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Talk of the Day -- The endless waiting for life, death in Taiwan

2012/07/29 20:12:07

Elected officials have been complaining that the things they have to help their constituents with now extend to securing hospital berths for women about to have children, hospital beds for people with illnesses and openings to be cremated at funeral homes.

In short, their services cover all stages of life, from its beginning to its end.

The high demand and the long waits are because many people want to choose "auspicious" times for Caesarian sections to deliver their babies or to cremate a body.

The following are excerpts of reports on the issue by the United Evening News:

Some lawmakers have said, in a self-mocking tone, that their constituent services now cover everything in life from cradle to grave.

Why are people asking their representatives to lobby for time slots to cremate a body? Lawmakers say the government has promoted cremation over burial and banned bribery in the funeral business, but people are still influenced by the superstitious tradition of choosing an "auspicious hour" for when people come into and leave the world.

In metropolitan areas, where public funeral houses are administered by local governments, such services are transparent and cremation schedules are made public in advance.

Under such circumstances, it is difficult for publicly elected officials to intervene, and lawmakers often have to say "sorry, I can't help" to their constituents.

According to one lawmaker's assistants, the representative receives tens of requests a year for favorable cremation slots, but only half are given a favorable response because some funeral parlors simply cannot agree to such "special requests."

An even greater number of requests are made each year to help people get a hospital bed -- either in an emergency room or ordinary room -- or to schedule surgery. Sometimes, the patient's family members simply request help in changing a room from one division of a hospital to another.

Lawmakers say they receive such requests because their constituents were told by the hospital that no beds are available. Even when a patient is staying in an emergency ward, the family does not know when a normal hospital bed will become available.

"This is the reason for people requesting help in getting a bed in a hospital. The hospital should design a system to tell people, in a more transparent way, when they will get a bed," said a lawmaker who declined to reveal his name.

The crowded situation is not limited to services for the sick and the dead. Taiwan's declining birth rate has not helped free up openings in hospitals for procedures to give birth.

Gynecological services are distributed unevenly because of manpower problems in hospitals in rural and in urban areas.

Huang Ming-chau, the secretary-general of the Taiwan Association of Obstetrics and Gynecology, said many parents-to-be prefer to have their babies born in a large hospital, leaving smaller or rural hospitals without many opportunities to deliver babies.

For example, the three gynecologists at Cathay Hospital in Hsinchu need to deliver 250 babies a month -- a work rate that almost crushes the doctors. To make matters worse, the hospital does not have enough beds for child bearing mothers.

Huang's association said 43 percent of rural hospitals do not have a single gynecologist, and 60 percent cannot even arrange for one to help give births.

Huang said the lack of incentives under the national health insurance program for childbirth services and the high frequency of medical disputes in this medical discipline have driven down the number of physicians who choose to become gynecologists.

As a result, the association is thinking of promoting a Japanese-style "pre-registration" system under which a pregnant women is given a "new mother's manual" that tells her to go to a certain hospital for regular check-ups during her pregnancy.

Shih Chung-liang, director of the Medical Affairs Bureau of the Department of Health, supported the association's idea, calling it "very feasible" since childbirth is not an emergency but something that can be planned.

Taiwan's hospitals are often crowded not just for childbirths, but also for surgical procedures. One reason, again, involves the tradition that the lunar month of July -- or "ghost month" which begins Aug. 17 this year -- is not considered a good time to go under the knife.

The folkloric taboo puts pressure on hospitals to perform more surgeries ahead of ghost month, leaving doctors extremely busy.

Compared with this "seasonal" uptick in requests for operations, the overcrowdedness in hospitals' emergency wards is a year-round phenomenon.

Chu Hsien-kuang, head of R&D at the Taiwan Healthcare Reform Foundation, said some major hospitals receive so many emergency care patients that they have to "seize" ambulance stretchers as beds -- and stop ambulances from bringing in more patients.

Chu pointed out that emergency rooms are overcrowded partly because patients without urgent needs, who have failed to make a clinical appointment for weeks, simply turn up and use the emergency room as a service that "costs just a bit more than usual" to get a prescription.

He suggested that hospitals screen out such patients and treat them as non-urgent cases to ease the burden of medical workers at emergency wards. (July 29, 2012)

(By S.C. Chang)