Chapter 1880 - Out with the Old, In with the New (Part 16)

After hastily issuing several orders, Liu San realized his knowledge of public health and epidemic prevention was limited to the general courses he had taken during his years at the legislature—merely at the level of "awareness." His commanding and directing here was in any case "unprofessional."

"Quick! Prepare the sedan! To the Provincial-Hong Kong General Hospital." Liu San suddenly seemed to remember something and issued the loud command, then grabbed his briefcase and headed out the door.

As the Guangdong situation gradually clarified, the tiny Naval Hospital in Hong Kong could no longer meet the medical needs of Guangdong's military and civilians—it couldn't even satisfy Guangzhou city alone. Though the Health Department had organized a mobile medical team for the South China Army, this team's medical center was stationed at Sanshui, the Fubo Army's logistics hub. The only thing that could meet the health needs of Guangzhou's citizens and cadres was the lone Commissioner Liu San that the Health Department had sent.

Liu San had incorporated the "medical officers" of the medical tradition in Guangzhou and received support from the Runshitang pharmacy, barely managing to provide minimal medical services for naturalized cadres and Elements. Some difficult emergency cases still had to be transferred to Hong Kong's Naval Hospital. But this service was becoming increasingly unsustainable as large numbers of local civil servants and police were hired—never mind providing medical services to Guangzhou citizens.

Under such unbearable circumstances, he still had to attend to Guangzhou's epidemic prevention work. Liu San had no choice but to telegram the Health Department, requesting that "no matter what, send people to support us immediately."

When this telegram reached Deng Bojun's hands, it became an excellent weapon. He went to the Department Head to discuss it, and by the time he came out of the office, the "Provincial-Hong Kong General Hospital"—a case that had long been "discussed but never decided" by the health authorities—was finally officially settled.

Like other hospitals under the Executive Council's governance, the newly established Provincial-Hong Kong General Hospital had a grand name but minimal staffing—not because they were denied staff, but because qualified personnel were simply too scarce. But it was still a breakthrough from nothing to something. As the Element Dr. Lin, who was appointed as the General Hospital's director, later wrote in his memoirs: it "brought the first ray of dawn to the pitch-dark Guangdong health enterprise."

Before the transmigration, Dr. Lin had been an unremarkable young surgeon in Guangzhou. Though he was a graduate of Sun Yat-sen University Medical College, he unfortunately had only a master's degree—in a medical world where "masters were as common as dogs and doctorates were everywhere," that really wasn't an impressive credential. Having barely squeezed into a Guangzhou Grade-A hospital, he could only bitterly wait his turn for advancement.

After transmigrating, the unremarkable Dr. Lin had quickly gained importance at Baireng General Hospital: there weren't many professional physicians among the health-related Elements, and professional surgeons were even rarer. Selecting him for Guangzhou as hospital director naturally also implied supporting the front lines—after all, battle wounds mostly required surgical treatment.

The sedan moved slowly through streets piled with rubble and mud. Liu Xiang's "dig up the whole city" campaign had made the already narrow streets even more impassable. Not only could the public service horse carriages transported from Lingao not be used, even rickshaws were unusable. Elements going out either walked or had to use sedan chairs.

The sedan carried him out the Great East Gate, heading straight for Guangzhou Great World.

The Provincial-Hong Kong General Hospital was really just a signboard. Its physical basis was the health station originally in the Great World, with no more than twenty beds—but it did have a simple operating room, which was quite a high standard among the Health Department's subordinate medical facilities. Deng Bojun had made a fuss about setting up the Provincial-Hong Kong General Hospital for revenue precisely because he had his eye on the Great World health station's equipment.

Liu San, carrying a stomach full of worries, was carried into the Great World. The Great World had two parts: an "inner world" and "outer world." The "Inner World" was accessible only to Elements and relevant naturalized citizens. The health station was on the first floor of this "Inner World."

Though the Great World was heavily guarded, once inside the "Inner World," the atmosphere relaxed considerably. Liu San alighted from the sedan and came to the room bearing the sign "Provincial-Hong Kong General Hospital Office." Pushing open the door, he found Lin Motian studying a document with a grave expression, making marks with a pencil while sighing. He was so absorbed he didn't even notice the door opening.

"Old Lin, what are you reading?" Liu San found Lin Motian's expression quite familiar—not from knowing Lin Motian well, but because Element Liu had recently been seeing this expression frequently in his own mirror.

"Oh, Dr. Liu..." Lin Motian quickly stood up. "Please, come in... have a seat."

"Why such a suffering expression?" Liu San didn't sit but walked to the desk and picked up the document that had furrowed Lin Motian's brow. Just glancing at the title, Liu San's heart sank—Report on the Progress of Epidemic Prevention Work in Guangzhou Special Municipality.

"May I look at it?"

