SURGERY IN CHINA
Chinese Medicine Mobile Clinic Cao Dongxian, a middle-aged school teacher traveled to Beijing in May 2015 from his home in Shandong province for a risky intestinal cancer operation after local doctors refused to do it. According to Reuters: State insurance coverage is limited in China, meaning patients often have to pay a large part if healthcare costs themselves, especially those with major long-term diseases like cancer or diabetes. [Source: Adam Jourdan, Reuters, April 12, 2016]
Caesarean sections (C-sections) are often pushed in China because doctors can make money from them and they are less off a burden on hospitals (a C-section operation can take as little as 10 minutes while labor can sometimes extend for 10 hours or more). The C section rate in some urban areas is 74 percent. Some hospitals offer a C-section and five nights ib a luxury suite for $11,560. The package includes 3-D ultrasound images of the baby (“unborn baby video shoot”) and offers to mothers see if the “baby is ugly like dad, or beautiful like me” (viewed by some as an allusion to sex selected abortion). [Source: Gabrielle Jaffe, The Times, March, 2012]
In the 1960s, birth were completely natural. In most cases anesthetic was not given and doctors were called in only if there was a problem. In 2012 the cost for a standard birth and three nights in a standard room in an urban hospital was around $5,000
Cancer Treatment in China
Jiayang Fan wrote in The New Yorker: “Mu Zhixia discovered the lump in her left breast on an unseasonably warm night in March of 2014. At twenty-seven, she was strong and healthy, and hadn’t seen a doctor since giving birth to her son, Xuan, two years before. But her mother, Sulin, told her not to take chances and marched her to their local hospital, in Pingding, a small city in the province of Shanxi. A doctor conducted a swift examination and wrote a prescription. “Doesn’t she need a scan?” Sulin asked. “No need!” the doctor responded. “The medication will be enough.” [Source: Jiayang Fan, The New Yorker, March 30, 2020]
“Zhixia dutifully took the pills, but after a few months the lump was still there, so Sulin accompanied her to a hospital in Yangquan, a nearby industrial city of 1.5 million people. The doctors said that she needed immediate surgery. As is typical with dire diagnoses in China, they did not tell Zhixia that she had breast cancer, informing only her mother. Sulin, in turn, assured her daughter that the growth was benign.
“After the operation, a biopsy revealed that the cancer had spread. The doctors put Zhixia on a course of chemotherapy, and she was hospitalized for several weeks. A year later, the cancer returned, and the doctor who had prescribed the chemo remarked casually that if they had followed it up with radiation the outcome might have been better. Sulin wanted to know why they hadn’t done that, but she felt too intimidated to say anything.
“In the next three years, Zhixia had four more long stays in the hospital, emerging frailer each time. The cost of her treatments, a hundred thousand yuan (almost fifteen thousand dollars), plunged the family into financial crisis. The cancer progressed to her lymph nodes, her lungs, her bones. Her body became so ravaged that she was almost unrecognizable. When her son was taken to visit, he had to be prompted to call her Mother.
End of Life Care in China
Jiayang Fan wrote in The New Yorker: “In Taiyuan, Li and I went to the Shanxi hospital’s residential compound to visit his friend Song Jianguo, the former head of the hospital’s respiratory department. Song, who was in his early sixties, had just retired, after having received a diagnosis of Stage IV stomach cancer. Greeting us at the door of his apartment in pajamas and slippers, he explained that he had just finished a round of chemotherapy. He had sharp cheekbones and exuded a placid, scholarly air. In his left nostril was a thin nasogastric tube. [Source:Jiayang Fan, The New Yorker, March 30, 2020]
“When I apologized for bringing up end-of-life care, Song laughed dryly. “It’s a subject we should talk about more openly in this country,” he said, pointing out that, even in a hospital of this scale, there was no consistent palliative care. Again, distorted incentives were part of the problem: doctors earned far less for prescribing pain medication than for ordering chemotherapy or surgery. There were cultural factors, too. Many patients in severe pain were wary of opioids, which they associated with addiction, and China’s newfound wealth inspired unrealistic expectations. “There’s this very optimistic idea that, if we spend enough, diseases will be cured at the rate that new skyscrapers are built and bullet-train tracks are laid,” Song said. “But that’s not how the human body works.” Richer patients couldn’t accept that money wouldn’t guarantee survival, and those who couldn’t afford treatments, he said, “sometimes jump from their window to spare their family the burden of caretaking and the expense.”
