By Bob Van Leer

  Patients appeared to be doing well but Nanxishan Hospital would have trouble passing a Medicare inspection in the United States. Members of the NNA China Study Mission toured the hospital in Guilin, China, Oct. 18, 1991 as part of fact-finding on the tour.

  For a decade I've been on the board of a health district that operates a small hospital in Gold Beach and was particularly interested in touring the hospital. The biggest problem noticed was maintenance. Peeling paint and cracked plaster was noted throughout the hospital.

  All long the study tour we had problems working through an interpreter wondering if the question we asked was the one actually getting through to the person being questioned. This was particularly apparent at the hospital asking technical questions. Our translators had considerable trouble with medical terms.

  Nanxishan is not an old hospital. According to our hosts it was built in 1967 as a rear-area hospital for North Vietnamese casualties of the Viet Nam War. The same rail line that brought our party to Guilin continued on to Hanoi 400-500 miles south.

  Closed after the war, it was reopened as a civilian hospital in 1976. It is a big hospital, 700 acute care beds and 210 recovery beds. It is a general hospital capable of a full range of treatment, surgery (including a range from chest to plastic surgery), urology, eye-ear-nose-throat, dental, x-ray, radiology and other services. There are over a thousand on staff, which, on a per bed basis, is less than for U.S. hospitals.

  Troubling to me was that factories we toured (textiles, air conditioners) were better maintained and in generally better shape than this hospital. We passed other hospitals in the tour that looked better from the outside but had no opportunity to tour them so it is not possible to say if Nanxishan Hospital was representative.

  In spite of the not-very-good facilities the patients seemed well cared for and in good spirits. One man who had lung surgery undid his gown and proudly showed me how he was bandaged from armpits to navel. The nursing staff seemed competent and motivated and morale appeared to be high. The oxygen bottle by the bed might be rusty and the paint on the walls peeling but the bed linen was clean and tidy.

  Hospital charges were low, about 40 yuan ($8.00) per day but it appeared that the charges were paid for by direct government subsidy or through the place of work. The average length of stay is long by U.S. standards, 15 days. Occupancy was high, over 90 percent.

  The administrator said the hospital had a small (11 workers) department of traditional Chinese medicine but the rest of the hospital was conventional medicine. In Guilin he said there was an entire hospital for traditional medicine.

  We asked about pay scales at the hospital and we were told the pay of nurses ranged from 150 yuan ($30.00) per month for beginning nurses to 300 yuan ($60.00) per month for the chief of nurses. Mr. Qiang said the top pay for a doctor would be 500 yuan ($100) per month. Actual pay, however, is difficult to calculate. So much of the compensation is in the form of subsidies we found it difficult to pin the total down. Direct pay may be only a third of actual compensation.

  After touring Nanxishan I have a better appreciation of our own hospital in Gold Beach.