Lijiang City, cited as "Shangri-La" in James Hilton's portrayal, is now a booming tourist site attracting 2.1 million tourists from home and abroad last year.

Internet cafes and coffee houses are scattered around its old, twisted downtown streets, with an inscribed tablet on the World Heritage List by UNESCO.

However, in its several remote villages poor pregnant women still do not have easy access to medical services.

The maternal mortality rate Last year reached 135.5 per 100,000 in Lijiang's 13 poor townships, while the infant mortality rate was 60.3 per thousand, according to the local government.

"We found that most maternal deaths in Lijiang happened in poor families that lack money to send the would-be mother to see the doctor or be delivered at hospital," said He Daofeng, secretary general with the China Foundation for Poverty Alleviation.

The foundation initiated a 10-year project, called Action 120 for the Safety of Mother and Baby, in Lijiang last September and it will expand the project to another nine poverty-stricken counties in some parts of west and central China.

Poor pregnant women will get subsidies to for prenatal checks so that those with high risks can be sorted out and sent to hospital prior to giving birth free of charge, said Bai Zheng, director of this project.

Other women, who are not expected to complications during delivery, are urged to be delivered by a trained village doctor at home and sent to the nearest township hospital if there is an emergency, also with subsidies provided, he added.

The foundation had thought of setting up a first-aid team like those in urban areas, but decided it would be impossible to send an ambulance in time if an emergency occurred in a village isolated from the highway, he noted.

"The pregnant woman would always be delayed by the inconvenient transportation and bad road conditions," said Zhao Shufang, a local gynecologist.

Wang Guojun, 31, of the Naxi ethnic group, lost his wife and even children during childbirth. He lives with his 70-year-old father and 68-year-old mother in a remote village called " Maonuzhai" in Baoshan township, Lijiang's poorest township.

"She died in my arms without a word left," Wang said, with a tremble in his voice. Wang has been wearing his wife's gold bangle since her death.

Wang's wife, Shu Jinkang, aged 21, died at home in February 1997 when giving birth to a boy, an "angel" the couple longed for, but the placenta remained inside of her after the delivery, causing bleeding, and she died three hours later.

Although a village doctor was sent at the last moment, there was little she could do. It had taken four and a half hours for a man to get to the township by car.

Shu would have not died if she had been delivered by a trained doctor with proper equipment and medicine, said Zhao Shufang, who has worked in a township hospital for 11 years.

The baby boy, their first child, also died of pneumonia after seven months due to malnutrition.

As the wife is the backbone of a Naxi family, her death not only causes psychological hurt but usually reduces the living standards of the whole family, said Zhang Yunping, deputy magistrate of the Lijiang Naxi Autonomous County.

Wang's family earned about 1,000 yuan annually when his wife was alive, but now they earn only 600 to 700 yuan a year.

"If she was with me and took care of the family, I could find a job outside and earn more money to improve our life," Wang said. Now he has to stay at home to support his aging parents.

China has promised to reduce the infant mortality rate to 33.5 per thousand and the maternal mortality rate to 47.4 per 100,000 by the end of this year.

However, there are huge differences in the maternal mortality rate throughout the country, varying from 12.5 per 100,000 in Shanghai to more than 100 per 100,000 in seven western provinces including Yunnan, Guizhou and Gansu in 1998.

"Most of the government's budget for medical service in poor areas goes to infrastructure like hospitals, but the inability to pay the fees is another main reason why poor people do not see the doctor," He Daofeng said, "Our project is to work as a supplement to the government's efforts."

All the information on individual pregnant women will be monitored by the headquarters in Beijing through a computer network linked to Lijiang's county hospital, he said.

The foundation established an 30-million-yuan assistance fund, 3 million yuan for each sub-project like the one in Lijiang.

"We expect the fund to keep growing through marketing and support from society, and have all poor pregnant women giving birth at hospital," He Daofeng said.

The China Foundation for Poverty Alleviation was founded in 1989 and about 50,000 poor people benefit from its assistance annually.

China Daily 12/01/2000)