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New Law Combats the ‘Yinao’ Phenomenon

China has launched a new law to cope with the increasing ‘Yinao’ Phenomenon. The growing violence of patients against medical staff has made being a doctor a dangerous job in China.

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China has launched a new law to cope with the increasing social problem of patient-doctor violence, also called the ‘Yinao’ Phenomenon. The growing violence of patients against medical staff has made being a doctor a dangerous job in China. The new law makes it possible to sentence hospital troublemakers to up to seven years in prison.

The yinao (医闹, ‘medical disturbance’) phenomenon has become a growing problem in China’s medical sector over the past several years. Yinao is the organized disturbance and violence in hospitals against medical workers, mostly meant to get compensation for medical malpractices. It is often done by criminal groups that are hired by patients or their family when they are dissatisfied with the provided medical care.

The disturbance includes protests and violent attacks on staff. Some even involve the murder on health professionals.

Chinese media have covered roughly thirty medical related disputes from October 2013 to June 2015. These were only the terribly violent disputes (including fatal stabbings) that had a large societal impact; the thousands of small disputes happening in hospitals across China every day were not taken in account.

 

“The Ministry of Public Security has advised hospitals with 2000 beds to have at least 100 security guards.”

 

In October of 2013, the Ministry of Public Security has advised hospitals with over 2000 beds to have at least 100 security guards. The growing numbers of security staff, however, have not helped to combat hospital violence.

In November 2013, hundreds of medical workers protested at the No. 1 People’s Hospital in Wenling, after a dissatisfied patient overpowered security guards and stabbed three doctors, leading to the death of one of them.

The new law, that will be implemented on November 11th of this year, is to punish those who threaten and assault medical staff, damage hospital facilities or equipment, or in any way hinder the hospital staff and doctors from doing their work.

 

“Medical workers are constantly bullied, humiliated or physically hurt by ignorant people.”

 

On Sina Weibo, the topic “medical disturbance crimination” (#医闹入罪#) was posted immediately after the news was released. Over a million users participated in a discussion about the new law.

Among all the users commenting, there were are also many medical professionals and students. “Us as poor medical students can finally relax a little bit. Medical violence should have been incriminated years ago!” says user Sunshine Without Tears: “There have been so many hospital disputes, and medical workers are constantly bullied, humiliated or physically hurt by ignorant people. We need a law to combat hospital disputes so that the relationship between doctors and patients will improve.”

Doctor CSY summarizes the major factors contributing to the increase of violence in China’s health care: a rising consciousness of patient rights, deepening misunderstandings between patients and doctors, and provocative media reporting. He then adds: “I’ve witnessed a lot of disputes in the hospital over the past few years. All doctors want their patients to get better and healthy. We work so hard with not much income, and yet have to worry about our own safety. If any medical worker neglects his duty, he should be punished by the law instead of being hit by the patient’s family.”

 

“Patients sometimes spend their entire life savings when suffering from serious illnesses. When treatment fails, despairing patients and their families are quick to blame doctors.”

 

The market-oriented reforms of the Chinese health sector is also a major cause of the yinao phenomenon. With China’s economic liberalization, the state is no longer responsible for providing health care. Because public hospitals have started chasing profits to survive, people have to take more responsibility for their own care.

Patients sometimes spend their entire life savings when suffering from serious illnesses. When treatment fails, despairing patients and their families are quick to blame doctors and the hospital.

Most patients and their families are unwilling to solve medical problems through legal channels; not only is the process time-consuming, it also might end with no financial compensation. They believe a quicker way to get some money back is to cause trouble at the hospital.

Weibo user Huohuo is worried about the feasibility of the new law: “I don’t think ordinary people will go to court to deal with medical issues. In China, there is a long tradition of the law failing us, while the violators win. I just hope that China will be a developed country soon so that all Chinese people can enjoy free healthcare. It might be the best solution to decrease hospital disputes.”

 

“Doctors are the perfect target of revenge.”

 

There are also Weibo users who understand negative sentiments towards medical staff. Chinese doctors and other medical professionals are generally underpaid. The low income causes some of them to make extra money in “grey areas” such as drug kickbacks, over-prescription, and bribery. For many patients, this has ruined the image of doctors, and they find it hard to trust them. This partly explains why, when medical misfortune happens, doctors often are the perfect targets of revenge.

