By Lua Wilkinson
“I had to leave our son back in the village when he was two months old,” the 20-something sitting across from me explained on the hard-seat train heading from Shanghai to Xi’an. “I had to get back to work. This will be the first time I’ve seen him in five months”.
The young woman had met her husband when working at a restaurant in Shanghai in her late teens and decided to get married soon thereafter. Their marriage has been problematic; both live more or less equal distances from their hometowns, one to the north, one to the south. Because of their low-paying jobs and status, taking care of a child in the city where both of them live and work was out of the question.
Encountering women who have moved from the village to the city without their children is an everyday occurrence in China. During my last year here, I have interviewed dozens of women about their migration experiences. A registered dietitian and medical anthropologist, I came to Shanghai on a US Fulbright fellowship, where I planned to study infant feeding practices among China’s internal migrants. I have always been intrigued by the cultural contexts of health and nutrition, but realized migrants’ experiences extend far beyond “cultural contexts”.
Due to policies promoting urbanization, internal migration has skyrocketed in the last thirty years in China. According to China’s National Bureau of Statistics, there were 131 million rural to urban migrants at the end of 2008, representing just over ten percent of China’s total population. Of course, as anyone living in China knows, this number is incredibly fluid and difficult to actually assess, but it is estimated that women of childbearing years represent more than one-third of these workers. Because of China’s household registration system and healthcare policies, a pregnant migrant woman often must return to her natal township to deliver her child, but may need to return to work in the city immediately post-partum. Children are often left behind in their natal villages with grandparents as caregivers when the mother migrates.
Estimates put the number of these children, known as liu shou er tong, or “left behind children”, at 23 million. Working to understand the causes and implications of this startling trend has caused nothing short of headache in Beijing. China has experienced some of the fastest economic and social changes since the history of capitalism, and this new mass migration – and what to do about it – provides one of the most evocative case studies in China today.
Labor migration is a worldwide phenomenon and often a sexy subject for grad students coming to China. When I started thinking about this project, I had some exotic far-away idea of what a “migrant” exactly was in China. I dare admit to everyone that in my media-filled American mind, a “migrant” worker in China was a farmer-moved-to-city, working hard in a sweat-filled factory, peddling goods on street corners, doing whatever he or she could to scrape by in the big bad city. I had this romantic notion of them struggling through hardships on waves of dreams, always looking for a better life at the other end of the factory, the urban street corner, or the massage parlor.
In actuality, “migrant” is difficult to define. I have met numerous “migrant” Chinese women who have college educations, have lived abroad, and send their kids to private schools in Canada, all while their household registrations are still considered “rural”. Because of this lack of definition, blanket policies are difficult to implement. I quickly realized that my own romanticized idea of sweatshop migrant, while a reality in many areas, did not represent the only group of people moving around China looking for work at any given time.
“My children are the same ages as the ones I take care of here,” explained the nanny of a well-to-do foreign family living in Shanghai. “There’s nothing really for me to do back in the village though. I’d love to be home raising my kids, instead of someone else’s, but what choice do I have? I never went to college. But I have to make money so they can have opportunity. Thinking about my kids though makes my heart sting.”
Women are often forgotten in the shaping of migration policies, and therefore many of the services necessary for women or families are not included in policy guidelines or program assistance. Policies and laws that protect migrants, for example, rarely mention women outside the context of sexual trafficking. While trafficking of women is a global crisis that deserves special attention, not all women who migrate are trafficked. Most migrant women in China move to find educational opportunities, jobs, and access to resources that aren’t available to them in rural areas. But there is little to facilitate their specific needs of childcare, infant feeding support, educational training or healthcare.
“We came to the city after our son was four months old,” a woman giving me a manicure explained to me while caring for my nails. “We were thinking maybe we could bring him here after we both had jobs and some savings. But after a year, my husband left me and now I’m just scraping by.” Now six years old, her son has been living away from home as well, boarding at school during the week. “But what can I do? There’s no life for me back there. There’s no life for me here either, but at least it’s interesting.” She looked at me happily and said, “But my life is still okay, being single. I don’t have to put up with anyone I don’t want to! I miss my son so much, but how am I supposed to take care of him here? My house doesn’t even have plumbing!”
Schools came up in almost every conversation I have had with these women. Migration, family planning policies, and urbanization are putting a strain on the education system. Local schools are closing due to low attendance, and are being centralized into boarding schools. This causes more pressure on families to work to provide for school expenses.
“I have one son, who is 21,” one of the caretakers of my apartment building explained to me, mop in hand. “And a daughter who is 11. My son works in town outside of the village fixing bikes. But my daughter…well, my husband and I had to make a decision early on: do we send her to school or not? Schools cost money nowadays, we have to pay for room and board. So we decided that we had to come work in Shanghai and send her to school.”
This phenomenon has absolutely affected children. Studies show children of rural-to-urban migrants experience feelings of abandonment, anxiety and lonliness, But another perhaps less obvious problem is childhood malnutrition. In recent years, China’s Ministry of Education has implemented a rural primary school Merger Program (PDF), merging small rural schools into large centralized ones. The hope was that by concentrating resources, schools would be better fit to serve the needs of these children. Unfortunately, s tudents at boarding schools are actually more likely to have chronic signs of malnutrition, including micronutrient deficiencies. The reasons behind this are numerous (PDF), but include poor storage facilities for food brought from home, poor provisions of food by the school, and lack of nutritional knowledge of staff. Iron deficiency anemia is high as 60% in some counties, adversely affecting students’ ability to learn. Chronic malnutrition, in the form of growth-stunting rates, is much higher in rural areas and among students who board.
It is clear that when a mother moves away from her child, multiple other people must step in to make decisions for that child, all the way from infancy to adolescence. What do grandparents feed infants when the mother is unavailable to breastfeed, if they cannot afford infant formula (i.e. soymilk or rice)? What are the roles of the media, infant food companies, pediatricians and health care workers in shaping families’ perceptions and practices about what a child should be consuming? How do households make these decisions, and what is the influence of the mother as a wage earner versus the grandparents as caregivers? Among the many mothers I’ve spoken with, their answers are pretty straightforward. “I don’t have any choice in how my son is being raised. I wanted to breastfeed, I know it’s the best. Mei banfa [There’s nothing I can do], I have to work.” said the woman on the train. “I hate that my son is being raised on milk powder, full of chemicals. But I have no choice. Mei banfa.”
In Yunnan, at a women and children’s clinic, I spoke with the chief pediatrician on our walk home from clinic one day. I asked her what she thought the effects on the health of infants were of these liu shou er tong. ”Huge impact, definite influence,” she said, her slightly raspy Yunnan southern drawl rich with angst. “Right now, the main causes of infant mortality are pneumonia and diarrhea, both related to malnutrition. Sometimes the grandparents have no idea what to feed their kids, and they might not recognize something is wrong until the baby is very, very sick. They then have to come into the hospital.” I asked what the answer was, how can we start an education campaign, what kinds of things can we do?
She sighed. “It’s not education. It’s the breakdown of the family. There is no family anymore here. That is the problem.”
Lua Wilkinson recently finished her graduate degree in medical anthropology at the University of Colorado Denver and is currently in China as part of the Fulbright U.S. Student Program. A registered dietitian, she has worked in clinical nutrition settings, public health and policy development, and health education projects. Her current research interests include nutrition and the role of social inequities, infant feeding among migrant women, and the worldwide impacts and causes of malnutrition.