A Ledendary Bridge for 120 Years

It took generations of visionary and courageous people from Yale and from China, working together, to build trust and mutual respect across the deep divides of culture, politics and history. Yale-China Celebrates its 120th Anniversary.

Surviving and thriving for 120 years is no small achievement!  To have accomplished all this across the terrible upheavals and astounding changes of the 20th century and the four decades of China’s Reform and Opening Up Period is simply miraculous. This spring, Yale-China celebrates twelve decades of Sino-American partnerships, the building of famous and resilient schools and hospitals, and the many hundreds of thousands of Chinese and American lives transformed by immersive education, courageous cooperation, and modern healthcare. 

There is also a very forward-looking reason to celebrate our history at this moment in 2021. Yale-China’s work today is possible because of 120 years of building trust. As we re-emerge from a pandemic, as we acknowledge the crisis in anti-AAPI hate across America this spring, and as US-China relations hang by a thread, the Yale-China experiment—as our community’s work was frequently called during its first century—is a rare and important counter example of successful Sino-American engagement. If the two most important nations of the 21st century are going to cooperate and solve global challenges together, it will be because of efforts like Yale-China that maintain bridges and train global citizens for the work ahead.

Founded in 1901 by Yale graduates and faculty in response to the suffering of the Boxer Rebellion, the early goals of Yale-in-China were to bring modern education and medicine to China. Choosing to be in a more remote area of China then unfamiliar with foreigners—Hunan Province—in order to have a deep impact, Yale representatives arrived in 1903 and rapidly began to build trust and a reputation for practical, modern education and medical care. Within a decade, partnering with their Chinese colleagues and local officials, Yale-in-China established a series of remarkable educational institutions. Starting in 1906, they founded Yali High School, and opened central China’s first Western Medicine clinic—which became the “Xiang-Ya” (“Hunan-Yale”) Hospital. They founded China’s first Nursing College, followed by Xiangya School of Medicine, and then a full campus of Yale College in Hunan that lasted for a decade, and in the late 1920s, co-founded Huazhong Normal University in Wuhan.

The Yale-in-China education and health institutions in central China grew and flourished despite the tremendous tumult of the first half of the 20th century. The Yale-China Experiment witnessed and survived the Fall of the Qing Dynasty in 1911, political and xenophobic movements and warlordism, the May Fourth Movement and the rise of communism, the worldwide Depression, fires and epidemics in Hunan, the invasion by Japan in the 1930s, the devastation of World War II—including the destruction of Changsha by a massive fire in 1938 (文夕大火), and finally the revolution that resulted in “New China” in 1949. Throughout these upheavals and dangers, Americans and Chinese worked alongside each other, graduating tens of thousands of prominent students, nurses and doctors, rising to national prominence, and encountering Mao Zedong and Chiang Kai-shek—both of whom praised Xiangya Hospital. Remarkably, “this on-going idealistic enterprise” intentionally transferred leadership of the educational and health institutions from Americans to local Chinese by the late 1920s  (fundraising and overall guidance remained the responsibility of a board based in New Haven). In the words of Ruth and Phillips Greene, who spent nearly thirty years at Yale-in-China (as an educator and surgeon, respectively): “From the beginning of his association with Yale-in-China, Dr. Edward Hume (胡美) had seen and stressed the importance of a shared responsibility between Chinese and Americans. He had lived it out in his close association with his colleague, Dr. Yan Fuqing (颜福庆). Together they had formulated the policies by which the medical work was largely locally self-supporting and, by 1926, the Governing Board of the Medical School was entirely Chinese. Yale-in-China and its first president were well ahead of their time.”

During World War Two (1937-1945), Xiangya Hospital and the medical and nursing schools cared for thousands of casualties, soldiers, officials and refugees, before moving in 1938 to escape the bombing and invasion of the rural town to Yuanling in western Hunan, and to Guiyang, Guizhou Province. Americans and Chinese on the hospital staff survived the vicissitudes of war together. American-trained medical staff, like Maude and Winston Pettus, nurse and chief surgeon, respectively, worked alongside their Chinese colleagues, like Hospital Director Dr. H.C. Chang, through the bombings and terrors, managing to provide care, staff and medical supplies despite the constant dangers and uncertainties. Yali High School, likewise, relocated to Yuanling and carried on throughout the war, with Yale-China bachelors (called Fellows today) continuing to arrive from Yale to teach and support student life, a tradition started in 1909. When Xiangya Hospital, Yali High School and the Yale-in-China staff returned to Changsha in 1945, they found most of the campus destroyed by Japanese bombing. Hospital care and school life resumed and continued throughout the period of revolution and the establishment of the People’s Republic in 1949. An American fundraising campaign (led by Yale-educated magazine founder Henry Luce) enabled the rebuilding of the hospital and campus, which was completed in 1951—just as the Korean War began. The new war meant that Americans and Chinese were now enemies, and all Americans had to depart China. The Xiangya Hospital and Medical School were nationalized and the long-time Chinese and American partners tragically lost communication with each other for three decades.