User East South West North comments: “Medical disputes happen for a reason. The truth is, that some doctors require patients to do unnecessary inspections so they can make profits. Patients have even died from counterfeit drugs prescribed by doctors.”

 

“I’m afraid no one wants to pursue a career in medicine if this vicious cycle keeps on growing.”

 

China’s violence against doctors has been cited as an important reason for a decrease in the popularity of healthcare career. User J_tomorrow points out that the government should heighten the punishment of ‘medical disturbance’ to ensure the safety of medical workers at hospitals: “Doctor is a high-risk and low-paid occupation in China. I’m afraid no one wants to pursue a career in medicine if this vicious cycle keeps on growing.”

Weibo user called Bottle of Chili admits that she has lost her passion of being a medical worker: “I used to be full of passion for my work, and I treated my patients with kindness. But after being misunderstood and humiliated by patients and their families years after years, I’m now doing my job like a robot. The whole society expects us to show selfless devotion, but we are humans after all!”

‘Medical disturbance crimination’ is the first step in improving the doctor-patient relationship. Many more measurements need to be taken in order to cope with this social problem. User Liyun expresses his support of the legal protection of medical worker. At the same time, he says: “We need to understand the underlying reasons of medical disturbance – the distrust between doctors and patients. Hospitals should not hide or cover up medical negligence. And patients should give medical workers the respect they deserve.”

By Yiying Fan

Image used: http://focus.cnhubei.com/consensus/200912/t883804.shtml

©2015 Whatsonweibo. All rights reserved. Do not reproduce our content without permission – you can contact us at info@whatsonweibo.com.

About the author: Yiying Fan is a world traveler and Chinese freelance writer from Shanghai.

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China Health & Science

‘Sister Blood Points’ Controversy: Shanghai Woman’s Tibet Blood Donations Ignite Privilege Debate

Dozens of local public officials in Tibet donated blood to rescue a Shanghainese woman. Netizens believe it’s a matter of privilege.

Manya Koetse

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The medical rescue of a critically injured Shanghai woman in Tibet has recently triggered major controversy on Chinese social media after netizens suspected that the woman’s treatment may have been facilitated through the abuse of power.

What was supposed to be a romantic honeymoon getaway turned into a nightmare for newlyweds Yu Yanyan (27, 余言言) and her husband Tao Li (29, 陶立).

On October 14, just two weeks after their wedding, the couple from Shanghai was driving on China’s National Highway 219. Their destination was Ngari Prefecture in Tibet’s far west, where the average elevation is 4500 meters.

As they drove by the famous mountain pass Jieshan Daban (界山達阪), situated at an altitude of 5347 meters, they suddenly realized that the altitude was affecting them. Soon, Tao Li, who was driving the car, lost consciousness and crashed the car. Yu Yanyan, on the passenger side, was badly injured in the crash.

The crashed car, image via Beijing News/Xinjinbao (source).

What followed was a complicated, time-sensitive, and costly rescue operation. At the Ngari People’s Hospital (阿里地区人民医院), Yu was diagnosed with a ruptured liver, abdominal bleeding, hemorrhagic shock, and thoracic trauma. She was losing a lot of blood in a short time and required surgery, but there was not enough blood available for a blood transfusion at the time in the sparsely populated region, as reported by Beijing News.

 
Tibetan Civil Servants to the Rescue
 

While the hospital made efforts to secure donations, specifically requiring an adequate supply of A+ type blood, Yu’s husband was reportedly advised to reach out to the Shanghai Municipal Health Commission (上海卫健委) to inquire about potential assistance. One of his aunts, or his ‘auntie’, allegedly helped him to contact them.

These efforts appeared to be fruitful. Between October 16-17, just days following the crash, numerous members of the public and dozens of local civil servants in Tibet, including firefighters, policemen, and military personnel, stepped forward to donate blood, contributing to over 7000 mL of A-type Rh-positive blood that ultimately saved Yu’s life.

Allegedly thanks to the Tibet office of the Shanghai Municipal People’s Government, a medical specialist from Shanghai was even sent to assist in the medical treatment of Yu at the Ngari hospital.

