In the mountainous terrain of Ning'er County, Yunnan, a county-level hospital has produced a remarkable "health report card": significant declines in maternal, neonatal, and under-five mortality rates, paired with steady increases in outpatient visits, inpatient admissions, and the case mix index (CMI). This set of "three declines and three rises" paints a clear and heartening trajectory of progress on the path of health assistance. Since June 2016, the Shanghai Children's Medical Center has actively responded to national calls, continuously dispatching key medical personnel to Pu'er, Yunnan. In 2021, with the signing of an assistance agreement, the Ning'er County People's Hospital welcomed seven batches totaling 35 medical team members. They brought with them 134 new medical techniques and, through a master-apprentice "passing on of skills" approach, deeply embedded knowledge and hope into this land. Over the successive rotations, concepts took root and technologies sprouted, as if a beam of light illuminating life had been carved into the mountain valleys of southern Yunnan.
The medical team dispatched by the Shanghai Children's Medical Center is composed entirely of members holding master's degrees or higher, with specializations spanning over ten clinical and technical fields including pediatric internal medicine, orthopedics, hematology-oncology, and medical imaging. This team represents the cream of the crop from the center and is also the first medical assistance team sent by a pediatric specialty hospital to Yunnan Province. Comparing data from the same periods in 2021 and 2024, each figure on the "three declines and three rises" report card is a testament to the team's relentless dedication: the neonatal mortality rate dropped from 4.57‰ to zero; the under-five mortality rate fell from 10.27‰ to 3.97‰; and the maternal mortality rate also decreased from 1.27‰ to zero. Concurrently, outpatient visits at the Ning'er County People's Hospital increased from 248,434 to 283,242, inpatient admissions rose from 15,162 to 18,950, and the CMI improved from 1.067 to 1.156. These changes clearly signal that the overall local medical service capacity and the complexity of cases treated have reached a new level.
However, for the benefits of assistance to take lasting root, simply relying on the slogan "Shanghai experts are here" is far from sufficient; the key lies in building a solid foundation of local medical capability. Zhang Hao, President of the Shanghai Children's Medical Center, explained that each dispatched team of experts establishes a temporary Party branch and builds a branch co-construction mechanism linked by disciplines, truly guided by local needs to promote the adoption and routine operation of technologies. Through this process, numerous new technologies have been introduced and solidified: in 2024, the Ning'er County People's Hospital successfully began performing magnetic resonance imaging (MRI), becoming the first county-level hospital in Pu'er with this capability; by 2025, the local team was able to independently perform 30 cardiac MRI examinations. Furthermore, 17 minimally invasive techniques for fractures introduced since 2022 have been used by local doctors to independently perform 38 surgeries. The team members deeply understand that modern medical assistance has transcended the simple leap from "giving a fish" to "teaching how to fish"; the more critical aspect is building a sustainable, systematic disciplinary development framework. To this end, the expert team assisted the Ning'er County People's Hospital's pediatrics department in establishing a Neonatal Intensive Care Unit (NICU), which drastically reduced the external referral rate from 36% to 9.7% and maintained a record of zero neonatal deaths for nearly three years. The team also successfully treated a low-birth-weight premature infant born at 33 weeks and performed complex procedures like a lumbar puncture on a newborn just 18 hours old, successively filling multiple core technology gaps in the hospital. By advancing simultaneously on the dual tracks of building a "team that never leaves" and "rooting technology," the Shanghai Children's Medical Center is helping Ning'er's medical and health services achieve a profound transformation from "blood transfusion" to "blood generation."
