all other land in question, but China refused this offer as the lands or Aksai Chin were truly Indian. (Hoffman 107)
While India continued to creep further and further northward, China began to become wary of Indian expansionist plans. In the fall of 1961, India had fortified its military strength along the border. China viewed this action as a Russian backed Indian build up for an invasion. (Maxwell 286) But the greatest argument for China was that India had altered the McMahon Line. The line was drawn relatively straight, so that when Indians began to regularly patrol it, they realized adjustments were needed to accommodate natural geographic obstacles. However, these adjustments all were in favor of India and done without consulting China. (Hoffman 69) These adjustments can be viewed as either Indian expansion or as simple border realignments permissible under international law. But what was not permissible by the Indians was the establishment of bases north of the line. Throughout the border dispute, India had always asserted that the McMahon Line was the standard and true border between India and China. Therefore, then, any activity north of the line would be, by India’s own decree, in Chinese territory. India set up a base at Khinzemane, north of the line, and the Chinese, though they complained, allowed the base to stand. (Maxwell 293) Later on, though, after the establishment of another base north of the line, at Dhola, China began to protest. India then made an offer for each side to maintain the status quo, an offer the Chinese quickly rejected for the same reason India had rejected the similar Chinese offer. In addition, China adroitly pointed out that if India can make minor adjustments to the McMahon Line, then not only should China also be allowed to do so, but even more importantly, India was silently admitting that the McMahon Line was not a sound border and needed to be renegotiated. (Maxwell 299) India refused the Chinese invitation to send a delegate to discuss the complete redrawing of the line.
With tensions rising and border incidents becoming more frequent and more hostile, China launched a large- scale attack of India in late 1962. The war was fought on two fronts, both in the western area near Aksai Chin, and in the east along the McMahon Line in NEFA. But very soon into the war, circumstances had already begun to look bleak for the Indians, for “by and large, the army offered little resistance to the Chinese.” (Prasad 7)
Many Indians viewed the war as a horrible betrayal of India by China. Nehru had hoped to firmly establish at Bandung an Asian bloc, and Chou Enlai, though this statement would come later, had offered promise by saying, ‘Our two people’s common interest in their struggle against imperialism outweigh by far all the differences between our two countries.” (Enlai, Oct. 24 36) India now saw itself as the victim of a sudden, unprovoked attack by China. Nehru said that in the Chinese invasion, “we see the grossest form of imperialism functioning here across our borders in India. China has said often enough that it is anti- imperialist. Now we see this so- called anti- imperialist country becoming itself an imperialist of the worst kind and committing aggression and invading a friendly country without rhyme or reason or excuse and justifying it by saying that they are being attacked. I must confess that I have seldom come across such a travesty of truth and decency in international behavior.” (Nehru 92) Further sentiment of betrayal was expressed in sayings such as, “We have been rewarded by China with trickery, chicanery, and faithlessness in return for our steadfastness, goodwill, and peaceability,” (Das 80) and “Falsehood and deception marked the Chinese Government’s policy towards India.” (Fraudulent Peace 3) The Chinese remarked that it was India who had rejected all offers at peace, and had forced themselves into this “Himalayan adventure” (Das 81) to secure the borders it claimed. Mao criticized India’s deceptiveness in its secret meetings and realigning of the McMahon Line, and said that Nehru is a man of “two faces, one is that of a man of peace, the other that of a demon.” (Menon 32)
Nehru’s envisioned Asian bloc would have India and China working together under Panchsheel, leading the continent, and making a large impact on the world. The border war shattered not only Nehru’s dream, but also Nehru’s spirit. Aside from the modern political implications of the war, having the largest democracy face the largest communist regime, the border war also was a competition between the two cradles of Asian civilization over influence in Asia. The general view was that China was adamant about being itself the dominant power in Asia, and to be so would have to put India down. Nehru admitted that, “The basic challenge in Southeast Asia is between India and China,” (Vertzberger 98) while Malaysian Prime Minister Tengku Rahaman warned that, “China does not want a rival in this part of the world.” (Menon 43) The view, then, was that India was nothing more than an obstacle in China’s way. “One thing is certain and that is, Mao wants to dominate Asia, if not the world. Only this can explain the recent Chinese invasion of India. India is the only country that can challenge China militarily, politically, and economically in Asia. It is Mao’s aim to humiliate India, militarily, isolate politically, and cripple economically to prove his maxim –the third way does not exist.” (Kini 84)
It would appear China was not the only nation that wanted to dispel the theory of non- alignment. The competition for influence in India was contested by the west and Soviet Union, who both supplied aid to India. By being non- aligned, India had not gone against either side, but then had also not gone for either side. This prevented either side from completely supporting India. “China’s aggression came as a God- send to the imperialist circles who were also out to humiliate India.” (Chaudhuri 53)
The celerity and ease that the Chinese had in overcoming Indian troops did have one other effect, and that was to gather international support for India’s claims. China was portrayed worldwide as a predator attacking an innocent. Indian losses helped give credence to Indian comments of China, such as one by Krishna Menon that said, “It is strange that in modern times, a country disregards international ethics and stoops almost to the level of medieval barbarism.” (Menon 31) Another popular view that began to circulate is that China had no regard for humanity, and was hoping to drag this border dispute into a mass war of attrition between the world’s two most populous nations. “For the Chinese leaders human life means nothing… since they have more than enough of them freely available.” (Menon 40) “It is heartlessly believed that this war would also help in balancing their population explosion. This policy envisages the cutting of human beings like carrots. To the communist masters of China, there is nothing wrong in this policy as it is the antidote to their population problem.” (Das 81) Mao did little to rebuke this argument, stating that, ‘China has 600 million people. Even if 200 million people were killed… 400 million would still survive. Even if 400 million people were killed, 200 million would still survive. Even if 200 million survived, China would still constitute a big country of the world.’ (Kini 83)
Whether or not “the events of October had indeed suggested that China’s objective in India was total conquest of the subcontinent,” (Rowland 171) can be determined by the lines of combat and the shape of the peace agreement. Maps used by the Indian military that showed movement and battles indicated heavy Indian activity north of the McMahon Line, clearly in Chinese territory. (Prasad 44) As for China’s grand expansionist schemes, China took control of Aksai Chin, captured Dhola and Tawang , and pushed the Indians back south of the McMahon Line. (Maxwell 361) China made an offer for each side to withdraw twenty kilometers from what the Chinese called the “line of actual control.” India rejected the proposal, calling it not a Chinese proposal for peace, but a sneaky trick to annex Indian territory by forcing Indians to retreat into their own territory and give it to China. The Chinese were denounced as being “adept in the art of double talk.” (Paul Line 57) However, it should be noted that if India had accepted to move to that line, China would have been retreating from far more territory. China would have had to withdraw to a point that was north of the McMahon Line, a situation that would allow India to keep the post at Khinzemane. (Maxwell 374) For the “line of actual control,” the Chinese used as reference the line as it was on November 7, 1959. India wanted to use the line as of September 8, 1962. This line would have placed practically all disputed territory into Indian hands. (Maxwell 418) China stated that it could not accept India’s proposal because that would entail the transfer of enough land to appear as though India was the winning nation. China argued that during the dispute, the Indian government “not only occupied 90,000 square kilometers of Chinese territory south of the illegal McMahon Line… it is also insatiable and wants to occupy another 33,000 square kilometers of Chinese territory.” (Renmin Ribao 9) Also, as India criticized Chinese maps that incorporated the disputed territory, Chou Enlai, in a letter to Nehru, pointed out that, ‘According to the original map, the western end of the so- called McMahon Line clearly starts from 27, 44.6’ N. Yet the Indian Government arbitrarily said that it started from 27, 48’ N.’ (Enlai November 4 39) The line used by China did, for the most part, did honor all of India’s claims. The McMahon Line would be the border in the east, with extra territory at that. The only notable Chinese acquisition was Aksai Chin. By submitting a proposal that forfeited all other gains and only keeping that one area, the Chinese were backing their argument that they had no other designs and only wanted Aksai Chin out of the entire dispute. (Hoffman 182)