As Yu later required more advanced medical care and surgeries, she was advised to go to a bigger hospital. She was then transferred via a specially arranged chartered plane. The total costs of this medical chartered plane flight from Ngari to Sichuan’s Huaxi hospital (四川华西医院), arranged by Yu’s father, allegedly cost 1,2 million yuan (US$169.230).

After receiving surgery at the Huaxi Hospital, Yu was in stable condition and was transferred to Shanghai.

 
An Abuse of Power?
 

Yu’s story began drawing notice, eventually garnering nationwide media coverage, after Yu herself posted a video on her social media account (Douyin) in which she recounted her experiences. Yu, who only had a relatively small group of followers, told about her rescue operation and her recovery. But instead of garnering sympathy, it led to many questions from netizens and went viral. The video was later deleted.

Screenshots from the since deleted Douyin video.

Who was the ‘auntie’ who reached out to the Shanghai Municipal Health Commission? How were Tibet public officials made to donate blood for this Shanghai patient? What power dynamics were in play that facilitated the mobilization of people in this manner by the family?

People became upset, as they suspected Yu’s life had only been saved because of an abuse of power, and that ordinary Chinese patients would never have never received a similar treatment.

They started referring to Yu as ‘Sister Blood Points.’ The Chinese term is xuè cáo jiě 血槽姐, with xuè cáo 血槽 (lit. blood groove) often being used in the world of gaming to refer to the health bar, an image in video games that shows the player how much energy or blood or strength they have left before it’s game over.

Various online AI-generated images featuring a portrayal of “Sister Blood Points.”

There were also various digital (AI-generated) images showing Yu surrounded by bags of donated blood, portraying her as a privileged, blood-sucking Shanghai ‘princess’ in Tibet.

Following the online commotion, the Ngari Propaganda Department issued a statement on November 29 promising to look into the issue. Additionally, in the first week of December, various Chinese media outlets also started to investigate the case.

 
An Ordinary Patient in Extraordinary Circumstances
 

On December 6, online newspaper The Paper (澎湃新闻) published an article together with Shangguan News (上观新闻) which answered some of the most pressing questions surrounding the case.

The Paper reported that they found no officially organized mobilization of public officials or members of the public to donate blood. Instead, local workers and individuals donated blood after learning about the woman’s situation through various channels, including from the hospital staff. Yu Yanyan’s husband Tao called the successful blood donation campaign a result of “multi-party mobilization” (“这是我们多方动员的结果,确实不是有组织的。”)

The Shanghai Municipal Health Commission also denied that they had contacted health authorities in Tibet to ask civil servants to donate blood. They claimed their members of staff did not personally know the patient nor any members of her or her husband’s family.

Furthermore, the article says that the woman known as ‘auntie’ is a 60-year-old retired woman who previously worked at a crafts factory. Upon learning about Yu’s predicament, she forwarded the information to her daughter-her-law, who works at a bank and also did all she could to spread the news and ask for help. This eventually led to the Tibet office of the Shanghai Municipal People’s Government being updated on the situation.

The Tibet office has refuted any suggestion that personal relationships influenced the procedures that resulted in the dispatch of a Shanghai medical expert to assist at Ngari People’s Hospital. A Shanghai medical team stationed in Tibet received a request for urgent support at the hospital and, following their ethical work guidelines, dispatched an expert to provide assistance.

The Paper further stated that nor Yu, nor her husband or their family were officials. In order to pay for the medical flight, Yu’s parents used family savings and borrowed money from others.

All of the information that was coming out about the entire ordeal seemed to indicate that Yu was just an ordinary patient in extraordinary circumstances.

 
A Sign of Distrust
 

While certain commenters believe that the latest information has put an end to weeks of speculation, others continue to harbor suspicions that there might be more to the story – they are not satisfied with the answers provided on December 6.

As some netizens dug up screenshots of online calls for help from Tao, Yu’s husband, some commenters responded: “This only makes it clearer that there’s no special status (特殊身份) here. Real influential officials wouldn’t go so low as to seek help online. A simple phone call would have quickly resolved their issue.”

