“By killing little kids, the most valued elements of society, you’re rejecting the most basic of social norms,” said Michael Phillips, a Shanghai-based psychiatrist who serves as the executive director of the World Health Organization’s Collaborating Center for Research and Training in Suicide Prevention and is also a professor at Emory University in Atlanta. “It’s an utter rejection of humanhood. It really makes you think it’s more than someone who’s just angry.”

Mental-health experts speculate that the attackers have used knives and other household objects as weapons because of the difficulty of obtaining handguns in China.

Mental illness is heavily stigmatized in China, and the psychiatric system tends to treat only the sickest of the sick, mental-health experts say. Prevention or early diagnosis of disorders is rare, though there is some effort under way to improve on this and other aspects of mental-health care. For instance, only urban areas have psychiatric hospitals, and gaining access to them from more remote regions is so difficult that individuals with less severe forms of illness, like mild depression, rarely get treated or even recognized.China is overhauling its health-care system, and reducing urban and rural discrepancies in mental health is one of the goals.

“At the central level, there’s an increasing awareness of the importance of mental illness and I think these recent events will magnify this,” said Dr. Phillips.

Some 17% of the Chinese population, or 173 million people, has a current mental illness, according to a paper published in Lancet last year by Dr. Phillips and his colleagues based on 63,000 surveys conducted in four provinces. Overall, only 5% of those have seen a mental-health professional. But 60% of people with psychosis have received mental-health treatment at some point.

On 12 April, the Jinghua Times published an article entitled “Closure of Beijing’s First Day Care Center Causes Embarrassment for the Aging Industry.” The article reads,

In Beijing the first elderly day care center, Shijingshan Apple Valley Street Elderly Day Care Center, recently declared that it would close. However, as this occurred, community based day care centers were sprouting all over the city due to government support.

The number of elderly day care centers has currently reached 2,484. Some are supported by community level cadres and government, and others struggle to pursue market driven growth. These types of care centers are important components of Beijing’s elderly care infrastructure. However, these 2,484 care centers and the recently closed center in Apple valley are, in nature at least, not all that different..

In truth, the Apple Valley Care Center’s model was unsustainable, and would not have survived longer. When the local government established this center, there was no support in terms of preferential policies or funding, and the center was instead dependent on the sub-district’s own resources. The elderly did not have to pay anything to enter, yet the center still hired two workers in charge of cleaning and door-keeping. As the policies concerning public finance underwent reform, funding requirements at every level of government became increasingly strict and “the day care center found it very difficult to secure any funding.”

There has now emerged another model which may prove more sustainable elderly care centers that rely on community service centers for resources, and mostly offer the elderly a variety of recreational activities. The spokesperson for the Beijing Aging Committee Ms. Yunfeng Yang stated that the centers “primarily offered the elderly a chance to be active in the community, which helped ease their loneliness.”

The incentive for becoming “reliant on the community’s service centers” is that having this source of support greatly reduces an elderly center’s costs. The Fuxue Community Neighborhood Center of Dongcheng district is representative of this model, as is the largest single chunk of centers among the 2,484 registered in Beijing. However, this model can only address the needs of seniors who are relatively healthy and independent, while many who are dependent on others for care or those who cannot be active without assistance are excluded from their services.

“Some residents brought their elderly family members in wheelchairs asking if they could leave the senior at the center and pick him up in the evening,” the center’s management said. “One problem is that the facilities are not adequate, and in addition there are not any professional care personnel. What happens if the elderly falls and is injured? Who will take responsibility?”

Ms. Yang stated that recreational care centers primarily accept healthy and independent seniors. She added that the community’s activity centers are a place specifically for the elderly.

According to the models prevalent in countries such as Western Europe and Japan, the target of elderly day care service can be divided into three groups: first are healthy and independent seniors, second are seniors who need some assistance and require a degree of care, and thirdly are seniors who cannot function independently and have often been diagnosed with numerous chronic diseases.

For the first group, the care centers primarily offer a platform for social interaction, and group recreational events. In developed countries where the population is not densely populated and where there is little interpersonal interaction out on the street, this type of service offers seniors a safe space for activities and engagement, and for them it is an invaluable service. However in China, urban areas are densely populated and many of the residential communities already have public or common space, resulting in rather friendly relations between neighbors or at least offers a space that facilitates interaction. Healthy seniors do not need to pay a fee and go to a care center to participate in social activities, so why would they need a closed area that restricts the range of their activity? Not to mention that the “senior activity centers” and “senior day care centers” as well of the activities they offer are unattractive, and often became known simply as “decorative projects,” a title given to some of the large elaborate initiatives that earn a lot of “face” for some officials but end up written-off as non-performing projects.

For the third group, there needs to be someone to provide complete care but it appears that the only options that fulfill this demand are either nursing homes or for the seniors to stay in their own homes rather than moving back and forth everyday. This group is more suited to in-home care, and would greatly benefit from having professional caregivers providing care in their own homes. Even if families are willing to consider these day care centers’ service, the lack of professionally trained staff would prevent the centers from accepting these seniors. The activity centers model has already excluded such dependent participants.

The second group, the group that needs partial assistance, seems be the right target for elderly care centers in China. What this group needs most is not to find a place for recreation or to pass time, but an opportunity to improve their physical and mental situation as well as improve their quality of living. From the perspective of an aging person, one should ask oneself this question: if everyday I go to the same place (and this place by chance happens to be unappealing) where there are no new or exciting activities (aside from playing cards or reading), and if there are no beneficial effects, even if I could go for free would I really be willing to go? Alternatively, if I could go to a place not necessarily everyday but on a regular basis, a place with professional, enthusiastic and reliable caregivers who use a series of different exercises for physical and mental well-being, and who can help me recover some of my abilities for independent living, might this be a more attractive option?

Regardless of what service is provided, it requires a market orientation and from the perspective of the user, there needs to be tangible value offered through the service. Only by offering something that is truly valuable to the user, can this type of service achieve real long-term sustainable growth. Currently, the over two thousand care centers lack a clear goal and offer little concrete value, and it is of little wonder why these centers have floundered. Through a simple calculation, one finds that even though every center may only invest 50,000 RMB (although the actual amount may very well be more than this), there is an estimated one hundred thirty million in funds that had perished in the process, and many elderly have not see any benefit. Who should be responsible for the efficiency of these public funds?

The difficulties encountered by elderly care centers reflect a discomforting reality in China’s elderly care industry. From policy formation, service design, implementation to quality control, there are still too many areas of weakness that need to be addressed. Potentially, the publication The Innovator’s Prescription could give us some inspiration to find a solution here. The book draws a parallel between the healthcare industry and personal computers. In the dawn of the technological revolution, the true visionaries did not simply target the existing market for large computers manufactured for research purposes, but recognized consumers’ latent demand for personal computers (see the author’s conceptual model). Similarly in elderly care centers, the real opportunity might lie in the group that is currently not using elderly day care services (non-consumers) who are a much larger group than current users (consumers), and in addition are a group with much simpler demands to satisfy. To begin with, a simple solution would be to create day care services tailored to the most urgent nursing care needs of seniors with willingness-to-pay rather than the wishful thinking of making self-sustainable activity centers.

Thank you nozomiiqel for your wonderful Flickr photo stream.

North Korea: For the record. A Japanese news source reported that the reason Kim Chong-il was to go to China was for a kidney transplant. According to the report, an unnamed but renowned Japanese kidney transplant surgeon was contacted to perform the surgery in Beijing. The surgeon replied that it was not possible on such short notice.

Comment: North Korean media continue to report Kim’s public appearances at a wide range of activities, but those are likely to be body doubles. No two hairs lines are ever identical in the photos. In addition, he supposedly is making more public appearances since his stroke last year than he ever made when he was much healthier. Cumulatively, the data seems to weigh in support of the less frequent reports of his declining health.

I’m wondering if anyone has ever put together a list of leaders who visit other countries when seeking healthcare.  I’m betting that such a list would correlate nicely with the list of countries at the bottom of the world’s development rankings.

I’m thinking that this flickr picture taken by Eric Lafforque sums up N. Korea’s healthcare situation nicely.  And that the picture below at Pyongyang Maternity hospital may not be representative of N. Korea’s healthcare capacity.  Actually, I’m starting to suspect that the lab technician may, in fact, be short order cooks.

Dear Beijing Healthcare Forum,

In the wake of the earthquake that rocked Qinghai on Wednesday, a group of local NGOs have set up a relief consortium in Xining called Yushu Earthquake Response (YER). They are looking for doctors, nurses, and others with medical expertise from within China who could help in Jyeku/Yushu to supplement government relief efforts. If medical personnel can get to Xining, this group expects to be able to arrange permissions for them to proceed to the area. Medical volunteers should bring whatever equipment they can carry plus cold-weather clothes. Current reports say additional medical expertise is urgently needed.

For further information for any one who might be able to get to Xining, please contact Mr. Chris Jones, cc’d above (ph 187 8363 6805), or teacher Tashi yushuearthquakeresponse@gmail.com.

Please let Mr. Jones know if you have further questions or if additional information is needed.

Best,
Jared Glanz-Berger & Ray Deng

高志忠和邓腾

http://beijinghealthcareforum.com/

http://groups.google.com/group/beijinghealthcareforum

Wave of Anger Rises Over Vaccine Scandal
By Mitch Moxley

…On Mar. 17, the Beijing-based ‘China Economic Times’, a business and finance newspaper published by the state-run Development Research Centre, reported on alleged irregularities and safety concerns within Shanxi’s immunisation programme.

The expose said that improperly stored vaccines administered by the provincial Centre for Disease Control and Prevention (CDC) for encephalitis, hepatitis B and rabies between 2006 and 2008 had killed four children and made more than 70 others ill. People were exposed to the faulty vaccinations as late as March 2009.

The six-part series, which took six months to compile and includes interviews with families of 36 victims, has snowballed into a nationwide scandal involving children’s health. The ‘Times’ alleged that the vaccine provider, Beijing-based Huawei Shidai Co, began charging citizens for vaccines that should have been administered for free, and raised the price of other vaccines.

The report also charges that Li Wenyuan, former Shanxi CDC director, used more than half of the funds from Huawei’s initial deposit to buy a new car for his private use…

…The local government launched an investigation into the scandal, which was assisted by a group sent by the Ministry of Health and experts from other provinces. A week later, the Chinese Medical Association sent a team of eight experts to Shanxi, Xinhua reported. Meanwhile, the provincial food and drug administration launched an inspection campaign on vaccine quality and safety in late March

Kaiser Kuo and Other China Watchers Discuss on Sinica Podcast [Audio]

Welcome back to the Sinica Podcast, a roundtable on current affairs in China featuring China-watchers from a wide range of backgrounds. In this week’s installment host Kaiser Kuo talks about China’s delicate maneuvering in the Middle East, as well as the recent health scandals to emerge around the vaccination of children in Shanxi and Jiangsu. Our guests this week include Bill Bishop, a tech entrepreneur and blogger at DigiCha.com and Sinocism.com, along with public relations expert William Moss, who writes the blog Imagethief.com.

