Canadian comedian Mark Rowswell, the most famous foreigner in China, has made a lucrative career by telling jokes on Chinese television. But this week, he shocked many of his fans by confronting one of China's darkest and most persistent taboos: its hidden suicide epidemic.
It was a move that few Chinese celebrities would be willing to make. Suicide has always been a grim secret in Chinese society, stigmatized as an embarrassment and a shameful failure for the surviving relatives. Even today, many Chinese people are reluctant to talk about it.
But in one of the ironies of China's fast-changing social landscape, two Canadians are at the forefront of a revolution in thinking about suicide and mental health.
One of them is Mr. Rowswell, 37, of Ottawa, who is best known to a billion Chinese by his stage name, Dashan. The other Canadian, 53-year-old Toronto-born psychiatrist Michael Phillips, is the driving force behind China's first suicide-prevention centre, which held its official opening in Beijing this week.
Together, they are helping launch a campaign that aims to save 60,000 lives a year by reducing China's sky-high suicide rate by 20 per cent within the next eight years.
Mr. Rowswell is one of the main spokesmen for the suicide-prevention campaign, and Dr. Phillips has done more than anyone to document and publicize the astonishing extent of China's suicide crisis. Until his pioneering research, few people realized that rural Chinese women were suffering the highest suicide rate of any category of people in the world.
The strange reality of Chinese social taboos means that these two foreigners can talk much more openly about the crisis than almost any Chinese could do.
"Being an outsider is an advantage," Mr. Rowswell said. "This is not a culture that deals with problems openly. Problems are handled quietly, behind closed doors. You're not supposed to hang out your dirty laundry. If you had someone in your family who committed suicide, you would never admit it."
Mr. Rowswell has never had a relative who committed suicide, but he told a Chinese newspaper about an aunt of his who had suffered from manic depression for most of her life. Chinese friends who saw the interview told him they would never have admitted such a thing if it had happened in their families.
"That's exactly the attitude that we're trying to overcome," he said. "There are things the West can learn from China, but this is something that China can learn from the West. We're definitely way ahead of them in social and psychological services."
Mr. Rowswell has spent most of the past 15 years in China, arriving on a Canadian government scholarship and parlaying his language skills into television stardom.
He was recently described by a Beijing newspaper as "China's best-loved foreigner," and estimates that he is recognized by eight of every 10 people in any city in the country. His comedy routines, which showcase his amazing command of Chinese puns and tongue-twisters, are broadcast to hundreds of millions of people, and he earns as much as $500,000 annually from his commercial endorsements, television shows and personal appearances.
Some people advised him not to get involved in the suicide campaign, but he felt that China was becoming open enough to accept a new message on a long-hidden issue.
He disagreed with the cautious tone of China's educational campaigns on social problems such as AIDS.
"They do all these bland messages because it's safe to be bland. But I'm pretty honest and direct."
Dr. Phillips has lived in China since 1985. He is so dedicated to the country that he accepts only a small salary (the equivalent of about $750 a month) from the Chinese psychiatric hospital where he works.
This year he became the executive director of the new Beijing Suicide Research and Prevention Centre, after many years of research and public campaigning on the suicide issue.
"I'm willing to speak up, whereas others might not," he said. "Five years ago, I never would have been able to get hold of data or publish it, but things have improved."
To the surprise of many observers, Dr. Phillips persuaded the Beijing city government to contribute the equivalent of about $370,000 to finance the suicide-prevention centre, which has 11 doctors and 13 nurses on staff. He hopes it will become a model for similar centres across the country.
But Chinese authorities remain somewhat nervous. For example, the centre was not allowed to use the word "suicide" in the Chinese version of its name. Instead it had to call itself the "psychological crisis" research and prevention centre.
The centre is creating a 24-hour hot line to help people who are contemplating killing themselves. But some of its Chinese staff have admitted they are reluctant to ask callers whether they are considering suicide.
"They're afraid of the word 'suicide,' " said Marlys Bueber, a training supervisor at the centre. "Many nurses don't want to talk about it. There's a level of discomfort."
For decades, Chinese authorities suspected that suicide was an act of rebellion, a political statement by those who opposed the regime. They treated it almost as a crime. As recently as 1998, the government cancelled a conference on the suicide issue, and China's mainstream news media were still refusing to discuss the suicide problem.