In the end, the entire ordeal, now labeled “The Civil Servant Blood Donation Incident” (公务员献血事件) on Chinese social media, reveals more about public distrust in the transparency of China’s healthcare system than it does about Yu, her family, or the situation in Tibet.

While frustrations regarding privilege and power abuse within China’s healthcare system have existed for years, this issue has gained significant public attention this year in light of the launch of a top-down anti-corruption campaign targeting the healthcare industry.

This issue is especially important due to China’s longstanding struggle with public mistrust in the medical care sector. Some studies even suggest that China’s healthcare system has suffered from a “trust crisis among the public” since the 1990s (Chen & Cheng 2022, 2).

Multiple factors contribute to the relatively low trust in the Chinese healthcare system, but access and costs both play major roles. The sentence “Getting medical attention is difficult, getting medical attention is expensive” (Kànbìng nán, kànbìng guì 看病难,看病贵) has become a well-known expression among Chinese patients dissatisfied with the challenges they encounter in both accessibility and affordability when seeking medical treatments.

Most medical providers in China have become increasingly commercialized and profit-driven since the 1980s, leading to problems with crime and corruption within the medical system as medical professionals are expected to balance both a focus on patient well-being and financial gain. With doctors contending with low pay and incentive-based labor, bribery has emerged as a well-known problem, often considered somewhat of an “open secret” (Fun & Yao 2017, 30-31).

The prevalence of such issues has fueled public frustration, making individual cases like Yu Yanyan’s a source of intense controversy. In an environment where “getting medical attention is difficult, getting medical attention is expensive,” and where corruption is a notorious problem, many people simply do not think it is possible for one young woman to receive so much medical assistance from doctors and civil servants without the involvement of connections, power abuse, and bribery in the process.

Now that more details about the ‘blood point sister’ story have come to light, most netizens have started to question the truth behind this story and realize that Yu might just be an ordinary citizen, while some bloggers are still demanding more answers. In the end, most agree that it is not really about Miss Yu at all, but about whether or not they could expect similar medical treatment if they would end up in such a terrible situation.

“Is there currently an emergency response system in place that allows ordinary people to seek help in equally urgent crises?” (“当前是否存在一个紧急响应机制,可以让普通人在遇到同样紧急的危机时,能寻求帮助?”) one Sina blogger wonders.

“It is actually not important to know if they had special privileges or not,” one Weibo commenter writes: “I just hope that if patients need donated blood in the future, they will get the same treatment.”

By Manya Koetse, with contributions by Miranda Barnes

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References:

Chen, Lu, and Miaoting Cheng. 2022. “Exploring Chinese Elderly’s Trust in the Healthcare System: Empirical Evidence from a Population-Based Survey in China.” International Journal of Environmental Research and Public Health 19 (24): 16461-.

Fun, Yujing & Zelin Yao. 2017. “A State of Contradiction: Medical Corruption and Strain in Beijing Public Hospitals. In: Børge Bakken (Ed.), Crime and the Chinese Dream, Hong Kong University Press: 20–39.

Spotted a mistake or want to add something? Please let us know in comments below or email us. First-time commenters, please be patient – we will have to manually approve your comment before it appears.

©2023 Whatsonweibo. All rights reserved. Do not reproduce our content without permission – you can contact us at info@whatsonweibo.com.

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China Health & Science

Cancer Diagnoses in Young Doctors at Same Lab: About the Zhongshan Hospital Controversy

Within a short time frame, three Chinese young doctors received cancer diagnoses after working in the same laboratory at the Zhongshan Second Affiliated Hospital.

Manya Koetse

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Several medical workers who all worked at the same renowned oncology lab in Guangzhou recently were diagnosed with cancer. Although there are many concerns about whether or not their cancer is related to their working environment, the primary source of public outrage revolves around the handling of the controversy by the affiliated hospital.

Over the past week, a case of three young doctors working in the same laboratory at a renowned Guangzhou hospital being diagnosed with a rare form of cancer has repeatedly become a trending topic on Weibo and beyond.

The hospital involved is the Sun Yat-Sen University’s Sun Yat-Sen Memorial Hospital (中山大学孙逸仙纪念医院) – also known as the Zhongshan Second Affiliated Hospital (中山二院). Founded in 1835, the hospital is known for pioneering in western medical practice. It is also well-known for its cancer treatments and education.

