In August, China Development Brief and Oxfam Hong Kong jointly hosted a webinar, funded by the European Union, on the social inclusion of people with disabilities. The keynote speaker of the webinar was Ms. Li Hui, a senior social worker with eight years of experience at the Work Accident Rehabilitation Centre in Guangzhou. Ms. Li talked about existing problems in Chinese society that hinder social inclusion, and advocated for a shift in attitude towards this special group and strategies to help the disabled get more involved in family, work and social life. We are now following up our report on the webinar with a further interview with Li Hui from a different perspective, in which we invite her to talk about her experience as a social worker in a hospital and how her job as a social worker influenced her life.
Li Hui read Sociology for her undergraduate degree. After graduation, however, she chose to do a master’s degree in Social Work in Sun Yat-sen University. “Sociology includes many interesting theories, but I realised that I want to do something more practical,” Li Hui explains. “However a lot of my people told me that the salary for social workers would not be good and the industry has not been well developed. That is why a lot of people would not like to become social workers,” she adds. “I did not think too much about these issues when I first chose to do the master’s degree, but then many of my colleagues started telling me that if I became a social worker, my salary might only be one third of what my peers get. I have to admit that this news did give me some worrying thoughts, and back then I thought I would not become a social worker after finishing the degree.”
Nevertheless, two things happened in the final year of her master’s programme that changed Li Hui’s thoughts and her entire career plan. Li’s programme required all the students to intern with an organisation for 800 hours, and she went to work in a psychiatric hospital. This experience of working with people who suffered from mental issues touched her deeply. “I could truly do a lot of things in that hospital, and while the medical staff in the psychiatric hospital treated people as ‘patients’, social workers were able to consider them simply as ‘human beings’ and care about their human needs. It felt different from working in other places,” Li Hui tells us.
In the psychiatric hospital, Li Hui learnt more about the meaning of being a social worker, and how social workers in a hospital can not only assist the medical staff, but also provide something unique to the patients: a sense of warmth, and consideration of their human needs. Li planned to continue working with the hospital where she interned, but then a career fair happened on her campus that drove her attention to the Guangdong Work Accident Rehabilitation Centre, where she ended up working.
The Guangdong Work Accident Rehabilitation Centre was the largest rehabilitation centre in southern China, which means it has more resources and better networks within the sector, both in the Mainland and in places such as Hong Kong. “My first supervisor was from Hong Kong, she majored in counselling and so she gave us strict and comprehensive training on how to follow each patient’s individual case. After the Hong Kong supervisor left, my colleagues, who were my seniors and very competent, became my new supervisors.” Li Hui is grateful for the trainings she attended in the early stage of her career: “each year, I would learn and gain new skills. For example, in the first two years, we spent sufficient time on studying individual cases, focusing on skills and strategies that helped us track each patient’s situation and figure out under what conditions they could improve. We followed the supervisors’ guidance step by step, and in the end it was fruitful.”
Yet after focusing on individual cases for two years, Li Hui started to notice the limitations of this method and realised that organising sessions that could guide people with disabilities to work as groups might be a more effective approach. “The main job of our rehabilitation centre is to eventually help our patients ‘return’ to society, re-engage with different social circles and be included and accepted by society again. Based on previous practice, we are confident that the key to achieving social inclusion is community-centred work”, Li Hui states. “Meanwhile, this job has given me the insight that social workers are like farmers: we work with people who need our help and use our skills to sow the seed of hope in their heart, hoping that one day they will be able to re-engage with society again and thrive, just as any other individual in this society. I certainly believe that our efforts will come to fruition, and we are waiting patiently for the fruits to appear.”
Looking back on all these years of being a social worker, Li Hui considers that her path has been relatively smooth. Her resilience and the optimism make her view any difficulties in her work from a more positive perspective. “Certainly, there will be challenging times, when our plans do not work out. But I do not regard them as ‘problems’, because they may direct us to discover solutions from other angles, which is a good thing. I think that, when one door closes, a window will open. For example, at work there are different channels for us to collaborate with other organisations and collect funds, and if one channel does not work well, we will then try other channels.” As the field of social work is still developing, Li Hui thinks it is normal to encounter challenges. “When a new thing is growing, it will surely meet with ups and downs. Social work is a relatively new subject in China. When social workers are trying to apply theories, mostly from the West, to our domestic practice, it should not be surprising that we face difficulties from time to time.”