Since the Chinese were victorious, they could easily have made harsher demands on India. While China did later recant their acceptance of the Colombo Proposals after India had accepted, they had initially accepted quite readily. (Chaudhuri 52) A possible reason China may have renounced their acceptance was because the Colombo talks had a distinct pro- Indian platform. In addition, while China had already agreed, India was stalling and refused to sign an agreement that would cede any territory. At the Colombo conference, “there was never any objection or indeed comment of any kind by the Chinese Government at the time regarding the boundary between India and Tibet as shown on the treaty map.” (Chinese Aggression-Some Facts 3) India’s procrastination and China’s lack of aggressiveness in peace demands began to sway opinion, leading some to believe that perhaps the Chinese were not the angry imperialists the Indians made them out to be. “The Chinese move came as a surprise only because the Indian version of what was happening was so widely accepted.” (Maxwell 418) Chou Enlai described the Chinese stance by saying, ‘The fact that the Chinese government’s proposal has taken as its basis the 1959 line of actual control and not the present line of actual contact… is full proof that the Chinese side has not tried to force any unilateral demand on the Indian side on account of the advances gained.’ (Maxwell 376) A noted observer to this border conflict was Vietnam, and the Vietnamese made the observation that, “In the two conflicts with India in 1959 and 1962, Beijing clearly demonstrated its restraint. After giving India a heavy lesson, China did not attempt a greater military victory over India in either case. The unilateral withdrawal of its forces… indicated unmistakingly that the Chinese military behavior was well calculated and fully under control.” (Chen 4) Vietnam’s attitude towards China would change shortly afterward.
Similar to the situation with the British in India, the Chinese also felt they were the victims of French imperialism. In the aftermath of the 1884 Sino- French War, China had to relinquish all claims to Vietnam as a tributary state and recognize French dominance in Indochina. A border was drawn in the treaty after the war, finished in 1887, and then amended in 1895. The land border appeared to be solidly demarked. However, the aquatic boundary was not so well defined. A line was drawn through the Gulf of Tonkin, with the provision that all islands west of the line would be controlled by Vietnam and all islands east would be under Chinese authority. But, the treaty also made the point that the line in the gulf was not a border, just a marker to decide possession of the islands. (Chen 39) The significance of splitting the gulf had not as much to do with the smaller islands in it, but rather two larger archipelagos, the Paracel and Spratley Islands. Though the treaty deals more specifically with the smaller islands in the gulf, both archipelagos are located in the South China Sea, far east of the line, and therefore should be Chinese. (Chang 14) But both sides continued to debate and claim possession. Using the argument that the treaty that made this arrangement at the end of the nineteenth century by the Sino- French Convention on the Delimitation of the Frontier was not decided by the Vietnamese and the Chinese, but by the French and the Qing Manchus, China argued that both sides should disregard the treaties and redraw the borders, including the gulf. (Kaushik 112)
As it would turn out though, the 1979 war between China and Vietnam stemmed not so much out of a territorial dispute than it did competition for dominance in Southeast Asia. Mao, in 1965, had said, ‘We must by all means seize Southeast Asia… this region is rich in raw materials- it is worth the costs involved.’ (CPI Vietnam 15) Once the war for independence against the west had been complete, the three countries of Indochina began to have their own disputes. These disputes were in turn influenced by the competition between China and Vietnam. That competition was in turn influenced by the competition between China and the Soviet Union. In that regard, Southeast Asia became a region of multi- layered loyalty and aggression.
Vietnam had benefited by receiving aid from both Russia and China during all throughout its war to oust the French and later reunify the nation. When the Sino- Soviet split occurred, Vietnam played the role of deceiver, taking advantage of the two communist powers vying for influence with their aid, continuing to ask for, and receiving aid from both sides. Russian aid was used to finance the war, while Chinese aid went for supplies. (Lawson 179) As the aid continued to come, and the two sides continued to compete, the Chinese began to become wary of Vietnam’s actions. China offered Vietnam increased aid and promises of more support, though in exchange Vietnam would have to reject Soviet aid, leading to the observation that, “The Chinese leaders have made a great effort to organize an international anti- Soviet ‘crusade.’” (CPI Vietnam 19) As the war continued, though, the aid continued to come from both sides. However, once the war was ended, and Vietnam was a unified communist country, it was clear that Vietnam would have to choose one side. A military agreement allowing use of Cam Rahm Bay was signed, and the Soviet- Viet Treaty of Friendship and Cooperation in 1978 proved a heavy blow to Chinese ambitions in Southeast Asia, as China charged the treaty was just an attempt by Russia to check China’s communist clout. (Chen 27) China realized that since it had lost Vietnam, it would have to double its efforts for the rest of Indochina. But to do so, China would have to compete directly with Vietnam.
It was obvious, to the Vietnamese, that Laos would not side with China. When Laos and Thailand became engaged in a border conflict, Vietnam instantly sent troops to assist Laos, leading to poor Thai- Viet relations, and gravitated Thailand towards China. (Ross 78) In another incident, some 30, 000 Chinese were in Laos, building a network of roads along the northern border with China in 1975. At Vietnam’s request, the Pathet Lao asked the Chinese to leave. (Lawson 281) Laos was somewhat fearful of a possible Vietnamese takeover, however it quickly became involved in Vietnam’s plan for dominance of the region, the Indochina Federation. (Chen 27) The federation would be a union of the three states under the ideal of mutual advancement, though the federation would most certainly be under the direction of Hanoi. With Laos secured, Vietnam turned to its other Indochinese neighbor, though Cambodia would not be as easily won over. The two countries had their own border dispute, and there was regular violence along the border. In addition, the Khmer Rouge had forced out many ethnic Vietnamese, who returned to Vietnam along with many more Cambodian refugees. With the border troubles, and the Khmer refusing to join the Indochina Federation, Vietnam sponsored a coup of the Khmer Rouge in 1977. (Chen 34) Since the Khmer Rouge were against Hanoi, that made them, by default, allies of China, and so Cambodia received aid in their struggle against the Vietnamese. Thus, the “partition” of Southeast Asia was now complete into pro- Soviet/ pro- Viet and pro- Chinese spheres. (Ross 81) However, with the Khmer purgings now in action, “Chinese leaders were presumably uncomfortable publicly embracing such a leadership, calling it a ‘friend.’” (Ross 110) Thus, Sino- Cambodian relations were strengthened as a counter to Soviet- Viet relations. (Ross 75) Vietnam denounced China, alleging that their support of Cambodia was imperialistic, and that, “Like all great powers, China wants to have either weak neighbors, or better yet, puppet neighbors.” (Lawson 193) China, though, could easily have said the same about Vietnam, regarding the Indochina Federation.
Though both sides had agreed to seek a peaceful solution to the border problem, (Ross 75) violence again broke out along the Cambodia- Vietnam border, with the Khmer Rouge invasion of the Vietnamese town of Tay Ninh. General Giap countered with a full- scale invasion into Cambodia, not a defense of the town, that pushed Vietnam 10 miles into Cambodia, up to Parrot’s Beak. (Ross 156) When Cambodia did not surrender and leave Tay Ninh, Vietnam intensified its invasion, and drove even further into Cambodia. But despite the heavy bombardment by the Vietnamese, Cambodia refused to relinquish its hold, as it was immensely aided by China. (Ross 177) However, despite Chinese aid, Vietnam proved too powerful, and, in 1979, Pol Pot and the Khmer Rouge were forced to flee. Vietnam placed Heng Samrin in control of Cambodia as a puppet, arranged the signing of the Vietnamese- Kampuchean Treaty of Peace, Friendship, and Cooperation, allowing Vietnam involvement in Cambodian affairs and a military occupation of Cambodia, and thus completed the Indochina Federation. (Chen 38) China had thus lost all its influence in Southeast Asia to Vietnam, something Beijing saw as unacceptable. Deng Xiaoping announced that Vietnam would no longer be allowed ‘to go swashbuckling in Laos, Kampuchea, or even in the Chinese border areas.’ (Ray 106)
It was in early 1979 that China felt the time was right for “teaching Vietnam a good lesson.” (Ray 73) Aside from the Cambodian question, the territorial disputes and the treatment of ethnic Chinese in Vietnam all weighed heavily in the Chinese decision to invade Vietnam. Hanoi had once said that it had chosen the Soviet Union over China because that would stop the Vietnamese speculation that China sought to flood the country with Chinese immigrants as a measure of reducing China’s overpopulation. (Van Canh 241) This belief was fueled by the Chinese offer to restructure the border to accommodate the ethnic minorities on either side, a situation that would benefit China more than Vietnam, and a deal the Hanoi rejected by saying that the Sino- French treaties clearly defined the border and if the ethnic Chinese were uncomfortable they could return to China. (Ross 152) China lashed out at the quarantine of Chinese Hoa.. The persecution included not only the closing off of the Hoa in the slums of Ho Chi Minh City, but also the confiscation of stocks from Chinese merchants. (Van Canh 240) In addition, Vietnam began sweeping the border area with China, removing the Hoa. Vietnam claimed that its motive in clearing the border area was not to deport or bully the ethnic Chinese, but simply to avoid a possible conflict with China. (Chen 64) However, with the restraints placed on them, myriads of ethnic Chinese began to leave Vietnam and return to China, doing so by the thousands. Eventually, nearly 200 thousand refugees would enter China, leading Beijing to harshly criticize Vietnam as unhumanitarian. Vietnam pointed out that the Chinese had made no protest when their allies, the Khmer Rouge, had also forced thousands of ethnic Chinese from Cambodia, and had killed many others. (Ray 80)