“Song took a shallow, labored breath. He worried that a deepening distrust of doctors was undermining end-of-life discussions: “It’s impossible when the patient or the patient’s family is thinking at every turn, Oh, is the doctor saying there’s nothing we can do because that’s really the case or because he doesn’t think he’ll earn enough to be worth his effort?” Song adjusted his nasal tube. “Everyone should know what’s coming. When that day comes, we have to know the difference between giving up and letting go.”
Re-attached Limbs in China
Chinese doctors are very skilled at reattaching severed limbs, fingers, toes and genitals. They pioneered many procedures. In the 1960s, Shanghai-based Dr. Yu Chungjia performed hundreds of these operations, the most famous of which was the construction of the "Shanghai Hand" on a man who had both of his hands cleanly blown off when a blasting cap exploded in front of him. To make a new "hand," a toe was removed from each foot and attached to the man's wrist in a position that roughly approximated the position of the thumb and forefinger. A few months after the operation, the patient was able to write, light his own cigarettes and take care of most of his needs. Dr. Yu said the advantage of having a "live" hand over a artificial one was that the patient had feeling.
Also in the 1960s, a factory worker, who had his right hand chopped off by a machine, was rushed to the hospital by his boss and followed a short time later by a coworker who brought the hand in a paper sack. After a seven and a half hour operation the hand was successfully sewn back on. A Swedish journalist named Jørgen Bisch, who visited China in 1964, said he saw a film about the groundbreaking surgery, and afterwards got the shake the famous hand. [Source: Jørgen Bisch, National Geographic, November 1964]
Landmark operation in the late 1980s included reattaching a severed arm to its stump and attaching a forearm made from a leg onto a young girl's elbow. On the latter the China Daily reported: "Eleven-year-old Meng Xin's left arm and leg were severed in a train accident. To save her, six surgeons used part of her leg to make a forearm, to which they attached her hand. Following the 18-hour operation, Meng's skin on her transplanted forearm returned to normal, and her transplanted fingers have recovered their sense of touch. She can even clench her fist and move her left arm."
People who lose a thumb often have one of their big toes amputated and grafted onto the hand. A study of 50 men who had their penises reattached reported in the China Daily found that "98 percent of them found their penis functioned again" even though some operations were "one-stage reconstruction" in which a penis was pieced together from pieces of skin, bone and tissue. The article claimed that many of the men went on to father children. "A father who went through the one-stage reconstruction of the penis even mailed his daughter's photo to us," the article said. [Source: Paul Theroux]
In 2006, a military hospital announced that it was the second facility in the world — after one in France — to perform a partial face transplant. The patient, a farmer mauled by a black bear, had a donated nose, upper lip, cheek and eyebrow grafted onto his face.
Chinese Harvard Student Says His Mother Set His Hand on Fire to Cure a Spider Bite
In May 2016, in the first graduation speech at Harvard University delivered by Chinese citizen, He Jiang, a doctoral student in biochemistry, described the time his mother set his hand on fire when he was a boy, after a poisonous spider bit him. The incident inspired him to bring scientific knowledge to where it’s needed the most, he said. [Source: Zheping Huang, Quartz, May 28, 2016]
According to Quartz: “The graduate explained he grew up in a village in central China’s Hunan province. When he was bit by the spider in 2001 there was no doctor in the area. So his mother wrapped his hand with layers of cotton, soaked the cotton in wine, and ignited it. The pain made him want to scream, he said, but “all I could do was watch my hand burn—one minute, then two minutes—until mom put out the fire.”
