Dr. YU Hai is a Professor in Zhejiang University School of Medicine. He also serves as the Director of International Education Program and the Director of Center of Distance Education in Zhejiang University School of Medicine. Dr. Yu studied at Shanghai First Medical College (now Fudan University Shanghai Medical College) from 1962 to 1968. During 1968-1978, Dr. Yu served as a physician in Longde County in the Ningxia Hui Autonomous Region. He was enrolled in the graduate program in Ningxia Medical College in 1978 and then studied in Leeds University in U.K. during 1980-1983. Dr. Yu received his PhD degree in Cancer Research from Leeds University and returned to China in 1983. He has served as a Professor, Deputy Director of the Cancer Institute, Zhejiang Medical University, Vice President of Zhejiang Medical University, and Associate Dean of Zhejiang University School of Medicine. His main areas of interest are cancer immunology, cancer biotherapy, and cancer prevention studies. Dr. Yu has authored and co-authored over 100 publications. He has won more than 10 times the Award for Science and Technology Progress at the national and provincial levels.
This interview was conducted by Dr. Yi Pan, Emory University, through phone on June 2nd, 2012. Dr. Zhuo Chen also joined the conversation.
1. Personal Experience and Educational Background
Yi: Dr. Yu, I know that you studied in Shanghai First Medical College from 1962 to 1968. What prompted you to choose medicine as your life-long career?
Dr. Yu: My father passed away with health issues when I was very young so that I understood early on the importance of a healthy body to a person and to a family. My first wish was to become a doctor and treat patients with my medical knowledge and training. Unfortunately I only practiced for about 10 years. Although I'm not practicing anymore, I haven’t changed my goal to improve the health of human kind through my efforts in both medical education and public health.
Yi: After graduating from Shanghai First Medical College, you left Shanghai for Longde, Ningxia Hui Autonomous Region and worked there for 10 years because of the Cultural Revolution. What do you think of your experience in Longde?
潘羿： 从上海的医学院毕业以后, 由于当时历史的特殊原因,您从上海来到了宁夏的隆德,而且一呆就是10年。您觉得这10年给您今后的人生带来了哪些启发?
Dr. Yu: In 1968, I graduated from Shanghai First Medical College but my medical training was not completed due to the Cultural Revolution. I was assigned to the poorest county, Longde, in Mountain Liupanshan, which belongs to the Xihaigu Prefecture, Ningxia. It is one of the worst areas for human beings to live as reported by the United Nations Food and Agriculture Organization [in 1972]. But I worked there for 10 years. I worked in Shangliang community health center which is about 20 kilometers from the Longde county seat. There were no paved roads, no electricity, no tap water, and the temperature was about -20 degrees Celsius during winter time and there was no heating when I arrived. Before my arrival, there were only two local practitioners who treated both animals and people. There was no high-pressure sterilizer so the syringes were only boiled in a cooking pot for repeated use. The local people were very poor and most of the times they couldn’t afford their medical bills. They would trade eggs, grain, pork, or even house to see a doctor, and only when it was absolutely necessary.
I don't think that those 10 years were wasted -- I learnt that there were very poor people who even struggled to survive in China during that time. I leant that medical technology alone can solve the whole problem. Instead, economic development and social safety nets were desperately needed. For me, it was the most profound field lesson on social medicine and health economics that I took for ten years.
Yi: After the Cultural Revolution, you were enrolled as a graduate student in Ningxia Medical College with the highest score in Ningxia. So you never gave up your dream and goals?
潘羿：文化大革命结束后,您以宁夏地区第一名的成绩考上了研究生. 您是不是从没有放弃过对于理想和未来的追求, 坚信自己一定会通过努力走出这里?
Dr. Yu: Before 1978, without the return of Deng Xiaoping, nobody in China had any idea about personal dreams and the future of our country. Living in a place without electricity, tap water, TV and not even mention internet, there was no way to know what was going on in the outside world. The only connection I had with the outside world was a shortwave radio. Reading books under a kerosene lamp was also a great fun. I started to study English using the radio during that time. I still remember vividly the moment when I heard the words "VOA (Voice of America) special English, the news" that came from thousands of miles away.
