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Coronavirus, China: the healthcare crisis

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Coronavirus, China: today we are fully witnessing the crisis in the Chinese health system. So, instead of looking for unreal conspiracies, let’s analyze its inefficiencies

Coronavirus, China: the healthcare system crisis

Medical workers hug at the Wuhan Tianhe International Airport after travel restrictions to leave Wuhan, the capital of Hubei province and China’s epicentre of the novel coronavirus disease (COVID-19) outbreak, were lifted, April 8, 2020. REUTERS/Aly Song

The country where all this has begun is not among the ones which are best managing the current crisis: some observers, for a while, have been impressed by the Chinese forceful methods, and they suggested that maybe a dictatorship would dispose of better instruments to defeat a pandemic. The authoritarian nature of the Beijing regime, however, has imposed to its people much more brutality than necessary, despite the health emergency.

It is quite difficult to recall what happened in China, because of the strict control that Beijing wants to impose on the available information – an effort to which Chinese authorities seem more committed to than containing the virus spread. In trying to analyse the Chinese answer to the crisis, it is inevitable to come upon remarkable dark spots, confirming that Beijing government consider as crucial to manage what its population knows, and how it uses this knowledge.

What we can certainly reconstruct, however, is that China – and in particular the Hubei region, the core of the disease – has desperately tried to repress the Covid-19 pandemic, also silencing the healthcare personnel trying to raise the alarm. It appeared clear very soon that this was not possible. Therefore, after the first arrests, the Chinese authorities committed the country to a lockdown without precedents – both for dimensions and for strictness.

All the healthcare system’s issues which emerged in the last years have showed that it is no more possible to postpone a deep healthcare reform. One of the most serious questions, since a long time, is represented by the violence on the healthcare personnel, both by the patients and these lasts’ relatives. Last December, before the pandemic outbreak, Chinese authorities had finally passed a law to protect the health personnel from threats and abuse, following another victim – a doctor stabbed to death in Beijing.

There have been so many cases of doctors killed by patients or by these lasts’ families, that some of the best national hospitals started to teach self-defence technics to their personnel. Tragically, the law dedicated to their protection will be valid only in June 2020, while the extraordinary flow of people in the hospitals cause a large potential of abuse on the medical personnel. There are many causes of the rage and the violence against the health personnel, but these must be reconducted to intrinsic deficiencies of the system itself. The most serious issue is represented by the insufficient investments, which brought to a series of medical mistakes, due also to an inadequate education.

Furthermore, we have to consider the growingly numerous cases of corruption within the hospitals, a lack of communication between doctors and patients, and, again, a type of relation with media which did not prove itself able to diminish the existing tensions. The press, entirely controlled by the government, is continuing to spread triumphalist and excessively positive news, the effect of which is only the creation of unrealistic perspectives among the patients’ relatives – who in turn react with also deadly violence once they meet these perspectives with the real situation.

The disappointment is even worsened by the high costs of medical treatments: the incomes’ necessity brings many doctors to prescribe tests and analysis not entirely necessary – but expensive – leading many families to go into debt trying to cure their relatives. The disease is still one of the main causes of debt for entire family units since most treatments are paid since the State subsidies for the public hospitals are insufficient to cover the costs and cannot guarantee a minimum service.

Furthermore, there is also the frustrating awareness that a parallel system exists, where all the public hospitals disasters disappear: a system represented by the clinics for the high Party’s officials, where are present medical instruments unthinkable for the common hospitals – and accessible only for the more privileged.

However, besides the emerging of this series of postponed issues, it is difficult to say certainly what is happening in the country, and how much is possible to trust the official numbers on contagions, recoveries and deaths.

This difficulty is not only due to Beijing’s love for the inviolable official secrets, but also to the contradictions presented by the government structure. These lasts lead many Party’s officials to make many efforts in trying to delay the transmission of bad news, in order to not compromise their career advancement chances. After the Wuhan disaster, we know of the existence of second big outbreak in Heilongjiang province and in its capital, Harbin, but even the WHO, which did so much to shield China from critics, it has not been invited in the country for an on the ground investigation.

The pandemic began with arrests – such as the one of the doctor Li Wenliang, died from Covid-19, and now transformed by national propaganda into an hero who died for motherland – and is going on with arrests: activists able to avoid Internet checks, victims relatives and their lawyers – who tried to denounce the authorities for negligence –, and even volunteers who made any effort to contain the health emergency, now spreading a version of the events openly contradicting the official one.

While China and the rest of the world argue and make each other accusations, the ones who are risking more are the Chinese citizens, especially the ones brave enough to speak with the international press also during the worst days of the pandemic. The only certain proof that the most dangerous wave of contagions has really been controlled is represented by the fact that China has announced the dates for the annual full session of the National People’s Congress, which was supposed to be held in March and has been postponed to May.

It would have been very hard to imagine that the Party would have had put at risk the health of the national delegates, authorizing them to travel to Beijing, if the situation would still have remained dangerous. The appointment was supposed to be solemn, in preparation of one of most important China’s anniversary for the President (and Party Secretary General) Xi Jinping, that is the centenary of the foundation of the Communist Part, the 1st of July 2021.

The pandemic has already prevented Xi to ask to all the delegates to make efforts in order to reach an economic growth that would lead to a doubled GDP in comparison with the 2010 one.

It is not possible to exaggerate the importance of this anniversary for Xi Jinping: it is not casual that the confrontation with the US is not led by him, but by other government and diplomatic representatives. For Xi, the centenary must be his triumph, the triumph of the Chinese Dream began with his mandate. The pandemic outbreak has already hampered him, leading not only to an unprecedented health crisis, but also to an economic blow which is not going to be short-termed. The harshness of the reaction against internal and external critics has to be seen precisely as a way to maintain a strict control, at a time when this very control is getting out of control because of force majeure.

This article is also published in the June/July issue of eastwest.

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@IlariaMariaSala

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