China says probing report on deadly faulty vaccines
By Ben Blanchard

“(We have) immediately begun an investigation and demanded the Shanxi health authorities report as soon as possible any new abnormal reactions to the vaccines,” it said in a statement on its webside (www.moh.gov.cn) late on Wednesday.

State news agency Xinhua quoted Li Shukai, deputy head of the Shanxi Health Department, as denying the accusations. The ministry added that earlier reports about bad vaccines had prompted checks in November 2008, but that it had found no problems.

Rare complications can happen with any vaccine and it is usually hard to pin down the reason, which may relate to the quality of the vaccine or the person’s own immune system. The proper storage and refrigeration requirements for many types of vaccines sometimes present a problem when they need to be transported across vast distances.

The reporter who wrote the story, Wang Keqin, told Reuters he stood by his piece, saying it was the result of months of thorough investigation. “What I wrote was based on evidence,” Wang said.

China, often called the world’s factory, is struggling to convince a sceptical domestic and global audience it has won a battle to improve safety standards after scandals involving everything from pet food and dumplings to cough syrup.

In 2007, China executed former drug and food safety chief Zheng Xiaoyu. His misdeeds led to approval of many medicines that should have been blocked or taken off the market, including six fake drugs, a court found.

Two Chinese drug makers reject faulty vaccine scandal reports

Xinhua: Two Chinese vaccine makers Thursday confirmed they have shut down operations after their rabies vaccines were found to be substandard.

The State Food and Drug Administration (SFDA) announced in December that a total of 215,800 units of rabies vaccines made by Jiangsu Ealong Biotech Co. and Hebei Bioforwell Co. from July to October 2008 had quality problems.

The agency had ordered the two companies to halt production and sales.

The confirmation came after media reports saying Ealong Biotech had resumed production and seven executives had been detained. Reports said the company had mixed an additive with the vaccine to reduce costs, leaving as many as 1 million people affected nationwide.

Some local newspapers even reported that deaths or illness were likely caused by the faulty vaccines.

Yan Jiangying, the SFDA spokesman, said the SFDA was yet to release investigation results as the probe was still underway.

But Yan said people needed several injections to build up immunity as the 180,000 units of vaccines made by Ealong Biotech were not as effective as required by the drug watchdog.

Liu Wu, general manager of Ealong Biotech, said the faulty vaccines may not provide protection against rabies as they were not up to national standards.

But Liu said “We have not received any reports on adverse reactions in people receiving rabies vaccine shots.”

Liu also denied there were 1 million people affected, saying each person should receive five injections, or one unit, rather than receive one injection of each unit.

The company had not produced or sold even one dose of rabies vaccine since Nov. 30, Liu told Xinhua.

It also halted production of the A/H1N1 flu vaccine in February when the quality permit expired, he said.

Liu also denied that seven company executives had been arrested and that they had put an additive in the vaccines.

Ealong Biotech is the nation’s fourth-largest rabies vaccine maker with a market share of 11 percent. It took orders from the Chinese government for 6.3 million doses of A/H1N1 flu vaccines in 2009, ranking third nationwide.

Wang Kejing, deputy director of the food and drug administration in Sanhe city, where Hebei Bioforwell Co. is located, said the company had not sold even one dose of vaccine since April last year.

Hebei Bioforwell Co., which only produced rabies vaccines, had been shut down for rectification. It said earlier that all the faulty rabies vaccines had been used, but they had received no reports of adverse reactions.

In the northern Shanxi province, almost 100 children had died or fell ill after taking shots of vaccines for encephalitis, hepatitis B and rabies, the Beijing-based China Economic Times reported on March 17.

The Ministry of Health has launched an investigation into the case after media exposure.

NYTimes: Report Says China Sold Bad Vaccines to Hospitals By KEITH BRADSHER

HONG KONG — A newspaper article by one of China’s best-known investigative reporters has reawakened a controversy over whether provincial authorities improperly stored vaccines in rooms without air-conditioning, rendering them ineffective, and then let them be administered to children.

China’s Health Ministry said Thursday that it would look into the report, by Wang Keqin in The China Economic Times, while cautioning that it examined the evidence in late 2008 and did not find a widespread problem.

But Chen Taoan, the former chief spokesman of the Shanxi Province Disease Control and Prevention Center, who is still on the center’s staff, said Thursday in a telephone interview that a senior official there was relieved of all responsibilities at the end of last year because of improprieties related to the vaccines.

Mr. Chen said that the center, which is part of the Shanxi Health Department, had required all hospitals in the province to buy vaccines at steep prices. To monitor compliance by the hospitals, the center put a sticker on each package of vaccine to show that it had been approved.

But the stickers would not adhere to the packages in air-conditioned rooms, Mr. Chen said, so through 2006 and 2007 the center routinely had the vaccines transferred to a warm room where the stickers were attached.

“I saw boxes and boxes of vaccines piled up high like a hill in a hot room without air-conditioning,” he said. “Over the course of two years, I complained more than 30 times to the center’s leaders that these vaccines were no longer effective.”

Mr. Chen said that he was still on the center’s payroll but that he had been relieved of his duties because of his objections to the handling of the vaccines. The center stopped exposing them to heat in 2008 but did not issue a recall for those that might have already been damaged, he said.

The press office of the Shanxi Health Department declined to comment, saying that it had already made a statement to the official Xinhua news agency. Xinhua reported that Li Shukai, the deputy director of the department, had said that the China Economic Times article was “basically not true.”…

Editorial urges more action on vaccine scandal

Fearing that this story will be taken down, I have reproduced full text below.

By David Bandurski — The lead editorial in Saturday’s edition of Southern Metropolis Daily pushed for further investigation into the vaccination scandal in Shanxi Province, a story broken last week by investigative reporter and CMP fellow Wang Keqin. The commentary urged the government not to “sideline” the media, which it said should represent the interests of the people by exposing facts rather than coddle the public with positive stories about how leaders are handling the crisis.

A translation of the Southern Metropolis Daily editorial follows:

Pressing the Media to Pursue the Shanxi Vaccination Scandal to End

The series of China Economic Times reports on the “chaotic situation of vaccinations in Shanxi” has given rise to a very strong reaction. On the one hand, our hearts ache for those children who were harmed; on the other hand, we feel great indignation over the acts of collusion and profiteering by officials and businesses that lie in the background. Naturally, while the emotions of the public are cresting, Shanxi’s Provincial Health Department has categorically denied the “allegations.” Reading the China Economic Times report, people understand the seriousness of the problem. After seeing the “clarification” issued by the Shanxi Provincial Health Department, they might suppose the problem is not so serious. But there is only one version of the truth. So how serious is the problem?

Looking carefully at the two versions, it is clear that the most disputed question is whether the illnesses suffered by the children already recorded on the list [in Wang Keqin's report] were in fact related to vaccinations. On this point, the China Economic Times and the Shanxi Provincial Health Department are not too far apart on their basic facts. It’s just that former holds that “the illnesses are clear, but they cannot be spoken of, no one dares speak [the truth], and in no area of Shanxi are the doctors willing to tell you the true cause of the illnesses.” The latter, meanwhile, resorts again and again to provincial medical experts who insist the illnesses are not connected to vaccinations.

The point here is that the core question has now become whether the opinions of health experts in Shanxi Province can be seen as reliable. Will is be possible for doctors from other areas to conduct their own investigations, or for those [doctors] in Shanxi who don’t dare speak the truth about the cause of the illnesses to stand up and come clean about the pressures they have faced [to keep quiet]? If we really hope to learn the truth, this will require the disclosure of more facts, and more investigation will be
needed.

Another important focus of the case concerns the relationship between the Huawei company [which controlled the local market for vaccines], the Shanxi Provincial Center for Disease Control and the Shanxi Provincial Health Department. It is clear from the China Economic Times report that a large number of facts support the conclusion that Huawei is a shell company melding business and politics for monopoly control of the industry to generate windfall profits. But the explanation given by the Shanxi Provincial Health Department for the “exposure of vaccines to high temperatures” is to say that the Ministry of Health has already looked into the problem and found nothing. As for the tagging of [Huawei] monopoly vaccines [with a provincial standard], the explanation given is that only in this way could they take responsibility for their own vaccines . . .

All this beating around the bush gives people cause for skepticism. Moreover, when it is the Shanxi Provincial Center for Disease Control that steps out to answer these questions that concern the center itself, when there are no statements from third parties — how can this sort of “clarification” be seen as credible?

Perhaps that report from China Economic Times on the “chaotic situation of vaccinations in Shanxi” is not 100 percent perfect, because the full facts no doubt have yet to be revealed. For example, we still need medical experts from outside Shanxi to make a determination about whether the illnesses from which these children suffer are related to vaccinations. And we need to know from what direction the pressure on doctors within Shanxi has come. We need also to know what relationship Li Wenyuan (栗文元), the head of the Shanxi Provincial Center for Disease Control, has to the company Huawei. We need to know why Li Shukai (李书凯), deputy head of the Provincial Health Department, would say publicly that a shell company with no business qualifications is “a company of the Ministry of Health, a large company that specializes in the distribution of vaccines.”

The report leaves many questions unanswered, which relevant departments in Shanxi Province must come out and address. And other media need to continue to follow-up and make further discoveries, until the full truth has been revealed. This is not the time for the media to “make light of matters.” This is the time to get to the bottom of things.

If the government wishes to deal with a major issue, and to set the public at ease, the only way is to step out and address their questions, to offer up the truth and hold those responsible to account. These matters concern the safety of the public, and particularly the safety our our children — it is not something that can simply be glossed over with vague explanations.

Many people have compared this vaccination incident to the poisoned milk scandal [of 2008 and 2010]. Only when poisoned milk emerged [as a problem] again this year did people realize that the problem was never really dealt with properly. Looking back on that shocking tragedy, we in the media feel a deep sense of guilt that matters were never fully dealt with at the time, that the people and chains of interest behind the affair were never fully held to account, and that the media was unable to pursue the issue of compensation for the victims [of the milk scandal].

To a certain degree, the reason the poisoned milk scandal could not be cleaned up all at once was because the media were unable to pursue it to the end — and the sidelining of the media meant the sidelining of the public. When we look back on other “major incidents” we find without difficulty that every time an ugly case causes broad public concern and mass anger, the media’s investigations come to a screeching halt. All we have then are reports about how “the situation is being handled,” so that the full facts behind the case are never discovered.

It’s as though the media only responsibility is to discover problems, after which the people cry out, drawing the attention of the government. And then [we are to suppose] the problem is solved!

Quelling the situation is the government’s responsibility. But the media must learn to push ahead and get to the bottom of the situation. Because the media’s obligation is to the truth. Because only when eyes are present to question the truth can we ensure that the handling of this situation has been clean and adequate. Because only when the full truth has been laid before the public can the public feel safe and secure. We press the media to push ahead and get to the bottom of the matter, because this is the best and surest way to calm the situation down.