New Asia College and a Role in Hong Kong: Unable to stay in the Mainland and seeking a new way to fulfill its mission, in the early 1950s Yale-China embarked on a new partnership in Hong Kong, a territory then engulfed in a refugee crisis. The organization was introduced to a group of refugee scholars, led by eminent Confucian scholar Ch’ien Mu, who had launched a promising Chinese-language college that was in urgent need of connections and resources. Partnering with Yale-China, New Asia College began a rapid rise, growing five-fold in the next decade, and moving to new buildings in Farm Road in Kowloon, with the help of funding from Yale-China and The Ford Foundation, and Yale-China Bachelors providing English-language proficiency and student life activities. In the mid-1960s, New Asia joined with two other local colleges to become the The Chinese University of Hong Kong in the New Territories. Yale-China became an enthusiastic supporter and donor to the new university, contributing a health clinic, student life center, visitors hostel, language-teaching center, and supporting the internationalization of the campus through the launch of the International Asian Studies Program in the 1970s to bring foreign students to study at the campus. The special bond with New Asia College continued, as well. Bachelors (today known as “Fellows”) have taught English literature and American cultural studies now for nearly seven decades. Yale-China has sponsored scholarships and other opportunities for New Asia students, and Yale-China’s Hong Kong Director is resident on campus, teaching and engaging in campus life. In the mid-1990s, Yale-China launched an American Studies Summer Institute that ran at both the Chinese University and Yale campuses. And for more than 20 years, students at both New Asia and Yale have competed for places on the popular annual exchange program known as “YUNA” (Yale University New Asia), which brings undergraduate teams to each other’s campuses for several weeks mid-year to experience different academic lives and cities—a brief but deep experience that has changed the course of many college careers and built lasting friendships.

Back to the Mainland:  The Era of Reform and Opening Up:  In 1979, with the re-establishment of Sino-American ties, Xiangya Hospital and Medical School and Yale-China reached out to each other. Then called Hunan Medical College, the school had continued to grow, serve Hunan and advance its reputation, graduating many famous medical professionals in China. Building on their earlier successes, the renewed Yale-Hunan partnership in the 1980s and 90s identified new forms of cooperation to meet China’s late-20th century needs. These included extensive training of medical professionals through lectures and short courses taught by Yale professors in Changsha, and study by Xiangya physicians and professors who came to Yale. Areas of medical cooperation included pediatric cardiology, HIV/AIDS training, a manual for SARS care after the 2003-04 epidemic, and creation of the Yale-China Medical Journal. English-language training provided by Yale-China Bachelors/E.L.I.s/Fellows played an important role, since English proficiency opened doors for study abroad and professional advancement. Yale-China Fellows returned also to Yali High School and Wuhan’s Huazhong Normal University in the 1980s, and then explored other partnerships in Central China, including at the Ningbo Huizhen Academy and now, for 15 years in Anhui province at Xiuning High School.

In the past decade, Yale-China’s health work has expanded in scope and impact. New health initiatives build capacity in public health, nursing and medical ethics in China, autism training, and support women in the health professions through the Chia Fellows programs. Yale and Xiangya medical faculty formed a special collaborative team to create a new Medical Residency Training curriculum for China (a level of medical training China hadn’t had before), ultimately adopted for China’s national model—with an impact on tens of thousands of MDs completing their medical training each year – a story showcased this year in Yale Medical Magazine.

Yale-China in the New Century: As both China and the USA have changed during the past two decades, Yale-China’s programs have adjusted to rapidly-shifting needs—while maintaining the long-standing mission. We now envision our work as partnerships in New Haven, Hong Kong, Changsha, Kunming and Xiuning, with the benefits flowing in both directions across the Pacific. Yale-China mobilizes its strengths in medicine and nursing, immersive fellowship experiences, two-directional YUNA and L(U)CY exchanges for undergraduates, and the teaching of both American and Chinese language and culture to benefit thousands of lives and to train global citizens. Programs include a growing arts program with Hong Kong artists and arts activators in residence at Yale, designed to support Hong Kong’s rising arts scene and new arts institutions. A Chinese Fellows Program also brings young professional teachers from Changsha and Hong Kong to New Haven to teach Chinese language and culture in American classrooms. Our annual Lunarfest Chinese cultural celebration in New Haven now attracts close to 4,000 attendees across ten venues—Connecticut’s largest lunar new year celebration. Now we are turning our focus to health and educational inequity in the villages and townships of China’s rural areas. During the COVID pandemic, Yale-trained physicians and doctors were among the hundreds of Xiangya medical staff on the front lines caring for patients in Wuhan, and members of our community sent encouragement and PPEs to each other in both countries. Yale-China is nimble and responsive to change, even as our core values have been remarkably consistent across 120 years of partnership, learning and service, bridging divides to deepen tolerance and understanding, and solving societal problems together. And now we look forward.

Essay by David Youtz, who served as Yale-China’s President from 2015 to 2021, and Vice President and Director of the Hong Kong Office from 1991 to 1996.

