The baby started turning blue almost immediately after she was born in a small clinic last month in South Korea.

上月，一名女婴在韩国一家小型诊所出生后，几乎立刻就开始发紫。

There was a neonatal intensive care unit a short drive away, but the specialist there had reportedly resigned recently after years of grueling 90-hour work weeks. Another did not have any free beds. So the clinic’s staff rushed the newborn, who was struggling to breathe, to a third hospital. That facility was 30 minutes away by car, and by the time she got there, she died.

虽然开车不远就有一个新生儿重症监护室(NICU)，但据报道，那里的专科医生经历了多年每周90小时的高强度工作后，已于近期辞职。另一家医院则没有空床位。因此，诊所的工作人员将呼吸困难的新生儿紧急送往第三家医院。那家医院距离诊所有30分钟的车程，等婴儿到达时，已经不幸夭折。

The clinic later learned that the first NICU had been staffed by another specialist that night who could have treated the baby. But many in the medical community had assumed that the nearby facility had not filled the vacancy because of a growing shortage of specialists.

该诊所后来了解到，第一家NICU当晚其实有另一位专科医生值班，本可以救治这名婴儿。但是由于专科医生日益短缺，这个医疗圈子里的许多人都认为附近那家医疗机构一直没有填补空缺。

Her death, in the western city of Jeonju, detailed by lawmakers in parliament and local news media, was part of a bigger crisis in South Korea: a widening gap in emergency care. The shortage of neonatal doctors is particularly alarming because the country has been trying for years to increase its fertility rate, which is among the world’s lowest.

这起发生在西部城市全州的女婴死亡事件被议员在议会中详细描述，又经当地新闻媒体详细报道，揭示了韩国目前一场更大危机的一角：急救医疗缺口日益扩大。新生儿科医生的短缺尤其令人担忧，因为韩国的生育率处于世界最低水平，多年来一直在努力提高生育率。

As the birthrate dropped below replacement level in the 1980s, South Korea has gone through profound changes. Thousands of schools have closed in recent decades. Over 40 percent of day care centers have shuttered in recent years. The number of pediatricians, delivery wards and neonatal physicians is plunging every year.

自20世纪80年代生育率跌破人口更替水平以来，韩国经历了深刻的变迁。近几十年来，数以千计的学校关闭。近年来，超过40%的日托中心停业。儿科医生、产房和新生儿科医生的数量逐年暴跌。

Now the country has 77 NICUs where 240 specialists are tasked with caring for some of the most vulnerable patients, according to the government and doctors groups. The shortage is the most acute outside the greater Seoul area, the country’s population center. Some hospitals outside the capital only have one specialist to care for over 30 babies at once, doctors say.

据政府和医生团体称，目前该国拥有77个NICU、240名专科医生，负责照顾部分最脆弱的患者。在该国人口中心大首尔地区以外，这种短缺最为严重。医生们表示，在首都以外的一些地方，每个医院只有一名专科医生，却要同时照顾30多名婴儿。

Neonatal doctors say that government measures to reverse the birthrate have done little to improve their working conditions — long hours, low pay and litigious patients. These concerns echo those from the wider medical community in South Korea and contributed to an 18-month walkout by thousands of doctors that ended last September. The future of the neonatal specialty is particularly dire: The number of residents working in NICUs has decreased by 94 percent in recent years, according to government data.

新生儿科医生表示，政府为扭转生育率下降所采取的措施几乎没有改善他们的工作条件——工作时间长、薪酬低且患者频繁提起医疗诉讼。这些担忧与韩国整个医学界的担忧如出一辙，这样的担忧导致了数以千计的医生长达18个月的罢工（于去年9月结束）。新生儿专科的未来尤为严峻：根据政府数据，近年来在NICU工作的住院医师数量减少了94%。

Young-Ah Youn is a teaching doctor at the neonatal department of Seoul St. Mary’s Hospital. She said that during her 16-year career as a physician, she has worked more 100-hour weeks than she can count, particularly during her early years as a junior faculty member. Now her department does not have any residents, raising questions about the future of the ward.