Before the invasion, though, there were attempts made to clear up the border and territorial dispute. Back in 1887, both the French and the Qing had agreed that the line drawn in the Gulf of Tonkin was not a border. However, when China later raised the question about creating a borderline in the gulf, Vietnam argued that the line was indeed a standing aquatic boundary. (Chen 40) China argued that the line had only been a marker to determine possession of the islands in the gulf, and not the division of the body of water itself. In addition were the two archipelagos, that were not only claimed by both China and Vietnam, but also by Taiwan and the Philippines. The latter two countries would rescind their claims. The debate for ownership of the islands might not have become such a heated one were it not for the presence of oil, a commodity coveted by both nations. (Chen 41) Another argument made by both sides regarding the archipelagos was the traditional possession and use of them. Both governments released documents that showed long standing ties and ownership. Hanoi contended that it was the Vietnamese who had not only discovered the Paracels, but had levied taxes on their inhabitants since the seventeenth century, while archaeological finds reveal artifacts from early China. (Chang 62)
China made an official claim on the Paracels and Spratleys in 1951, claiming that they had been returned to China from Japan as part of the Allied Treaty signed with the Japanese. (Chang 18) At an international meeting, Vietnam laid claim to the archipelagos, and during the border dispute would assert that the islands were definitely the property of Vietnam, since no country had opposed the claim when it was made at the meeting, a meeting China did not attend. (Chang 18) In 1955, the Chinese and Vietnamese met, reviewed the ground border, and both agreed that the line drawn by the French and the Qing was well defined, sound, and needed no renegotiating. (Chinese Aggression 21) At a second meeting later in the decade, the two sides would again agree to maintain the status quo of the present border. China, though, would later argue that it had only agreed to temporarily keep the status quo because of the war situation and Vietnam, and would wait until Vietnam was not boggled with its independence movement and settled before the border can be redrawn. (Chang 37) Another offer was made by China to rework the land border, and China was prepared to make cessions to Vietnam on the mainland, but this was because China was adamant on its stand regarding the Paracels and Spratleys. (Ross 38) China made one other attempt at initiating a renegotiation of the land border, making the argument that the rivers that ran along the land border were, like the Gulf of Tonkin, also not clearly defined and should be redone, with the signing of a new treaty after the complete remarkation of the border, an argument Vietnam gave little attention to. (Chang 39)
As for actual armed conflict, there were several major and a host of minor skirmishes along the border in the late 1970’s. One of the major incidents occurred when the Chinese constructed a railroad, and a stretch of that railroad crossed over the border and into Vietnamese territory. When Vietnam raised the issue, China refused to reroute the railroad, setting off fighting. (Chen 49) But the bulk of armed battles leading up to the Chinese invasion took place on the more disputed areas, the Paracels and Spratleys. In 1959, Diem’s regime in Saigon overran the Chinese and occupied the Paracels. (Chang 22) Later, on January 19, 1974, with the U.S. sponsored “nation” of South Vietnam set to collapse and be integrated into the north, China seized the opportunity to oust the Vietnamese and take back the Paracels. (Lawson 277) Hanoi, though, argued that as Saigon had taken the islands, and Hanoi had taken Saigon, the islands were therefore now under the authority of Hanoi, and newly reunified Vietnam. (Chang 22) When China refused to relinquish the Paracels, Vietnam seized the Spratleys. (Ray 117) Beijing saw Vietnam’s occupation of the Spratleys, and contest for the Paracels, as an insult and a backstab after all the economic and military aid China had given to Vietnam during its independence struggle. (Ross 40) China had another legitimate argument, though. Since the last official agreement between the two countries was the 1958 agreement to keep the status quo, and at the time China still controlled both archipelagos, Vietnam was then in violation of the current agreement. (Ray 117)
Thus, China invaded Vietnam. Vietnam speculated the Chinese invasion served only as a “testing ground for the Chinese army, who had had no actual fighting experience since the Sino- Indian border war- almost twenty years ago. The Chinese army would gain experience from this attack.” (Chen 94) China’s plan for attack was to first capture the northern strip along the border, and then to capture and level the towns of Cao Bang, Lang Son, and Lao Cai. (Chinese Aggression 11) China intended to be swift and firm so that, as Deng Xiaoping said, ‘in teaching Vietnam a lesson, the myth of Vietnamese invincibility and the claim that it is the third strongest military power in the world will be shattered.’ (Ray 106)
Vietnam’s rousing cry during the invasion was that, “By attacking a country that stands as a symbol of struggle for independence and freedom, the Beijing reactionaries have put down their mask of sham revolutionaries and revealed themselves as extremely dangerous reactionaries who oppose peace, national independence, democracy, and socialism.” (Cuong 95) The Chinese accomplished much of their goal, capturing the towns and inflicting damage of the Vietnamese. However, Chinese advances were not without a heavy cost of casualties. A war of attrition would not be an efficient strategy here. It was certain that the Chinese had underestimated their opponents. (Chinese Aggression 13)
The Vietnamese developed a defense strategy that worked well against the Chinese. Along the border where the invasion was initiated, Vietnam defended itself by using smaller, local militias, while the larger, better equipped forces lie in wait deeper into the country. As the Chinese advanced, they were able to cut through the militia, but suffered losses and were weakened. Once the diminished Chinese force progressed deep enough, the full- strength Vietnamese force would attack. (Chen 106) This tactic proved devastating, not only trapping the Chinese, but also cutting off their supply lines. The resulting condition was that the Chinese remained close to the border for the duration of the invasion, and did not penetrate much into the country, never more than 50 km into Vietnam, for fear of the attack by the large force in waiting. (Chen 108) Another bonus for the Vietnamese was that the border militias, intended to be sacrificed as a means of weakening the Chinese, did a bigger job than expected, and caused more Chinese casualties than initially hoped for. (Chen 107)
But though they suffered many casualties, China was the larger and better equipped army. Once China had captured its targets, the last being Land Son on March 2, (Chen 110) China began its lesson. In commenting on the Chinese treatment of the Vietnamese during the invasion, the Vietnamese proclaimed that, “Their barbarity was on a medieval scale and the means they used were modern.” (Chinese War Crimes 6) In addition to the slaughtering of Vietnamese peasants in the villages, with mutilations of the bodies, the Chinese also destroyed any and all networks of modernity and use to the people. Schools, hospitals, roads, bridges, offices, and even electric and telephone wires were all destroyed, showing that the true Chinese intent was not to capture and keep any territory, but simply to cripple the economy by devastating towns and eliminating any and all progress made by independent Vietnam. (Chinese War Crimes 10)
Further evidence that China had no goal in Vietnam other than aggression was that as soon as the massacres took place, China withdrew. (Chinese Aggression 33) The withdrawal took place on March 5, 1979, just days after the occupation of Lang Son. Perhaps China withdrew because it had suffered too many casualties itself and decided prolonged involvement in Vietnam would only lead to more Chinese losses. (Chen 110) But to the Vietnamese, China left not because the border question would still remain unresolved, including sovereignty over the island groups, but because the Chinese had done the damage they intended, because, “The Chinese completed the large- scale destruction that the U.S. imperialists left unfinished.” (Chinese War Crimes 6) Genera l Giap called the Chinese ‘war criminals, worse than Hitler,’ (Ray 101) and the sentiment of the Chinese as genocidal was echoed in the exclamation that, “the crimes against the Vietnamese people perpetrated by the Chinese ‘People’s Liberation Army’ are comparable only to similar ‘exploits’ by the Khmer Rouge.” (Chinese War Crimes 9)
In both conflicts, China launched the attack, but not before making several attempts at a peaceful solution to the border question. Both wars could be viewed as imperialism, but not necessarily as Chinese imperialism, as both India and Vietnam also had clear goals in mind in terms of land acquisition and cementing of spheres of influence. It is not possible to completely condemn China because India and Vietnam both violated their own terms and both had ambitions of their own. However, it is clear that China is culpable as well, due to its belief that it is Asia’s premier power and its clear intentions to prove itself as such. The wars also show the importance of nationalism. Both India and Vietnam fought long struggles for their independence against European powers, as China had long fought with itself to establish a new government. However small and seemingly insignificant China’s demand might be, either the top of a hill in the Himalayas not otherwise used or a few square kilometers stretched out over several hundred miles, that is still territory that was fought for and earned through decades of revolution, and the two countries were not willing to simply hand those lands over to China. At the same time, it is clear that both wars could have been avoided, or at least mitigated, by cooperation and compliance to renegotiate borders that were not clearly defined and needed work anyway.