“Heat deactivates proteins, which is what a spider’s venom is made of, so his mother’s cure was actually effective. “I now know that better, less painful, and less risky treatments existed… why didn’t I receive one at the time?” he asked in the speech. He said he is “troubled by the unequal distribution of scientific knowledge throughout the world,” and dedicated to communicate what he has learned to those who need it, like “the farmers in my village.” “He was the first in his family to attend college. “If you don’t study hard and leave this village, you will be farming your whole life,” he said his father always told him.
Foreigners Who Seek Medical Treatment in China
hospital ChinglishA number of people paralyzed by accidents or debilitated by neurological illnesses such Parkinson’s disease have gone to China to get stem cell treatments that are not available in their home countries. Some take out double mortgages on their homes or are helped by community fundraisers to pay for their treatments and trips. Many claim success when they return home. [Source: Christopher Bodeen and Alan Scher Zagier, Associated Press, January 2008]
AP talked to a paralyzed man who said he could move his right arm after the treatment, a Parkinson’s disease sufferer who said her tremors largely disappeared and a six-year-old girl born with an optical defect that said she could see. The treatments usually involve the injection of steam cells from umbilical chord blood into the brains and spinal cords of the patients in conjunction with daily, three-hour doses of intravenous drugs intended to stimulate the production’s of the patients own stem cells. The paralyzed man mention above spent 2½ months in a hospital in Shenzhen where he received a series of injections of umbilical cord stem cells into his spine, followed up physical therapy. Another man who was disabled by a car crash that left him with limited use of his hands made little progress with his treatments in the United States but said he regained complete use of his left hand and improvements in his right hand after a $20,000 treatment in China.
Western doctors are skeptical about the results. The treatments have not been rigorously studied or subjected to trials. One informal study of seven patients with spinal cord injuries by three Western doctors found “no clinically useful improvements” — even though most patients said they felt better. Five developed complications such as meningitis
Blood Banks, Bloodheads and Vampires
China has a network of blood banks but they can not meet the demand for blood and blood products. Chinese rarely give blood because blood is considered sacred and they fear their bodies will be irreparably harmed if blood is taken away. So few Chinese are willing to donate blood the government recruit donors with promised $100 bonuses and free vacations.
To make or the shortfall private companies buy and sell blood. Much of the blood is supplied by peasants desperately in need of money. Newsweek reported a girl who sold her blood to a Beijing clinic so her family could buy fertilizer. Before major holidays, spring plowing season, and school-tuition time, hundreds of peasant with annual income of less than $20 line up to donate blood.
Donors off the street are given a $12 "nourishment fee" for donating the equivalent of a pint of blood. Blood sales have been banned since 1998 but the practice continues in rural areas. According to one estimate 5 million Chinese regularly sell blood.
Many of those who donate blood are recruited by blood brokers, called "bloodheads," who purchase blood mostly from peasants and migrant workers and sell it with a large mark up to clinics, small town doctors and individual patients. Patients who buy blood from blood vendors pay about $40 for 300cc of blood that is claimed to be fresher and cheaper than blood given at hospitals and clinics. The blood sold by bloodhead is sometimes contaminated with the AIDS virus. See AIDS
In 1995, a criminal gang of “vampires” was arrested in Hebei province that kidnapped victims, bled them and sold their blood for profit. One victim was lured with promises of a better job and kept in a windowless room for several weeks, during which time his blood was periodically collected. After the leader of the gang and 12 associates were arrested, 74 captives were rescued including one old man that had so much blood drained from his body he died six days after the rescue.
In October 2009, a Chinese-American man was sentenced to eight years in prison for selling and shipping human skulls. Police found him trying to ship 20 skulls via express mail. An additional 1,100 skulls were found at his home. The skull were over 60 years old.
Chinese Medical Research
Backed by the Bill and Melinda Gates Foundation, Chinese medical researchers, partnered with a firm in the U.S. beat out an Indian team to develop a new test for cervical cancer, that cost less than $5, in 2009.
In 2008, the Ministry of Science and Technology gave researcher two years to come up with 30 new medicines for clinical trials and only few days to apply for money to fund the research. This was even though in the last 60 years Communist China had only developed only one internationally-recognized drugs, the anti-malaria drug Artemisinin.