Full Chinese Text of Article via China Media Project

山西，近百名儿童不明病因致死、致残或引发各种后遗病症。家长伤心欲绝、四处求治、负担沉重。导致如此惨剧的病源何在？锲而不舍的患儿家长纷纷质 疑:“接种了乙脑疫苗怎么又会得乙脑？”“急性播散性脑脊髓炎难道不是接种疫苗所致？”……矛头直指用来保障人民生命健康的——疫苗！

问题究竟出在哪里？难道真的和每个人都必须接种的疫苗有关？

在山西，事关千千万万儿童生命安全的疫苗到底出了什么问题？

近百孩子不明病因致死致残

——山西疫苗乱象调查之一

本报记者王克勤

“永别了！我的孩子”

“永别了！我的孩子。”

31岁的山西省柳林县农民王明亮，看了自己9个月的儿子最后一眼，拖着已被雨水淋透的身体离开了北京香山植物园。

这是发生在2008年8月22日的一幕。

当天凌晨3时许，王明亮将整整抢救了6个多月，最终死于进京求医招待所中的孩子送到就近的香山植物园。

在给路人留下一封请求帮忙安葬的信之后，王明亮带着“不知哭晕过多少次的”妻子，回了山西老家。

四个孩子不明病因死亡

这个名叫王小儿的孩子，是王明亮唯一的儿子。2007年11月24日，王明亮盼来了“自己的命根子”。孩子出生当天，医院即为新生儿接种了卡介苗、 乙肝疫苗。剖腹产子的同时妻子做了绝育手术。

孩子满月后不久，2008年1月2日下午，柳林县柳林镇青龙村卫生所医生杨桂兰来到王明亮家，为孩子接种了第二次乙肝疫苗。

一周后，“孩子开始抽搐，不断出现，我们以为可能孩子冷着了。”

一个月后，“大年初三的晚上，吃完奶后，孩子便开始呕吐，两个眼睛往上翻，脸上、身上发青。”

正月初四，即2008年2月10日1时许，孩子被送到吕梁市人民医院抢救。入院病历上写道:“继而呼吸暂停，微弱，面色灰白，频繁惊厥，发作时面肌 颤动，口角抽动……”医院开出了《病危通知书》。

救治11天后，“控制不了抽搐，呼吸困难。儿科副主任高兰芳专程护送孩子到山西省儿童医院。”王明亮说。

该院的出院诊断为:吸入性肺炎伴中毒性脑病。

在山西省儿童医院住了36天后，医生讲，能做的检查都做了，就是找不到病因。2008年3月26日晚，山西省儿童医院神经内科主任医师韩红偕同一名 护士，一路护送孩子赴国内神经内科最权威的北京大学第一医院。

在北京大学第一医院住院6天后，主治医生熊晖通知王明亮:“我们也找不到病因，没有办法了，你们回家吧。”出院诊断:癫痫，多发性部分运动性发 作，部分性发作持续状态，遗传代谢病？

“西医不行，中医治！”有亲戚向王明亮推荐了北京香山医院的中医牛志刚，但无法安排孩子住院。王明亮只好带孩子回村，接受牛志刚医生的远程治 疗。

2008年8月15日，看到孩子病情恶化，王明亮与妻子一起抱着孩子来到北京香山医院。然而，“这成了孩子生命中最后的一站”。

与王小儿一样，经历过“接种疫苗——抽搐、发烧等——救治——诊断不明——死亡”的孩子，在山西境内记者还发现了3人。

他们分别是:长子县南陈乡善村的刘紫阳，来到这个世界仅仅8个月，便因“过敏性紫癜”死亡。还有阳泉市平定县县城南苑人家9号楼二单元的王仕超 与阳泉市郊区义井镇泊里村的刘一，这两个男孩死亡时都仅仅三岁半。死亡的时间相差一年，一个是2008年10月死亡，另一个是翌年8月死亡。死前他们都曾 被狗咬伤，均接种了狂犬疫苗，且都是在接种第4针次后，出现发烧、抽搐、呕吐等症状；均因抢救治疗无效死亡，医院给出的诊断结论均为“病毒性脑炎”。

不明原因发病者名单

记者从山西最北部的天镇县到最南边的运城市，纵横奔走，调查了解到，除上述4户家庭的孩子因病死亡外，还有74户家庭的孩子“因病致残或因病受 重大影响”。记者先后访问了其中的36户，发现他们有一个共同特点，“发病前不久，均接种过疫苗。”

现将部分不明原因发病者名单呈现如下:

燕燕（化名），女，2岁，家住大同市天镇县南河堡乡顾家湾村。目前不哭、不闹、不笑、不玩、不说、不会走路，“像个植物人一样”。

强强（化名），男，8岁，家住吕梁市交口县回龙乡回龙村出租房。家人称孩子目前会不定时地抽风。

君君（化名），男，5岁，家住柳林县县城出租房。医院诊断君君脑萎缩。

晨晨（化名），男，4岁，家住太原市寇庄西路。目前后遗症癫痫。

莉莉（化名），女，10岁，家住太原市小店区西温庄乡东温庄村。目前咬字不清，动作怪异，手、脚、头部常常不自觉抽动。

妞妞（化名），女，3岁，家住壶关县龙泉镇大山南村。目前留下肢体活动困难后遗症。

慧慧（化名），女，12岁，家住山西省高平市野川镇东沟村蒲沟。目前后遗症紫癜性慢性肾炎。

靳中逸（化名），男，17岁，家住高平市三甲镇底池村。目前后遗症头痛，时不时地发作，怕异味刺激。

玲玲（化名），女，16岁，家住临汾市洪洞县万安镇。目前后遗症癫痫。

豪豪（化名），男，8岁，家住运城市垣曲县广场路7号。目前后遗症癫痫。

蕊蕊（化名），女，2岁，家住运城市盐湖区解州镇。目前后遗症瘫痪。

病因何在

——山西疫苗乱象调查之二

本报记者王克勤

有的孩子因病死亡，有的孩子因病致残，有的孩子依然存在着这样那样的后遗症。记者所采访过的家长们忧心忡忡，许多人四处求助，寻找孩子患病的原 因，到底是什么造成了这些悲剧？

“我几乎排除了所有可能的病因”

王小儿死后，父亲王明亮开始查找儿子的死因，他向记者提出了自己的“排除法”:

孩子发病后，先后就诊柳林当地、太原、北京多家医院，做了无数检查。先后排除了“孩子大脑损伤引发的原因”，颅脑核磁共振“未见异常”，还进行 了遗传基因检查，均没有问题。“孩子出生近两个月时，都很健康。”“接种乙肝疫苗一周后，便开始抽搐了，找过的医院都查不明白，西医中医都救不了。”于 是，王明亮将质疑的目标落到了疫苗上。

经过四个月的苦苦努力，依然没有救活王小儿的北京香山医院中医大夫牛志刚，2010年2月22日接受本报记者采访时说:“这孩子发病的因素会很 多，疫苗可能也会是一个诱因。”

更多家庭的质疑

在山西，不单单是王小儿的父亲王明亮，记者见到的死亡、致残、发病孩子的家长们都在质疑与求证。

质疑之一:“接种乙脑疫苗何以又得乙脑？”

记者采访中所见到的几个孩子，交口县回龙乡回龙村8岁的强强、运城市垣曲县广场路8岁的豪豪、高平市三甲镇底池村17岁的靳中逸，均是在接种了 乙脑疫苗后发病，而后被确诊是得了乙型脑炎。

强强的父亲高长宏对记者讲:“我们给孩子接种乙脑疫苗，就是为了预防乙型脑炎，结果一接种却得上了乙型脑炎。太荒唐了！”

质疑之二:“急性播散性脑炎怎能与接种无关？”

运城市盐湖区解州镇2岁的蕊蕊和临汾市洪洞县万安镇13岁的中学生玲玲，均在接种疫苗后产生不良反应，均诊断为“急性播散性脑脊髓炎”，并落下 了后遗症。

他们的家长张海霞、易文龙认为，急性播散性脑脊髓炎又称接种后脑炎，如接种疫苗后近期患该病，就不能排除接种与患病的因果关系。他们提出了接种 疫苗异常反应与事故鉴定申请。

山西省预防接种异常反应和事故鉴定小组组织调查鉴定，结论为:与接种疫苗无因果关系，属偶合病例。

但是，运城市盐湖区疾病预防控制中心对蕊蕊的接种异常反应组织了相关调查。2009年2月24日，召开鉴定专家会议，得出结论为“不排除脊髓灰 质炎疫苗衍生病毒病例”。

质疑之三:“过敏性紫癜岂能与接种无关？”

只有七个月的刘紫阳2007年1月19日接种了乙肝疫苗后，3月1日儿科大夫诊断为“过敏性紫癜”。其父刘云斌提出质疑。

3岁的妞妞2008年8月8日接种了乙脑疫苗后，2008年9月22日突发病症，血小板减少，疑似紫癫、脑炎，而具体病因始终不明。其父贾海波 提出质疑。

12岁的慧慧2006年5月14日接种了麻疹、风疹联合疫苗后，2006年5月29日发病，诊断为过敏性紫癜。其父韦惠民提出质疑。

质疑之四:“免疫接种变态反应岂能与疫苗无关？”

4岁的晨晨接种百白破疫苗后，患“婴儿痉挛症”；其母田霞提出质疑；5岁的君君接种百白破疫苗后，脑萎缩，专家多次会诊没有断清病症，其父李常 勤提出质疑；10岁的莉莉接种流感、流脑疫苗后，语言不清，动作怪异，手、脚、头部常常不自觉抽动。其父高径提出质疑；2岁的燕燕接种乙肝疫苗后，患病毒 性脑炎，其奶奶张建云提出质疑……

求证医疗专家

太原市小店区西温庄乡东温庄村女孩莉莉的父亲高径不断到省卫生厅上访。2008年11月7日，省卫生厅组织了专家论证会，7个专家中有山西省儿 童医院神经病内科主任赵早鱼，她是山西最权威的神经内科专家之一。鉴定结论是:与疫苗接种无因果关系。

2009年12月28日，记者随同莉莉父女，携带鉴定时的所有资料找到赵早鱼，做完相关化验后，赵与数名医生一起会诊却未诊断出病因。

随即，又挂了该科李朝阳医生的号。全面细致检查后，李表示，这个病他很清楚，但就是不能说、不敢说，在山西任何地方都不会有医生告诉你真实病 因，如果到北京的大医院诊断，可能会有专家告诉你真实病因。

为此，记者先后约访北京大学第一医院、北京儿童医院等几家医院儿科、神经科的权威专家，未果。

法院判决:“属接种疫苗后的异常反应”

12岁的慧慧（化名），家住山西省高平市野川镇东沟村蒲沟。

2009年12月10日，在慧慧的家里，其爷爷韦雷生告诉记者，孙女1998年4月19日生。2006年5月14日，在高平市野川村卫生所注射 麻疹、风疹联合疫苗，2006年5月26日大便出血、两腿出现大量水疹。3天后被送往高平市人民医院住院。6月2日后先后转入长治市和平医院、北京儿童医 院抢救治疗，诊断为过敏性紫癜，并引发肾炎，孩子病情经治疗并未好转，反而转化为紫癜性慢性肾炎。

北京儿童医院在抢救治疗中，帮助慧慧穷尽过敏原，寻找病因。结果，食物组过敏原检测、吸入组过敏原检测、C13尿素呼吸试验（幽门螺旋杆菌检 测）均呈阴性，全部被排除。

韦雷生将孙女过敏性紫癜的过敏原最后归结到疫苗上了。“我豁上老命也得给孙女讨个公道回来！”为抢救孙女卖完了50多头猪的“养猪专业户”韦雷 生，几年来坚持不懈地上访申诉。

