Why poverty should not be a death sentence

PUBLISHED : Monday, 18 August, 2003, 12:00am
UPDATED : Monday, 18 August, 2003, 12:00am

Unless money is forthcoming to pay for a kidney transplant or for dialysis three times a week, 20-year-old Sun Wenjuan faces certain death.

Strictly speaking, among the mainland's one million uraemia patients the migrant worker from a village in Hebei province can count herself among the fortunate. Most patients, particularly those in rural areas, are simply left to die as the costs of dialysis and transplants are beyond their means.

But Wenjuan has a supportive family and a loving mother who donated one of her own kidneys to her daughter. She was rushed to Beijing for the operation and the family sold all they had to pay her medical bills. Unfortunately, the kidney had to be removed because of complications, and another transplant was also unsuccessful. The family is now penniless, and heavily in debt.

Wenjuan deserves to be helped, if only because of the extraordinary pain she has suffered and the tremendous efforts by her family and others to save her. It would be sad if all their endeavours and her sufferings were in vain.

Her plight has highlighted the kind of heartless exploitation commonly practised on migrant workers who do not have residency rights in the city. Wenjuan was a waitress at a resort in Beijing run by a state agency. But the lack of a formal employment contract meant she was denied the medical insurance she was entitled under the law. Although a non-governmental organisation subsequently helped her obtain coverage, the benefits have been terminated after she was dismissed for extended absence from work. Even though it has been her illness that kept her from work, the dismissal was legal under mainland law.

Providing affordable health care is a challenge for any government, but all the more so for the Chinese government, which has 1.3 billion people to look after. Despite efforts to reach that goal, most urban-dwellers still find themselves heavily out of pocket when they or their family members become seriously or chronically ill. In the countryside, sickness remains the most common cause of poverty.

As Wenjuan's case shows, the country's hundreds of million of migrant workers whose roots are in the countryside but are working far from home in the cities, also face a unique problem. They could easily fall through the cracks, unable to benefit from medical coverage either in the city or the country. The young migrant worker's heart-wrenching story is a reminder of the importance of having a health system that does not deprive anyone of medical treatment for lack of means. It is a principle Hong Kong and many developed countries have managed to abide by for many years, but one that remains an elusive goal on the mainland and for other developing economies.