余海教授：在十一届三中全会之前，在邓小平还没有复出的时候，中国人就像身处在一条看不到尽头的黑暗隧道中， 没有谁知道该往哪里走，没有谁知道国家的前途在哪里，当然谈不到什么个人的理想和未来的追求了。在那个思想禁锢的年代，在那样一个没有电，没有水，没有电视，当然更没有互联网的与世隔绝的贫困山区，生活的艰苦还是其次，最痛苦的是消息的闭塞。我是通过一架短波收音机和所订的一份《参考消息》，获取外界的信息，不至于离开世界潮流太远。在晚上无所事事的时候，在煤油灯下看书也是一大乐趣，我的英语也是这个时候跟着收音机学的，印象最深的是从万里之外的播音员口中慢慢腾腾地播报的一句话”V.O.A，special English, the news”。
Yi: You were among the first generation of students who were sent overseas. How did you get such an opportunity? Did you feel a cultural shock considering the differences between China and the western countries at that time? Did it take long for you to adapt to the new setting?
Dr. Yu: The Cultural Revolution ended in 1978. I was enrolled as a graduate student in Ningxia Medical College. I learnt English by myself and passed the test organized by the Ministry of Education in China for the government-sponsored overseas study. Finally, on December 26, 1979, the birthday of Chairman Mao, I travelled with other 12 Chinese students for 11 days by train and over the sea from Beijing to London, passing through Erenhot of Inner Mongolia, Zamyn-Uud of Mongolia, Ulaanbaatar, Siberia, Moscow, Warsaw, East Berlin, West Berlin, and Hague. We finally arrived in London on January 5th, 1980. After studying English for three months at the Ealing College in London, I started my cancer research in Leeds University in April 1980. I graduated in May 1983 with a PhD degree from the Institute of Cancer, Leeds University. I did experience the cultural shock coming from China to England. But fortunately I adapted to the life in England quickly.
余海教授：1978年，文化大革命结束了，中国恢复了研究生招生，邓小平高瞻远瞩决定派遣留学生出国。这一年我顺利考上了宁夏医学院的实验病理研究生，同年又参加了教育部组织的出国留学考试。 我在高中、大学学的都是俄语，英语是自学的，基本是“哑巴英语”，我的英语笔试考了高分，但口试时张口结舌，答非所问，主考老师也许是出于同情或者是出于怜悯，给了我60分，总算勉强过了关。经过一年多的等待，终于在1979年的12月26日毛主席生日这一天踏上了西行之路。我们一行13个中国留学生，在北京搭乘火车，从二连浩特出境到蒙古的扎门乌德，经乌兰巴托，西伯利亚，莫斯科，华沙，东柏林，西柏林，海牙，再改乘轮渡，最终辗转到英国伦敦已是1980年的1月5日了，全程11天，时间却跨越了一年。在伦敦Ealing College 补了3个月英语后，1980年4月到Leeds 大学开始了我的肿瘤学研究生学习，第一年注册的是Mphil，第二年转成PhD，1983年5月顺利通过答辩拿到学位。从一个封闭的中国到一个开放的西方社会，当然有很多生活、思想、文化的冲击，好在我的适应性比较强，三年当中几乎没有对我的生活和学习有多大影响。
2. Back to China
Yi: When you came back to China in 1983, did you encounter any difficulties?
Dr. Yu: After attending the commencement at Leeds University in July 1983, I returned to China in September the same year. It's the most natural thing for me to do because China paid for my tuition and living expense while I studied at Leeds University. I first returned to the Ningxia Medical College and after a year, I took a position with the Institute of Cancer Research at Zhejiang Medical University, led by Prof. ZHENG Shu. The school is located in the city of Hangzhou, my parents’ hometown. There was a huge gap in advanced research between China and western countries back in the 1980s. I still remember that I received my first National Natural Science Grant of RMB Yuan 30,000, which was considered quite a lot of money at the time. The two pipettes I brought back from England were the only "imported equipments" in our lab. The two packets of disposable pipette tips were washed and dried for repeated use.