2009年3月28日，晋城市疾病预防控制中心委托的诊断专家组做出诊断报告，诊断报告称:“过敏性紫癜、过敏性紫癜性肾炎与接种麻风二联疫苗 在时间上和可能发生的常见疑似预防接种反应疾病上有相关关系”。

于是，韦雷生一家将疫苗生产厂商北京天坛生物制品股份有限公司及疫苗接种使用管理机构晋城市疾病预防控制中心告上法庭。2010年1月13日， 高平市人民法院判决:“接种麻风二联疫苗而诱发过敏性紫癜及过敏性紫癜肾炎属接种疫苗后的异常反应。”判赔慧慧医疗费、精神损失费等156178．52 元。

“接种合格疫苗不良反应概率极其微小”

2008年10月25日的《山西晚报》发表一篇题为“疫苗带来异常谁赔？这下清楚了”的报道，山西省疾控中心计划免疫科科长翟如芳在文中介绍: 专家表示，疫苗接种异常反应发生的概率极低，仅为200—300万人分之一。其中多为轻度异常反应，严重的异常反应很少。

中国疾病预防控制中心免疫规划中心主任梁晓峰曾公开表示:“（接种合格疫苗不良反应的）发生率极低，据查国外的资料，大概200万分之一或者 300万分之一。”

那么，这么多或死、或残、或病的山西孩子，他们的病因与疫苗到底有无关系？

“合格疫苗异常反应概率极其微小，而且多为轻度，严重的很罕见。但是，2006年以来，山西境内确实出现了大量的问题疫苗，也就是高温暴露疫 苗，这样的疫苗已在山西省长期使用，必然要大幅度提高疫苗接种不良反应概率。”山西省疾病预防控制中心专门负责防病信息的原信息科科长陈涛安说。

大量疫苗高温暴露

——山西疫苗乱象调查之三

本报记者王克勤

中华人民共和国《疫苗流通和预防接种管理条例》（以下简称《疫苗条例》）对于疫苗的概念是这样界定的:“疫苗，是指为了预防、控制传染病的发 生、流行，用于人体预防接种的疫苗类预防性生物制品。”

疫苗是异体蛋白物质，对光照、温度十分敏感。

国家法规规定

《疫苗条例》第64条规定:“疾病预防控制机构、接种单位、疫苗生产企业、疫苗批发企业未在规定的冷藏条件下储存、运输疫苗的，由药品监督管理 部门责令改正，给予警告，对所储存、运输的疫苗予以销毁。”

《预防接种工作规范》关于“疫苗的储存与运输”是这样规定的:

3．疫苗储存和运输的温度要求:

（1）乙肝疫苗、卡介苗、百白破疫苗、白破疫苗、乙脑灭活疫苗、A群流脑疫苗、A＋C群流脑疫苗在2℃～8℃条件下运输和避光储存。

（2）脊灰疫苗、麻疹疫苗、乙脑减毒活疫苗、风疹疫苗在－20℃～8℃的条件下运输和避光储存。

（3）其他疫苗的储存和运输温度要求按照药典和疫苗使用说明书的规定执行。

4．运输疫苗时应使用冷藏车，并在规定的温度下运输。未配冷藏车的单位在领发疫苗时要将疫苗放在冷藏箱中运输。

《预防接种工作规范》和《疫苗储存和运输管理规范》规定，疫苗一旦脱离规定的存储环境，就是质量可疑疫苗，也可能成为质量异常疫苗。

高温暴露疫苗

山西省疾控中心专门负责防病信息的原信息科科长陈涛安提出，从2006年以来，在山西境内出现了大量疫苗被高温暴露的情况。

陈涛安介绍:2005年12月，山西省疾控中心出现了一位来自北京的山西人，该人35岁，名叫田建国。12月28日，田建国被任命为山西省疾控 中心生物制品配送中心主任，“负责全省疾病预防控制工作所需的疫苗配送及二类疫苗的供应和管理”。

“疫苗是全民防病的武器。从这一天开始，保障3500万山西人民生命健康的疫苗使用管理权，就由田建国掌握了。”

山西省疾控中心位于太原市迎泽区双塔西街小南关8号，分为南、北两个大院。当时，省疾控中心的疫苗冷库位于北院，而刚建成未交工的疾控大楼位于 南院，两地相距约70多米。

山西省疾控中心物业科副科长卫军利告诉记者:“2006年、2007年，田建国管疫苗的时候，我看到他组织的人，将成箱的疫苗从冷库搬到还没投 入使用的疾控大楼一楼，拆开包装箱，将疫苗堆了一地，堆得像小山一样。许多人在往疫苗盒上贴”山西疾控专用”的标签。尤其是夏天，大家穿着短裤，他们依然 照常天天在闷热的大厅里贴标签。”

记者先后采访了山西省疾控中心的多位职工，他们均佐证了此事。

《药品经营质量管理规范》规定，从事药品验收、养护、计量、保管等工作的人员，应具有相应的学历或一定的文化程度，经有关培训并考核合格后持证 上岗。企业应定期对各类人员进行药品法律、法规、规章和专业技术、药品知识、职业道德等教育或培训，并建立档案。

“但是，为田建国贴疫苗标签的，都是临时找来的宾馆服务员、临时工、钟点工等。”山西省疾控中心的刘美丽（化名）回忆当时情景时如是说。

山西省疾控中心专职司机原江对记者说:“那两年，他们不仅一直在疾控大楼一楼里贴标签，还有一个同样严重的问题，给全省各地运送疫苗的冷藏车制 冷机一直坏着，没有维修过。跑地区一趟，尤其是夏天，都变成闷罐车了。”

“这是人为制造疫苗存储运输不应有的操作环节，使疫苗长时间脱离规定的冷藏避光环境，主观故意制造了高温暴露疫苗。应该依法立即销毁，否则即是 抗法杀人。”陈涛安分析说。

“由于高温暴露疫苗配送到各地没召回、封存，直到2008年底，山西老百姓还在接种高温暴露疫苗。”

陈涛安还告诉记者:“根据山西省公布的统计资料，这3年，全省每年至少接种疫苗1000万人次。疫苗因高温暴露而质量可疑，不知道全山西会有多 少人接种了质量异常疫苗？尤其是孩子！”

高温疫苗的背后

——山西疫苗乱象调查之四

本报记者王克勤

山西为什么会出现大量高温疫苗？原来疫苗是如何管理的？

疫苗原来实行封闭式渠道管理

疫苗是保障人民生命健康的武器。对于疫苗的生产、供应，几十年来中国一直实行严格的计划生产、计划供应的管理体制，即所谓“封闭式渠道管理”模 式——所有疫苗均由国家指定工厂生产，并由国家疾病预防机构统一逐级订购、分发和周转储存。并且要求“必须在卫生防疫机构监督指导下使用”。

作为由政府全额财政拨款组建的、实施山西疾病预防控制与公共卫生技术管理和服务的公益事业单位，山西省疾控中心的一个重要责任就是对攸关全省 3500万人生命健康保障之疫苗进行管理与配送。

与全国各省区一样，山西境内疫苗的配送、管理过去一直实行“封闭式渠道管理”。在2005年10月之前，具体配送工作一直由该中心的内部科室 ——生物制品供应站负责。

疫苗分为两类:第一类疫苗，是指政府免费向公民提供，公民应当依照政府的规定受种的疫苗；第二类疫苗，是指由公民自费并且自愿受种的其他疫苗。

接种第一类疫苗由政府承担费用，即“政府计划分配，个人免费接种，国家统一买单”。一类疫苗最小外包装的显著位置，均标明“免费”字样和“免疫 规划”专用标识。

接种第二类疫苗由受种者或者其监护人承担费用，即“个人自主自费接种”。

在这种模式下，生物制品供应站一方面根据免疫规划采购供应一类疫苗，同时经营二类疫苗，但是经营二类疫苗的收入全部进入财政专户，纳入国库。

然而，自从2005年6月1日《疫苗条例》正式实施以来，二类疫苗供应与销售方式发生了变化。

二类疫苗有“商机”

新颁布的《疫苗条例》规定，“疫苗生产企业可以向疾病预防控制机构、接种单位、疫苗批发企业销售本企业生产的第二类疫苗。疫苗批发企业可以向疾 病预防控制机构、接种单位、其他疫苗批发企业销售第二类疫苗。”

这一规定改变了过去疫苗统购统销的模式，打破了疾控机构垄断疫苗供应，特别是二类疫苗供应的体制，其根本目的是降低二类疫苗的价格，从而让百姓 受益。

国家放开二类疫苗流通市场，对于二类疫苗，各级疾控中心和接种单位可向疫苗生产企业或经批准的药品批发企业直接购买，即“企业自由买卖，市场平 等竞争”。

陈涛安对记者说:有人从《疫苗条例》中看到了巨大的“商机”。

首先，《传染病防治法》、《疫苗条例》赋予卫生行政部门、疾控机构疫苗使用管理的权力，二类疫苗可以企业经营，这就有了商业机会与利润空间。其 次，二类疫苗从出厂到零售的差价很大，出厂价10元，零售可达30元—50元，存在暴利。再次，疫苗市场需求不断增长。“非典”以后老百姓防病意识很强， 疫苗消费量逐年加大，特别是，卫生行政部门有权根据属地疫情发布接种二类疫苗“建议信息”。

更为重要的是，经过这些年的建设，全省已经形成了成熟而完整的疫苗系统网络。

“卫生部企业”空降山西

陈涛安说，就在此时，山西省疾控中心发生一系列耐人寻味的人事变动，许多业务骨干被陆续免职。

2005年7月，山西省疾控中心信息科科长陈涛安被免职。

10月，生物制品供应站站长陈宏生、副站长张俊书被停止工作。

12月，财务科科长杜碧杰被免职。

陈涛安回忆说，“单位一把手栗文元非常严肃地通知我，经过组织研究决定，你要离开本职岗位，调到后勤物业管理科从事杂务工作，具体的工作任务是 长期休息，工资、奖金一点不会少。一把手还说:你的工作很突出，没什么失误，调你去那里是中心党委的决定。”

在许多业务骨干被免职的时候，来自北京的山西人田建国，于12月28日被任命为当天成立的生物制品配送中心主任。与此同时，原来负责疫苗配送的 生物制品供应站撤销。

记者看到山西省疾控中心2005年12月12日的《会议纪要》这样写道:

经过慎重考虑，认真研究，仔细筛选，最后确定了卫生部部属企业北京华卫时代医药生物技术有限公司。该公司一直经营生物制品，并对山西市场比较了 解。单位设山西省疾病预防控制中心生物制品配送中心，由该公司进行二类疫苗的市场经营，每年交中心380万元，每季度交一次，另交50万元风险抵押金。

16天后，山西省疾控中心发布《关于成立生物制品配送中心的通知》，“希望各级疾病预防控制机构和相关生物制品企业”“支持和配合”卫生部部属 企业北京华卫时代医药生物技术有限公司（以下简称华卫公司）。该公司董事长田建国自此正式出任该配送中心的主任。文件规定:

