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Outraged Surgeon Forces China To Swallow a Dose of the Truth
Dr. Jiang Went Public to Put An End to the SARS Coverup
By MATT POTTINGER
Staff Reporter of THE WALL STREET JOURNAL
HONG KONG -- When Chinese troops gunned down civilian demonstrators near Beijing's Tiananmen Square on June 4, 1989, many of the dead and wounded were laid at the feet of Jiang Yanyong.
For years afterward, the then-chief of surgery at the capital's No. 301 Army General Hospital told friends and colleagues of his outrage over the bloodbath. But as a loyal cadre of the ruling Communist Party, he was mindful to keep his disgust out of the public domain. State reprisals against open criticism are often swift and severe.
On April 3, the tall, semiretired surgeon, 72 years old, watched Health Minister Zhang Wenkang report on national television a mere 12 cases of SARS -- or severe acute respiratory syndrome -- in the capital. He knew firsthand that the actual number of those suffering from the disease, believed to have originated last November in southern China, was much higher. This time he wouldn't keep quiet.
"I simply couldn't believe what I was seeing," he wrote April 4, in a signed letter to a state-run television station. "All the doctors and nurses who saw yesterday's news were furious." He reserved his strongest language for Mr. Zhang, who like Dr. Jiang had come up the ranks as an army doctor. "Zhang Wenkang is ... abandoning even his most basic standards of integrity as a doctor."
The state TV channel never reported on the letter, but copies were obtained by The Wall Street Journal and other foreign media outlets, which ran with it. (See related article)
Dr. Jiang's public outbreak of conscience set off a chain of events that culminated in Sunday's extraordinary sacking of two senior Chinese cadres -- including Mr. Zhang. "I saw the announcement on TV" about the sackings, Dr. Jiang said late Sunday. "The government is tackling the problem in earnest now."
While Dr. Jiang alone didn't cause heads to roll, his letter was the crucial lever that popped the lid off the truth. World Health Organization inspectors, citing in part Dr. Jiang's letter, extended a recent trip to Beijing to check the hospitals where he said there were hidden cases.
Late last week, the WHO turned up information vindicating his claims and delivered a humiliating public rebuke to Beijing officials for downplaying the extent of the disease. "Dr. Jiang's estimates are consistent with what we heard," James Maguire, head of the WHO team in Beijing, said.
Other health-care workers in the city, some citing Dr. Jiang's letter as inspiration, leaked more information. A letter from two staff members at Beijing's military hospital No. 309 said the hospital was playing a human shell game to hide SARS patients from the WHO. They alleged Beijing's motive was to protect the flow of tourists and investment to the capital. Their letter called Dr. Jiang's letter "terrific."
Soon thereafter, the country's new top leaders, President Hu Jintao and Premier Wen Jiabao, appeared on TV warning of "severe" punishment for anyone trying to play down the epidemic. Finally, on Sunday, after clinging to a claim for weeks that there were only a few dozen cases in the capital, city health officials announced a nearly 10-fold increase in the number of confirmed SARS cases in Beijing, to 339.
Beijing Mayor Meng Xuenong also was stripped of his Communist Party post and fired from his job.
Since news of his letter broke in the Journal, Time Magazine and other foreign media (the state media ignored him), Dr. Jiang, who is a member of the Communist Party, has been put under surveillance. Hospital officials warned him against speaking to foreign reporters and an army newsletter published a criticism of him.
That is a sharp turnabout for a man extolled by a government publication in 1991 under the headline, "An Honest Doctor." Indeed, Dr. Jiang enjoyed a hard-earned reputation for integrity all the way through to his recent decision to call officials on the carpet for their handling of SARS.
As a youngster in Shanghai, Dr. Jiang was more interested in basketball and volleyball than in schoolwork. But after watching his aunt succumb to tuberculosis, he resolved to become a doctor. In 1949, the year the Communist Party took power, he won a place at the prestigious Yanjing University (since renamed Peking University) as a premed student.
The bulk of his training was conducted in English at Peking Union Medical College, an American-style medical academy founded by the Rockefeller family. As a freshly minted doctor, he was assigned to the No. 301 military hospital. He did a stint early in his career as a field surgeon caring for soldiers building a railway in the country's mountainous southwest.