Sources

Banerjee, Purendu. My Peking Memoirs of the Chinese Invasion of India. Delhi: Clarion Books,
1990.

Chang, Pao-Min. The Sino-Vietnamese Territorial Dispute. New York: Praeger, 1986.

Chaudhuri, Sailen. Maoist Betrayal: India: A Case Study. New Delhi: Sterling Publishers Pvt.
Ltd., 1980.

Chen, King. China’s War With Vietnam, 1979. Stanford, CA: Hoover Institution Press, 1987.

China’s Fraudulent Peace Offensive. Faridabad: Publications Division, Government of India
Press, 1962.

The Chinese Aggression: How and Why It Failed. Hanoi: Foreign Language Publishing House,
1979.

The Chinese Aggression: Some Facts About the India-China Border.

“Chinese Foreign Ministry’s Note to Indian Embassy in China March 22, 1962.” In Selected
Documents on Sino-Indian Relations. Peking: Foreign Language Press, 1962.

Chinese War Crimes in Vietnam. Hanoi: Vietnam Courier, 1979.

Communist Party of India. The India-China Border Dispute and the Communist Party of India:
Resolutions, Statements, and Speeches 1959-1963. New Delhi: New Age Printing Press,
1963.

Communist Party of India. Vietnam in Chinese Strategy. New Delhi: New Age Printing Press,
1980.

Cuong, Phuc. “Beijing’s Hegemonic and Expansionist Strategy.” In Against Maoism: Beijing’s
Expansionism and Hegemonism. Hanoi: Vietnam Courier, 1980.

Das, Benarsi. “Now Not Buddha But Jawans.” In Our Northern Borders: India-China Border
Dispute. Rana Satya Paul, ed. New Delhi: Book Times Co., 1963.

Editorial Department of the Renmin Ribao. The Truth About How the Leaders of the CPSU Have
Allied Themselves With India Against China. Peking: Foreign Language Press, 1962.

Enlai, Chou. “Letter to Nehru October 24, 1962.” In Chinese Aggression in War and Peace: The
Letters of the Prime Minister of India. New Delhi: Publications Division, Ministry of
Information and Broadcasting, Government of India, 1962.

Enlai, Chou. “Letter to Nehru November 4, 1962.” In Chinese Aggression in War and Peace: The
Letters of the Prime Minister of India. New Delhi: Publications Division, Ministry of
Information and Broadcasting, Government of India, 1962.

External Publicity Division. Indian Communists Condemn Chinese Aggression. New Delhi:
External Publicity Division, Ministry of External Affairs, Government of India, 1962.

Gidwani, D.S.. Chinese Techniques of Expansion 1954-1962. Bombay

Ray, Hamen. China’s Vietnam War. New Delhi: Radiant Publishers, 1983.

Hoffman, Steven. India and the China Crisis. Berkeley: University of California
Press, 1990.

Hood, Steven. Dragons Entangled: Indochina and the China-Vietnam War. New York: ME
Sharpe Inc., 1992.

Kaushik, RP, and Susheela Kaushik. Back to the Front: The Unfinished Story in Vietnam. New
Delhi: Orient Longman Ltd., 1979.

Kini, MD. “China Under Communism.” In Chinese Invasion: Background and Sequel. VB
Karnik, ed. Bombay: Bharatiya Vidya Bhavan, 1966.

Lall, John. Aksai Chin and the Sino-Indian Conflict. New Delhi: Allied Publishers
Private Ltd., 1989.

Lawson, Eugene. The Sino-Vietnamese Conflict. New York: Praeger. 1984.

Linus, Joseph. The Sino-Indian Border Dispute. Singapore: Malaysia Publications Ltd., 1965.

Maxwell, Neville. India’s China War. London: Ebenczer Bayliss and Son Ltd., 1970.

Mohammad, Bakshi. “Fight For Democratic Values.” In Our Northern Borders: India-China
Border Dispute. Rana Satya Paul, ed. New Delhi: Book Times Co., 1963.

Menon, Krishna. Chinese Betrayal of India. New Delhi: Hind Gyan Mala, 1962.

Munshi, KM. Chinese Aggression and its Implications. Bombay: Bharatiya Vidya Bhavan, 1963.

Nehru, Jawaharlal. Prime Minister on Chinese Aggression. New Delhi: External Publicity
Division: Ministry of External Affairs, Government of India, 1962. In Indian Communists Condemn Chinese Aggression. New Delhi: External Publicity Division, Ministry of External Affairs, Government of India, 1962.

“Note From the Indian Ministry of External Affairs to the Chinese Embassy March 13, 1962.”
In Selected Documents on Sino-Indian Relations. Peking: Foreign Language Press, 1962.

Paul, Rana Satya. “Our Northern Borders.” In Our Northern Borders: India-China Border
Dispute. Rana Satya Paul, ed. New Delhi: Book Times Co., 1963.

Paul, Rana Satya. “The Indian Alignment.” In Our Northern Borders: India-China Border
Dispute. Rana Satya Paul, ed. New Delhi: Book Times Co., 1963.

Prasad, Niranjan. The Fall of Towang. New Delhi: Patel Enterprises, 1981.

Rana, Sudarshan. “September, 8 1962… And After.” In Our Northern Borders: India-China
Border Dispute. Rana Satya Paul, ed. New Delhi: Book Times Co., 1963.

Ray, Chris. Vietnam, Reconstruction, and the Chinese Invasion: an Eyewitness Account. Forest
Lodge: Australian Radical Publications, 1979.

“Report of the Chinese and Indian Officials on the Boundary Question” In Selected Documents
on Sino-Indian Relations. Peking: Foreign Language Press, 1962.

Ross, Robert. The Indochina Tangle: China’s Vietnam Policy 1975-1979. New York: Columbia
University Press, 1988.

Rowland, John. A History of Sino-Indian Relations. Hostile Co-Existence. Princeton: D. Van
Nostrand Co. Inc., 1967.

Sen, S.P., ed. The Sino-Indian Border Question: A Historical Review. Calcutta:
Institute of Historical Studies, 1971.

Sinha, Satya Narayan. The Chinese Aggression. New Delhi: Ramakrishna and Sons Inc., 1961.

Van Canh, Nguyen. Vietnam Under Communism 1975-1982. Stanford, CA: Hoover Institution
Press, 1983.

Varkey, Ouseph. At the Crossroads: the Sino- Indian Border Dispute and the Communist Party
of India 1959-1963. Calcutta: Minerva Associates, 1974.

