The clinics that can kill

Within Shanghai's often ultra modern and efficient medical system there is a disease that is preying on people. It's a disease that can cause permanent harm, sometimes death. It is the disease of the illegal medical clinics which flourish in outer suburbs and attract their patients from poor people, migrant workers who do not qualify for the city's health insurance or unfortunates who seek quick cheap remedies for illness.

Like the attractive 20-year-old Xiao Li who attended a clinic in Minhang district, complaining of the symptoms of a common cold or flu. She died the next morning after suffering an anaphylactic shock from an intravenous antibiotic she was given at the clinic.

The "doctor" was 35-year-old Cong Shanguo from Anhui Province. He was unlicensed to practice and in fact only had a diploma from a medical trade school which trained nurses or medical technicians, not doctors. He was running the underground clinic in Minhang district in 2005 and had never had a license for it. He has now been arrested and thrown into jail, on the orders of the local prosecutor, for medical fraud and malpractice, according to the Jiefang Daily.

Medical fraud is when an unlicensed or unqualified person offers medical diagnosis or treatment or establishes a clinic. These illegal clinics are usually hidden away in apartment blocks or small villages in the suburbs and rely on word of mouth or small, localized advertising to attract business.

Thousands closed

Last year the city government shut down 2,052 illegal clinics, confiscating 3,295 boxes of medicines and 39,267 medical instruments in the process. From this, 191 cases were handed to the police and 102 people were prosecuted for criminal offences. Some 33 percent of the clinics raided offered dental treatments.

The section chief surnamed Fu with the supervisory department of prevention and control of infectious diseases at the Minhang Institute of Health Inspection said, "Most of the illegal clinics in Shanghai deal with general medicine, gynecology or dentistry. In recent years, there's a new trend with the emergence of illegal cosmetic treatments."

Located in the outer suburbs of Shanghai, Minhang is one of the districts where illegal clinics have thrived. Before 2009, there were more than 500 clinics there but after crackdowns Fu said there were only about 100 left now.

Ni Yiyuan is one of the many people who wish that there were no such things as illegal clinics. The migrant worker was diagnosed with gallstones in 2011 and her doctor had suggested surgery but the cost was prohibitive, she thought. Her husband found a business card advertising a clinic locally and they decided to have the gallstone operation at the clinic which promised to perform the operation for a great deal less.

However, when she was given a 60-yuan ($9.65) antibiotic IV drip she suddenly felt her temperature drop and struggled to breathe. She was rushed to hospital where she was treated and recovered. The "doctor" at this clinic was Xu Feng whose medical training consisted primarily of some village-based courses in nursing and medical technology.

Xu said that he opened the clinic because he could not find any other work in Shanghai. With only some basic medical training, he handed out business cards to workers on a neighboring building site. He had no idea that Ni had a history of allergies and had not inquired. The local prosecutor said that Xu had been caught for similar offences twice before and this time he was sentenced to seven months in jail for running an illegal clinic.

The problem is often a matter of economics. "Most of the clients of these illegal clinics are migrant workers and low-income residents who are ignorant about professional medical practice and believe that these clinics are more convenient and cheaper than the State hospitals," Fu told the Global Times. "Migrant workers have been accustomed to outdated and very basic medical care in their hometowns, where people just have to answer a few easy questions to get medicine quickly."

To help relieve the economic burden on migrant workers and dissuade them from using the illegal clinics, Minhang district is now offering pregnant migrant women a 600-yuan obstetrical examination, half the price of a public hospital exam. It leads the city with this move. As well, for workers with minor complaints like flu or coughs, Minhang is also offering discounts at general hospitals. Patients will be able to see a doctor and collect prescribed medicine for 10 or 20 yuan. "This is an effective way of preventing cash-strapped migrant workers from seeking out illegal clinics," Fu said.