China Senior Living 中国养老

喜 寿 会

The Practical Challenges of Cultural Translation

同 志 好! Throughout Amy Tan’s The Joy Luck Club, the various female narrators meditate on their inability to translate concepts and sentiments from one culture to another. The incomplete cultural understanding of the mothers and the daughters is a result of their incomplete knowledge of language. Indeed, the barriers that exist between the mothers and the daughters are often due to their inability to communicate with one another. Although the daughters know some Chinese words and the mothers speak some English, communication often becomes a matter of translation, of words whose intended meaning compared with their accepted meaning are in fact quite separate, leading to subtle misunderstandings with big consequences.

I could transcribe the above paragraph nearly word for word and have it apply to a western company’s experience in bringing their business to China, especially geriatric healthcare. This experience for many has been frustrating and this is almost entirely due to both party’s inability to understand that the translation being provided for them at the banquet table is imperfect. Each party departs that table with a partial comprehension of the conversation that transpired. Like the mothers and daughters in The Joy Luck Club, it is also fair to say that the misunderstanding  between an American businessman and his Chinese counterpart is not relegated to the superficial; in fact they approach their meetings assuming they are very different and neither of them realizes that they have more in common than not. Consider for a moment that these two have richly mixed identities rather than identities of warring opposites.

Said another way, the differences between American culture and Chinese culture can be summed up as follows:

Consider China a high-context culture (by context, I mean the whole situation, background, or environment connected to an event, a situation, or an individual) in which the individuals have internalized meaning and information, so that little is explicitly stated in written or spoken messages. In conversation, the listener knows what is meant; because the speaker and listener share the same knowledge and assumptions, the listener can piece together the speaker’s meaning. China is a high-context culture.

In contrast, a low-context culture is one in which information and meanings are explicitly stated in the message or communication. Individuals in a low-context culture expect explanations when statements or situations are unclear, as they often are. Information and meaning are not internalized by the individual but are derived from context, e.g., from the situation or an event; America is a low-context culture. At some point because we are all human, low context culture communication meets high context culture communication; this stratum is not a bright line but a seam that is broad and contains meaning and perspective to both cultures.

When American businessmen fear that the American and Chinese cultures cannot mix and therefore doing business in China is perilous, they are contemplating the combination of two extremes of the high/low context dynamic. In reality, each identity is itself mixed: just as the American culture is not wholly about autonomy, liberty and individuality, the Chinese culture is not wholly about passivity, obedience, and self-restraint. Nonetheless, the challenge of finding a way to combine aspects of both into a successful venture is a challenge faced not only by the American businessman in China but the Chinese businessman in America.

Membership in The Joy Longevity Club

There are four fundamental principles of working in China which I have found to be essential to beginning to understand the Chinese. This last phrase, “understanding the Chinese” is the catch here and it leads me to the frustrating and slightly contradictory statement that one must understand the Chinese culture before you can understand the Chinese. It is a rich, complex culture with boundless mysteries all of which have been developed over the past 5,000 years. So, understanding the Chinese and their approach to business is a puzzle. Nevertheless, these four principles, which I call the “Four philosophies of The Joy Longevity Club”, regard situations and people which you will inevitably come in contact with; they will help you and, tongue in cheek, are below:

1)     The man with a hundred wives: He’s a clever chap, this one, squeezes Yuan from stones. He’s got a piece of every action imaginable; the taxi driver’s fare he hailed to take you to the hotel, the lunch he “paid” for, and if money changes hands within his sight, he has a cut. He is not dishonest; he is the pinnacle of an entrepreneur, the ultimate broker and China is full of them. Knowing him as such is a first step in understanding him and using his considerable network for your gain.

2)      False-positive affirmation of non-confirmation: Here’s simple axiom for doing business in China, learn it, internalize it and life will be much simpler for you: Yes means maybe, yes can also mean no and yes might indeed mean yes but no invariably means no…..got it? Don’t be frustrated, just practice and master this sly bit of linguistic subterfuge and you are half way there….maybe.

3)      Same-same but different: This is a disarmingly innocent but crafty little riddle that really only serves a person to advance a particular situation at another’s expense. All I can say is “At what point in time are two dissimilar objects identical?” Answer: When the salesperson is desperate for a sale. But be especially concerned when the attorney you’ve hired to represent your interests says the same thing to you about a matter of Chinese law. Usually the use of this phrase means that your powers of critical thinking are paying off….the questions you are asking are exasperating him…..keep it up.

