HHS SECRETARY SEES SOUTHWEST CHINA HEALTH CHALLENGES

UNCLAS SECTION 01 OF 03 CHENGDU 001252 SIPDIS SENSITIVE SIPDIS STATE FOR EAP/CM, EB, AND OES HHS FOR RICHARD MCKEOWN AND WILLIAM STEIGER E.O. 12958: N/A TAGS: SOCI ECON ELAB PGOV SCUL SENV TBIO CH SUBJECT: HHS SECRETARY SEES SOUTHWEST CHINA HEALTH CHALLENGES CHENGDU 00001252 001.2 OF 003 ¶1. (SBU) Summary. Health and Human Services (HHS) Secretary Michael O. Leavitt visited rural health-care providers in Sichuan Province and met with Central Government and Provincial health authorities on southwest China's health-care challenges. While touring the small village of Yujian, about two hours outside of Chengdu, the Secretary talked with a young girl who contracted the H5N1 strain of avian influenza in early 2006, and with the young doctor who initially treated her. Although Sichuan is proud of its efforts to deliver at least basic health care to a largely agricultural population, significant challenges remain, especially the provision of health insurance coverage. The visit appeared to be very well received by local residents and the media alike. End summary. ¶2. (U) HHS Secretary Michael O. Leavitt visited Chengdu and rural areas of Sichuan Province on December 8-10, 2006 to meet with local, Provincial, and Central Government health authorities on the challenges of delivering health care in China's southwest. Secretary Leavitt brought a delegation of 15 persons, including HHS Chief of Staff Richard McKeown; HHS Assistant Secretary for Public Affairs Suzy DeFrancis; HHS Assistant Secretary for Health Admiral John Agwunobi; Chinese Vice Minister of Health Chen Ziaohong, M.D.; and Dr. Ren Minghui, M.D., Deputy Director of the Department of International Cooperation in the Chinese Ministry of Health. Chinese local and national media covered the visit extensively, and a separate note on press coverage follows at the end of this cable. -------------- --- HEALTH CARE AT THE MOST BASIC LEVEL: THE VILLAGE -------------- --- ¶3. (SBU) Secretary Leavitt reached out to Sichuan's rural residents with a December 9, 2006 visit to Yujian village, approximately two hours by car east of Chengdu, which had a human case of highly pathogenic avian influenza (AI) in April ¶2006. The village is home to approximately 2600 people, many of whom have left for jobs in urban areas. ¶4. (U) The Secretary toured the Yujian Village Clinic (a very simple, two-room, two-bed facility, open to the main village dirt road) and met with the clinic's physician, Dr. Liang Rong. �00A;Dr. Liang outlined the clinic's operations, and said she typically sees ten patients a day, usually for relatively minor problems such as upper respiratory infections. She also described her work in delivering health education and preventive care, and gave the Secretary a packet of medicinal ginger root. ¶5. (SBU) Secretary Leavitt met with the clinic's two elderly inpatients, and Dr. Liang introduced the Secretary to a nine-year-old girl named Sun Yue, who contracted AI. Dr. Liang explained that Sun Yue came into the clinic with a high fever and cough, and that she had come to suspect AI after learning of dead chickens in the area. At that point, according to Dr. Liang, the patient was transferred to the township hospital at Tangjia (five minutes away),and then an hour later to the municipal hospital in Suining City (30 minutes away). ¶6. (SBU) The Secretary then toured the home of a local villager. The two-room house was low-roofed, with packed- earth floors, and a brood sow and her litter of piglets occupied one room. The family also maintained nine chickens. Note: Government officials had installed two televisions with cable access and a refrigerator in the house just before the Secretary's visit, and had freshly white-washed the house's interior. End Note. ¶7. (SBU) In an open-air meeting with village residents, the Secretary heard how many residents had left the village to seek SIPDIS employment elsewhere. The villagers appeared to express pride in having elected their village chief. That official stated his belief that, with the basic problems of food and shelter solved, the village's biggest problems were a lack of reliable transportation to the city and the need for better quality housing. He said fuel for cooking came from methane generated by biogas digesters fed by pig manure, and that most homes had electricity, telephone service, and even cable television. A question-and-answer session with Chinese press followed. Vice Minister Chen also participated in the visit and spoke to the media. -------------- ONE STEP UP: THE TOWNSHIP HOSPITAL -------------- ¶8. (U) The township of Tangjia received the Secretary and his CHENGDU 00001252 002.2 OF 003 delegation enthusiastically; a local school band and dancers lined the streets to welcome the HHS visitors. Director Dr. Tan Shenchun greeted the secretary and explained the hospital's system for reporting cases of contagious disease via the Internet to the Municipal hospital and to the county Center for Disease Control (CDC). Recent examples of reported cases included mumps, urinary- tract infections, influenza, and non-gonococcal venereal disease. ¶9. (SBU) Upon hearing about the Secretary's interest in traditional Chinese medicine (TCM),Dr. Tan introduced the Secretary to the hospital's TCM practitioner, Dr. Peng. At the SIPDIS Secretary's request, Dr. Peng felt the Secretary's pulse, and SIPDIS prescribed a concoction of herbs, roots, and other ingredients to treat headaches. ¶10. (U) In the hospital's immunization clinic, the Secretary saw a computer-based system for tracking routine immunizations. He then administered oral polio vaccine to four small children, an event photographed intensely by the Chinese press. -------------- AN OVERVIEW OF SICHUAN'S HEALTH SITUATION -------------- ¶11. (U) After a brief courtesy visit with Vice Minister Chen and Sichuan Health Department Director Shen Ji in the nearby city of Suining, the Secretary received a more complete briefing from Director Shen on the Province's health situation and prospects. According to Director Shen, in 2005 the Province had a