To extend medical care to people living south of Hualien, the management of the Tzu Chi Hospital took over the Hungte Hospital in Yuli and established the Tzu Chi Yuli General Hospital on March 15, 1999. The hospital has twenty beds for acute diseases and prioritizes daily clinics and referral services. Each day there are three to four hundred outpatients. Each week thirty-three physicians from fifteen departments at the Tzu Chi Hospital in Hualien travel to the Yuli hospital to attend clinical sessions. Each physician is responsible for one session a week, serving an average of forty patients. In addition to day clinics on weekdays, there are night clinics that last until ten o'clock and weekend clinics provided by three resident doctors and doctors from other local hospitals.

The Kuanshan area is comprised of five small towns--Chihshang, Kuanshan, Haituan, Yenping and Luyeh--and has a population of roughly seventy thousand people. It is located at the midsection of the East Rift Valley and the exit of the Southern Cross-Island Highway. Many popular tourist spots are situated in this area, therefore traffic is heavy and accidents frequently occur. There was no large hospital in the area and patients in critical condition could only be sent to Hualien or Taitung. The one- to two-hour drive often took up precious time needed to save lives. With the donations and efforts of local residents, the Tzu Chi Hospital took over the local Poai Hospital, which had never gone into operation, and established the Tzu Chi Kuanshan Hospital on March 15, 2000.

In the future, the Yuli Hospital will focus on general clinical c are, and the Kuanshan Hospital will focus on treating patients with emergency and acute cases. With the Tzu Chi Hospital in Hualien as the referral hospital, a complete medical network has thus been established for eastern Taiwan.

Master Cheng Yen often says, "The most valuable thing in the world is life; the most unbearable suffering is sickness." With the inauguration of the Kuanshan Hospital, we anticipate that people in eastern Taiwan will be able to receive professional and humanized care from dedicated medical personnel motivated by Great Love.

A typical day at the Yuli Hospital

At seven thirty in the morning, a vehicle carrying physicians from the Tzu Chi Hospital leaves Hualien and speeds along the scenic East Rift Valley. When the vehicle reaches the Yuli Hospital at nine, the waiting room is already packed with outpatients. The doctors enter their consultation rooms and proceed to diagnose patients, perform examinations and prescribe medicine.

Around noontime, the physicians working the morning shift wrap up their sessions and have a quick lunch. At twelve forty, the same car that brought them here sets out on the drive back to Hualien. A little earlier, doctors responsible for the afternoon sessions had already gotten on the train heading for Yuli.

"It spares many patients from traveling long distances when the doctors go to the Yuli Hospital," said Dr. Kuo Hang-tsung, head of the urology department. "For instance, if a patient can save three hours and if a physician can treat fifty patients each time, then a total of a hundred and fifty hours can be saved, which is a substantial number."

Pan Tsai-yun is one who benefited from the arrangement. Since she gave birth to her first child, she had suffered from frequent urination. For more than thirty years, she underwent operations and tried various informal remedies, but still could not be cured. In 1999, she was finally alleviated from this recalcitrant problem when she went to the Tzu Chi Hospital and was treated by Dr. Kuo with anti-coagulants.

Her frequent urination had been caused by interstitial cystitis. She said that before she received the treatment, she had to use the bathroom more than ten times every night, which seriously affected her sleep. When the cystitis worsened, it was so painful that her husband had to put aside his work to take her to the Tzu Chi Hospital.

"During the two-hour trip I could hardly wait to get off at each gas station to use the toilet. Now I can ride my motorcycle alone to Yuli Hospital, and I no longer have to ask my husband to give me a ride." Mrs. Lin is happy to note how her condition has improved since receiving treatment.

Combining local resources

"Yuli Hospital plays the role of a high-level joint clinical center," said Dr. Wang Chih-hung, director of the hospital. The clinics are attended by experienced senior physicians. "For instance, the internal medicine department is subdivided into cardiology, gastroenterology, etc. Many illnesses that have no apparent symptoms can be diagnosed and treated early by specialists."

But he also admitted that although the hospital is furnished with such equipment as x-ray and ultrasonic machines, computerized tomography (CT) scanners and electrocardiographs (ECG), other frequently needed equipment such as an endoscope for gastroenterology and multifunction ECG for cardiology are not available due to limited space.

To make up for this inadequacy, Dr. Wang invited Dr. Ko Lung-chi, a physician who runs a clinic nearby, to become a part-time attending physician and perform endoscopy for patients who require the examination. "The Yuli Hospital was founded out of a respect for all life and to serve patients. By combining our resources with locally available resources, we can avoid unnecessary waste."

In addition, the Yuli Hospital is only a forty-minute drive from the Kuanshan Hospital. "The strength of Kuanshan lies in surgery and orthopedics--patients who need to receive surgery can be sent there," said Dr. Wang. These two branch hospitals can cooperate closely to establish a comprehensive medical network for the southern region of the East Rift Valley.

A smashing team

Director Wang, a cardiologist, has to devote most of his time at the Tzu Chi Hospital to perform cardiac catheterizations. He therefore delegates the responsibility of expanding the medical services of the Yuli Hospital to Huang Hsin-chiao, director of the management office.

Huang has set clear goals. During the first year, she and her colleagues worked on making the hospital a pleasant environment where patients can feel comfortable and at home. In the next year, the goal is to enter the local communities. After the morale of the hospital staff lifted off after the initial adjustment period and a harmonious atmosphere set in, Huang and Wang Wen-chien, director of the general affairs office, led medical teams to rural areas. They explored the possibility of holding medical seminars at local senior citizens' clubs, and they went deep into aboriginal settlements to conduct health examinations and free clinics.