In April 2010, Chinese scientists at the National Institute of Biological Science in Beijing announced in an article published in Nature that they discovered a gene believed to be responsible for fat growth and obesity while doing studies of genes in different ethnic groups’ Caucasians Chinese, Japanese, and South Koreans — and want to use the finding to design a means of shutting down the gene down in an effort to fight obesity.
Medical Technology and Devices Made in China
The Economist reported: “Ninety minutes north-east of Beijing lies what may be the future of medical technology. Weigao, a Chinese firm that started as a state-owned “township enterprise”, has built a research and manufacturing center where the laboratories are surprisingly chilly. Only the clean room, it seems, is fully climate-controlled. And that offers a lesson about frugal innovation. Whereas Western technology firms have plush premises, in China the people shiver while fancy equipment stays warm.” [Source: The Economist, January 20, 2011]
“Though cold, Weigao’s labs are a steaming cauldron of creativity. Medtronic, a giant American maker of medical devices, entered a joint venture with the Chinese firm two years ago. Its designers and engineers work side by side with local talent, and have already launched half a dozen inexpensive, novel products that Medtronic would not have made on its own. This is new territory for Medtronic, which has hitherto made high-end, costly kit. Simon Li, the well-connected head of the joint venture, says that three things persuaded the American firm to see China “not as a host but as a home”.”
“First, local demand: as China’s second-tier cities boom, their clinics are crying out for cheap gizmos. Second, the Chinese government is pushing “indigenous innovation” by favoring local firms in tendering, procurement and so on. An engineer gleefully points out that as a local entity the Medtronic joint venture can buy essential rare-earth metals cheaply, despite Chinese restrictions on their sale. Third and most important, Medtronic “just had to localise”, says Mr Li, because it faced sudden and intense competition from local rivals.”
“A decade ago America’s medical-technology firms dwarfed all others and China’s were barely visible. But according to PwC, a consultancy, America’s lead will shrink over the next decade on all important measures of innovation. China could well become a bigger force in this market than Europe by 2020 — both by creating new medical technology and by using it. Take sutures (for closing wounds), for example. The old approach was to make disposable ones and sell lots of them. But Chris Wasden of PwC notes that Chinese firms have undercut Western rivals by developing reusable ones.”
“The market for heart stents is another straw in the wind. Seven years ago, says Mr Li, Western firms like his thought their dominance was secure. When MicroPort, a Chinese upstart, came out with products that were 40 percent cheaper, he recalls, doctors were initially sceptical. But it did hundreds of clinical trials and now it owns 70 percent of the Chinese market, he notes. Similar tales are legion. Investors have noticed. MicroPort and Lepu Medical, a local rival in the stent market, have both had successful public placements (the former in Hong Kong, the latter in Shenzhen). Trauson, a Chinese firm specialising in orthopaedics, listed last year in Hong Kong. Mindray Medical, a New York-listed Chinese firm that makes cheap monitors, exports lots of them to rich countries.”
Sales of medical technology are exploding. The market in China is forecast to grow by 15 percent a year to 2015, reaching $43 billion by 2019; India’s is galloping at 23 percent, and should top $10 billion by the decade’s end. The Chinese government plans to spend $125 billion over three years to expand health care outside the biggest cities. That should boost demand even more.”
Frugal Invention and Medical Technology in China
“There are two Chinas: one fancy, one frugal, “The Economist reported: “Ronald de Jong of Philips, a Dutch multinational, reveals that his firm sold more high-end CT scanners in China last year than it did in America. But mindful of China’s big push to extend health care into rural areas, Philips has also made numerous local acquisitions. He says the chief benefit is access not to cheap labor but rather “to a culture of frugality.” [Source: The Economist, January 20, 2011]
“Omar Ishrak of GE argues that the term “frugal innovation” understates the revolution under way, in which price is only one element. In designing new products, firms in emerging markets are leapfrogging to the latest technologies, such as miniaturization, mobile communications and advanced materials. That enables them to build devices that are both cheaper and better than rich-country models. He cites the example of Brivo, a locally developed line of MRI and CT scanners.”