Vertzberger, Yaacov. Misperceptions in Foreign Policy Making: the Sino-Indian Conflict, 1959-
1962. Boulder, Co.: Westview Press, 1984.

TERRITORIAL DISPUTES IN POST-INDEPENDENCE ASIA

Frank Cavitolo
History 53.11

Inidan labor

It is somewhat ironic that the British needed to import labor into their African colonies, considering that for centuries prior Africa had been the supplier of surplus labor around the world. Still, however, the British needed a large workforce to develop infrastructure in the East African colonial holdings of Natal, Uganda, and Kenya. To meet this demand, the English turned to their largest colony, both in terms of wealth and population, India. The use of South Asian labor was not without precedent, though. The British had already seen, with satisfaction, the efficiency of Indian labor on several penal colonies, such as Ceylon, the Andaman Islands, and Burma.

The most successful among these penal colonies, though, and the one that eventually convinced the British to use Indians in Africa, was the island of Mauritius. Originally unsettled, the Dutch first attempted colonization of this small island east of Madagascar, only to abandon the island to French control in 1710, who in turn would be expelled from the island by the British a century after. (Anderson 1) Between 1814 and 1837, the British sent over thousands of Indians to serve out prison terms laboring mostly on the island’s sugar plantations or on building roads and bridges. In addition to the convicts sent over, many more free South Asians went to Mauritius as either indentured servants or as entrepreneurs. The new arrivals transformed the once unpopulated island into a thriving agricultural enterprise and major Indian Ocean trading port.

Although criminals had been first shipped in 1814, it was not until May of two years later that the British Empire established Mauritius as an official penal colony. (Anderson 14) The two arriving ships, both carrying 150 convicts, had left India in September of 1815. Afterward, however, the number of transported Indians per ship was reduced to forty. The reason for that number was that it was believed that the ship’s crew was adequately equipped to handle forty convicts in the event of an uprising, while a larger number indeed might successfully overtake the ship. (Anderson 14) During the passage to Mauritius, the low number of convicts sent per ship had a beneficial effect in that the mortality rate on board the transfer ships remained below 3 percent, as compared to a death rate of 7- 9 percent on the island. (Anderson 23)

In some cases, prisoners actually preferred to be sent to labor in Mauritius instead of being sent to prison. Criminals were given prison terms of fewer years if sent to the colony instead of a prison house, and also may have been attracted to the idea that, while they would be involved in state mandated labor, they would not be subject to prison conditions in India. By 1820, a growing number of convicted felons actually requested transportation to Mauritius rather than prison incarceration. (Anderson 18) Those who were selected for transfer to the penal colony were given terms of transportation of 7, 10, or 14 years, or life in cases of serious offenses. (Anderson 29)

As for the ethnic makeup of those transported, the British were not as indifferent about who was sent as they were not eclectic. From Bengal, the largest single group, accounting for just over one- third of all transported convicts, were Muslims, while shudras made up just under one- third, and most of those remaining were either from the dalit or adivasi caste. From Bombay presidency, the latter two represented nearly three- fourths of all transportees. (Anderson 18) In
addition, throughout the over twenty years of transportation, only six female convicts were sent- one from Bengal, one from Ceylon, and four from Bombay. (Anderson 19)

The nature of the work on the island was labor intensive, but there were benefits to those who proved good and dedicated workers. On the island, both criminals and indentured servants who arrived were assigned to work days of 9- 10 hours per day. For laborers who performed their tasks well, the specific work that person did may be lessened, or that person given an easier crop or better land, or may even be promoted to a managerial or supervisory position, while those who refused to work, or were uncooperative, would be punished with more intensive labor and even longer hours. (Anderson 34) In addition, flogging was also used as a punitive measure. The convict was also singled out by a marking to distinguish him from a non- criminal worker, although the difference in status was not necessarily better. Convicts and indentured servants were kept together on the plantations. In addition, some of the British plantation owners and wealthy residents and also some of the remaining French settlers on the island owned slaves, and so the marking of convicts served only not to confuse a criminal with a slave, another forced laborer. (Anderson 35) Those not employed on plantations built roads and bridges, dug canals, and rebuilt the island’s capital, Port Louis, destroyed by fire in 1816. Rations were given to the laborers every ten days, and included rice, lentils, ghee, fish, salt, and wood, along with one new set of clothes every year, although workers were also permitted to raise small animals for consumption. (Anderson 41)

Most indentured servants arrived after 1837, when the import on convicts ceased. More and more indentured servants were sought, as the convicts were now being gradually emancipated through acts of the government. As their terms expired and they remained on the island as free hired labor, the number of convicts on Mauritius dwindled, dropping from 611 in 1830 to 382 in 1846. (Anderson 111) It is key to note that the convicts remained on as free labor because in 1853, when the government officially freed all remaining convicts, it did so on the condition that the convicts did not return to India. (Anderson 118) Two key acts were passed between 1837 and that helped speed up emancipation. One was the granting of the power to pardon to the Governor of Mauritius, Lionel Smith in 1841. (Anderson 113) The other was the 1849 act freeing any convict laborer who was either over the age of 65 or had worked on the island for 30 years or more, freeing a large portion of the remaining convict labor force. (Anderson 116) Smith had several times proposed general manumission, but had been rejected by the government, since some of the convicts had been uncooperative and had committed more crimes on the island, or had served in the 1816 mutiny of 230 convicts.

Seeing the relative success of the use of Indian labor on Mauritius, the Great Britain decided to import South Asians to some of its other African holdings, the largest of whom being Natal, in present day South Africa. The first arrivals in Natal came in the early 1860’s, a significant date because that would make it shortly after the failed Sepoy Mutiny of 1857- 1858. In these years, the British exercised harsh policies and many Indians found themselves unable to find employment at home, and so South Africa began to appear attractive. India began to look attractive to white plantation owners who found the indigenous black population of Africa uncooperative, even as paid labor. (Henning 7)

It was in 1859 that the first steps were taken to set up a new kind of labor transport. Natal was to be a colony of indentured Indians and black natives, both working for white settlers. The Natal Immigration Laws were set up in 1859, among them Law 14, giving the government the right to transfer an indentured servant from one master to another, and setting up guidelines for recruitment. (Henning 9) In November of 1860, the first two ships left for Natal, the Belvedere and the Truro, each carrying 342 indentured servants. (Henning 30) In these initial voyages, there was a high percentage of women passengers, as females accounted for one- third of the passengers on the Truro, and one- fourth that of the Belvedere. (Henning 32)

Advertisements for indentured laborers offered 9 hours of work per day, 6 days per week, with monthly payment of 10 shillings to adult males and half that amount to women and children, with gradual increases of 1 shilling as the time of service played out. (Swan 188) These, along with other provisions such as decent living conditions, were the terms of the contract, though they were not met. Agricultural indentured servants worked sometimes as many as 18 hours per day, and were huddled into unventilated and unheated rooms, along with an inconsistent and insufficient food ration. (Swan 121) Masters also set up a system of deductions to withhold pay from the servants based on illness or unsatisfactory output, even though there were laws clearly stating that an indentured servant’s salary was guaranteed under all conditions except when stopped by, and only by, the Magistrate’s Court, although this avenue was seldom taken. (Henning 43)

A Protector of Indian Immigration was installed in 1859 under the Natal Immigration Laws for the indentured servants and free immigrants who came to Natal to address grievances to, and this individual indeed was given a swarm of petitions because many Indians felt they were not receiving fair treatment under the terms of their contract. The community in the city of Durban wrote in 1877 that, “It is painful and disheartening to us Indians after inviting us into this colony and thus treated as slaves instead of free- born subjects.” (Muslim 6)

Conditions were slow to improve. As more and more South Asians arrived in South Africa every year, there was a growing concern among the white settlers to curb their potential influence. A slew of restrictions were placed on the Asian minority that crippled their legal status and sought to marginalize them as much as the black population. In 1883, the viceroy was petitioned to lift a 9 P.M. curfew for Asians, along with government protection of temples, legislation requiring the rations of indentured laborers to be raised, and the provision of a South Asian jury to decide cases where the perpetrator was an Indian. (D. Pillay 10) An 1884 letter to the Protector of Indian Immigration complained of no attempt to search for missing children who were suspected of being kidnapped for use of forced labor on railways or in mines, along with accounts of routine beatings of indentured servants, certainly conditions that were not bargained for in the contract of servitude. (Bhagoo 5) The greatest strike to the indentured servants, and the growing Asian community in South Africa, came in 1894, when the colonial government passed the Immigration Law Amendment Bill, stating that when an indentured laborer’s period of servitude was over, he must return to India or enter into an extension of the term, in addition to the new annual tax of three pounds placed on all free Asians living in Africa. (Bill 53)