配送中心的具体工作委托北京华卫时代医药生物技术有限公司负责。该配送中心的主要工作是负责全省疾病预防控制工作所需的疫苗配送及二类疫苗的供 应和管理。该中心从2006年1月1日起正式运行。2005年12月31日前山西省疾控中心生物制品的债权债务委托北京华卫公司负责清理。

“标签疫苗”横空出世

自2006年1月1日起，“卫生部企业”华卫公司负责山西省疾病预防控制工作所需的疫苗配送及二类疫苗的供应和管理。

“山西全省疫苗的供应管理权被华卫公司托管了！”

山西全省的一类疫苗由政府统一采购，交由田建国领导的生物制品配送中心向全省配送。“田建国只能赚点有限的配送费，很不积极。”

于是，垄断山西二类疫苗市场的“标签疫苗”出现了。

陈涛安介绍说，从2006年3月开始，田建国便找来一些宾馆服务员、临时工、钟点工等，在山西省疾控中心刚建成未交工的大楼楼道里长期人海会 战，往各类二类疫苗最小包装盒上粘贴“山西疾控专用”标签。

有接种者家人给记者提供了部分贴有标签的疫苗包装盒。记者看到，每个疫苗盒上均贴着比一分钱硬币小一点的椭圆形标识贴。该标上半部是“CDPC 长城图案”，即国家疾病预防控制机构的公益标志；下半部是“HW”，为华卫的拼音缩写；底部是红色的“山西疾控专用”字样。

记者发现，这些贴有“山西疾控专用”标签的疫苗，是由长春、北京、武汉、兰州、江苏等地的相关疫苗生产企业生产的。

在疫苗盒上贴“山西疾控专用”标签，是否合法？

《药品说明书和标签管理规定》第三条规定，药品标签不得超出说明书的范围，不得印制暗示疗效、误导使用和不适当宣传产品的文字和标识。因此，药 品标签不得印制“××省专销”、“原装正品”、“进口原料”、“驰名商标”、“专利药品”、“××监制”、“××总经销”、“××总代理”等字样。药品标 签要经国家食品药品监督管理局核准。

卫生部办公厅《关于启用疾病预防控制机构统一标志的通知》规定:该统一标志使用范围仅限于“各级各类疾控机构的建筑标识及其相关物品、设备；疾 控机构的指示性路标”。同时，“疾控机构标志的图案使用时，不得在标志中增删任何内容。”

“有了这个标签，他就可以垄断山西二类疫苗市场，将其他疫苗经营企业排除在山西市场之外，即排除异己，制造暴利。”

“田建国不仅在山西推出了全国独创的标签疫苗，而且让山西卫生厅为其进行行政推销。”“这个标签既没有我单位的承办印制科室，更没有保管部门， 经费来源也不明。”陈涛安如是说。

省卫生厅连续发文推销“标签疫苗”

2006年4月6日，山西省卫生厅下发晋卫疾控200613号文件，在其附件《山西省2006年麻腮风联合疫苗免疫接种活动实施方案》中规 定:“疫苗由省疾控中心统一订购，逐级分发，严禁任何单位和个人从非正规渠道购苗接种，一旦发现严肃查处。”“为保证免疫接种的安全有效，全省要统一使用 山西省疾病预防控制中心逐级配送的标有”山西CDC专用”字样的疫苗。”

2006年5月22日，山西省卫生厅下发晋卫疾控200621号文件的附件《山西省2006年乙脑疫苗预防接种工作实施方案》、《山西省 2006年流脑多糖疫苗预防接种工作实施方案》中，又重复了上述文字。

2007年3月16日，山西省卫生厅又下发晋卫疾控20074号文件，在其附件《关于加强流行性乙型脑炎防控工作的通知》依然有上述文字。

晋卫疾控200621号文件还规定，在有条件的地区和免疫规划以外人群主要推广使用效果更好安全性更强的“北京牌”乙型脑炎（Vero细 胞）纯化疫苗（乙脑纯化疫苗）。各级应在活动开始前充分利用电视、广播、报纸、标语、板报等媒体，开展多种形式的宣传活动，并规定了一系列宣传推广二类疫 苗的标语。

2007年3月，晋卫疾控20074号文件，再次重复了以上内容，要求做好宣传推广工作。

“华卫成了垄断疫苗网络的官商”

“仅仅通过标签控制还不够，田建国为全面控制山西疫苗市场，在原有预防接种服务网络基础上，成立了各地疾控中心配送中心分中心，从而形成一个庞 大的疫苗垄断经营网络。”陈涛安说。

从2006年4月开始，山西省疾控中心主任为甲方（由主任栗文元签名），华卫公司董事长田建国为甲方委托代理人，与长治、晋城、临汾、吕梁、忻 州、朔州等地疾控中心签订了合作协议。

省疾控中心保证不向分中心以外的单位和个人配送二类疫苗，市中心保证从省中心采购疫苗。同时《合作协议》第19条规定:“在所辖区域内执行综合 市场治理计划，沟通和协调区县CDC和接种单位的疫苗采购渠道，确保市场控制力和较高的市场占有率。”

根据山西省卫生厅和山西疾控中心的规定，山西各地统一使用省疾控中心订购和逐级配送的疫苗，同时必须贴有“山西疾控专用”标签，如有违反，承担 免疫接种是否安全、有效的责任。严禁任何单位和个人从非规定渠道购苗接种，一旦发现严肃查处。

这样，华卫公司拥有了既能使用疾病预防控制机构的职能调控、引导市场，又能以疫苗批发企业的身份向社会倾销疫苗的双重身份。

疫苗垄断利益揭秘

——山西疫苗乱象调查之五

本报记者王克勤

“卫生部企业”华卫公司进入山西，通过省卫生厅下发的一系列相关文件，推出了标签疫苗，“还做成了一笔又一笔可观的生意。”

华卫公司从中获取了多少利益呢？为何相关部门如此热情相助？这背后又有着怎样的关系？

尚未开张，先获资产

山西省疾控中心提及华卫公司的第一份文件，即将省疾控中心“一千多万元资产送给华卫公司了”。

2005年12月28日，山西省疾控中心出台200521号文件，向各市级疾控中心发出《关于成立生物制品配送中心的通知》。通知 说:2005年12月31日前山西省疾控中心生物制品的债权债务委托华卫公司负责清理。

几天后，2006年1月6日，山西省疾控中心生物制品配送中心向各市疾控中心下发《货款结算账户告知函》称，“依据山西省疾控中心 200521号文件，由山西省疾控中心成立生物制品配送中心，委托华卫公司托管运营和处理债权债务。”

《告知函》列出两个账号，除了省疾控中心的财政专户外，另一个就是华卫公司在交通银行北京分行水碓子支行开设的账号。

山西省疾控中心原生物制品供应站站长陈宏生，根据2005年11月11日省疾控中心出具的《2003年3月至2005年10月31日生物制品供 应站收入支出情况》算了一笔账:田建国接手之前，生物制品供应站拥有债权:2960．07536万元；库存:二类疫苗库存374．4098万元（其中包括 过期疫苗8．4317万元）；债务:省疾控中心欠二类疫苗生产、批发企业2003．7935万元。

债权＋库存－债务＝1330．69166万元。

也就是说，华卫公司接手省生物制品配送中心时，实际接手了1330多万元的国有资产。

扭曲卫生部文件销售二类疫苗

华卫公司的第二笔大生意就是“扭曲卫生部文件变相销售收费的二类疫苗”。

2006年1月28日卫生部下发《关于加强麻疹控制工作的通知》，要求各地做好一类麻疹疫苗查漏补种工作，加强对麻疹疾病的控制。

陈涛安说，2006年4月5日，山西省卫生厅以落实卫生部《通知》名义，发布了《山西省2006年麻风或麻腮风联合疫苗预防接种工作实施方 案》，实质上是推销二类疫苗。省疾控中心根据该《方案》要求，印刷发行了“预防接种通知单”，约束全省基层预防接种门诊，必须为幼儿接种“普祥立适”牌麻 腮风联合疫苗。

麻疹疫苗是免费的一类疫苗，而麻风或麻腮风联合疫苗是收费的二类疫苗。

山西省疾控中心出台的《预防接种通知单》进一步规定“普祥立适”牌麻腮风联合疫苗84．2元／人份。

“省卫生厅扭曲卫生部文件，压制一类免费疫苗，推销二类高价疫苗。疾控中心直到2008年1月10日，即一类免费麻疹疫苗失效前20天，才向基 层接种点配送，导致全省各地大量一类麻疹疫苗失效。”陈涛安说。

记者看到中央电视台某栏目在此期间制作的部分采访录像显示，太原市周围一些地方当收到麻疹疫苗时，业已失效。

反季节销售乙脑疫苗

2006年8月11日，山西省卫生厅下发了晋卫疾控200626号文件《关于加强流行性乙型脑炎防控工作的紧急通知》，要求山西省各地积极 开展应急接种。

陈涛安认为，乙脑是山西省常见传染病，截至8月9日，全省11个地区，有6个地区存在散发乙脑病例，总共发生69例，其中44例散发在老疫区运 城市的一些县区，山西省大部分县区并无乙脑疫情，开展全省乙脑疫苗反季节应急接种很不正常。他的理由是:

首先，乙脑病是由蚊子叮咬传播，乙脑疫苗每年3—5月份接种较合适，8月中旬已过了乙脑疫苗的接种时期。2006年9、10、11月，山西省都 在应急接种乙脑疫苗，接种后1个月产生抗体，那时蚊子已经没有了，老百姓不但白花了钱，而且，对于感染乙脑病毒未发病的人，接种会增加发病的可能性。

其次，灭蚊防蚊、清理卫生应是预防乙脑流行的有效措施。卫生厅文件却强调，预防接种是最有效的控制疫情措施，加上部分媒体不断报道零星散发的乙 脑病例，于是，在山西省形成了反季节接种社会运动，争抢接种的拥挤现场不但提高了乙脑传播几率，由恐慌、混乱带来的社会经济损失更是难以估计。

再次，根据《疫苗条例》第二条规定，应急接种疫苗都应是免费的。但是，本次应急接种，每人份却收费28元。

业内人士指出，乙脑疫苗2006年的出厂价为每人份9元，而山西接种者以28元购买，其中的环节是:北京华卫公司销售疫苗时，每人份收取4元的 配送费、3元的贴标签厂家返利，以每人份13元价格给市疾控部门，市疾控每人份加4元给县疾控，县疾控再加4元给乡镇一级。

根据山西省卫生厅2007年11月7日发布的消息，2006年运城等地发生乙脑疫情后，山西省疾控部门及时组织第二类疫苗240万人份，实际应 急接种192万人份。

以每人份赚取7元、共接种192万人份计算，华卫公司在运城乙脑疫情中净赚1344万元。

陈涛安估算，全省应急接种共消费疫苗500余万人份，以每人份赚取7元计算，可净赚3500万元，乙脑疫苗在春季采购的是9元／人份，但到了秋 季生产厂家要销毁即将失效的疫苗，8—10月采购乙脑疫苗价格极低，一人份不到一元钱，如此计算，每人份赚取12元，可净赚6000余万元。