余海教授：1983年7月参加了Leeds大学的学位典礼之后， 9月份回国。当时并没有像众多的有关海归的报道中所写的那样“婉拒国外高薪聘请，毅然回国”，没有那么高尚，只觉得是国家出钱供我留学，回国工作是最自然不过的事了。但是回到了宁夏之后，发现国外所学在这里发挥不了多大作用，但是要离开又觉得对不起宁夏医学院，很纠结。 当时的社会和我出去时已经有所不同，对于人才流动自主择业有一定程度的宽容，这样经过近一年的坚持我终于调到了我父母出生地杭州，到郑树教授领导的浙江医科大的肿瘤研究所工作。八十年代的中国和西方国家在科研上的差距还是很大的。我记得在80年代申请到的第一笔国家自然科学基金只有3万元，当时还算是不少的。我从英国带回的两个移液器（pipette），还是实验室唯一的“进口设备”，而带来的两包一次性的移液头（tips）用了以后舍不得丢掉，还要冲洗烘干后反复使用。
Yi: You have served as a consultant for the World Bank and also the World Health Organization. How did you transform from a clinical and laboratory researcher to a pioneer and advocate for health policy and systems science?
Yu: I started with biochemistry and immunology research when I first arrived in Hangzhou. At that time, Zhejiang Medical School was in charge of the colorectal cancer prevention project. I threw myself into studying public health, epidemiology and statistics, and conducted field research in Jiashan and Haining, both areas with high prevalence of colorectal cancer. This project received the Third Class Award of the National Science and Technology Research. Starting in 1980s, the World Bank funded health projects in China through soft loan, and I was invited by the World Bank Loan Office to evaluate implementation of China's health projects. I participated in the Second Health Sector Study in China conducted by the World Bank, leading to a World Bank Report released in 1990 titled “China, Long-term Issues and Options in the Health Transition”. This report pointed out that China was experiencing a health transition, from the end of the first health revolution to the beginning of the second health revolution. Chronic non-communicable diseases have replaced communicable disease as the biggest health problem in China. The report also pointed out that cigarette use is a preventable risk factor of multiple chronic diseases associated with heavy burden of mortalities, and proposed tobacco control policies and measures including raising tobacco tax. Now, 20 years later, the report is proven to be correct in its assessment and the proposed solutions effective. Participating in such projects was an enriching experience for me. It also got me involved in public policy and health economics, which were not a familiar topic to researchers in China at that time. Through the World Bank projects, I also met a lot of domestic and international experts, including Dr. Jeffery Koplan (Director of the U.S. Centers for Disease Control and Prevention (CDC), 1998-2002), currently the Vice President for Global Health, Emory University, and the Director of the Emory Global Health Institute. Jeff visited China more than 50 times. He loves the Chinese culture and contributed significantly to the development of China's public health. We have maintained a close friendship for nearly 30 years.
余海教授：刚到杭州时和在英国一样，我做的是肿瘤的生物化学和免疫学的实验研究，当时浙医大肿瘤所承担的是国家“六五”，“七五”攻关的大肠癌防治研究项目，由于课题需要，自己恶补了些公共卫生、流行病学、统计学的知识，在浙江省的大肠癌高发区嘉善、海宁从事大肠癌的人群筛检和预防研究，这个课题还得过国家科技攻关三等奖。从八十年代开始，世界银行通过软贷款形式资助中国的卫生项目，我受卫生部世界银行贷款办的邀请参加了世界银行在中国的卫生贷款项目的评估，实施监督工作，并参与世界银行第二次中国卫生部门报告（Health Sector Study）的调研工作。世界银行的报告“China， Long-term Issues and Options in the Health Transition”（1990年发布）就是在这次调研的基础上写成的。报告指出中国正在经历着一场健康模式的转型（health transition）,从第一次卫生革命基本完成转换到第二次卫生革命， 慢性非传染性疾病已经成了中国最大的健康问题，报告明确将吸烟定位为导致慢性病死亡的第一位的可预防的危险因子，并提出了控烟的具体政策和措施，包括提高烟草税。这个长期是指40年，是真正的长期。20多年过去了，当时报告的观点和措施还是那么正确有效，这就是科学的力量：远见卓识，经得起时间的考验。这段时间的工作开阔了我的视野，学会从一个宏观的角度来观测评价卫生问题，也使得我对中国当时还没有多少人研究的公共政策学，卫生经济学有所了解。在世行项目的工作中，我也结识了不少国内外的专家，包括Jeffery Koplan，他在1998到2002年间当过美国CDC的主任，现在是埃默里大学副校长兼全球卫生研究所主任。Jeff到过中国五十多次，热爱中国，热爱中国文化，对中国的公共卫生事业的发展贡献甚大，我和他保持了近30年的友谊，至今还有紧密的工作联系。
Yi: How do you view the future of health policy and systems sciences (HPSS) in China?