尹英雅（音）是首尔圣母医院新生儿科的一名指导医生。她说，在16年的行医生涯中，她每周工作超过100小时的次数多得数不清，尤其是早年担任初级医师的时候。现在，她所在的科室已经没有住院医师了，这让人对该科室的未来产生疑问。

“Who would want to work here when there’s so little support or protection for us?” she said. The hospital relies on contract doctors or nurse practitioners to fill in staffing gaps.

“既然我们几乎得不到任何支持和保护，谁会想在这里工作呢？”她说。该医院依靠合同制医生或执业护士来填补人员空缺。

Government efforts, doctors argue, have been focused on increasing the birthrate. Over the past two decades, South Korea has invested the equivalent of hundreds of billions of dollars in programs like cash stipends for new parents, egg freezing procedures for women and free wedding venues for soon-to-be spouses. But experts say the outlays have not tried to secure the medical infrastructure to provide adequate care for the nation’s youngest citizens.

医生们认为，政府的努力一直集中在提高生育率上。在过去的20年里，韩国在为新父母提供现金津贴、为女性提供冻卵项目以及为准新人提供免费婚礼场地等项目上投入了相当于数千亿美元的资金。但专家表示，这些支出并没有用于保障医疗基础设施，为该国最年轻的公民提供充分的护理。

There is still “an imbalance in incentives to ensure adequacy in trained medical specialists,” said Professor Tan Poh Lin, a pediatrics expert who teaches public policy at the National University of Singapore. She added that policy focus has been “overly oriented toward the family formation process.”

新加坡国立大学教授公共政策的儿科专家陈宝玲（音）教授表示，“在确保有足够数量、受过专业培训的专科医生方面，激励措施仍存在失衡。”她还说，政策重点一直“过度偏向于家庭组建过程”。

The Korean Society of Neonatology has described government policy that encourages people to have children while largely ignoring a lack of emergency medical care for newborns as a “paradox.” NICUs outside the Seoul metropolitan area, it said in a statement last month, are near “a state of catastrophe.”

政府鼓励人们生育，却在很大程度上忽视新生儿紧急医疗护理短缺，大韩新生儿学会称这一政策是个“悖论”。该学会上月在一份声明中表示，首尔首都圈以外的NICU已濒临“灾难性状态”。

The government has announced that it would increase fees for deliveries and high-risk procedures — a move designed to raise doctors’ pay. It also said that it would increase the number of dispatchers on call at the National Medical Center’s Central Mother and Child Medical Center to expedite emergency transfers.

政府宣布将提高分娩和高风险手术的收费——此举旨在提高医生的薪酬。政府还表示，将增加国立医疗中心中央母婴医疗中心值班的调度员人数，以加快紧急转院速度。

Choi Han-seon spoke about her premature delivery and the importance of NICUs at a policy forum at the National Assembly in June. She needed surgery after a hemorrhage in the 20th week of her pregnancy. Her son was born three weeks later, only weighing about 1.4 pounds, and had a series of health complications like high blood pressure and a brain hemorrhage.

今年6月，崔寒仙（音）在国民议会的政策论坛上讲述了她早产的经历以及NICU的重要性。她在怀孕第20周大出血后需要接受手术。三周后，她的儿子出生了，体重只有大约630克，并伴有高血压和脑出血等一系列健康并发症。

He was left with developmental disabilities, but survived after nearly five months in a NICU. Ms. Choi said, “NICUs are not an option, they are an essential service that saves the lives of babies.”

他留下了发育障碍，但在NICU接受了近五个月的治疗后，他活了下来。崔寒仙说：“NICU不是可有可无的选择，它们是拯救婴儿生命不可或缺的基础服务。”

But if the number of neonatologists continues to dwindle in South Korea, that care may be at risk.

但如果韩国的新生儿科医生数量继续减少，这种护理可能会面临风险。

“I’ve worked tirelessly out of a sense of duty,” Professor Youn said. “But I fear that, if things continue this way, there will soon be no one left to care for these babies.”

“出于责任感，我一直不知疲倦地工作，”尹英雅说。“但我担心，如果情况继续这样下去，很快就会没有人留下来照顾这些婴儿了。”