“All very impressive. But Chinese firms are not going to take over the medical-technology market just yet. They are good at making relatively simple devices and strong in non-invasive fields such as imaging, but they have yet to penetrate risky and sophisticated markets such as those for implanted defibrillators, says Rajesh Parekh of McKinsey, a firm of consultants. What is more, says Rachel Lee of the Boston Consulting Group, the in-country laboratories set up by foreign firms are doing better at cutting-edge research than are their local rivals, which are focused on development. That suggests that Western firms still have a few years to master frugal innovation — and import it to their home countries — before the Asians arrive.”
Several Western firms insist that this is precisely what they are already doing. They trot out a few colorful examples of frugal products they offer in rich countries. But careful scrutiny reveals that such examples are rare. A disarmingly honest Mr Ishrak of GE explains that America’s risk-averse regulators and its complex systems of financing health care are a problem, but he adds that “manufacturers are also to blame.” The sales and distribution systems at firms like his, set up to sell $100,000 scanners, are ill-suited to sell versions at a tenth of that price. Also, he confesses, makers “do not present comprehensive evidence of value”; rather, he thinks, they rely on “an emotional kind of sale”.
Unusual Treatments and Medicines in China
People drink heated apple vinegar to clean the stomach. In the 1960s, million of people went to hospitals to get injections of chicken blood extract in hopes that it would extend their lives.
People with spinal chord injuries are sometimes treated with the mucous cells from aborted fetuses. In the treatments patients are injected with cultured cells — collected from the noses of the fetuses — into an area around the injured areas of patients with spinal chord lesions. Although the legality and effectiveness of such transplants have not been worked out doctors who do the treatments claim they helps regenerate nerve cells of the spinal chord and help patients regain some feeling and movement. The procedure is carried out by a doctor at the Medical Science Hospital in Beijing. Many foreigners with spinal injuries travel to Beijing for the treatments.
Urine is used to extract steroids, pituitary hormones and sublimated hormone crystals used in endocrinology. The Chinese have been using human urine for medicine for thousands of years. In ancient China it was used it to treat a number of conditions, including impotence, hypogonadism and dysmenorrhea. More recently hormones taken from urine has been used to straighten out hermaphrodites. [Source: Paul Theroux]
Urine is collected for medicinal uses and fertilizer in 65-gallon drums. . Theroux saw a sign over a urinal at a public restroom that read "We would like good quality urine, so please do not put anything in — no spitting, no paper, no cigarette butts."
Caterpillar fungus, See Tibet
Health Gurus and Medical Fraud in China
Health gurus attract large crowds at local arenas, stadiums and legislative halls. One guru described by the New York Times wore and grey suit and stood before a flower-decked table for two hours, telling a large crowd “Comrades! Take care of yourself, teach yourself, liberate yourself, love yourself...health is gold and the key is in your hands.” Among the things he told his listeners were to drink a liter of milk everyday to make you “taller,” “smarter” and give you “better skin,” eat tomatoes to “ward off cancer,” and walk:. “the best exercise.” He then encouraged people to buy his book.
Journalists Fang Shimin and Fang Xuanchang have investigated Xiao Chuanguo, a urologist who invented a surgical procedure aimed at restoring bladder and bowel functions in children with spina bifida, a congenital deformation of the spinal column that can lead to incontinence, and when untreated, kidney failure and death. [Source: Andrew Jacobs, New York Times, October 6, 2010]
In a series of articles and blog postings, the two men uncovered discrepancies in Dr. Xiao’s Web site, including claims that he had published 26 articles in English-language journals (they could only find four) and that he had won an achievement award from the American Urological Association (the award was for an essay he wrote).
But even more troubling, they said, were assertions that his surgery had an 85 percent success rate. Of more than 100 patients interviewed, they said none reported having been cured of incontinence, with nearly 40 percent saying their health had worsened after the procedure, which involved rerouting a leg nerve to the bladder. (In early trials, doctors in the United States who have done the surgery have found the results to be far more promising.).