Many would anticipate that as a social worker in China, it is hard to obtain sufficient resources. However, Li Hui has a different opinion on this. “If social workers are able to make full use of all the resources they already possess, it can definitely lead to something remarkable. Social workers are not saviours, and the most important thing in our job is to walk with our patients, using all the resources we have in hand to serve them and assist them to use these resources productively. If social workers have as many resources as we want, and yet do not have the full knowledge of how to put these resources into full use, then many of them are actually going to be wasted. This would be discouraging for both us and the people we serve. That’s why I reckon that no matter how many resources we own now, it is important for social workers to learn and explore how to use these resources effectively and wisely. What matters might not be the quantity but rather the quality of the services, derived from all kinds of resources, that we can provide.”
“Frankly speaking, as frontline social workers, we are always exploring our own way. Yes, there are precedents from other countries available as reference but we cannot just take everything from previous theories and cases and apply them on our own patients. The context and local needs are different, so the same method that works in another location might not work here. Some people may have the attitude that this sector can improve only if we are following the standards from the West, but that’s not entirely true. There are many advanced theories and skills that we should learn from other countries, but acknowledging the difference in the social context and the needs of our own patients is equally crucial. In my opinion, at the current stage we should first learn about our own cases to figure out what needs our patients have and what challenges we face. When the time has come for us to exchange ideas with colleagues from other countries, I believe we will be more ready to share our observations and learn from theirs. On saying this, I do hope social workers in our country will be given more opportunities to go out and see what our counterparts all over the world are doing in their positions. The exchange of information and ideas should go beyond national borders.”
Like Li Hui, thousands of social workers in China are working diligently in hospitals or other institutions to serve and empower their patients. But where does their strength come from? When asked this question, Li Hui admits that the most significant support is from her colleagues in the hospital. “Our team in the hospital gives me much space and freedom to explore and experiment with new methods. I am a person who tends to have many ideas, and my colleagues are very supportive with me being creative and bold, and give me a lot of channels to help turn my ideas into reality. They allow me and trust me to lead the team to try new things and take risks, supporting me with their hard work and wise suggestions when they notice any issues. The relationship between the people in our team is wonderful, which makes the whole team highly productive”, she explains with a confident smile.
Li Hui illustrates a few factors that she thinks will keep motivating the team to work diligently. “Everyone in the team shares a common goal: we want to push hard to achieve a more inclusive society. Working in the hospital, we see the evident difference that having a team working on social inclusion programmes for people with disabilities has made to our patients. Each member of the team acknowledges the value of our job, and together we are like-minded people who want to make our contribution to the realisation of social inclusion.”
Li Hui also believes that it is the changes their service brings to patients’ lives that helps them persevere. “No one would want to leave this job, for the changes we see our work make in people’s lives are huge. Some patients visit us every time they pass by after being discharged from the hospital. Seeing their improvements makes us glad. Another reason, I guess,” Li Hui smiles, “is that people would not like to leave our team. Most of us are girls; everyone gets along very well and we are working towards a great common goal.”
But external support from other sources is also important for social workers like Li Hui, as she reflects. In the daytime at work, many of the scenes social workers face are filled with sorrow and hopelessness resulting from accidents that happen in people’s lives, and social workers alone cannot cure everything. “We need more collaboration between individuals and organisations who are devoted to people with disabilities. I think more collaboration will create an environment for innovative ideas, which may lead to good programmes and even funding for these programmes.”
Yet funding is another significant problem. Any good programmes require money and other resources to guarantee a smooth implementation. Li Hui notices that nowadays there is little funding directly going to hospitals to support programmes led by social workers. Most funding and resources go to communities for children and elderly people’s programmes. “Our programmes in the hospital are mainly concentrated on adult patients, but adults are unfortunately not the focus of this funding, either. If special funding can be set up for hospital programmes focusing on adults, that will be helpful for our work.”
Why do these programmes need to be stressed? Li Hui explains that it is because, after receiving help from programmes focusing on social inclusion, many people with disabilities will in fact devote themselves to the same area once they are able to do so. “I reckon that more than 98% of people are willing to launch programmes similar to those they attended in the hospital or other places, if they are provided with the opportunities, platforms and resources. However, the reality is that not everyone has those. But the seed of the spirit of mutual help has already been sowed through programmes like the one we have in our hospital, ‘The Hope Family’, in which we focus on people’s selfcare, employability and confidence building. I have witnessed examples of patients of mine who, after returning home from the hospital, are eager to help those who are in the same situation, who are ashamed of going out of their home to engage with society and live their lives.” Those who have recovered will go to visit people who stay home all day long, share their experiences with them and encourage them to step out of their dark comfort zone. “This behaviour should be considered ‘charitable’ and therefore encouraged by society, because the drive of these actions is the willingness to help others, despite uncertainties in funding and support.”