Originally, the indentured persons were intended for work on plantations, though the British soon afterward found huge labor shortages in some of the other African colonial industries. Though signed up for agricultural work, many Indians, upon arrival in Natal, found themselves instead put to work on railroad construction and in mining, since these were more profitable enterprises. Conditions in these sectors was even worse, since miners were given little or no equipment to preserve health, and rail workers were given still fewer rations along with being exposed to a host of foreign diseases. Since a growing number of indentured servants wrote home in complaint, some companies looking to recruit more Indians attempted to include some mining duties in all contracts, though this attempt was blocked by the government. (Swan 124)

The status of the free Indian was only slightly better in that he was not bound to any one particular master. However, the government was highly restrictive of this class, and much fearful as well. The indentured servants could be expected to return to India after their contract had expired. The immigrant, though, was in South Africa to begin a new life, and thousands of them arrived each year. In 1885, the Group Areas Act arose, intending to set up reserves for Indians to keep them out of white areas, and make Asians a self- contained community in poorly sanitized and outlying areas. (B. Pillay 5) There was also Law 3 that, in addition to also restricting places of residence, also imposed registration fees on Asians, while denying them both citizenship and property rights. (B. Pillay 11) The government argued that the removal of Indians “was required on sanitary grounds,” since Asians naturally carried a plethora of diseases that may affect whites, but now would grant property rights in those designated areas, along with reducing registration fees. (B. Pillay 17)

Other restrictions included a tax raise in 1890 that effectively cut Indian immigration, forced many Asian merchants to close their shops, and placed huge fees on farming and polls. (B. Pillay 33) In the Transvaal, legislation was put in place by the Executive Council in 1902 restricting Indians from buying speculative land, leaving that opportunity for the Boers who were not restricted in any way from obtaining land and accumulating wealth. (B. Pillay100) Morality Law 2, passed in 1897, prevented both blacks and Asians from having relations with white women. (B. Pillay 63) In 1899, Gandhi wrote in protest of a newly proposed law that wished to expel Indians from Johannesburg, arguing that the removal would cost Indian merchants dearly if their shops would have to be closed and relocated. (Gandhi 46)

Despite the heavy and escalating restrictions, the Indian minority did benefit from having the Wragg Commission set up in 1885. This group was established to decide what should be done with the exploding immigration population. The Wragg Commission found that the Indians were given inadequate hospital facilities and had a high incidence of venereal diseases. Among its recommendations were the establishment of cemeteries for Indians to improve sanitary conditions, for prisons to have a medical examiner in order to curb the horrible outbursts of disease that lead to a high prison mortality rate, and the registration of marriages. (Henning 69)

With immigrants arriving by the thousands each year, the Indian population surpassed that of white settlers in South Africa in 1894, leading the government to look for serious measures to stop entry of Asians into the colony outright. One measure taken was that the legislature required that all indentured Indians must return to India upon completion, with the guarantee of repatriation by the Government of India. (Henning 95) Whites began to fight for the removal of all Indians, and Indians fought for their right to stay. In 1897, when two ships arrived at Durban carrying immigrants, the two ships were sent back and their passengers not given entry into South Africa. A group of five thousand Indian protestors gathered to protest and force the government to allow the immigrants in. Rioting ensued. In response, the government passed the Immigrant Restriction Bill, blurring the difference between the indentured servant and the free Indian laborer by reducing the status of the former, and placing more restrictions on movement and taking away rights, making the bill a clear message from white settlers that Indians, regardless of function, were no longer welcome in South Africa. (Henning 136)

Indian labor was not confined to South Africa, either. Another potentially lucrative holding was the Ugandan Protectorate and its abutting neighbor, Kenya. These colonies established at the close of the nineteenth century, with Kenya formally annexed in 1920. An interior colony centered around Lake Victoria, extensive roads and railways, the major one set to link Mombasa with Kisumu, were needed to penetrate into Uganda, and indeed to open the interior of the Dark Continent. (Ramchandani 19) The British hoped that, upon completion, the rails would give Britain an edge to win domain over more African land, and the use of Indians on this new infrastructure might open up new colonies. (Mangat 28)

Indian labor began to be imported, although unlike the case in Natal, these Asians were being specifically recruited for industrial labor. A large number, though, were also brought in as agricultural servants. Another reason for the import of Indians was that India provided the British with a huge labor force to tap into, allowing them to develop their East African colonies faster than their imperial competitors. “The resources of her empire in India gave Britain an initial advantage in Kenya and Uganda such as Germany lacked in Tanganyika.” (Mangat 28) In Uganda, Asians were used primarily in the industrial sector, while in Kenya there was a large number of free immigrants who set up businesses in Nairobi. In either case, the British were both pleased and upset about the Indian presence. The colonial government was not resorting to working with the indigenous peoples, but were still operating with an inferior class. “By nature of the administrative and economic roles the colonial government had permitted the Indian and Pakistani immigrants, the capacity of the Asian to hurt the African was limited. Moreover, having himself suffered from British colonial rule, the Asian had a natural affinity with the African.” (Prem 22)

The first step towards the import of South Asians to east Africa came with the 1888 Royal charter for the Imperial British East Africa Company, purposely set up to plan out Indian work for expansion into the African interior. (Mangat 28) The first arrivals to work on the railways in Uganda came in 1896, only three years after the establishment of the protectorate. The bulk of the recruitment was done in Bombay and other areas of Northern India, until an outbreak of plague in 1897 caused the British to cease importing from there and begin attracting migrant laborers from Calcutta. (Mangat 36) Not all those who were brought over and given passage was an indentured servant. A number of different functions awaited South Asians in these colonies. Some Sikhs were hired as a protective measure for the rail workers in the thickly vegetated regions, while a number of other Indians served as a police force in port towns, while entire crews of skilled artisan labor were brought in to work on the railroads as masons and smiths. (Rai 15)

Similar to Natal, conditions of the contracts for the indentured servants were not met. In 1896, not the servants themselves but the Government of India made several demands for improved quality of life and working conditions for the laborers, among them demands for a reduction in the terms of service, establishment of a minimum wage, and more detailed accounts of the specific nature of the work to be done in Uganda. (Mangat 34) laborers On the rail lines also were subject to severe food shortages since supply lines were not so easily run as for agricultural servants. Salaries for the indentured servants was 55- 65 rs per month for the blacksmiths and masons, while those who cleared the way or laid track were given 20 rs permonth.

Some Indian servants were promoted to higher positions where they would supervise the work of other servants rather than work themselves. All Indians, though, eventually had to answer to a white officer, though it should be noted that the British officers placed in command of the laying of railroads had all first spent a number of years of service in India. (Rai 19) The average term of servitude was three years, and 32, 000 indentured servants arrived between1896 and 1901. (Mangat 37) Under terms of a settlement in March of 1897, indentured servants were required to work 9 hours a day 6 days out of the week, under penalty by fine or even termination of contract for infractions, but added a stipulation that for performance over the allotted quota, or extra hours put in, an additional bonus would be added to the pay. (Rai 21) Another benefit that was included by the Government of India was that upon completion of the term, the indentured servant would be provided with free passage back to India, though the return passage was not a pleasant one, as return ships were heavily overcrowded, had poor sanitary conditions, and were in decay, leading to a very high mortality rate, and of those who did survive the return passage, many had been permanently affected by the contraction of a disease while on board. (Rai 25)