The three medical workers, two breast surgeons and one trainee doctor, all developed cancer just before or in 2023 after working at the Breast Cancer Center (乳腺肿瘤中心实验室). The issue first became a big topic of discussion around the night of November 6 and on November 7, when netizens’ posts started circulating on social media about how several people connected to the oncology lab got diagnosed with cancer.

One of the claims made is that one of the young doctors was expelled from the research team’s WeChat group by the team leader Dr. Su Shicheng (苏士成) upon revealing her cancer diagnosis. This assertion was later confirmed to reporters by the woman’s sister, Lele (乐乐). The staff member involved, Huang Mei (黄敏), is battling pancreatic cancer and she is currently not doing well.

The other researchers, all approximately 30 years old, are suffering from synovial sarcoma and breast cancer.

The topic soon gained traction as people assumed the lab safety at the Zhongshan Hospital must be blamed for the cancer cases. When the research center in question suddenly got dismantled on November 8, the discussions intensified as social media users speculated that the hospital was trying to get rid of evidence.

The hospital denied that the medical workers had contracted cancer due to exposure in the lab environment. Staff members later claimed that the alleged dismantling of the lab on November 8 was already scheduled as part of the fire department’s orders, emphasizing that it was unrelated to the ongoing controversy.

Photos of the lab getting dismantled shared on Weibo.

On November 9, the China Association for Science and Technology (中国科学技术协会) posted on their official social media account, calling for a thorough and professional investigation into the case to uncover the truth.

 
Online Anger and Suspicions
 

Chinese political commentator Hu Xijin (@胡锡进) also posted a lengthy column about the issue on his social media. In his post, Hu critiqued the manner in which Zhongshan Second Affiliated Hospital handled the controversy. Although he also stressed that he did not necessarily believe that the renowned hospital purposely crossed scientific ethics that might have increased cancer risks for students working in the laboratory-if their cancer is indeed related to their working environment,- he argued that the hospital should handle this case with greater transparency.

According to the Shanghai Morning Post (@新闻晨报), the laboratory was first opened in 2009 and has since trained more than 200 students. The three cancer patients have only started working at the laboratory in recent years.

Various international studies (e.g. here, here, here) have previously indicated that research in biomedical laboratories might involve an increased risk of certain types of cancer among employees.

While some Weibo commenters voice concerns about safety protocols at the hospital lab, the prevailing online anger is more about how the hospital is handling the situation. There is a sense that those involved are being silenced, that evidence is being tampered with, and that there is a special relationship between the lab team leader, Dr. Su Shicheng, and the hospital director, Song Erwei (宋尔卫).

Adding to the suspicions, Dr. Su not only works directly under Song as a deputy director of the Breast Cancer Center but has also co-authored an academic essay with Song’s son, Song Shijian (宋世键). Some people believe they are all covering for each other.

“If they [the hospital] finally holds a press conference, they’d better invite Ms. Huang who was kicked out of the WeChat group!” some commenters on Weibo wrote.

Meanwhile, there is an increased media focus in China on the lab safety protocols at other hospitals as well. With Chinese media outlets interviewing medical students from other institutions, it has come to light that many say they have never actually received formal training regarding lab safety rules (#5位医学生眼中的实验室#, #多数受访学生称未接受实验室安全培训#).

As attention on the Zhongshan Second Affiliated Hospital case intensifies from various fronts, including the public, media, and medical associations, the pressure on the hospital is mounting to provide a clear and transparent response to the situation.

While many might wish for this case to fade away, this storm is not going to blow over anytime soon. Beyond the public’s need for answers, it is the medical workers who are struggling with their illness and navigating through this whirlwind who especially deserve the clarity they need.

“Let’s build up the pressure,” some netizens suggest, trying to keep the case trending.

“I’m so disappointed,” another Weibo user wrote: “I was determined to study medicine since senior high school, but the older I get the more I realize the ugly face behind the healthcare system.”

By Manya Koetse

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©2023 Whatsonweibo. All rights reserved. Do not reproduce our content without permission – you can contact us at info@whatsonweibo.com.

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