Kunming City Profile
The Availability of Healthcare in Kunming
Kunming is a second tier city, developing at an exponential rate. Located in the country of China, a Less Economically Developed Country (LEDC), one of the fastest developing nations in the world, developing their economy at consistently high growth rates. In 2014, the real Gross Domestic Product (GDP) growth rate of China amounted to a 7.4% increase. Furthermore, the nominal Gross Domestic Product of China in 2014 was the second highest in the world, amounting to approximately 10 trillion US dollars. Therefore, it is unsurprising that Kunming, too, is expanding and developing, despite its more remote situation.
Nestled amongst a plethora of ethnic minorities and geographical wonders, the city has a rich and unique mixture of culture and scenery. However, the city, and the province encapsulating the city, Yunnan (of which Kunming is the capital), are quite underdeveloped, detached from the rapid development of the rest of the country. This has left the area backwards in culture and technology, and the area is rampant with diseases, such as AIDS and HIV. This situation is further worsened by the ubiquity of congenital disorders, as a result of inbreeding amongst small ethnic minority clans, as explained by a Dr. Vivienne Ho, a Hong Kong based doctor who frequently visits the area to treat patients with such disorders. With the presence of such a variety of healthcare issues, is the infrastructure of Kunming sufficiently developed to treat those in need?
The number of hospitals in Kunming
Firstly, a hospital is defined as a medical institution with 20 or more beds. Above is a visual representation of the hospital diversity in Kunming. As stated above, there are 157 hospitals in Kunming. Furthermore, there are over 1100 clinics spread out across the city.
The most common type of hospital in Kunming is a general hospital, which is usually a large hospital with multiple departments, that seeks to treat a wide range of health-related issues. In most contexts, general hospitals practice Western-style medicine, performing surgeries and antibiotics.
On the contrary, and more surprisingly, Chinese Medicine hospitals were much less common, with only 10 hospitals distributed across the city. This is an interesting finding, as Chinese people usually prefer Chinese medicine, with 34% preferring traditional Chinese medicine over Western medicine. Furthermore, a significant contingent of the Chinese population distrust Western medicine completely. However, the lack of Chinese medicine hospitals can be attributed to the definition of a hospital. It is extremely possible that Chinese medicine is limited to smaller shops and clinics, instead of large institutions, like that of a hospital. Furthermore, Chinese medicine is often applied at a domestic level. However, it must be noted that in many Chinese general hospitals, Traditional Chinese Medicine has been incorporated, to appeal to a larger demographic.
Revisiting the distribution of hospitals in Kunming, it is most likely that in the instance of an emergency, the general hospitals would be the only ones equipped with the facilities to respond to emergency situations, i.e. an emergency intensive care unit. Therefore, it can be assumed that the general hospitals would be the destination of ambulances. When analyzing the map above, detailing the distribution of general hosptilals, it can be seen that they are distanced quite evenly over the entire city, and that the furthest away from a general hospital one can be while in the city is 2.5km. Therefore, distance-wise, the city is quite well equipped to prepare for emergency response.
However, according to Ms. Choi, a student attending Kunming International School, whose interview is available below, the traffic in Kunming can be quite serious, and at rush hour, it can take her an hour to travel 10km. With this taken into consideration, it can be assumed that it can possibly take up to 45 minutes for patients in critical condition to be exfiltrated and brought to a hospital. In certain cases, this is not enough time to save the patient. While this may be the case, this is quite standard for many places, and therefore isn’t greatly lacking.
The population of Kunming was at 3.8 Million people, according to the Economist, very similar in size to that of Los Angeles. However, in contrast, Los Angeles has 124 general hospitals alone, 27 more than there are in Kunming. In the United States, especially in large cities such as Los Angeles, the availability of health care is not as major of an issue, and by comparing the two cities, we can then gauge the severity of the issue. As seen above, there is a large difference in the number of hospitals in the area, indicating that the healthcare already available in Kunming may not be sufficient to accommodate all of the people in the city.
Accessibility of Healthcare - Can the Population Afford it?