"You're a leader in the health sector—of course you can. But this is just a draft."

By rights, this wasn't work for a clinical surgeon like Lin Motian—Lei En was the genuine epidemic prevention specialist. But this Lei En had long been anchored in Gaoxiong as the responsible person for health work and as the Element doctor there. Even after the refugee transfer operation had largely concluded, Taiwan's malaria prevention work remained extremely demanding.

So Guangzhou's epidemic prevention work had fallen on the shoulders of this recently-arrived Director Lin. Though Lin Motian had always shown great respect for the senior figures in the health authorities and had never actively sought positions—seeming to maintain the aloofness of a "pure technical cadre"—those who had worked with him knew he was absolutely not someone with few desires or no pursuit of power. Quite the opposite: having missed the first wave of promotions and titles, Lin Motian was quite active in seeking advancement. His requesting approval to establish the Provincial-Hong Kong Medical College and Anesthesiology Department as soon as he arrived in Guangzhou was good proof.

However, this didn't make him annoying. Having ambitions meant he wanted to do things, Liu San thought. In an environment where many Elements were content with their comfortable lives on Hainan Island, those dedicated to practical work were still valuable. Since everyone had transmigrated without any noble idealistic motives and were almost destined to become founders or leaders in their respective fields, having such aspirations was only natural.

"To tell the truth, it's pitch dark." Lin Motian watched him flip through the report, smiling bitterly. "The things that need doing are as numerous as ox hairs, yet we can't do a single one!"

Though Liu San hadn't drafted this report, it looked familiar: much of the data and many passages came from research reports he had organized.

From a public health administration perspective, Guangzhou's health work progress could hardly be called satisfactory—even though these advances were already earth-shattering for Ming dynasty citizens. Because the New Life Movement promoted by the Executive Council and the implementation of basic immunization programs like cowpox vaccination were gradually being rolled out, common epidemics like dysentery, smallpox, and intestinal infections had all shown marked improvement compared to previous years. Especially the control of smallpox—Ming dynasty citizens were no strangers to "human pox" inoculation for preventing smallpox, so they accepted the safer cowpox much more readily. Moreover, "cowpox vaccination" came with fee reductions. With the promotion of the "New Life Movement," habits like "don't drink unboiled water" and "three managements, one elimination" were gradually spreading through the Fubo Army's bayonets, the health police's batons, and the baojia wards' propaganda and supervision.

Urban hunger was also being progressively eliminated, so the dysentery and various intestinal infectious diseases common in spring and summer had also been greatly mitigated. Moreover, the Executive Council had powerful weapons against gastrointestinal infections: intravenous infusion plus antibiotics. The spread of these three diseases in Guangzhou had improved considerably compared to previous years.

On the other hand, from a less politically correct perspective, for Elements or high-ranking naturalized cadres who had early on received various vaccinations and enjoyed special food supplies and incomparable sanitary conditions, infectious diseases like smallpox and cholera were preventable and treatable—not so frightening. So they weren't especially worried about these types of epidemics.

But the health authorities were still dissatisfied with the overall situation. By old-timeline standards, both plague and cholera were Class A infectious diseases of the highest level—the kind that required immediate reporting upon discovery. Yet now they hadn't even established basic community health centers or village health stations. Grassroots institutions were a mess. Apart from the health police under the national police system, they could hardly claim to have any frontline epidemic prevention workers. The difficulty of mobilizing the masses for health work far exceeded the situation in Qiongzhou. Therefore, infectious disease control could only be "relatively improved"—"elimination" was truly an unreachable goal.

"When it rains, the roof leaks!" Liu San exhaled heavily. "We've got a suspected plague case!"

Lin Motian was shaken. The terror of the word "plague," even in the old timeline, was enough to alarm medical personnel: high infectivity, extremely rapid onset, high mortality rate.

He forced himself to stay calm: "What's the specific situation?"

Liu San immediately told him everything from the report.

"...From the looks of it, it should be bubonic plague. That's something of a blessing."

"But for us, what difference is there between bubonic plague and pneumonic plague? We have nothing." Lin Motian said. Bubonic plague being "better" was from modern medicine's perspective; for them, both were hard to prevent and treat, both virulent infectious diseases.

In the old timeline, there were no definite records of plague outbreaks in Guangdong—only vague records of "great pestilence." But from Liu San's surveys of the medical officers and the epidemic reports received by the health authorities, the picture wasn't optimistic. From the incomplete reports sent by subordinate prefectures and counties, sporadic suspected plague cases had already appeared.

Due to Guangdong's limited medical and health conditions and lack of sample preservation capabilities for laboratory testing, and with no biochemistry lab in Guangzhou to culture bacteria, confirmation was impossible. To be prudent, similar cases were all handled by completely incinerating corpses and all contacted items, while isolating all contacts.

(End of Chapter)