Earlier, the British did not frown upon Indian immigration into their East African colonies.However, after the decision that Kenya was to become a settler colony, there became a growing urgency to cut the flow of non- whites into the region. Under the Emigration Act of 1883, many free Indian merchants, mostly from Gujarat, came and opened shops, enjoying a more or less equal status with the initial white settlers. (Mangat 51) There was a brief period where immigration dwindled, but was renewed in 1906, and by 1920, when Kenya was formally annexed, the growing white population was adamant about limiting the South Asian presence, and reducing the status of those already there. In Uganda, measures taken to check Indian influence included both placing trade restrictions on merchants and even the removal of Indian residents to reserved living areas. (Mangat 112) There was a huge concern that Indians would gobble up much of the good land and, if their businesses proved prosperous enough, and some had because many merchants had by that time began expanding and opening stores in other parts of the colony, that the Asian minority, though believed to be inherently inferior to the British, would nonetheless have a more prominent role in the administration of Kenya and Uganda because of their wealth. (Mangat 100)

The legacy of Indian importation and immigration to Africa remained on shaky ground.Many Africans remained indignant of the Asian communities, for though they also were repressed,they were given better treatment than blacks, and did have more economic opportunity, opportunities many Indians took advantage of. The result was that as more blacks became involved with government, there was an increasing movement to stifle their rights, such that after independence, Indians were now the target of repressive black governments rather than repressive white governments. Uganda went so far as to expel its Asian population. To this day though, Asians remain a sizable minority in many African nations. It should be noted, though, that while they constitute an African people, they were not always welcome. The Wragg Commission declared that if the indentured servant did not return to India after his contract expired, than “his status should be reduced.” (Henning 75) Harry Escombe, a prominent white politician said, ‘The Indians are to come here appreciated as laborers, but not welcomed as settlers or competitors.’ (Henning 95) The sentiment was reiterated in other colonies. Indeed, “the one central theme running through all stages of Indian emigration was that Indians were needed as ‘indentured laborers but not as freemen.’” (Rai 13)

WORKS CITED

Anderson, Clare. Convicts in the Indian Ocean: Transportation from South Asia to Mauritius, 1815-1853. New York: St. Martin’s Press, 2000.

Gandhi, Mohandas. “Letter Written by Gandhi 21 July 1899” in A Documentary History of Indian SouthAfricans. ed. Surendra Bhana and Bridglal Pachai. Stanford, CA: Hoover Institution Press, 1984.

Henning, CG. The Indentured Indian in Natal. New Delhi: Promilla and Co. Publishers, 1993.

Immigration Law Ammendment Bill, 1894 in A Documentary History of Indian South Africans. ed. Surendra Bhana and Bridglal Pachai. Stanford, CA: Hoover Institution Press, 1984.

Mangat, J.S.. A History of the Asians in East Africa 1886-1945. London: Oxford University Press, 1969.

Natal Archives, I.I/1/18,189/1884 “Bhagoo, an Indentured Servant to J. Meikle” in A Documentary Historyof Indian South Africans. ed. Surendra Bhana and Bridglal Pachai. Stanford, CA: Hoover Institution Press, 1984.

Natal Archives, I.I./1/3,105/1877 “Muslim Group in Durban” in A Documentary History of Indian SouthAfricans. ed. Surendra Bhana and Bridglal Pachai. Stanford, CA: Hoover Institution Press, 1984.

Natal Archives, G.H.318, 1883-1886 “Petition to Viceroy by Doorasamy Pillay” in A Documentary History of Indian South Africans. ed. Surendra Bhana and Bridglal Pachai. Stanford, CA: Hoover Institution Press, 1984.

North-Coombes, MD. “Indentured Labor in the Sugar Industries of Natal and Mauritius” in Essays onIndentured Indians in Natal. ed. Surendra Bhana. Yorkshire: Peepal Tree Press, 1990.

Pillay, Bala. British Indians in the Transvaal: Trade, Politics, and Imperial Relations 1885-1906.London: Longman Group Ltd., 1976.

Prem, Bhatia. Indian Ordeal in Africa. Delhi: Vikas Publishing House Pvt. Ltd., 1973.

Rai, Kauleshwar. Indians and British Colonialism in East Africa 1883-1939. Patna: Associated Book Agency, 1979.

Ramchandani, RR. Uganda Asians: The End of an Enterprise. Bombay: United Asia Publications, 1976.

Swan, Maureen. “Indentured Indians: Accommodation and Resistance, 1890-1913” in Essays onIndentured Indians in Natal. ed. Surendra Bhana. Yorkshire: Peepal Tree Press, 1990.

The Use of Indian Labor in British Africa

Frank Cavitolo
History 63

Resume

Frank P. Cavitolo

NYS Licensed Registered Nurse

Professional Experience

7/2017- current             Medical Associates of Wall Street         65 Broadway Ste. 903   New York, NY 10006

Registered Nurse- per diem preventative care providing immunizations to Parks Department Employees, provide            education on preventative care and the importance of screenings, build trust for health care professionals through    community outreach

7/2017- current             Jewish Home Lifecare Management LLC           120 W106 st     New York, NY 10025

RN Clinical Case Manager – coordinate care and services for clients in the community, including referrals for preventative and specialty care, authorization of durable medical equipment, planning and facilitating skilled and custodial admissions and discharges, complete telephonic assessments of members to identify triggers, develop and implement plans of care

 

Non-related Work Experience

7/2013- 7/2017             Sears Holdings Corporation,      770 Broadway                          New York, NY 10003

Locator- monitor on-hand counts of inventory, consult and coordinate with department leads and management,transport and store equipment, mentor and train new associates in policy and procedures

9/2008-6/2012              NYC Department of Education, 65 Court St                               Brooklyn, NY 11201

Teacher- instructed global and United States history at 9th, 10th, and 11th grade level, instructed 12th grade economics, design and implement remedial program, prepare students for NYS Regents examinations, collaborate       with teachers of other subjects in multidisciplinary team teaching, attend weekly multidisciplinary and biweekly department meetings, assist on departmental exam design committee, adapted instruction for needs of inclusion          students, establish course outlines and objectives, assess, evaluate and document student abilities

9/2006-4/2007             Glass Gardens Shop Rite of Brooklyn, 1080 McDonald Ave       Brooklyn, NY 11230

Cashier/Non-Food Associate- trained new associates in customer interaction and use of equipment, maintained             weekly inventory counts in Non- foods department, listen and resolve customer complaints

4/2006-6/2006    Communications University of China Pattison English                 Beijing, China

English Instructor- Instructed students in immersion English training program, assist in designing and planning   curriculum, conducted biweekly evaluation reviews of student progress, hosted weekly English Corner

2/2006-4/2006             Beijing Renwen University                                                       Beijing, China

English Instructor- Instructed 300 graduating students in oral and written English, with emphasis on situational             ability and workplace preparedness, instructed review course for National Proficiency Exam

9/2002-2/2006             Duane Reade Pharmacy                                                            Brooklyn, NY

Cashier/Stock Associate- Trained new associates, coordinated and arranged weekly display windows, received and inventoried weekly warehouse / vendor deliveries, placed weekly orders with vendors/ warehouse, assist with      managerial functions such as scheduling and layout design

9/2001-7/2002              Chuan A English School                                                          Handan, Hebei, China

English Instructor- Instructed weekly lessons in immersion English at primary school level, instructed biweekly lessons for adults at Handan Public Library

8/2001-7/2002              Hebei Industrial University                                                       Handan, Hebei, China

English Instructor- Instructed 200 students at undergraduate and graduate level with emphasis on oral English ability, coordinated and co-chaired weekly English Corner, participated in biweekly departmental meetings and discussions, served as coach and judge in departmental end of semester English speech evaluations, served as  school representative at other Handan area schools and businesses

 

Education

New York City College of Technology           Brooklyn, NY

9/2016-current  BSN

Clinical sites: Kingsbrook Jewish Medical Center- nursing leadership     Woodhull Medical Center- Geriatric  Wellness Center, community health screening and immunizations,Mazarek Towers- urban health issues

9/2012-6/2016  AAS: Nursing

Awards: Henry Wentz award for psychiatric/ mental health nursing

Clinical sites: Medical/Surgical- Coney Island Hospital, Maimonides Medical Center, Lutheran Health Center

Psychiatric- Coney Island Hospital

Pre/Postpartum- Kings County Hospital Center

Brooklyn College                                         Brooklyn, NY

9/2002-5/2009  MA: Social Studies Education, 7-12

9/1996-6/2001  BA: History

Awards: 2001 History Department Arthur Cole Award, recognized by Department of Modern Languages and             Culture for excellence in Chinese

Activities: 9/2000-6/2001 President: Newman Catholic Center, 2/2001-6/2001 President: Italian Culture Club,

9/1997-6/2000 Vice President: Brooklyn College Circle K

Other

9/1993-6/1996     Coney Island Hospital Health Careers Exploration Program

Volunteer: take and record vital signs, assist patients with ADL, assist in repositioning of patients, change bed linens, perform filing and clerical duties

Awards: 1996 Medex of the Year

 

 

Strengths

Pessisimism is not often looked at as a strength, but it is a useful approach. If one is only planning for the best, then the best better happen. Recognizing the possibility of, and planning for, the worst case scenario does several things. One, it keeps you well prepared. If the worst comes to pass, then you are ready for it. But you are also ready for any alternatives, and planning for the worst challenges you to find the best and most far reaching solutions. Even if they are not used now, they can be adapted for other situations. Another way pessimism pervades is to look at the entire workload as it hangs over the looming deadline. This creates a positive stress that forces you to devise ways of prioritizing, chunking, and forcing yourself to meet targets and keep moving rather than get bogged down.