Dr. Yu: Here I should mention the China Medical Board (CMB). I have been in charge of the CMB projects in Zhejiang Medical University since 1989, which has since merged into Zhejiang University. The CMB made significant contributions to medical health services and medical education in China. Dr. Lincoln Chen, President of the CMB, proposed that the focus of CMB in phase IV [in CMB’s history] should be promoting HPSS among Chinese medical schools. The medical colleges in China and China's public health system were built on the Soviet model in the 1950s. Due to the lack of research in HPSS in China, health policies implemented in China were not necessarily evidence-based. Of course, this situation has seen improvements in recent years. In March 2009, “Opinions of the CPC Central Committee and the State Council on Deepening the Reform of the Medical and Health Care System” was issued and based on proposals from several academic institutions, WHO and the World Bank. The first CMB project after Dr. Lincoln Chen became the president of CMB was to sponsor Zhejiang University to organize the first Westlake Forum. The Westlake Forum became a series of meetings discussing critical health policy issues, and provided a platform for communication between the medical schools, health policy researchers and government officials. The first Westlake Forum was hosted in Hangzhou in 2007, with a focus on health equity. The second Westlake Forum in 2009 focused on the strategic plan "Healthy China 2020". In 2011, Zhejiang University School of Medicine and Emory Global Health Institute successfully co-organized the third Westlake Forum to discuss the similarities and differences of health care reforms in China and the United States. In November 2012, the fourth West Lake forum will be held in Shanghai to explore ways to strengthen China’s academic health systems. The series of CMB sponsored Westlake forums and CMB’s strategies significantly promoted and enhanced HPSS development in Chinese medical schools and made profound impact on China's public health.
余海教授：这里必须提到美国中华医学基金会（China Medical Board，CMB）对我的影响。我从1989年起就参与浙江医科大学第一个CMB项目的工作，到现在CMB换了三任主席，我还负责学校的CMB项目，20多年来唯一的变化是浙江医科大学变成了浙江大学医学院。 CMB对中国医学卫生事业和医学教育的贡献是巨大的，特别是Lincoln Chen 2006年接任主席后，经过一年多的战略规划，提出了CMB历史上第四个时期（phase IV）的工作重点是提高中国医学院校卫生政策和体系科学（Health policy and system science, HPSS）的能力建设。这真是真知灼见，一针见血地指出了中国医学院校的短板，中国公卫的体系是1950年代参照前苏联的模式建立起来的，重点是疾病预防和“五大卫生”。全国的医学院校卫生政策卫生系统科学的研究能力普遍薄弱，对国家卫生政策的影响力非常有限，而政府的决策往往也不是建立在研究证据的基础上（Evidence-based）。 当然这种情况近年来有所改变，2009年3月出台的“中共中央国务院关于深化医药卫生体制改革的意见”就参考了国内几所高校和世卫组织、世界银行提出的几套方案。Lincoln Chen 担任CMB主席所批准的第一个grant就是资助浙江大学举办西湖论坛，该论坛讨论当前重要的卫生政策问题，为医学院校，卫生政策专家和政府官员的对话提供平台。2007年在杭州举办的第一届西湖论坛探讨了中国卫生公平性问题，2009年的第二届西湖论坛讨论了“健康中国2020”战略规划。2011年浙江大学医学院和埃默里大学全球卫生研究所(Emory Global Health Institute)在美国亚特兰大成功组织了第三届西湖论坛，探讨了中美医疗体制改革的异同问题。今年11月份将在上海举办第四届西湖论坛，论坛的主题是探讨加强中国教育研究型医学体系（Academic health system）问题。近年来CMB通过召开会议，人员培训，建立研究中心，公开招标项目和合作项目的资助等手段切切实实地推动中国医学院校的HPSS能力建设，可以预计，由于CMB的远见卓识的资助战略，必将对中国HPSS人才的培养，卫生政策研究能力的增强和卫生事业的发展产生深远的影响。
3. Words to Young Students and Scholars
Yi: Since China’s economic reform and open-up in late 1970s, more and more Chinese students could study abroad. After graduation, some students return to China while some choose to continue working abroad. What do you think of their career choices?