Fang Xuanchang told the Los Angeles Times, “The doctor boasted an 80 percent success rate with 100 patients, but only nine of the 70 people we contacted said they were helped. A third had lost use of their leg.” [Source: John Gliona, Los Angeles Times, August, 2010]
Dr. Xiao was incensed. He filed a string of libel suits against Fang Shimin and told anyone who would listen that revenge would be his. In summer of 2010 both men were brutally attacked on the street in Beijing — Fang Xuanchang by thugs with an iron bar and Fang Shimin by two men wielding pepper spray and a hammer. When the police arrested Dr. Xiao in September 2010 he quickly confessed to hiring the men to carry out the attack, according to the police report. His reason, he said, was vengeance for the revelations he blames for blocking his appointment to the prestigious Chinese Academy of Sciences.[Jacobs, Op. Cit]
Despite his confession, Dr. Xiao’s employer, Huazhong University of Science and Technology, appeared unwilling to take any action against him. In the statement they released, administrators said they were shocked by news of his arrest but said they would await the outcome of judicial procedures before severing their ties to him. [Jacobs, Op. Cit]
Evan Osnos wrote in The New Yorker: “With the Chinese health-insurance net in tatters, patients are increasingly desperate. In the hutongs of Beijing, and in small towns across China, I’ve watched crowds of older citizens huddled around silk-tongued sidewalk heath-tonic vendors, with headsets and merchandise that can be hustled away when the cops arrive.” [Source: Evan Osnos, The New Yorker, April 20, 2010]
Mung Beans and the Bogus Doctor
There was also a run in mung beans — little green beans — after a television guru claimed they had miraculous health benefits. Their price doubled.
Zhang rise to fame began in 2000 when he started selling health care products and teaching Chinese medicine. In 2007 he published a book called “Diseases You Have Eaten” — mostly recipes based in mung beans, radishes and eggplants — which sold more than three million copies. Through television shows, DVDs and a best-selling book, he convinced millions of people that raw eggplant and huge amounts of mung beans could cure lupus, diabetes, depression and cancer. Long lines formed at his clinics, where treatments cost around $450. Patients were told they would have to wait two years to see Zhang even though he saw 50 patients a day.[Source: Andrew Jacobs, New York Times, October 6, 2010]
Evan Osnos wrote on The New Yorker website: “Patients traveled from around the country for the treatments. Well-heeled devotees could get in for an emergency session by paying five thousand yuan, or more than seven hundred dollars.) More often than not, the great man’s advice was consistent and easy to remember: eat mung beans — bushels and bushels of them, sometimes more than five pounds a day.”
When the price of mung beans skyrocketed Chinese journalists uncovered that many of Zhang’s claims were bogus. Contrary to statements he made in his website, Zhang, was not from a long line of doctors (his father was a weaver). Nor did he earn a degree from Beijing Medical University (his only formal education, it turned out, was the brief correspondence course he took after losing his job at a textile mill).
Wuben Eric Mu wrote on Danwei, “He claimed his family to be “aristocrats” of Chinese medicine and that he started to study Chinese medicine with his father from the age of six”. As if this Chinese medicine family background is not convincing enough, the bio page of Zhang’s website claims that he graduated in 1981 from China’s then most prestigious medical school, Beijing Medical University, the predecessor of Peking University Medical School”. Then Zhang’s critics discovered that both he and his father were workers in Beijing Weaving Factory and his experience with Beijing Medical University was limited to a short-term night course. His purported possession of an “advanced level nutritionist” license was denounced by the Ministry of Health. On one occasion, Zhang’s father claimed that he had no idea where his son learned his trade.”
Worried about the impact on inflation, the government responded to mung bean run by discrediting the guru, Zhang Wuben, declaring he lacked medical qualifications, and arranginghis disappearance. And, as fast as he emerged, Zhang and his mung beans lost their magic. By May, Chinese newspapers were full of stories about his rise and fall.
Image Sources: Wikicommons, Nolls China website
Text Sources: New York Times, Washington Post, Los Angeles Times, Times of London, National Geographic, The New Yorker, Time, Newsweek, Reuters, AP, Lonely Planet Guides, Compton’s Encyclopedia and various books and other publications.
Last updated September 2022