排除竞争对手，独享疫苗暴利

2007年10月9日，位于运城市的山西省亨通医药连锁有限公司（以下简称亨通公司）致函山西省人大常委会，提出，山西省卫生厅、省疾控中心发 文要求统一使用贴有“山西疾控专用”标签疫苗等行政行为，严重破坏了二类疫苗市场平等竞争，损害了消费者的权益。

亨通公司储备了数万支疫苗，当他们向当地疾控部门推销疫苗时被告知，所有二类疫苗必须经过山西省疾控中心生物制品配送中心配送并贴有“山西疾控 专用”字样，才能被接种。亨通公司的疫苗16元一支都卖不了，贴有“山西疾控专用”特权标签的疫苗，28元一支还供不应求。

2007年9月12日，山西省卫生厅副厅长李书凯接受某媒体采访时说:华卫公司是卫生部的大公司，山西人民确实受益了，2006年以前，一只乙 肝疫苗，打三次的，卖到21元，最便宜15元。2006年以后，打三次总共只花7至8元。

这样算，乙肝疫苗每针次收费不超过3元。但是，大同市天镇县南河堡顾家湾村的燕燕2008年5月29日接种乙肝疫苗，一针次收费就达82元。就 此，记者于2月22日通过当时负责接种的天镇县南河堡乡接种员王振中核实，王没有正面回答，抱怨了很久自己到各村庄接种疫苗多不容易，花销多么多么大。最 后告诉记者:“说不收钱是假的。”但他始终没有回答每针次收多少钱。而燕燕的奶奶张建云告诉记者:“村里打乙肝疫苗都是收82元。”

2008年3月6日，山西电视台“都市110栏目”播出《定期接种疫苗收费不明不白》的报道称，太原市尖草坪区卢女士的女儿出生20个月，累计 接种疫苗27次，花费达1233元。其中仅脊髓灰质炎疫苗享受了国家免费政策，其余都是有偿接种。

据陈涛安估算，华卫公司在山西垄断经营各类疫苗，2006年可获得8000万元利润，2007年可获得4200余万元利润，两年合计利润1．2 亿元，经营额2．5亿元。

“50万元抵押了3500万人的生命保障权”

根据华卫公司与山西省疾控中心为期五年的《合作协议》，华卫公司获得“全省疾病预防控制工作所需的疫苗配送及二类疫苗的供应和管理”权利与权 力，而条件是“每年交中心380万元，每季度交一次，另交50万元风险抵押金”。

陈涛安质疑:且不说年380万元是否按时上交，单说这50万元风险抵押金，大头其实并未到省疾控中心账上。

2008年1月7日，山西省卫生厅纪检组发布的《关于对反映省疾控中心主任栗文元贪污受贿洗钱等问题的初核报告》记载:根据省疾控中心与华卫公 司业务托管合作协议，“甲、乙双方合作期限为5年，乙方在签署协议之后，交纳50余万元人民币或甲方认可的价值50余万元资产作为风险抵押金。2005年 12月华卫公司用该公司的非基本账户资金购买广本雅阁2．4L汽车，以27万抵押在省疾控中心（车牌号为:京JD7033），该车由栗文元使用至2007 年10月，之后封存在省疾控中心车库之内。2006年2月22日华卫公司电汇省疾控中心风险抵押金23万余元。”

“北京华卫公司抵押在省疾控中心的车未在双方固定资产账上体现。”陈涛安对记者说:“华卫公司用50万元，抵押了山西3500万人民的生命保障 权。而这50万元抵押金，田建国又给领导买了小轿车，居然没有上公家的账，这不是慷国家之慨，行贿赂之实，是做什么？！”

“卫生部企业”真相

——山西疫苗乱象调查之六

本报记者王克勤

如此垄断山西疫苗市场、左右山西省卫生厅及全省疾控网络、坐拥财富的“卫生部企业”到底是怎样一家公司？

华卫是个私人企业

记者看到华卫公司总经理田建国的名片上是这样写的:

卫生部全国卫生产业企业管理协会副秘书长；

卫生部全国卫生产业企业管理协会医药科技开发专业委员会常务副秘书长；

卫生部北京华卫产业开发公司总经理；

卫生部北京华卫时代医药生物技术有限公司总经理；

山西省疾病预防控制中心生物制品配送中心主任。

那么，这个与山西省疾控中心合作的华卫公司到底是否“卫生部部属企业”？

其实，早在1984年12月，中共中央、国务院就发出《关于严禁党政机关和党政干部经商、办企业的决定》，2003年专门又发文重申这一规定。

田建国的“卫生部部属企业”又是从何而来？

记者根据田建国名片上的电话致电卫生部全国卫生产业企业管理协会询问，对方称:“我单位有此人，华卫时代不是我们协会的公司，具体情况工商局一 问就知，那是他个人的公司。”

北京市工商局提供的北京华卫时代医药生物技术有限公司工商注册资料显示:该公司2004年1月6日在北京注册成立，法人代表:田建国，股东:田 建国、黄彦红、于莉，股份分别占80％、10％、10％。

在该公司的工商注册资料里，记者发现一份2007年度的工商年检表，上面写着:“北京华卫时代公司为三人合伙的私有企业。”

有意思的是，2007年9月6日，即相关部门开始调查这个公司后，该公司召开第一届第一次股东会，做出变更股东决议。2007年9月13日，得 到北京市工商局朝阳分局核准。黄彦红、于莉退出股东，分别以5万元的价格，将各自10％的股份转让给“全国卫生产业企业管理协会”开办的北京华卫产业开发 公司（集体所有制）。

此后，北京华卫时代医药生物技术有限公司的股东只有两个，田建国个人占80％，北京华卫产业开发公司占20％。而这个北京华卫产业开发公司的法 人代表也是田建国本人。

“华卫是个空壳公司”

山西省卫生厅副厅长李书凯曾公开称:“华卫是卫生部的公司，专门搞疫苗配送的大公司。”

在北京华卫时代医药生物技术有限公司的工商注册资料中，记者发现了一份2005年7月26日北京市工商行政管理局做出的《行政处罚决定书》。

这份编号为“京工商朝处字（2005）第03769号”的《行政处罚决定书》指出:在北京市朝阳区十里堡北里农民日报社五层520房间办公的北 京华卫时代医药生物技术有限公司，“当事人在开业登记时，委托代办公司采取垫资方式办理了公司登记。领取执照后代办公司将垫资款50万元全部提走，当事人 未按规定补足出资。”

“当事人的上述行为属于虚报注册资本行为。”

“依法责令当事人60日内补足出资，处罚罚款50000元。”

而2004年1月6日这家公司在北京注册时，表明注册资本为50万元。股东出资表显示田建国40万元、黄彦红5万元、于莉5万元。企业类型是 “有限责任公司”。

华卫没有疫苗经营资格

田建国的北京华卫时代医药生物技术有限公司，从2006年1月1日“负责全省疾病预防控制工作所需的疫苗配送及二类疫苗的供应和管理”直到 2007年10月15日失踪，一直在经营管理山西全省的疫苗。

然而，记者在该公司的工商注册资料中发现，这个公司在山西经营期间根本没有疫苗经营资格。

2004年1月6日，由北京市工商行政管理局颁发的该公司《营业执照》显示，这个公司的经营范围如下:

技术开发、技术转让、技术咨询、技术服务、技术培训；销售生物制品、仪器仪表、电子计算机及配件、化工产品（不包括危险化学品、不含一类易制毒 化学品）；投资咨询；会议服务；企业形象策划；营销策划；承办展览展示活动；组织文化交流活动。（未取得专项许可的项目除外）

2007年9月6日，即在相关部门开始调查这个公司后，该公司召开成立近4年来的第一次股东会，做出经营范围变更决议。

也即该公司连续经营疫苗达1年零8个月后，2007年9月13日，北京市工商局朝阳分局正式核准，在这个公司的经营范围中增加了“疫苗”二字。

然而，2008年1月7日，山西省卫生厅调查组公布的《初核报告》却称:华卫公司2004年1月6日注册成立，经营范围中存在疫苗销售。

华卫公司突然失踪

2007年8月，太原市人民检察院立案调查山西疫苗问题。2007年10月12日，当地媒体曝光山西疫苗问题，山西省卫生厅纪检组开始立案调 查。

10月15日，山西省疾控中心生物制品配送中心突然关门，华卫公司员工全部撤离山西。山西省卫生厅调查组《初核报告》称，“2007年9月北京 华卫公司向省疾控中心提出了中止合同的请求，2007年10月12日，省疾控中心解聘了华卫公司总经理田建国配送中心主任的职务。”

“当时，我已经举报四个月后，田建国针对相关部门的查处，给华卫公司突然加上了”疫苗”经营范围，增加了20％的卫生部协会集体所有制股份，想 把自己私营公司变成与卫生部沾边的企业后逃之夭夭，这些都是骗人的把戏。”陈涛安说。

华卫老总田建国:“由政府部门来回答”

针对上述种种问题，记者设法联系到了“卫生部企业”北京华卫时代医药生物技术有限公司总经理田建国。

对于记者提出的华卫与山西省疾控中心是否合作关系、高温标签疫苗、市场垄断、华卫是否卫生部企业等一系列问题，田建国称:“这些事情，我不好回 答。请你到山西省疾控中心和政府部门了解吧，由政府部门来回答。”

山西省卫生厅:“你去问省纪委吧”

2010年2月23日，记者来到山西省疾控中心。得悉，此前一直与田建国“密切合作”的该中心主任栗文元前不久刚刚被免职，“另有安排”、“出 国旅游了”。

为此，记者找到了目前负责该中心工作的张杰敏副主任。张称:“我知道有标签疫苗，但没有见过他们贴标签。卫生厅纪检组只调查了经济问题，其他的 具体情况，我不好回答，你最好找卫生厅纪检部门。”

而山西省疾控中心党委书记闫明亮的回答几乎与张杰敏完全一致。

针对山西疫苗市场存在的一系列问题，记者试图采访山西省卫生厅副厅长李书凯与卫生厅疾控处，被告知:“没有厅新闻中心的同意，不接待记者”。该 厅新闻中心的小刘告诉记者:“情况变化了，我们新闻中心领导让我告诉你，你这属于跨行业采访，需要相关部门批准。”

记者见到了参与查处此案的山西省卫生厅纪检组办公室主任武瑞明，他对记者讲:“我没有权力回答这些问题，这个案子早就移交省纪委了，你去问省纪 委吧。”

记者随即赶往山西省委，省委传达室告知记者:“省纪委没有时间接待记者。”

之后，记者设法找到负责查处此案已达一年半之久的省纪委931室薛进仓处长，薛进仓反问:“你采访这个案子，想要干什么？”记者回答:“舆论监 督。”面对记者的不断追问，薛进仓称:“这个案子我们还没有查完呢。”便挂了电话。

高温疫苗举报风波

——山西疫苗乱象调查之七

本报记者王克勤

山西疫苗高温暴露问题能够浮出水面，49岁的山西省疾控中心原信息科科长陈涛安成为最关键的人。

三年举报30余次

2007年初，陈涛安在省疾控中心正在建设的新办公大楼里，发现了有许多生面孔的人在给疫苗盒上贴标签。“感觉很异常。”