hospital-bed occupancy rate of 2.13 per thousand people. The number of physicians was 1.32 per thousand, and there were 0.71 registered nurses per thousand. The Province's average life expectancy at birth was 71.9 years, while the death rate among pregnant women was 78.4 per hundred thousand. Infant mortality was 27.9 per thousand. ¶12. (U) Director Shen said the Province had a five-point plan to improve health care: (1) increased investment in the CDC system; (2) greater attention to prevention and control of infectious and chronic diseases (he mentioned HIV/AIDS, diabetes, cardiovascular disease, and schistosomiasis); (3) better rural health care through the construction of more township hospitals, and greater participation in the Rural Cooperative Medical System (RCMS) (he claimed that RCMS now covers 56 percent of the Province's agricultural population); (4) the development of more urban community health service institutions; and (5) an increase in exchange and cooperation programs with the United States and other developed nations. ¶13. (U) In the context of the last point, Director Shen mentioned two exchange programs with the State of Utah: one that had taken place in April of 2002, when a medical delegation from Sichuan undertook a three-month training program in Utah; and another in April 2006, when the Chinese Ministry of Health (MOH) signed a memorandum of understanding with the Utah State Health Department for TCM training. ¶14. (SBU) After the briefing, the Secretary conversed informally over lunch with Vice Minister Chen and Director Shen. Discussing China's aging population, Chen said there was a need for greater Government care for the elderly, especially as a result of the one-child policy. In response to a question from the Secretary about the MOH's role in the 2008 Olympics, Chen said the MOH was preparing for the possibility of a major outbreak of contagious disease. Chen raised the subject of food safety, and mentioned a serious outbreak of food poisoning that had taken place recently in Xi'an in connection with school lunch boxes. However, at that point Chen stopped himself, and asked the Secretary not to mention this to others; he added that the Mayor of Xi'an would "scold" him if he heard Chen had been talking about it. -------------- -- MEETING WITH PROVINCIAL EXECUTIVE VICE GOVERNOR -------------- -- ¶15. (U) On the evening of December 9, 2006, Secretary Leavitt met in Chengdu with Sichuan Executive Vice Governor Jiang Jufeng, whose portfolio includes the health care system. Jiang outlined the Province's history and basic demographics, and repeated the points made earlier by Provincial Health Department Director Shen about the Province's five health care priorities. ¶16. (SBU) Later, in a side conversation at dinner between Vice Minister Chen and A/S DeFrancis, Chen discussed medical pricing CHENGDU 00001252 003.2 OF 003 and payment issues. He said the Ministry's Bureau of Pricing oversaw the fees charged at all health care facilities for medicine and interventions, but that the system's biggest problem was payment for health care. He claimed China's Government had too little money to pay for an effective public system, and said the RCMS did not yet cover the village and township visited by the Secretary that morning (Yujian and Tangjia),so residents must pay full prices for all services. Chen also expressed interest in methods for controlling the prices of prescription drugs, for which patients now pay largely out of pocket. -------------- A VISIT TO THE PROVINCIAL HOSPITAL -------------- ¶17. (U) Vice Minister Chen and Hospital Director Li Yuanfeng gave the Secretary a tour of the Sichuan Provincial People's Hospital in Chengdu, a facility that serves 1.35 million patients per year. They showed the Secretary the hospital's Computer Tomography Center and its Center for Human Molecular Biology and Genetics, headed by Dr. Yang Zhenlin. Dr. Yang had worked as a Senior Research Associate at the University of Utah, and mentioned a cooperative research program that is ongoing with that University in the field of age-related macular degeneration. Another stop was the Long-Distance Medical Network Center, which the director said the facility had served as the Provincial "command center" during the 2003 outbreak of Severe Acute Respiratory Syndrome. He also demonstrated a satellite-based communication system which he said permitted video conferencing with 30 medical centers in Sichuan and another 370 facilities elsewhere in China. The final stop was a visit to a TCM specialist. ¶18. (SBU) Note: An obviously unscheduled incident took place when an elderly man, apparently a hospital patient, attempted to cross the hospital lobby just as the delegation entered. Chinese security guards moved to stop him, but the man began protesting loudly. The guards then clapped their hands over the man's mouth and forcibly moved him out of earshot of the delegation. End Note. -------------- PRESS COVERAGE: EXCELLENT -------------- ¶19. (U) The Secretary engaged in a question-and-answer session with the press during his visit to Yujian village, and that session as well as the visit to the village clinic, the Tangjia township hospital, and the Sichuan Provincial People's Hospital all received very positive mentions in the local and provincial press, as well as on the Internet. Photographers took numerous shots of the Secretary during his visit, and Agence France-Presse (AFP) and Reuters photographers participated. More detailed information on press coverage will follow by e-mail as it appears. -------------- COMMENT -------------- ¶20. (SBU) Although the Chinese hosts had no doubt carefully prepared the sites visited, the effort made by the Secretary to visit a rural area of Sichuan made an obviously positive impression on the area's residents and on the Chinese press. The unusually frank talk about the presence of AI in the village was also noteworthy. The overall tone of the visit was quite upbeat, and could pave the way for expanded exchange programs and cooperation in rural health care. ¶21. The HHS delegation has cleared this cable. BOUGHNER