The use of explosives to blast away rock caused frequent and severe injuries. Dr. Jiang was skilled at treating even the most gruesome wounds. He had another quality that in later years would make him the subject of other articles in party newspapers: compassion for his patients.
But when the decade of political repression known as the Cultural Revolution began in 1966, Dr. Jiang was an easy target for Mao Zedong's Red Guards. Dr. Jiang's father had been a well-to-do banker. Dr. Jiang also had a cousin, Tsiang Yien-si, who was a rising star with the nationalist Kuomintang in Taiwan -- the arch enemy of the ruling communists on the mainland.
Dr. Jiang was quickly branded a "counter-revolutionary." He was imprisoned for two years, and then sent to do labor on an army horse-breeding farm in the remote province of Qinghai, bordering Tibet.
But when he wasn't toiling on the horse ranch, he was treating those around him. When a Tibetan woman began hemorrhaging during childbirth, he saved her by giving her a transfusion as she was being carted to a clinic, clutching the pouch of blood inside his coat so it wouldn't freeze in the cold.
Politically "rehabilitated" in 1972, Dr. Jiang went back to work at No. 301 hospital. He worked his way up to chief of surgery in the 1980s, operating on difficult cancer cases in both senior party officials and common civilians. Shocked by the Tiananmen crackdown, he, like many Chinese, held his tongue and went back to work.
Several publications profiled him for his skills, but also for his refusal to accept gifts or cash for his services -- something that was becoming increasingly rare in a health-care system where doctors typically earn between $600 and $1,200 a month. The Beijing Review, a periodical published by the national cabinet, featured him as an example of "An Honest Doctor."
Dr. Jiang retired as head of surgery about a decade ago. He has continued to treat patients, serving as a kind of surgeon emeritus at No. 301, consulting younger doctors on difficult operations and teaching postgraduates -- who are now scattered like disciples throughout the city's health-care system. He has even visited hospitals in the U.S. in an effort to stay current. His daughter, Jiang Rui, a computer programmer living in California, says he still rides his bike to work.
His pleasant retirement was disturbed in early March when a patient from Shanxi province checked into No. 301 with severe pneumonia. The patient, accompanied by his wife, was quickly transferred to a sister hospital, No. 302, that specializes in infectious disease. The patient and his wife died. Doctors and nurses at No. 302 also fell ill.
That episode followed the same pattern as a mysterious respiratory illness in the southern province of Guangdong. But a government-imposed blackout on news about that outbreak meant that most people, even in Beijing, didn't know about it, or how to prepare. Soon, the disease hit Dr. Jiang's hospital, No. 301.
As that was happening, a key meeting of the National People's Congress -- which would endorse the transfer of power to Messrs. Hu and Wen -- was getting under way in the capital. According to Dr. Jiang, the health ministry called a meeting among hospital heads and acknowledged the occurrence of atypical pneumonia in the capital but told hospital heads not to publicize the fact in order to avoid disrupting the meeting. The health ministry didn't respond to a request for comment.
On April 3, Mr. Zhang made his fateful TV appearance reporting just a dozen SARS patients in the capital. Dr. Jiang wrote his letter the next day. He e-mailed it to CCTV-4, a state television channel that covers health issues, and Phoenix TV, a Hong Kong channel that usually toes the Communist Party line. Dr. Jiang said there were some 60 SARS cases in a single medical ward at the No. 309 hospital. Those stations sat on his news, but foreign media ran with it.
In a subsequent telephone interview with the Journal, Dr. Jiang detailed dozens of other cases in the capital.
Almost immediately, the dominoes began to fall. A WHO team, which had been conducting research in the SARS epicenter of Guangdong, said it would inspect several hospitals in Beijing, including ones cited by Dr. Jiang. Soon, health-care workers across the city began leaking information about cases in their hospitals -- even as others held their tongues. But the dike had been breached.
Those closest to Dr. Jiang say his motivation was simple. "His goal wasn't to make China lose face," said his daughter. "He just saw that he had a chance to save lives."
-- Leslie Chang and Peter Wonacott in Beijing contributed to this article.
Write to Matt Pottinger at matt.pottinger@wsj.com
Updated April 22, 2003
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