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THE SINO-SWEDISH PROJECT

 

THE SINO-SWEDISH PROJECT ON
PREVENTION AND REHABILITATION OF
IODINE DEFICIENCY-RELATED
MENTAL
RETARDATION

Mehari Gebre-Medhin, Karin Sonnander,
Kent Ericsson and Patricia Ericsson

The initiative
The first phase

THE INITIATIVE

A meeting between the Ministers for Social Affairs of Sweden and China in 1992 led to a joint project on the issue of mental retardation. This was an understandable outcome considering the situation in both countries. During the modernization of China a greater attention is being given to persons with disability, in particular mental retardation. The lack of iodine in vast areas of China, and the mental retardation it causes, is still a considerable problem. Sweden, on the other hand, has a very good international reputation for its ways of preventing mental retardation as well as providing support to persons with mental retardation.

During the preparatory phase of the project, 1992-1994, the partners involved in realizing the project were CDPF, China Disabled Persons Federation, and Uppsala University. CDPF is a semi-governmental and national organization which has the function of safeguarding the rights of persons with a disability and, in some areas, to provide services. The project is financed by China contributing two thirds, one third from central Chinese bodies, a second from local Chinese sources, while the third part comes from Sweden, through "Sida".

Three subprojects

The project is unique in that it works with prevention as well as development of services. Therefore it consists of three subprojects, all related to each other. With a subproject on "Prevention of Iodine-deficiency related Mental Retardation" strategies, methods and routines are developed to provide iodine in salt and oil to key groups of the population, for example newly wed couples. Professor Mehari Gebre-Medhin is responsible for this project. The expert partner on the Chinese side is professor Chen Zhupei of the Endocrine Research Institute of Tianjin Medical University.

The extent of the problem is identified through a project for "Developmental Screening" of children of pre-school age. This gives baseline information for prevention and identifies the children to receive services being established through the project. Professor Karin Sonnander is responsible for this subproject. The expert partner in China is professor Zhang Zhixiang of Beijing Medical University.

The task of the third subproject, "Rehabilitation Services", is to develop a programme, based on modern ideas and standards, to provide support and services to pre-school children with mental retardation. The corner-stone in this programme is a rehabilitation station, a platform for all support to children with mental retardation. A number of stations are to be localized to cover the project counties. The role of families is recognized in that they partly are being given support to understand and to cope with the problem of mental retardation, but are also given guidance to be able to train their own child in the home. Dr. Kent Ericsson is responsible for this sub-project. Psychologist Patricia Ericsson contributes with expertise on issues concerning the training programmes. The expert on the Chinese side is professor Xu Jiacheng of Chongqing Teacher College.

The project was launched in November 1995, in Beijing. The first phase covered the years 1995-1998. The second phase, 1998-2002, has been a period of summing up, evaluation and further planning. The third phase starts in 2003 with a new input of activities.

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THE FIRST PHASE

A choice of areas where the project was to be carried out during the first phase had, for understandable reasons, to be made. Therefore 14 counties, in 8 provinces, are included in the project. This project area covers over 400 townships and 6.000 villages, with a total population of 6.5 million. These are predominantly rural and poor areas of China and are located mainly in the north-west of the country, and are recognized as those with a high frequency of iodine-deficiency related mental retardation.

During the first phase much progress has been achieved. The exchange of experiences, know-how and knowledge between the project partners has been extensive. This has taken place with regard to CDPF and in relation to Chinese as well as Swedish experts in each of the three subprojects. On several occasions Chinese delegations have visited Sweden not only to work with the counterparts but also to visit Swedish services of relevance for the project. The Swedish partners have also visited China on a number of occasions, apart from project work, to participate in training programmes and site-visits.

In the three subproject areas staff have been trained for their tasks, information and educational material has been produced and distributed and early experiences have been followed up. The striking impression from this project is its magnitude. In the initial awareness programme on the importance of iodine deficiency in mental retardation 151.000 pamphlets were distributed and estimated to have reached over 700.000 people, while video material is purported to have been seen by 800.000!

Within the subproject on the prevention of iodine deficiency over 800.000 iodinized oil capsules were distributed within the first project period and over 100.000 children have been screened for mental retardation. By the end of this year over 60 new rehabilitation stations will have been established, their localization been based on the results of the screening programmes. Essential to these developments has been the training of staff in all three subprojects and in the project on rehabilitation services even training programmes for the families of children with mental retardation. During the process of the project the necessary teaching materials and equipment have been developed and distributed.

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