The Chinese Dream? A Hangzhou children's hospital tries to help poor families who can't afford to keep their children alive

by Michael Woodhead
An amazing article from a Hangzhou hospital reveals the appalling Dickensian situation that now exists in one of China's wealthiest cities, where sick children of the poorest rural migrant workers literally die in the streets from neglect. 
Dr Zhang Weifang of the Children’s Hospital, Zhejiang University School of Medicine writes about the efforts the hospital puts in to try provide medical treatment for seriously ill children of rural migrant families, most of whom are not covered by urban medical insurance cover. The situation arises because migrant families living in cities are uninsured or only covered by rural medical insurance policies that have meagre payouts and are not 'portable' to the city. The creates a problem when children become seriously ill with conditions such as leukaemia, congenital heart disease and oddly, scalds (the third most common serious problem they treat at the hospital). The hospital tries to treat such children and makes ad-hoc public appeals through the media and relies on donations from 'warm-hearted people'. It also seeks one-off funding from the government and from a handful of medical charities such as "Love Without Borders". The hospital has been modestly successful in soliciting funds in this way - bringing in almost 4 million yuan in donations in 2011. But to put that in perspective, that amount is only about 0.6% of the hospital's budget. And this did not cover the treatment costs of the most seriously ill children - the hospital also waived half a million in unpaid medical bills for the most severe cases. Nevertheless, most poor families are asked to medical fees pay upfront, in advance of treatment, and many simply can't afford this and "abandoned treatment".
As Dr Zhang writes: "At times, the hospital will reduce or remit the treatment cost for these patients. However, the hospital cannot afford to provide all the uncompensated care these children need ... We try to establish a long-term relationship with media and solicit contributions for low-income families. However, the situation is still far from perfect."
This, then, is the stark reality of China's lack of a health and social security safety net for its most vulnerable citizens. It also explains the huge disparities in health outcomes between China's wealthiest and poorest residents - a six-fold difference in child death rates. President Xi Jinping is often quoted in the Chinese media talking about the "Chinese dream". Martin Luther King had a dream of all Americans being equal, in which "the sons of former slaves and the sons of former slave owners will be able to sit down together at the table of brotherhood." Perhaps Xi Jinping could try realise the dream of all sick Chinese children being equal when it comes to getting hospital treatment.

'Retired' Hangzhou physicians are busier than ever in their eighties

Two retired doctors have become famous in Hangzhou's Cuiyuan Sanqu community.
Gynecologist Zhang Zhumei, 86, and pediatrician Rao Rujin, 86, have helped hundreds of people for free since retiring in 2006 from Hangzhou No. 2 People's Hospital. They were supposed to retire in the early 1990s, but later were rehired by the hospital due to their expertise.
The married couple jokes that they offer a one-stop package of services for pregnant women and those with young children.
During their career, both doctors earned strong reputations due to their excellent medical skills, and after they retired people asked for their contact information.
"A few sterile women found my apartment and I helped cure their infertility, so they gave my telephone number and address to more people. More people kept coming seeking help," Zhang says.
Nowadays, the majority of Zhang's patients are from suburban areas of Hangzhou such as Yuhang, Linping and Kangqiao although some have come from other cities after hearing about Zhang's expertise in helping women conceive.
Zhang says most patients coming to her have already had medical examinations in hospitals but still cannot conceive, thus they turn to her.
Zhang has helped numerous women conceive including one Hangzhou woman who saw doctors at several hospitals in the city.
Zhang checked her medical history and asked her symptoms. She then gave her a prescription. The doctor called her from time to time to track her condition and reminded her to take good care of her body. Six months later the woman became pregnant. The woman chose to give birth at Hangzhou No. 2 People's Hospital. In order to ensure the mother and child's safety, Zhang phoned her former colleagues to advise them on the patient's specific needs.
Eventually, the woman gave birth without any problems. When the infant was three months old, she took him to the couple's apartment, so Rao could do the check-up.
"The baby is really healthy," Rao says. "My wife helps women conceive and I help treat their babies, we provide a one-package service," Rao laughs.
Patients are required to book an appointment, but Rao and Zhang will also help when there is an emergency.
One day, a neighbor knocked loudly at their door around midnight. His child had a fever and was twitching. The father didn't know what else to do so he asked for Rao's help.
Rao took a look and prescribed some medicine. The child was fine within a few days.
Parents in the community often think of Rao when their child faces health problems.
Years ago, a girl in the community who was born premature was skinny and dying. Doctors in several hospitals were unable to save her. The parents brought her to Rao as a last resort.
Rao changed the toddler's medication and diet. She recovered and is now five years old.
Patients also admire Rao because of his ethics - he prescribes cheap and effective medicine whenever possible.
"Although our country's economy has improved, the living standards of most people are not very high," the pediatrician says. "Expensive medicine is a burden for common people. I have to help ease the pressure."
In their spare time, the doctors translate medical theses.
Thus far they have translated 700 theses from the American Journal of Obstetrics Gynecology, which was borrowed from the library. Zhang does the translation while Rao proofreads each thesis. They type all the translated theses into a computer and print them out.
Every once in a while, they give these translations to doctors at Hangzhou No. 2 People's Hospital.
"We should learn advanced medical skills from developed countries to help our medical science keep up with them," Zhang says.
Despite their age, they adhere to the concept of live and learn, and spend time keeping up on the latest developments in medicine.
Source: Shanghai Daily