VZCZCXRO2610
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 
 
 
¶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 
 
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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. 
 
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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 
 
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Secretary's request, Dr. Peng felt the Secretary's pulse, and 
 
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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. 
 
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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. 
 
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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