陈涛安还发现配送中心分发二类疫苗使用企业票据；新来的田建国主任转移了配送中心分发二类疫苗的财政收入；“卫生部部属企业”账户替代了省疾控 中心基本账户；山西二类疫苗批发企业告状，指责华卫公司特权标签垄断了全省疫苗市场；山西二类疫苗价格不搞市场竞争，由田建国的配送中心定价；省卫生厅不 断发布文件推销标签疫苗等不正常的情况。

从2007年5月25日开始，陈涛安向山西省人民检察院、山西省纪委、卫生部、山西省药监局及太原市人民检察院实名举报“山西3500万人民生 命健康保障权被官员出卖的一系列问题”。

三年来，陈涛安向有关部门举报、复议、信访山西疫苗问题30余次。

2007年9月14日，山西当地媒体刊发了《这个“权”能被“托管”吗》，将山西全省疫苗管理权出卖给私人老板的问题第一次公开曝光。

10月12日，由山西省纪委派出督察员参与的省卫生厅调查组正式开始调查。

这个调查组正式开展工作的第三天，田建国及华卫公司便“突然失踪了”。

2008年1月7日，山西省卫生厅召开会议通报了《关于对反映省疾控中心主任栗文元贪污受贿洗钱等问题的初核报告》，结论是:

关于省疾控中心第二类疫苗供应合作方式，省卫生厅已向省政府作出答复，认为符合《疫苗流通和预防接种管理条例》等有关规定；

省疾控中心原生物制品供应站经营二类疫苗的国有资产没有流失；

华卫公司抵押在省疾控中心的本田雅阁车未在双方固定资产账上体现；

省疾控中心在财务管理债权、债务处理以及用轿车抵押风险保证金等方面的问题，栗文元负有一定责任。

“不可理解的是，对栗文元、田建国制售高温疫苗问题置之不理。”陈涛安这样对记者说。

随即，陈涛安将多篇揭露山西高温暴露疫苗问题的举报材料发布在网络上，引起了社会各方面广泛关注。

受到质疑的官方调查

2008年5月，山西省洪洞县万安镇村民易文龙找到了陈涛安。易文龙的女儿接种流脑疫苗后，患上“急性播散性脑脊髓炎”，最后落下了“继发性癫 痫”。

医学常识让陈涛安意识到:“急性播散性脑脊髓炎”又称“接种后脑炎”，与接种疫苗关系密切。

这让陈涛安高度警惕，并开始怀疑——省疾控中心院内大量高温曝光的疫苗，是否就是引发孩子病症的祸根呢？

陈涛安随即又向有关部门反映这一问题，未引起重视。

其间，山西各地许多家庭开始信访、要求复议，质疑他们的孩子接种疫苗后得病，甚至致死、致残，与疫苗存在因果关系。

对此，2008年7月，山西省纪委立案重新复查；当年11月，卫生部监察局也立案开始调查山西疫苗问题。

“相关部门在调查高温疫苗过程中，又发生了一系列匪夷所思的事情！”陈涛安这样讲。

“专家鉴定违反回避原则”

在易文龙等部分质疑家庭不断上访、申诉后，从2008年8月28日开始，山西省卫生厅委托山西省预防接种异常反应和事故鉴定小组对其中5户当事 人提出的质疑作出了鉴定结论:“与接种疫苗无因果关系”。

这些质疑家庭当事人接到山西省卫生厅的文件后，发现省卫生厅对上访所涉材料进行讨论分析的7名鉴定专家，未按《预防接种异常反应鉴定办法》的有 关规定由受种方在专家库中随机抽取，且7名专家中有3名是省疾控中心人员，违反了有利害关系的人员应当回避的原则。

2008年12月8日，易文龙、王明亮向卫生部提出行政复议申请。2008年12月下旬，他们收到了卫生部不予受理的决定书。

2009年1月20日起，王明亮、易文龙等7个家庭，相继向太原市迎泽区法院投递了诉状，状告山西省疾病预防控制中心、北京华卫时代医药技术有 限公司制售“山西疾控专用”标签高温暴露疫苗致使其子女被伤害，要求人身损害赔偿。但该法院至今不予立案也不驳回。

被改动的患儿接种史

2008年9月23日，太原市小店区西温庄乡东温庄村10岁女孩莉莉的父亲高径向省卫生厅送去“控诉书”。

2008年11月7日，高径被通知来到省卫生厅，卫生厅《关于对高径信访回复的函》内写着:“西温庄乡东温庄村防疫员证明，莉莉在东温庄村卫生 所仅于2006年9月接种乙脑疫苗（有记录）。接种后1年零7个月出现有关症状与接种省疾病预防控制中心高温曝光变质疫苗无因果关系。”

高径立即回村找到了村防疫员，询问这是为什么。村防疫员答，“上面找了我多次，不能随便提供接种史，如果不听话就不要干了。”

高径给记者展示了一张红桃3扑克牌，上有如下文字:“流感06．10．20、07．10．25流脑07．11．28”。高径告诉记者，这是给省 卫生厅提交材料前，找村防疫员时，对方随手在一张扑克牌上写的莉莉疫苗接种史。

于是，高径向省纪委、省检察院、卫生部纪检组举报，“山西省卫生厅调查结果严重失实，存在舞弊问题。”

对此，本报记者采访了该村防疫员闫胜艳，闫胜艳告诉记者:“我在扑克上写的，便是这孩子接种疫苗的情况。当时他们找上门来，我顺手便在一张牌上 写了接种情况。”“后来，省卫生厅来人调查，也是这样讲的，是什么就是什么！”

“虚构卫生部调查结果”

山西省疾控中心2009年第四期《中心会议纪要》记载:“2009年3月17日，山西省疾控中心召开了中层干部会议。”卫生厅纪检组长李双才在 会上谈到，“针对举报山西省疾病预防控制中心疫苗存在曝光变质问题，厅纪检、省纪委配合卫生部监察局对此事进行了调查。卫生部监察局对存余疫苗的四个县进 行了取样监测，检验结果全部合格，表明疫苗是安全的。”

对此，2009年3月18日，陈涛安向卫生部监察局快递了《关于山西疫苗问题情况的反映》，监察局立即派出关跃进副局长及两名随行人员，来到山 西太原与陈涛安进行了两个多小时的谈话。

陈涛安提供给记者的谈话录音中，关跃进对陈涛安讲:卫生部监察局是调查疫苗案中的行政违法、违规问题，疫苗抽检鉴定属业务问题，不是我们的调查 范畴，我们既没有在山西的县区抽样送检，更没有出具“曝光标签疫苗是安全的”调查结果。

“由此证实，山西省疾控中心会议纪要发布了虚构的卫生部监察局调查结果。又一次实施欺上瞒下的伎俩！”陈涛安说。

陈涛安认为，该《会议纪要》中“对存余疫苗的四个县进行了取样监测”的陈述，表明山西省疾控中心承认山西高温暴露疫苗客观存在，直到2009年 3月以前，山西人民仍在接种质量可疑的高温暴露疫苗。（中国经济时报）

An article popped up on the AFP wire this weekend detailing how this procedure is being sought out by Chinese eager to get taller, and move up in society.  Fearing that the link for it will be broken I have reprinted the article at the bottom of my commentary.  Otherwise, if you want to see video it’s below;

Watch CBS News Videos Online

Soviet doctors started performing this procedure in the 1950s.  One can only speculate as to why though I believe that it has something to do with Stalin’s wish to create an army of genetic super-humans and upright walking chimpanzees.

Back then, in the pioneering days, horrific side effects were commonplace: amputations, uneven legs, horribly disfiguring infections.  So, by comparison, the scars of today are nothing to fret about.

If this procedure works, and people do get taller, why isn’t it commonplace throughout the world? Probably because no doctor in a country where patients can actually hold doctors accountable would be willing to go through with this surgery.  Guaranteed scarring means that you’re guaranteed to get sued.

So far Chinese Ministry of Health authorities have publicly stated that these surgeries are discouraged if the patient has no medical need to have a limb lengthened.  But, as of yet, enforcement of the book law has been lacking.  It’s hard for doctors to make a buck in China – average state funded salary is about 500 USD a month – and its hard for patients to find a good, professionally trained doctor.  Dangerous surgeries are going to be a fact of life in China until somebody figures out how to properly incentivize the doctors so they don’t have to moonlight.

Article Reprinted Below:

With saw and screwdriver, China doctor gives gift of height
Posted: 11 April 2010 1259 hrs

SHANGHAI : Orthopaedic surgeon Bai Helong hikes up his trousers, places his foot on his desk and marks the spot just below his hairless knee where he cuts into the legs of patients who want to be taller.

Over the past 15 years, Bai has given the gift of height to about 3,000 patients aged 14 to 55 — Chinese, Americans, Germans, Japanese — about half of whom went through with surgery simply because they did not like being short.

“I’m something of an authority in this field,” explains Bai, who uses a technique he developed himself at a modest private clinic in the suburbs of Shanghai.

He saws through both the tibia and the fibula below the knee — “without touching the bone marrow”, he says — to “make the dream come true” of those who say they suffer psychologically from being short.

One week later, the bones begin to regenerate. Heavy braces made of nickel and titanium, each weighing about half a kilo (one pound), are screwed into the inner part of the patient’s legs.

Every day for the following four months, Bai expands the braces to gradually stretch the leg.

“We need four months to get six to eight centimetres,” or two to three inches, the surgeon says. After that, for four more months, the bones get stronger and patients are allowed to begin to walk.

Leg-lengthening was first performed in the 1950s in the former Soviet Union, and then in China, but with sometimes catastrophic results.

In the past, the leg was cut in three places, affecting the delicate bone marrow, and pins were used to steady the bone. In some cases, one leg was left shorter than the other and infections were common.

Today, Bai says, the procedure is safe. Instead of stretching the leg by 1.0-1.5 millimetres a day as in the past, he aims to progress half as fast.

“We’ve not had a single failure since 1995, and now it’s not painful,” insists the doctor, who charges 75,000 yuan (11,000 US dollars) for the surgery.

So who is willing to endure such a procedure, which involves months of total immobilisation and a fair amount of discomfort?

“A small person can encounter all kinds of problems — in his or her marriage, family life, workplace,” Bai says.

“The person feels inferior, and experiences psychological problems. I even have met people who wanted to kill themselves.”

Dan Dan, a pretty 25-year-old Chinese woman who is studying Japanese, says she was unhappy when she stood 1.53 metres (five feet) tall. Four months after surgery at Bai’s clinic, she is smiling — and six centimetres taller.

“I wanted to improve my self-image. I am very happy,” says Dan Dan, grimacing as she walks at a snail’s pace on crutches through the halls of the clinic, her body contorted.

“I hope that within a year, I will be able to walk normally. Running, that’s another story,” she says.

Only Dan Dan’s mother is aware of what she is doing — her friends have no idea where she is.

“It seems pretty dangerous at the beginning — they cut through your bones, that is not really socially acceptable in China. It’s not like getting your eyelids done,” she explains, referring to a surgical procedure some Chinese women undergo to give them rounder, wider-looking eyes.