4)      General Copycat’s spicy chicken with tasty sauce: This is the main meal that has nourished the Chinese economic miracle. Usually the first generation of copied product is a blatant failure while the second is an improvement and works but is still commercially unacceptable. The third generation however is an inferior product but marketable and the fourth is nearly indistinguishable from its foreign counterparts in nearly every respect except for one: it is much less expensive. This last point, the cost of the product being substantially less, is the point of liminality when the Chinese “gotcha”.

I was recently at a Chinese banquet, the guest of a successful man who owns a large company and was looking to get involved with senior housing; I’m interested in selling him some business. Here is how the conversation went:

Me: Attempting to demonstrate proficiency with chopsticks, I remark in high context language, “Mr Chang your interest in senior housing is quite timely and I like your project’s location.”

Mr. Chang: Displaying supreme ability with chopsticks as he draws his spicy chicken nearer, he says “Xie-Xie. We have diligently been preparing for our opening.”

Me: …..”Opening?” The slippery chicken I had managed to pinch with my chopsticks drops back onto my plate, splattering my shirt with spicy sauce. “I was under the impression you were interested in receiving our proposal for strategic operations assistance?”…I stammer, in full retreat with low context language.

Mr. Chang: Never taking his eyes off his plate, he devours his chicken, gnawing voraciously on the bone. He responds with false-positive affirmation of non-confirmation, “Yes!”

Me:  Batting away the subterfuge, I penetrate, “How can we help you Mr. Chang?”

Mr Chang: Smiling broadly and gesturing to the waiter that he is finished with his chicken, he says,  “We return from our USA trip where we visit two senior facilities. We took a lot of pictures! We would love to read your proposal.”

Me:  Mr. Chang’s hundred wives are useless against me now! I counter with a masterful same-same but different tactic, “Ah, this is a clever move Mr. Chang and I am sure you learned a great deal. What you learned on your trip will be of great use…..” I pause to release the obligatory burp that demonstrates my deep satisfaction with the taste of the chicken…exhaling, I continue,”…especially…. your newly found knowledge of geriatric nutrition and memory care”.

Mr. Chang: On his heels and defensive, using false positive affirmation of non-confirmation, he responds, “Yes.”

Me: At this point I must enable Mr. Chang face, I reply in high context language, “Your knowledge of this industry will make you an icon of China senior living! I only hope to offer you support in this voyage, Mr. Chang.”

As it turns out, Mr. Chang not only thought he could build a skilled nursing facility using pictures but he had plans to establish a hospital as well….also from the pictures they took on their recent visit to the US. After an initial attempt at replicating a facility from pictures, Mr. Chang quickly became a client. Fortunately for the geriatric healthcare consulting business and Western geriatric care companies, the fourth generation of SNF/ALF and liminal profitability for the Chinese is 10 years away.

Now, a serious word about the future

With all joking aside, explosive economic growth has been one of the major driving forces behind almost every industrial sector in China; and the healthcare industry is no exception. The country represents one of the most rapidly growing major healthcare markets in the world with total healthcare spending having produced compounded growth of nearly 23% over the past four years making China the fifth largest healthcare market in the world. And with its current momentum, many expect China to surpass Japan by 2013 to become the second largest healthcare market in the world.  If that isn’t enough, China’s healthcare expenditure accounted for a microscopic 4.6% of its GDP in 2009, well below the global average of 10%.  By way of further comparison, its East Asia and Pacific neighbors spend 6.3% of their GDP in healthcare; so the potential growth is obvious.

China’s increasing affluence has brought upon it a frightening rate of urbanization. Accompanying this urbanization are natural lifestyle changes such as western diets, modernized transportation, and intensified work schedules; all of which have shifted disease patterns from communicable to chronic.  These shifts increase demand for recurring healthcare treatment.

The higher acuity of care a geriatric services company offers is proportional to their longevity and profitability in China; whereas the extent to which one reduces specialized services, the more you diminish your advantage.

Western geriatric care companies interested in China would be well advised to heed the following: the Chinese demographic that is most attractive and, frankly, the most natural play for Western healthcare IP is, at present, the high end of the market that will avail itself of assisted/skilled nursing care facilities and other specialty services such as dementia care. And while I believe there is opportunity for Western companies to get involved with independent senior living in China, this market has much more competition. The more you reduce specialized services, the more you diminish your advantage.  So while the economic story is compelling the real difficulty in China is execution and mastering the low context culture vs. high context culture dynamic; for Western geriatric care companies, membership in The Joy Longevity Club is exclusive and takes time.

为 人 民 服 务!

Note: Certain material in this post was drawn from Cowen and Co. Hong Kong and Lilia Melani of Brooklyn CUNY.