"A woman who mindfully does her work is the most beautiful," Director Wang praised Huang. Her devotion to the hospital is such that when her husband, who currently lives in Singapore, comes to visit her, she still goes to the office and takes her husband along.

In response to the director's compliment, Huang said, "Director Wang has never put on airs with us. He is just like the rice plants: the fuller they are, the lower they bow. He is very humble and he treats all the staff very well." Judging from their opinions of each other, we can tell what a smashing team they make.

Glad to help

When the medical team goes to aboriginal settlements, Huang specifically arranges for aboriginal nurses to serve as interpreters so that they can serve their tribespeople. The responses have been encouraging.

"That the medical team goes out to rural areas is a great help to my people," said aboriginal nurse Kao Li-min. "In the past, they didn't even know that Yuli Hospital had an ophthalmology department. Now they ask what other departments there are in the hospital. They have become more active in seeking medical help." She believes that medical seminars in the Yuli Hospital help gain the trust of local people. The effect is reflected in the twofold increase of outpatients at the ophthalmology clinic.

Although the Yuli Hospital is understaffed with only some thirty employees, they do not complain. "Instead of saying that we are dedicating ourselves to the hospital, it would be more accurate to say that working at the hospital makes us feel honored to be able to help our own people," said Chen Hsiu-chin, a local nurse.

"The essence of the Tzu Chi spirit lies in selfless giving, much like what is taught in Catholicism--both aim to serve people unselfishly," said Kao Tsui-ping, another aboriginal nurse. Even though she is a Catholic, the difference in religion does not prevent her from feeling at home in the Buddhist Yuli Hospital. She is committed to stay as long as she can!

The first hospital in Kuanshan

The opening ceremony of the Kuanshan Hospital on March 15, 2000, was interrupted several times by the shrill wails of ambulance sirens. Four emergency patients with trauma on the abdominal wall, bone fractures caused by traffic accidents and acute myocardial infarction were sent to the hospital. The medical team standing by in the emergency room immediately went to work.

Kuanshan town magistrate Hsu Jui-kui harbors deep gratitude toward Tzu Chi for establishing the Kuanshan Hospital. He stressed that along the Hualien-Taitung Highway, major traffic accidents often occur. But for the more than 70,000 inhabitants in the five townships along the highway, including Chihshang, Kuanshan, Haituan, Yenping and Luyeh, there is not a single hospital. The serious lack of medical resources had long worried him.

In March 1999, when the Yuli Hospital was opened, Hsu took the opportunity to report to Master Cheng Yen about the lack of medical resources in the Kuanshan area. Soon, Tzu Chi sent people to investigate the situation and started making preliminary arrangements. In July the same year, Tzu Chi signed a contract to take over Poai Hospital in Kuanshan, which had never actually been in operation, and devised plans for building a community health care structure. Beginning in December, a series of seminars on health care were conducted in local communities.

"The time we most look forward to each month is when Tzu Chi holds activities here," said cheerful Chung Cheng-chun, the 76-year-old chairman of Kuanshan's senior citizens' club.

Besides measuring their blood pressure and pulse, nurses from the Kuanshan Hospital also patiently teach old people how to prevent diseases and take care of their health. They also give each of them a "Health Passport," which records their health condition and provides health tips for daily life.

Upon learning that Tzu Chi was setting up a hospital in their hometown, many Kuanshan residents working in other cities expressed their desire to donate money. Some entrusted others with their money, others made a special trip home to make their donations. Many old people approached Tzu Chi to inquire about the possibility of serving as volunteers in the hospital. Tsai Wen-chen, senior member of the Kuanshan community mothers' club, also showed her support by recruiting more than ten club members to become volunteers at the hospital.

"Tzu Chi comes all the way from Hualien to take care of us, and this gives us local people all the more reason to contribute our efforts to our community," said Tsai heartily.

We will go wherever we are needed

Dr. Lin Yu-sheng, director of the department of anesthesiology of the Tzu Chi General Hospital and also director of the Kuanshan Hospital, has a deep concern for the predicament of the aboriginal people. "Their employment opportunities are limited and financial difficulties are common, while travel is inconvenient and medical resources are scant... I feel that they really need to be helped."

"Although we are only doctors in a small town, we hope to be the best ones," said Dr. Li Ming-che, one of the four surgeons in the Kuanshan Hospital and also an attending surgeon in the Tzu Chi General Hospital. "Where I can do much to help is where I will go..." Two other surgeons, Wu Wen-tien and Cheng Tun-jen, were urged by Li to join in the cause. Dr. Cheng said that the facilities and manpower in the Kuanshan Hospital are not as sufficient as those in the Tzu Chi General Hospital, so physicians here have to be versatile, which motivates him to keep studying and broadening his medical knowledge. His objective is to continue challenging his own limits.

As to the plans and objectives for the various development phases of the Kuanshan Hospital, Director Lin said that the planning committee has devised a preliminary scheme. The short-term goal is to meet local medical needs, emphasizing treatment of surgical, orthopedic, emergency and acute disease cases. Since the local population consists mainly of older people and children, they also want to implement medical care for chronic diseases and subdivide the present departments to become more specialized, so that health care for emergency cases as well as chronic diseases can develop evenly.

As to the long-term goal of the hospital, an expansion plan must be taken into consideration as the present capacity of fifty beds will soon be inadequate. Dr. Lin said that they will start a series of surveys, covering public health, demographic distribution, evaluation of subdivisions to be set up, etc. All this information is essential for future recruitment of staff members and the integration of medical resources.

The inauguration of the Kuanshan Hospital was welcomed by the residents of Taitung with joyful spirits, and the medical staff who went there to offer their services also harbored their own ideals and vision for the future of the hospital. As they said: "We are not afraid of being tired--we only fear that we might not be able to offer the best services to the patients."