To ensure that all insured of Taiwan receive adequate healthcare, the National Health Insurance Administration (NHIA) has been making concerted efforts to implement the administrative plans of “refining NHI medical resource allocation” and “localizing rural region and offshore island medical care” advocated by the Executive Yuan and Ministry of Health and Welfare, respectively. Substantial budgets have been committed to increase the medical resources of regions lacking in such resources, and input from the private sector has been actively sought. Chiayi County Government held a joint donation ceremony on June 20 for the county’s newly received oral and vision care mobile clinics, and invited Shih-Chung Chen, Minister of Health and Welfare, as well as Chun-Mei Lin, Director of the Southern Division, NHIA, to speak at the ceremony and present certificates of appreciation to the representative of Rotary International Taiwan which has generously donated the mobile clinics.

        There are a total of 57 dental clinics in the 18 administrative regions of Chiayi County, the majority of which are concentrated in Puzi City and Minxiong Township; in contrast, the other regions are significantly lacking in these resources. According to the Improvement Plan for Medically Underserved Areas under the NHIA Dental Medicine Global Budget System, a total of 12 townships in Chiayi or as high as 66% of all administrative regions have insufficient resources in dental medicine. The “Study on changes in oral status of populations over age 45 in Taiwan” conducted by the Health Promotion Administration also finds that the ratio of fully edentulous senior citizens living in Chiayi County is approximately 29.24%, a number significantly higher than the national average of 21.5%. As of October 2019, senior citizens over age 65 comprise 19.54% of the county’s entire population, but only 22% seek dental care (compared to the national average of 40% for citizens in the same age group), while school children under age 14 comprise 9.26% of the county’s overall population with just 46% seeking dental care (compared to the national average of 50% for those in the same age group). Not only are both of these numbers below national average, Chiayi also has the disadvantage of a highly scattered population distribution. The reallocation of dental care resources is therefore of imminent concern.

        To provide people living in remote areas with adequate healthcare and rebalance the allocation of dental care resources, in 2020 the NHIA contributed a total of NT$280 million for increasing availability of dental medicine in regions lacking in such resources. The Chiayi County Dentist Association has in particular been tasked with providing mobile dental care in the county since October 2002 through its dedicated medical team. According to statistics compiled by the NHIA, the Chiayi County Dentist Association has offered clinic services for a total of 2,738 times to 17,408 patients from 2017 to March 2020, the medical expenses of which totaled NT$32 million. Of the times of services offered, 1,847 took place on campuses and care was provided to 15,133 students amounting to medical expenses totaling NT$27 million. One noteworthy advantage of mobile dental services is that dental care is not only provided to local communities at fixed times and locations but also made available to school children and teachers in need of routine checkups and treatment. The mobile clinics furthermore offer information on oral hygiene, enabling senior citizens to maintain their chewing ability thereby facilitating their overall general health, and assuring that the younger population is familiar with proper habits of oral hygiene.

        In the past, campus visits have had to be preceded by an arduous setup process consisting of the transportation of dental chairs and equipment onsite. Starting this year, with the help of the fully equipped oral care mobile clinic donated by Rotary International, logistics will become much easier. The vehicle is also the first mobile clinic in Taiwan with two dental chairs installed as well air conditioning and a complete set of medical equipment including dental radiography. The mobile clinic costing NT$4.5 million took six months to assemble and was donated by Rotary International at the request of the NHIA. The Chiayi County Health Bureau will be responsible for managing and maintaining the vehicle which will be staffed by the Chiayi County Dentist Association. Oral care mobile clinics are an effective solution for issues such as difficulties in renting suitable offices and equipment shortage. They are also able to access remote areas and are highly flexible in terms of both schedule and location. All of these advantages will serve to rebalance the availability of oral health resources throughout Chiayi and ensure the oral health of communities residing in the rural areas.

        Rotary International has also donated one fully equipped vision care mobile clinic to St. Martin De Porres Hospital in Chiayi that will be managed by hospital staff and tasked with providing mobile vision care in Alishan Township. In the future, it will serve as a mobile point of care throughout Yunlin, Chiayi and Tainan.

        At today’s donation ceremony, Director Chun-Mei Lin expressed appreciation toward Rotary International as well as other public and private entities including medical associations for their generosity and commitment. It is with the concerted efforts of all that Chiayi is now able to provide citizens living in the more remote areas of the county with continuous, comprehensive healthcare within the vicinity of their homes.