One strength that can be a great asset to a nurse is humility. A nurse definitely has to be confident and assertive, but should also know his/her limits. After going through the nursing curriculum, one learns very quickly that one person does not, and can not, know everything, and has to rely on others. We rely on classmates to explain things the text is not clear on, to give rationales for answers, and for quick advice and assistance in clinical. That last part is crucial. What nurse can say he/she was never given any assistance from anyone? Yet somehow, there are nurses in the field who refuse assistance when asked, or will say they learned on their own. Even if that were the case, then the question can be rephrased as what nurse has never wanted or needed assistance at some point. By being willing to ask for assistance, a nurse can recognize faults and deficits, show deference towards more experienced colleagues and superiors, and show a willingness to learn and adapt. Likewise, a willingness to help others when asked helps build trust and lay the groundwork for future collaboration.

Another strength that is needed for success is a willingness to learn and improve. Some practicioners get set in their ways. They cling to what they learned in training and how they learned it. While it is important to keep a firm foundation, the reality is that knowledge and technology are constantly advancing. The standard practices of today may well be obsolete not long from now. New graduates enter the field with new techniques and new medications that will go against what veteran practicioners are accustomed to. It is important to keep in mind, even after 5, 10, or 20 years, that you too were once that new graduate. Keeping an open mind can also help keep the profession fresh and stave off burnout, as each day and each encounter would be viewed as a possible learning experience and not just another day at the office.

 

Learning Analysis

One of the key differences between the associate and baccalaureate programs is scope. Coursework in the associate program is focused on specific disciplines, and is technically rooted. Advancing to the baccalaureate program was an eye opener because the focus has shifted to the broader picture. It is no longer about assessing a particular patient at a particular time, but on looking at the population as a whole, seeing the case from the risk factors and culture and community influences through care and return to the community. The role of advocate takes on a whole new meaning because it is no longer a question of providing an extra blanket for the night on the unit but on alerting lawmakers to the need to funnel funding into programs to provide blankets to needy children or families in schools and community centers.

At the same time, there has also been the realization that a nurse also has to be an advocate for himself. I recall one session in psychiatric clinical where it was mentioned that nobody puts their head out into the hallway and calls, “Doctor”, but rather the call bell, patients, and families are calling “Nurse”. It is incumbent then to not only represent the profession and uphold its ideals, but seek ways to further advance it. As medicine continues to become more complex, nursing has to not only grow but change to meet current and future demands. There is far more reliance on specialists and other professionals to execute some of the tasks associated with care, but it falls on the nurse to act as the go between and tie the disciplines together. This also falls in line with the bigger picture of nursing as a profession; assessing not only the patient but nursing itself- the scope of practice, the rationales for interventions, the overlaps with other functions in the continuum of healthcare, and the changes on the horizon due to social, political, and economic shifts.

Another key learning point comes from the broadness of nursing. The traditional view of a white uniform dutifully standing next to a hospital bed is still commonly found, to be sure. But there are many other ways and capacities to address healthcare.  We are only beginning to realize that medicine is not limited to the acute treatment of an emergent condition. As the concept of health continues to change, so will the role of nurse, and those in or looking to enter the field will need to assert a voice in shaping what the final form will be. This, ultimately, is the purpose of advancing nursing education beyond the essential clinical skills needed to perform at the bedside. Many students, including myself, have questioned the validity of the baccalaureate program, with the argument that if the classwork is not geared towards learning and mastering assessment skills or practicing clinical procedure, then there is little use for it. But you to come to realize that the purpose is not to train the new nurse for the immediate position, but to see the larger picture of advocating for oneself and the profession rather than just for the patient.

Getting back to the argument, a nurse can treat patients without a syringe and an iv bag. Especially in the primary preventative care model healthcare is trying to move to, the key interventions will be providing education on identifying and modifying risk factors, or managing medications and activity regimens. This is where the “big picture” view comes into play. Also in this regard, the nurse becomes a salesperson, trying to get the client to buy into the care plan. In some ways, this is even more challenging. The person rolling on the ground in excruciating pain is not likely to question the nurse’s interventions or rationales. The one who believes himself to be in good health will need some convincing. Experience will teach the means of managing this situation more than any book will, but the books will lay the groundwork for experience to do its magic.

Philosophy Statement

What does it mean to be a nurse?

A person is perhaps no more vulnerable than at a time of illness. The individual is physically limited in some way, may be confused, may be scared, and these feelings can extend to the person’s support system if any exists. In the midst of this uncertainty, there must be someone to serve as an anchor. As the personnel who spends the most time at the bedside, who interfaces most with the patient, who advocates for the patient and caregivers, it is the nurse who fills this role. In essence, the nurse takes the complicated science of medicine and makes it human.

A number of people of written about and formulated nursing philosophies. Ultimately, though, a person’s outlook will be shaped by experience, and while some parts of a philosophy are fixed, others are fluid. Core values, such as approaching each patient as a person and not an illness, as offering a service to someone in a time of need, of following through on requests, do not change over time. But another key to both survival and success in nursing is an understanding that the profession, and therefore the practitioner, must be open to change. The way to do this is to approach the profession, and the bedside, with humility. Nobody has all of the answers, all of the supplies and skills, and nobody has gotten to where they are without any help whatsoever from anyone whatsoever. Be willing to listen to and constantly learn from colleagues, from supervisors, and from patients and families, rather than place all trust in oneself. Another means of expressing humility is through continuing education. There are common everyday items that are indispensable today yet did not exist a few decades ago, as there are now treatments that for years were only dreamed of. Imagine what awaits in the years to come. So one cannot approach nursing as another every day job. Rather, the nurse, whether one fresh out of school or one with 30 years experience, has to remain the child in the candy store- wanting it all but not knowing where to start. This will keep the profession fresh, and keep the nurse in a position to grow rather than stagnate.

There have been several instances that have demonstrated this concept to me. Without giving too much information- even here the long arm and eye of HIPPA loom- I recall in my first semester a patient who did not want me to care for her, but in the middle of our time there, after several failed attempts to assess her and discuss her care, I poked my head in and casually asked if she wanted any change of gown or water. After bringing her a new pair of socks, her entire demeanor changed, and we spent the rest of the shift talking, and suddenly she was asking me to conduct all my assessments and confiding personal information to me. In my psych clinical, there was a difficult patient in the hallway, and staff was considering calling a code. The patient suddenly came running up to me, of all people, and said he wanted to talk to me. My professor was cautioning me not to, but I figured I might as well give it a go. After a few minutes with him, it turns out all he wanted was a blanket. My clinical professor complimented me on managing a challenging situation, but really all I did was listen, something apparently nobody else was. On a med-surg unit, one of my most memorable, and most successful days came caring for a patient with a gastric tube who mentioned he had trouble breathing from time to time. I explained the purpose of his tubes and taught him to use an incentive spirometer. The point, here, is that my greatest lesson in nursing school is that it is not the big, complex procedures, but rather the simplest and most basic interventions that prove the most effective.