One particular challenge, and at the same time a skill that the disabled who are willing to help other people with disabilities have to obtain, is to figure out where they can find useful channels that connect them to opportunities, platforms and resources. But that is not an easy task. Li Hui mentions that building relationships with their local social workers, with organisations focusing on people with disabilities and with the Disabled Persons’ Federation is essential. “If we have any resources or networks that could help them, we will give them a hand; but most of the time they need to find their own way. There will be obstacles for them along the way, some will get discouraged, and after a few discouragements some people might totally give up. The initial will is always strong, yet keeping it strong demands not only efforts from the disabled themselves; support from outside matters very much, too.” As programmes similar to the “Hope Family” begin to emerge across the country, it is obvious that resources are not equally distributed in different provinces, and between cities and the countryside. In some cities there are more programmes being launched, and in other cities there are few or even none. But Li Hui also reveals that when resources are available monopolies can take place, which makes it even harder for individuals with disabilities to start their own organisations or programmes.
Nevertheless, lack of resources or monopolies on resources are not the end of the world. What Li Hui shares next brings a glimpse of hope. “Being an entrepreneur is another way that people with disabilities can achieve their goal to help others. For instance, a previous patient of mine taught himself beadwork when he was in our hospital receiving treatment and counselling. When he returned to his hometown, he initially wanted to get in touch with the Disabled Persons’ Federation and get support from them for his own organisation. Then he realised that the local Disabled Persons’ Federation did not have a strong awareness of social inclusion, so they did not have any plan to fund these programmes. This man had to start the organisation all on his own, which was not realistic for him. But then he remembered what he learnt during his time in the hospital, so he began to teach a group of disabled people who often came to visit him about making beads. In the end, they started a small company selling handmade beaded jewelries and their business has been going really well. This is another way to contribute to disabled people’s social inclusion.”
It is very encouraging to see people with disabilities, after they have striven to regain their own lives, try and help those who are stuck in their previous situation. But what triggered their willingness to help? In other words, how have programmes such as “Hope Family” in hospitals and other organisations helped people with disabilities cultivate such a willingness? Li Hui answers these questions with details of what she and her colleagues do in the Hope Family programme. “In Hope Family, we often have conversations about the concept of ‘disability’. We as social workers introduce the history of this concept and how it has been constructed, and then lead our patients to think what problems this concept has and how we can rewrite it in the present time. Rewriting the concept depends on the actions of each one of us, and together we can become a group, a community with one shared voice. One prominent feature of people with disabilities is that they like to stick together; when they leave the rehabilitation centre and return home, they will also get together with other disabled individuals from their hometown, for they have much in common and never lack things to talk about. So it is easy for them to form groups.”
“Moreover, in the Hope Family programme, the notion of ‘helping one another’ is not mentioned directly. Rather, we set up a number of group exercises for our patients, through which they can experience the strength of collaboration, of working together and supporting each other. During the process of each individual’s recovery, they rebuild themselves through the help of social workers and of other people who are in the same boat. Physically people with disabilities might be weaker than ordinary people, but once they get together and help each other, their union becomes very powerful. That, I believe, is the drive behind their willingness to set up programmes to help those who share the same experience.”
“As you can see, the impact of social workers in this process is both direct and indirect. On the one hand, we make it known to our patients that the current concept of disability is biased, and directly invite people with disabilities to create their own definition of disability based on their own experience. On the other hand, through group activities we indirectly pass on the notion of ‘mutual help’, and they witness its significance by participating in group activities. One fundamental element of the job of a social worker is to believe that engaging with people is important. We have displayed this belief in our daily work, and we have seen our patients come to realise this belief, appreciate it and apply it to any job they do in their lives.”