While we have already established above that there are a number of medical institutions residents of Kunming can avail from, it is another matter whether the residents of the area can avail of these services. The gross domestic product per capita of Kunming is quite low, at 4,556 USD per year. As mentioned previously, Kunming is quite remote and backwards, and the standard of living in the city is not very high. While there are health care facilities, a more important question to ask would be whether the residents of Kunming can afford them.
In China, healthcare is not subsidized by the government. Furthermore, with the average person living on such a limited amount, these people would not be able to avail of insurance to cover healthcare costs. It would not be surprising if the healthcare was too expensive for the residents of Kunming to afford. Therefore, the problem extends from the city lacking in healthcare to people not being able to access the healthcare due to monetary concerns.
However, there have been numerous examples of charitable efforts to help combat this problem. Many humanitarian organizations have been sending doctors to the area to work with underpriviledged patients in the area, to give them ready access to healthcare. Dr. Vivienne Ho, a Hong Kong-based doctor, says she has been to Kunming many times to help treat children who cannot afford this healthcare, especially those of the many ethnic minorities in the area. She says that she has visited the area both with charitable organizations, as well as independently, with colleagues in her hospital. In a brief exchange with her, she mentioned that her activities in the area included open heart surgery, amputation and removal of gangrenous extremities. She also mentioned that such trips to Kunming, and other under privileged parts of the world, were common with the doctors in her circle. Another example of a charitable effort in the area is the Sanford-YMCI Calmette clinic, a non-profit pediatric clinic treating underprivileged children.
Public Opinion on the Healthcare in Kunming
While it was previously mentioned that a large percentage of the Chinese population distrust Western medicine, it can be noted that amongst wealthier Chinese people, they have been turning to foreign corporations to get their healthcare. In 2011, Sanford opened a clinic in Kunming, to cater to th increased demand in the area. Furthermore, in an article released by BBC, it was expressed that multinational health corporations, such as Phillips, are doing very well in China, as the demand for foreign health services grows.
Interview - KIS Student
To gain an understanding of the residents opinions towards healthcare in Kunming, a student at Kunming International School Ms.Choi, was interviewed regarding their opinion towards healthcare.
Do you trust healthcare in Kunming?
Not entirely. Being an expatriate in a community not often frequented by foreigners, there is a certain stigma towards us foreigners. Also, being an expatriate, we do feel kind of entitled… So when looking for hospitals or doctors, we usually go to other foreigners or people working for foreign health companies for our treatments.
Do you feel that this is the case for expatriates in other parts of the world?
No. I have moved around quite a bit, and lived in Seoul, Tokyo and Bangkok. In Seoul and Tokyo, I would go to local hospitals, as the standard of healthcare in these areas was quite high. What also might have helped was the fact that I spoke the language. However, in Bangkok, I would look for expatriate or more high end hospitals, as we didn’t really trust the local hospitals. Finally, in a place like Kunming, with lower living standards, and minimal external exposure, we really don’t trust the hospitals.
Which hospitals do you trust then?
The US Embassy Chengdu website has a very comprehensive list of the trustworthy hospitals in the area, that practice western medicine to a standard deemed acceptable to the US.
What makes a hospital trustworthy?
Being a foreigner, I have foreign standards towards healthcare. In China, these standards don’t necessarily match up with those of the other places I have lived in. So to me, trustworthy hospitals are hospitals that reach the standards that I am used to in my home country.
Do you think the majority of the Chinese population can access the healthcare?
While it isn’t as expensive as it is in other countries, it is still pretty expensive, and I don’t think that many of the residents in Kunming can afford it.
Looking to the Future
Kunming is undergoing urban growth at an extremely rapid rate, with the population expected to increase by 50% by 2020. As already stated, there is a deficiency in healthcare in the city. It is very questionable whether the development of the healthcare can keep up with the rapid growth of the city. Furthermore, with such rapid rates of growth, it is questionable whether the standard of living will also improve. Often, with such rapid rates of growth, the infrastructure cannot develop at a sufficient pace to keep up. Also, especially in underdeveloped communities, the wealth gap widens. Therefore, healthcare in Kunming does not have an optimistic outlook.