FEATURE: Medivac baby kicks up a storm

Penghu baby Gan Yi-chen is pictured in Taipei after being transferred from Penghu to the Tri-Service General Hospital on a military aircraft last Thursday. PHOTO: CNA

"Penghu preemie baby refused evacuation to Taipei," ran the Chinese-language United Daily News headline last Thursday. "Medivac service won't transport palm angel -- mother enraged," read the Chinese-language Apple Daily headline of the same date.

At the center of the controversy was three-month-old Gan Yi-chen (甘宜貞), whose collapsed lung and retina problems necessitated her transfer from Penghu's Tri-Service general hospital to a larger facility on Taiwan proper.

The National Aeromedical Approval Center (NAAC) approved the baby's evacuation by plane to the closest hospital in Kaohsiung or Taichung, but the baby's mother, Lin Chung-wei (林瓊薇), was adamant that Gan be taken to Taipei's Tri-Service general hospital.

"I'd rather have her remain in Penghu if she can't be sent to Taipei," Lin was quoted as saying in the United Daily News.

NAAC executive medical director Tsai Shin-han (蔡行瀚) said the plane's cabin was not pressurized or air-conditioned, and therefore: "The longer the baby is in the air, the more dangerous the flight is likely to be."

The NAAC service, which began in 2002, provides emergency medical transport for people on Penghu, Matsu and Kinmen by taking them to the nearest appropriate hospitals on Taiwan proper.

The impasse was only broken when President Chen Shui-bian (陳水扁) intervened, authorizing the use of a military airplane to transport the baby to Taipei. The airplane, a C-130 Hercules, is bigger than a medical airplane and has a pressurized cabin.

The baby arrived safely at Taipei's Tri-Service general hospital the next day, but the controversy over the propriety of the decision has only just begun.

The director-general of the Taiwan Health Reform Foundation (THRF), Hsiao Min-hui (蕭敏彗), criticized the decision that made an exception for baby Gan.

"It's unfair that baby Gan received special treatment because of the media attention," Hsiao said. "A good system should work for everyone regardless of whether they appeal to the press or to politicians."

"The case raises a legitimate question of whether medical evacuation airplanes serving the Penghu area should be pressurized for the sake of cases like baby Gan whose lung functions are compromised," she said. "However, any improvements should be systemwide rather than to help any one individual. Life is precious whether or not we read about it in the newspapers."

A system should be implemented and put in place so that those who wish to designate a specific location for evacuation can pay the difference between the cost of transporting to the nearest medical facility that meets their needs and the medical facility they desire, Hsiao said.

"Otherwise, the detour is a waste of taxpayer money, regardless of whether it is done on a medical or a military airplane," she said.

While talking with reporters after a press conference on the matter, Mary Huang (黃美娜), chief of the Department of Health's (DOH) Bureau of Nursing and Health Service, described Lin as "self-centered."

"Her request was out of line," Huang said. "There are many excellent medical centers in Kaohsiung capable of giving baby Gan excellent medical care."

"Whether or not the mother's home town is Taipei should not be a factor in medical evacuations,"Huang said. "Our policy is to take patients to the closest medical facilities where they can get the care they need."

"I strongly hope that other people don't follow this mother's example," Huang said. "The system can't work properly if people don't play by the rules."

Some observers, however, offered a different view.

"It is not wrong for the mother to want to be near her family when her baby is so sick," said Lyu Shu-yu (呂淑妤), director of Taipei Medical University's School of Public Health.

"It is not improper to take an individual's non-medical needs into account when evaluating evacuations," she said.

"It's not as if the DOH never makes exceptions ... especially for people in positions of influence," Lyu said.

"The DOH should get over its self-righteousness," she said.