Another crucial point for the lives of people with disabilities is to have intimate relationships. “Intimate and close relationships are much more important for people with disabilities than anyone imagines,” Li Hui emphasises. “They are a great motivation for them to get re-involved in society as well as start their own organisations and businesses. Among all relationships, the relationship between husband and wife is possibly the most powerful one.” Li Hui gives the example of the first disabled couple that got married in her area, in 2019, to reiterate the impact: “The marriage was unprecedented, and therefore a tremendously encouraging news for other people with disabilities. Seeing this first couple both sitting on wheelchairs, other disabled people realised that they could also enter into a relationship or a marriage and live a good life. It raised much hope for other disabled people, especially those who are young. The first couple broke the convention, and after they appeared in public more and more couples with disabilities emerged.”
“Back in 2012, when we discussed the topic of relationships and marriage in some of our workshops, reactions from our patients were all very negative. They assumed that they would never enter into any intimate relationship because they are disabled, and any ordinary person would not be willing to be with them. They also did not think they could live with another disabled person, because both of them would need to be taken care of by others. This sentiment did not change much until last year, when the first disabled couple got married. After the union of the first couple, many people were very curious about their married life, so they went and asked them and the couple showed people how they cope with their life. Recently we have been receiving many young male patients but less young female patients, and if any of our workshops have young ladies attending, a lot of young men will be interested in attending too.”
“In addition, the assistive devices for the disabled have had significant improvements over the past few years. Unfortunately, there are still many places in our society that are not friendly to people with disabilities, but assistive devices have certainly helped people with disabilities live a more convenient life. This indicates a positive change of mindset for both the disabled as well as for the whole society, and it shows that everyone deserves a dignified life. Also, the companies that make assistive devices are eager to invite young men, women and couples with disabilities to help advertise their products to the public.”
Li Hui firmly believes that people with disabilities can be powerful practitioners who lead to changes in our social concepts, norms and mindset. “Marriage between disabled men and women, the development of assistive devices and disabled people being brand ambassadors for companies, all of these phenomena have been pushing for social change. These actions are mostly done by people with disabilities themselves, they are very brave.”
The role social workers have played in this process, according to Li Hui, is that of facilitators rather than directors. “The role of social workers is not to make decisions for our patients or plan their lives for them. We show our patients a life that they deserve, a life that is still very possible for them, and if they would like to receive our help, we provide them with all we have – facilities, resources, platforms and channels. However the final decision is on them. Whether they will achieve the life they desire, and whether they will have other surprises on the way to that end, does not depend on social workers. Because of this, I think social workers should be open-minded when serving each one of their patients, that is we should not restrict what we and our patients are able to do. Serving our patients has brought me many surprises, and a lot of times I can only cry out with joy: ‘My goodness, how could this happen!’ But then I realise, things can turn out to be above my expectations if I do not set limits for my patients and myself.”
Partnerships between social workers and people with disabilities are Li Hui’s expectation for the future. “I hope social workers and people with disabilities can work together, and this will be of great help for us. Our hospital has had four or five partnerships with our former patients, and I am currently also working with one person with a disability. It has made a huge difference to have them working by our side. Their voice is surely louder and more effective than ours because they are speaking for themselves, they are telling their own stories. It is more important that social workers leave the central position on the stage to people with disabilities, let them perform and flourish,” Li Hui says with a passion. “Sometimes, we social workers tend to consider ourselves the most important actors and put ourselves above the ones who we work to serve, and this I believe is not right. If we create a stage for our patients and hand it over to them when they are ready, the result, many times, will be better than we have estimated. Social workers need to know when they have to return to the backstage and hand over the limelight to the main actors.”
Li Hui holds that being a social worker is more than a job for her. “It is a mission, a mission full of wonderful meaning, and the joy and hope it brings me, when we see our patients are recovering and improving, is incredible. The ultimate goal of this mission is empowerment: through serving others, social workers are trying to empower our patients; but social workers are also empowered through the changes we make in many lives and by learning to be emphatic. We have learnt to understand our patients’ and their relatives’ emotions, and also the emotions of our own family. We have realised that in many circumstances insufficient communication and misunderstanding between our patients and their families have caused much harm. Through helping our patients and their families, we can also reflect on our own relationships with family and friends, and then try to communicate properly with our loved ones, care for them, listen to what they say and accompany them when they need us. This job holds many reminders for me to consider how to express my love and thoughts to my family and friends.”
“It is rewarding to be a social worker,” concludes Li Hui. “It is not an easy job, but precisely because it is not easy we need more people to step up and work together on the things that may seem hard or even impossible to achieve. In various ways, we are all playing a role in the path leading to a society that is more inclusive, diverse and civilised.”