120th Anniversary of Yale-China: Pioneering Equal Partnership in Medicine

Two figures in the history of the Yale-China Association, Dr. Edward Hume M.D. and Dr. Yan Fuqing M.D., exemplify the organization’s long-time spirit of equal Chinese-American partnership. These two medical doctors, both Yale-educated, worked together to establish a modern medical practice in Changsha, the first of its kind in central China.

Yale-China’s early medical work was led by Edward Hume, M.D., Yale class of 1897. Dr. Hume came to Changsha with dreams of opening a modern medical college and hospital in China. The early stages posed numerous challenges: the hospital formally opened its doors in 1906 in a renovated inn in the center of the city. One of the greatest challenges lay in many of the clinic’s patients’ deeply held beliefs about traditional healing practices. Hume, acutely aware of the importance of the Chinese medical tradition, wrote in his memoir documenting 20 years of his experiences establishing western medicine in China, about the various superstitions he worked to overcome and the trust he built with locals, often through his excellent command of the Chinese language. He vividly described the elation his clinic felt when a high-ranking official decided to visit, only to have him promptly burst into a rage because Hume had taken his pulse on only one wrist instead of the traditional Chinese practice of taking both wrists’ pulses. Anxious not to lose even more credibility, Hume had to reluctantly send seriously ill patients home in case complications were further blamed on the “foreign clinic.”

In 1910, an immensely important figure for the progression and history of the hospital and medical college arrived at the clinic: Dr. Yan Fuqing M.D., also known as Fu-chun Yen, the first Chinese graduate of the Yale School of Medicine. Yan’s medical expertise and diplomatic skills proved crucial for the acceptance of the clinic in Changsha. In a notable break from customary practice at foreign institutions in China, Yan was hired on equal terms with his American counterparts, an early affirmation of Yale-in-China’s commitment to equal Chinese-American partnership, and Yan and Hume became close friends and colleagues.

Surgery and public health were at the time the greatest innovations that western medicine could bring to China, but it could not compete with traditional Chinese practices in every area, as Hume soon discovered. For instance, in one diagnosis, Hume had concluded that a pregnant woman would die unless she ended the pregnancy, but a famous Chinese doctor was able to save both her and her child; Hume never did learn what herbal remedy the doctor had prescribed.

Setting out to build a fully modern hospital, Hume managed to secure funding from the millionaire and Yale benefactor Edward Harkness in 1912. With the dream in reach, Yan’s diplomatic skills proved essential to brokering the “Xiang-Ya (or Hunan-Yale) Agreement” in 1914. This important agreement secured official government support for the Xiangya Hospital, Medical College, and the new School of Nursing (founded in 1911), including land and construction. One innovation agreed to was that leadership of the venture would in time shift to local Chinese control, a landmark achievement that was completed by the 1920s.

Representatives of the two parties to the innovative Xiang-Ya Agreement (1914): Drs. Yan and Hume (first and second from right) representing Yale-in-China, with officials from the Hunan government.

The Xiangya Medical College was inaugurated in 1914, and Dr. Yan served as its first Dean. The 180-bed Xiangya Hospital’s construction was completed in 1918. In the 1920s, enormous political unrest caused by growing nationalism and anger with foreign “cultural imperialism,” and other antiforeign movements made it increasingly difficult for foreign institutions to continue teaching. As strikes became more violent, in 1926 the Yale-in-China institutions closed down. While many feared the violence might mark the end of Yale-in-China, the organization survived the 1926-1927 crisis and resumed work the next year.

Dr. Yan Fuqing departed for his birthplace Shanghai, where he went on to found the National Shanghai Medical College, now known as the Medical College at Fudan University, one of the top medical schools in China. He also served as Minister of Health in the 1930s under the Nationalist government.

Dr. Hume and Dr. Yan’s “partnership as co-equals” was very unusual for its day. Hume was ahead of his time in respecting Chinese partners as equals and valued professionals and contributors to the “Yale-China experiment.” Dr. Yan’s expertise and unique background proved invaluable to the creation of the Xiangya Hospital, School of Nursing, and Medical College, institutions still renowned in China to this day.

In collaboration with the Yale-China Association, China Hands Magazine is returning to our Yale roots to explore the complex, impressive, and often dramatic history of the organization. In this second article we have looked back on Yale-China’s pioneering of equal partnerships in medicine. This year marks its 120th anniversary, and we will be sharing weekly articles largely sourced from Nancy E. Chapman and Jessica C. Plumb’s The Yale-China Association: A Centennial History and books by Yale-China authors like Dr. Edward Hume’s Doctor’s East, Doctors West, about notable themes, figures, and events from the organization’s rich past. We invite you to follow along via Yale-China’s Instagram page.

Aurelia Dochnal can be contacted at aurelia.dochnal@yale.edu. Aurelia is a student at Yale and history researcher at the Yale-China Association. She is an editor at China Hands, and is leading the Yale-China History Project to examine Yale’s long history of collaboration with China and to celebrate the organization’s 120th anniversary this year.