Identifier
Created
Classification
Origin
06CHENGDU1252
2006-12-12 11:18:00
UNCLASSIFIED//FOR OFFICIAL USE ONLY
Consulate Chengdu
Cable title:
HHS SECRETARY SEES SOUTHWEST CHINA HEALTH CHALLENGES
how-toVZCZCXRO2610 RR RUEHGH RUEHVC DE RUEHCN #1252/01 3461118 ZNR UUUUU ZZH R 121118Z DEC 06 FM AMCONSUL CHENGDU TO RUEHC/SECSTATE WASHDC 2325 INFO RUEHOO/CHINA POSTS COLLECTIVE RUEAUSA/DEPT OF HHS WASHINGTON DC RHEHAAA/NATIONAL SECURITY COUNCIL WASHINGTON DC RUCPDOC/DEPT OF COMMERCE WASHINGTON DC RUEHCN/AMCONSUL CHENGDU 2797
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
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.
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
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.
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