“I held off for a long time. I was really scared.”

Wang Lijun has not told her friends where she is either and as a result, they no longer contact her.

That was a price the 30-year-old was willing to pay during 13 months of treatment, which began in 2008 and took her from 1.52 metres to 1.60 metres — a height gain easily achieved with a pair of stilettos.

“It was my secret. I told no one,” says Wang, who now works on the administration side of Bai’s clinic and says she can run and jump “almost like before”.

“I had lost all of my self-confidence. I wanted a better life.”

Beyond the loss of her social circle, Wang says there were other sacrifices to make — the months of painful treatment, the dark, vicious-looking scars on her legs. Her next step? A plastic surgeon, perhaps.

Is Bai a miracle worker or a sorcerer’s apprentice with a screwdriver and a tire iron who is making a profit from the suffering of others?

The surgeon hits out at his critics, especially “those who oppose me without knowing what my work is all about”.

But as is often the case in China, Bai may be working in a grey zone.

In 2006, the health ministry sent a notice to provincial authorities, ordering them to limit leg-lengthening operations to orthopaedic cases — excluding patients requesting surgery for purely cosmetic reasons.

The recommendation said the operation could only be performed on the disabled, whose legs were disfigured due to “congenital, accidental or disease-related conditions”.

“It is forbidden to perform this surgery on people whose limbs are not deformed,” the ministry said.

When asked about the notice, the ministry declined to comment on whether the recommendation was still in force. And Bai is still a member in good standing of China’s Orthopaedics Association.

The report left me feeling inspired, uplifted even. For information to be maximally useful, it needs to be unadulterated and neutral. Censored information is adulterated information, and its neutrality is lost. On first glance democracies would appear to have the upper hand since, in theory, they are built upon the principles of open government, transparency rules, and a particularly egalitarian leadership ethic.

Gathering and profiting from information in a country where the tradition of open information is strong should, in theory, be easier than in a country that treats all information as a potential detriment to the state. The thought of the very principles of democracy creating a lasting economic advantage shines like a beacon of hope in a world where democratic economies, for the most part, are getting their asses kicked by the forever up-and-coming, forever centrally controlled China.

But, it can’t be as simple as all that can it? Is it plausible that, in a few years, despite anything that China does, Democracy is going to unleash its Perspicus et Equus (PEE) super weapon, which, once activated, is going to give every business venture from the democratic world a boost of economic nitrous, effectively forcing China to change its political system or self-combust? Is Democratic freedom going to PEE all over China’s communist fire[wall]?

This question would take more than several life times to satisfyingly answer. At bottom the PEE superweapon question is asking which system, China’s or some other, more democratic country’s is more conducive to taking advantage of the ongoing data explosion. It also requires that any assessments one makes be seasoned with a certain amount of self-awareness since imperfect and selectively chosen information is being used to predict the outcome of a world in which people attain something closer to perfect information and the ability to harness it.

Instead of a detailed answer, therefore, I’m going to shrink the question even further so that it involves only American and China. Within that playing field I am going to hypothesize on which country has the edge in terms of potential to profit from this data revolution, and I encourage you to give your own assessment in the comments area. This feels like something that upholds the spirit of China Divide, and I thought I’d try that type of article out here to see how it was received.

The comparison:

Let’s first look at the positives.

China’s central control is useful insofar as it’s possible to create an army of information diggers. Someone already created armies of Chinese cubicle warriors to censor the internet, and that group of individuals has gotten very good at collecting a vast amount of information, in a sophisticated manner.

We spend a lot of time comparing Baidu to Google, and going on and on how superior Google is at parsing out valuable information, but it might be a mistake to take each of those companies as a baseline for China’s ability to collect data from the web. The relevant comparison is Google versus the Great Firewall, as ironic as that might be considering what’s going on today with the Google.cn shut down. Both the GFW and Google have become exceedingly good at collecting all available data from the web and then using the data exhaust deemed important for their purposes. The difference is that one uses it for good and the other, well, uses it for censorship; something I consider not so good.

Could you imagine if the lessons gained from the GFW were applied elsewhere, in China, towards more noble pursuits, with the might of explicit politburo backing? That could give rise to a second battalion of internet commandos whose sole job is to collect public opinion and public ideas for the improvement of the country. In essence, the Politburo could create a state sponsored Google-like company over night. Maybe we’d come to call it the Great Lego Set because their whole job would be to monitor the internet and figure out what stuff the government needs to build in order to keep people happy. Again, the key here is that this could literally happen overnight.

Complaints could still be censored, but so long as the GLS still got to analyze it wouldn’t much matter; the relevant information would still be collected. By 2025 China’s city planning would be improved and traffic jams would be a thing of the past and the third tier city; cars would be equipped with GPS, which in turn would be linked directly to a government feed, and people would only drive four days a week. Hospitals would no longer do that stupid ticket thing because they wouldn’t have to since patients would know what hospitals are crowded, in what departments, and then go to the un-crowded ones.

Transparency, in some cases, also leads to accountability. Already today we are witnessing the willingness of some Chinese officials to take a step towards accountable, naked government. As China’s central controllers got more familiar with the cost-benefit analysis of transparency in various spheres they might figure out that it’s a much more politically expedient way to keep an eye on plucky local government officials. What if this became the norm at the levels of government most directly responsible for helping the average citizens, and all local officials have to disclose everything that they do via a twitter like interface, and only spend money via credit card so all purchases could be catalogued? Bye-bye Gucci man purses, hello sanitary public toilets. China could create some of the most efficient local governance on Earth.

BUT, China would achieve what it does by implanting everybody in its cities with a microchip that lets the Great Lego Set operatives know where everybody is at all times. Apart from it becoming obvious that a lot of people figured out ways to hack Foursquare so they could become the mayors of popular bars and restaurants without ever actually visiting those bars and restaurants, increased transparency would actually strengthen the centralization of state power.

Also, due to constraints on how many GLS workers could be hired, the benefits of the GLS would remain pretty localized. The rural areas would develop at a much slower rate than the urban centers despite their increased government transparency. Did I mention that the urban centers are getting overpopulated at a rate faster than anyone predicted?

Chinese citizens also get no better at understanding the world. The Great Lego Set is the one doing all the analysis work. Sure, there are elites who’ve gotten pretty good at analyzing data, and hi-tech Chinese industry is doing just fine, but the average person is duller than a career sorority girl. Information is still considered a danger to the state.

By contrast, America’s citizenry would learn how to make money off meta-data across the board, in all industries and businesses, big and small, and the Freedom of Information Act would get stronger every year. Small businesses becoming more efficient means that the suburbs would be just as dynamic as the cities. Americans would know the most random details about most things.

Government, in America, would more likely be outsourced to the enterprise and good will of American people, possibly through a hundred different offshoots of Google. The government itself, thanks to the Freedom of Information act and a tradition of transparency would largely butt out, and be cut out.

Somebody would have the good sense to create a public servant wiki, complete with interactive score cards and all sorts of fun widgets like potholes left unfixed in the politician’s district. As a result, roads would get paved a lot faster and schools would constantly be updated with the latest e-books. Congress at all levels would be publishing live voting and attendance.

Also, internet programming would make networks irrelevant. FOX, the network, would fold and Republican lawmakers would be emancipated from their bonds of slavery, signed with the blood of minorities members of the GOP. Then, somebody would eventually figure out for certain that Tea Partyers compromise approximately .2% of the American population outside of Utah.

Federal government would be a much more smoothly run operation.

Healthcare’s ceiling would improve. Thanks to an iPodNext app that takes three thousand different measurements of the human body every second and a trillion trillion megabytes worth of information from these apps would make it possible to predict the onset of a wide range of cancers, respiratory ailments, and cardiovascular problems. Another app would let you book the next available appointment with the doctor closest to you.

Here are the negatives. Even more so than now, American would be the worlds ADHD capital. Yes, roads would get fixed when people called potholes in with their iPhone apps, but only on roads sponsored by NGOs that ran promotions for free shit if you voted to fix the potholes. Otherwise, who has the time, really?  The more that people interacted with information and the more that their online personalities became integrated with people’s sense of their own real world value the harder it would become to get anyone to do anything selfless for free.

Also, a lot of Americans would self implant themselves with microchips. It would just make things a lot easier. Swipe my credit card? Pshh, frak that, I’ll just run my arm over your scanner. Self awareness would be at an all time high, unfortunately awareness of others, even in a world where everyone knew more about others than ever before, would be at an all time low.

Final verdict:

By only a hair, America takes the edge.

China will see benefits from the system, but nothing revolutionary outside of the main centers of culture. Rural China today will remain rural China today, tomorrow.

America will change dramatically towards a country that learns to build more together, but the people will become even harder to deal with and more self obsessed.

I’ll take self obsessed over stagnant any day.

Chinese parents have good reasons to be wary of fake goods, whether its toys or vaccines, Sascha writes.  And, the way they get around a parallel information system – whereby those selling the goods communicate with one another using one set of information while communicating with consumers through another, parallel set of information – is by depending on networks of connected friends and family that can get relatively worry free goods from abroad.

This applies to dealings with the healthcare system which is loathe to give any information to the public about, for example,  disease outbreaks without explicit permission from presiding political authorities, and with established companies like Carrefour which, despite their large size and international pedigree, still source much of their product from China.

Sascha’s article is good reading, and while you peruse through it, give some thought to where else problems arise, in China, due to parallel streams of information.  Big Hint: everywhere.

The demand for private health management services has grown in China. A survey conducted by Southeast University and Nanjing AHCC Health Consultation Ltd last year showed that 79.9 percent of the respondents desired private health management services. Over 60 percent of those surveyed said they would accept an annual expenditure of 2,000 to 3,000 yuan per year for these services

The survey covered over 3,000 citizens, mainly corporate executives, senior civil servants, academics and celebrities. They were between the ages of 30 and 75 with an annual income exceeding 50,000 yuan in Nanjing, Guangzhou and Shanghai.[...]

A study by Song’s research institute showed that China’s private health management sector is now worth 10 billion yuan, with year-on-year growth of between 20 percent and 30 percent over the last decade. The private health management services sector is expected to be worth 20 billion yuan in the next three to five years, the survey predicted.[...]

The Chinese want a private healthcare sector probably because they’re already paying 2-3k per year when all of the under the table payments are counted up.  Just look at the money that these mother’s paid in Taiyuan paid on top of the public hospital fee.

Twenty-four per cent of Chinese mothers gave hongbao (red envelopes with money) to doctors before they delivered children to ensure that they receive better care during birth, a survey showed.

The envelopes contained an average of about 620 yuan (S$132), according to the random sampling survey released on Tuesday.

The survey interviewed 1,227 pregnant women and mothers with children aged 1 to 6 years old in cities nationwide.

Wang Zaoxia, a mother of a one-month-old baby from Taiyuan, capital city of Shanxi province, said that giving money to doctors before the birth of a baby is a common practice.

“I gave 1,500 yuan to the doctor and 500 yuan to the anesthetist before giving birth, which is relatively expensive because I had difficulty giving birth and had to accept cesarean section,” she said.