Yunnan's scenery is picturesque, but dangers lurk unseen—the chigger mites in the humid, hot jungles pose a significant public health challenge. Scrub typhus, also known as tsutsugamushi disease, is an acute natural focal infectious disease caused by Orientia tsutsugamushi, transmitted through the bite of trombiculid mite larvae. Clinical manifestations include fever, myalgia, rash, characteristic eschar, and lymphadenopathy; severe cases can lead to complications like bronchopneumonia, myocarditis, meningitis, acute renal failure, and even thrombosis, with a fatality rate of up to 60% if not treated promptly. Over the past decade, infection rates of scrub typhus have been rising annually in southern China, including Yunnan, with occasional local outbreaks. The ability to identify cases "quickly, accurately, and reliably," thereby minimizing misdiagnosis and missed diagnoses, has become a critical challenge for healthcare workers. An Kang, a doctor from the Innovative Diagnosis and Treatment Center, Zhangjiang Campus, of the Shanghai Children's Medical Center, and a member of the 14th medical team aiding Yunnan, collaborated during his assignment with doctors Wang Ziyu and Huang Lihua from the Nephrology and Hematology Department of the Ning'er County People's Hospital to systematically review 118 scrub typhus patients admitted to the department over the past three years. The study found that local scrub typhus incidence peaked between June and September, with sporadic cases in other months; 73% of patients presented with the typical eschar, located across various parts of the body. "Clinically, most local doctors are aware that scrub typhus has a characteristic eschar, but the early symptoms are often atypical, and medical staff in non-endemic areas have relatively insufficient awareness, which can easily lead to misdiagnosis and missed diagnosis," An Kang pointed out. Additionally, the Weil-Felix test, a commonly used laboratory test, has a sensitivity of less than 80%, which also affects diagnostic efficiency. Facing these challenges, the Shanghai Children's Medical Center team launched targeted efforts. It is reported that the team is working on adopting a plasma colloidal gold method for early and accurate diagnosis of scrub typhus. This method offers advantages of rapid testing, low cost, and good sensitivity and specificity, and standard product verification in vitro has been completed. The medical team calculated that if diagnosis is delayed, the average medical cost for a scrub typhus patient is about 5,000 RMB per person; with early and definitive diagnosis, the cost can be reduced to around 100 RMB per person. This clinical research also achieved a "zero breakthrough" in SCI publications for the hospital. At the end of 2023, an image correspondence titled "A Case of Typical Eschar in Scrub Typhus" was officially published in the British Journal of Dermatology, a renowned journal in the field. This not only provides an important reference for medical staff and the public in non-endemic areas to understand scrub typhus but also marks a crucial step forward for the local scientific research capability. From clinical discovery to paper publication, and onto the development of diagnostic reagents, this path of "clinical research and成果转化" originating from a top-tier research medical institution in Shanghai is leaving firm and unique footprints in this small border city of Yunnan—writing the thesis not only in the laboratory but also in the fields and jungles. The collaboration between medical experts from Shanghai and Yunnan is gradually changing the health future of this land through persistent, incremental efforts.
In 2023, a 2-year-old girl with congenital heart disease, weighing only 6 kilograms, captured the concern of the medical team. She had experienced developmental delays since birth, combined with patent ductus arteriosus and patent foramen ovale. Her family relied on the father's migrant work for income and were deeply in debt from treatment costs, yet they never gave up hope. In the same year, the Shanghai Children's Medical Center launched the "Heart Voyage" public welfare project at the Ning'er County People's Hospital, dedicated to lighting the path to rebirth for more children with congenital heart disease. In Yunnan, the incidence of congenital heart disease is 1.5 times that of Shanghai, imposing a heavy burden on families and society. Since their deployment to Ning'er at the end of 2021, the medical team has focused on strengthening early screening and treatment within 48 hours of a newborn's birth. Among 858 newborns screened, 34 diagnosed children received treatment through medication-induced closure, interventional occlusion, or follow-up monitoring. In the past year, the team also traveled to the Honghe Prefecture Maternal and Child Health Hospital to perform 75 congenital heart disease surgeries with a 100% success rate. Outside of work, team members visited the Baosteel Hope Primary School in Wenquan Village, Ning'er County, to conduct heart health education. The children learned about the heart through vivid explanations, and their smiling faces upon receiving gifts and nutritional supplements were as warm as spring. Over the years, the medical team has consistently focused on promoting the improvement of healthy lifestyles in Yunnan, and these efforts are gradually bearing fruit: they have written a series of popular science articles addressing local malnutrition; conducted sun protection research considering the high-altitude, strong ultraviolet radiation environment, promoting skin disease prevention. Studies such as "High-altitude UV protection" and "Liver fibrosis screening" sow the seeds of health management in the public's mind and solidify the "Shanghai-Yunnan joint research" model. Zi Zhanchun, Director of the Department of Pediatrics at the Ning'er County People's Hospital, who studied under seven Shanghai experts over two years, remarked emotionally, "The teachers, through clinical mentoring, systematic training, and special lectures, helped us build a complete pediatric knowledge system. The Shanghai Children's Medical Center also donated professional medical equipment, building a platform for remote consultations and technical exchanges between our hospital and township health centers." "Our hearts have long been deeply connected to this land," said Ren Yijiong, Deputy Director of the Hospital Office at the Shanghai Children's Medical Center. After the 17th medical team completed its mission, Dr. Cui Xian voluntarily extended his stay for six months to continue research on liver injury, while team members who returned to Shanghai, motivated by their experience aiding Yunnan, continue to refine their skills and safeguard the health of Ning'er's children. This is a management empowerment effort spanning years—the Shanghai Children's Medical Center team provided comprehensive support for the construction of a critical neonatal救治 center, assisted in the standardized construction of the NICU, enabling the survival of extremely low birth weight preterm infants; promoted the implementation of the first cardiac MRI and neonatal gastrointestinal contrast studies, making diagnosis and treatment more precise; and that SCI论文, which ignited local research enthusiasm, injected intellectual momentum into the broader health cause in the border region. As Li Jing, President of the Ning'er County People's Hospital, movingly stated, "We will forever remember this profound assistance that跨越山海. We look forward to continuing our collaboration with Shanghai experts to jointly weave the web of health protection denser and warmer, ensuring that this Shanghai-Yunnan friendship remains forever fervent in the guardianship of life on the frontier."
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