Doctors Overwhelmed By China Quake Victims

After 11-year-old Zhang Jiazhi wriggled free of the rubble that remained of his middle school, he and his parents faced a new ordeal - saving his arms, which were crushed to a pulp.

The nearest hospital to their farming village turned them away because aftershocks from Monday's thunderous earthquake were rattling the building. They dashed across to the city's main square, which was turned into a triage center teeming with thousands of injured overwhelming the doctors and jostling to get on ambulances.

Getting medical treatment for victims in China's disaster zone is proving a struggle, both for the injured and for exhausted medical workers who survived the quake.

Medicines, blood, needles, doctors and just about everything is in short supply, except for the injured.

Twenty hours after Jiazhi's arms were smashed by debris - after he and his parents squeezed into an ambulance with nine other people, then waited hours in a packed emergency room at another hospital - the doctors operated.

By then, it was too late. Jiazhi, who loves pingpong and carving wooden toys for his friends, had both of his arms amputated.

"So many people were also hurt, many worse off than my son," said his father Zhang Qingyou, a farmer with high cheekbones and a sad smile. "I tried to ask the doctor to at least save his right hand, which he writes with. But they said it was too late."

Across the earthquake zone, many hospitals were obliterated or rendered unsafe. Options for the injured are the ones that remain standing or the numerous makeshift care centers that have sprung up on the front lines of badly damaged towns. All are overwhelmed with injured still pouring in from hard-hit areas three days after the quake killed nearly 20,000 people.

"What do we need? We just need some rest," said Wu Tianfu, a doctor at a tent set up by the Red Cross Society of China in the town of Hanwang, where hundreds of school children died.

"Then we need gloves, masks, iodine, sutures, cold medicine," said Wu. "It's a long list."

The disaster has hit a health system that has been sorely neglected in China's spectacular economic rise. Underfunded by the government and unaffordable to most, health care is acutely poor in inland areas like Sichuan province where the magnitude-7.9 quake struck, highlighting the yawning gap between increasingly prosperous urbanites and still-struggling rural Chinese.

"The public health care system in China is insufficient," Vice Minister of Health Gao Qiang told reporters in Beijing on Thursday. Gao suggested that the government would pick up the costs of care to earthquake victims, many of whom have insufficient or no insurance.

"How are we going to solve the medical expense this time will be an issue," Gao said. "The government should be responsible for providing medical treatment to them."

So far, Gao said there were no reported outbreaks of epidemics. But he called on officials to ensure the safety of drinking water, prevent infections, immunize those left homeless against diseases and properly dispose of corpses.

Some of those tasks are likely to be difficult, given the shortages in the disaster area. Gao said disinfectants - a basic need - were scarce. The International Red Cross has issued an emergency appeal for medical help, food, water and tents.

Deyang City People's Hospital, the largest in an area of several quake-devastated counties and where Jiazhi was treated, has seen more than 1,000 injured. Supplies of blood, disinfectants and needles were used up in the first two days, said the hospital's Communist Party secretary. Operating rooms were moved from the 12th floor to the 2nd in case of large aftershocks.

Ambulances rush up every few minutes to the 800-bed facility, carrying people swaddled in quilts, faces swollen and crusted with blood. Teams of doctors and nurses immediately swab their wounds with alcohol and murmur diagnoses.

"They just keep coming, group after group of people who are hurt," said Deng Xiaoling, a doctor who was examining a crying 11-year-old girl, her back, head and legs were gashed after escaping from the ruins of her school in Hanwang.

"Under normal circumstances, the children shouldn't have complications," said Deng. "But now the weather is very hot, they aren't eating, their immune system is weak and this could lead to complications or problems that we don't want to face."

In the driveway of the emergency center, a handwritten list is tacked to a notice board with name after name of the injured. "These numbers are not complete," it says. Nearby, makeshift shelters with plastic sheets as roofs are crammed. Patients' limbs are wrapped in think gauze bandages and their arms are hooked up to intravenous tubes. Relatives surround them, and volunteers offer them porridge, cakes and sweets.

On Monday, Jiazhi was on the second floor of his school in the village of Libing, outside the city of Shifang, when the quake roared through area. Two chemical plants in Shifang collapsed and more than 600 people were buried. Panic spread.

Jiazhi was among the last to leave the building before it crumbled. Knocked over by debris, he was helped up by a classmate and stumbled out on his own, his scalp gouged by chunks of concrete.

"His flesh was ripped from his arms. I could see his bones," said his father, who rushed to the school when he felt the ground shake. "We didn't know what to do."

Turned away from Ningjie Hospital, the family ended up at Shifang's main square 12 miles away, fighting for doctors' attention, Zhang said. Of the nine people in the ambulance, Jiazhi and two other passengers were injured and on stretchers; the rest were family members.

The normal 30-minute drive Shifang to Deyang took more than twice as long over accident-clogged roads. Then came the packed Deyang hospital, as he and his parents had to wait yet again for a diagnosis. After four hours, Jiazhi was sent to an operating room, where seven other patients lay on tables and doctors performed surgeries at the same time.

The doctors couldn't save his arms, Zhang said, because "after two hours, they said the nerves and blood vessels die and there's no way to get it back to normal."

On Thursday, Jiazhi lay on his bed, his left arm amputated just under his elbow. His right arm was cut off close to his shoulder. The boy, who has a round face and long lashes, is silent and expressionless.

Lin Yiping, his mother, said her son was always at the top of his class and always went to school early to sweep the floors. He loves riding his bicycle and his toys - imaginative creations he carved himself - were a favorite among his friends.

"He hasn't talked since the operation," said Lin, sobbing. "He's only cried once since the earthquake, when they told him he no longer had his arms."