Dr. Yu: There is a great tradition among overseas Chinese scholars. No matter what their nationalities are, and no matter how advanced their career achievements are, they have close ties with their home. This tradition is rooted deeply in the Chinese culture. Prominent examples include Professors William Hsiao and Teh-wei Hu. Although they work and live overseas, they visit China numerous times to contribute to the development of health reform and public health in China. Personally I'm happy to see more students of the young generations have the opportunities to study abroad. Whether they choose to return to China or not after completing their studies, they care about China's development, just in different forms. The CMB pays close attention and has devoted investment to the collaboration between overseas scholars and domestic institutions. In the 2009 Westlake Forum II, 12 overseas young scholars were invited to join the Forum and met with the Vice Chairman of National People’s Congress, Professor HAN Qide during the meeting. More overseas scholars participated in the third Westlake Forum held in Atlanta in 2011. For the coming Hangzhou Westlake Summer Youth Forum in August, nearly 20 oversea young students and scholars working in HPSS areas were invited to participate.
余海教授：中国的旅外学者有一个很好的传统，不管现在是什么国籍，也不管他们的地位成就多高，对祖国的感情血浓于水，一如既往，至死不变，这是由血缘联系和文化基因所决定的。老一代的旅美学者像萧庆伦教授（William Hsiao）、胡德伟(Teh-wei Hu)教授人在海外，心系祖国，改革开放30年来，他们无数次飞越重洋，为祖国的事业呕心沥血、出谋划策、秉正直言，他们为中国医疗卫生事业的现代化所作出的贡献是不可估量的。现在的大环境和以前相比有了很大的不同，互联网的进入使得国际交流越来越容易，我也很高兴看见这么多年轻的学子有机会去海外学习。我很希望有更多青年学者能像前辈学人一样，身在国外，心系祖国，关注国内的问题，研究国内的问题，不管回来不回来，以各种形式关心国家的发展，促进中国的进步。CMB非常关注海外学者和国内高校的合作，2009年第二届西湖论坛，就邀请了12位海外青年学者的参与，会议期间全国人大副委员长韩启德教授还同他们进行了亲切的交谈。在亚特兰大召开的第三届西湖论坛更有数十名旅美的中国学者参加，今年8月在杭州举办的“西湖之夏青年论坛”也将邀请近20名从事卫生政策和体系科学研究的海外青年学者参加。
Yi: We appreciate your strong support to CHPAMS. Do you have any words to share with CHPAMS members and readers of the China Health Review?
潘羿：我们非常感谢您对我们 中国卫生政策与管理学会（海外）（CHPAMS）的大力支持，为我们提供了各种支持和帮助， 您对我们CHPAMS的会员和《中国卫生评论》的读者还有什么寄语呢？
Dr. Yu: CHPAMS is an influential organization that made substantial contributions to public health advocacy and provided communication channels between Chinese and international public health researchers. CHPAMS members played a critical role in the second Westlake Forum in 2009 and the overseas scholars invited to the 2012 Westlake Summer Youth Forum were selected with help from CHPAMS. China Health Review is a very good platform to promote public health and HPSS in China. Dr. Lincoln Chen commented that “based on the very little amount of money and the hard dedicated volunteers” the magazine is a success. I hope that these efforts and communications could be continued. I recommend the magazine to strengthen outreach to domestic readers and authors [in China], to better facilitate the communication between scholars in China and abroad.
余海教授：CHPAMS是一个很有影响力的组织，为宣传和沟通国内外的公共卫生的学术人才作出了不少贡献。在2009年在杭州召开的第二届西湖论坛上，CHPAMS的成员就发挥了很好的作用；而即将召开的西湖之夏青年论坛的海外青年学者就是通过CHPAMS 协助遴选的。China Health Review也是一个非常好的宣传和探讨中国公共卫生的平台。CMB Lincoln Chen主席也对China Health Review给予了好评，认为是用有限的资源办了很好的一份杂志。我很希望这些交流和宣传能够很好地继续延续下去。并且我建议杂志要加强发展国内的读者群和作者群，更好的便利于海内外学者的交流并且更贴近国内的现实需求。
By Yi Pan, PhD, Emory University