WHEN Chinese pediatrician Zhang Shuyun was transferred in 1988 to the Shanghai Children's Welfare Institute, China's premier orphanage, she soon learned of a practice called ''summary resolution.''
Dr. Zhang, who spent 10 years at a medical research institute prior to her job at the orphanage, found that ''resolutions'' were invariably aimed at abandoned infants, often girls or those physically disabled. Medical care and food were drastically reduced, and the children were often sedated or beaten and abused. In time, the orphanage medical staff examined them and wrote a formal ''consultation.''
Zhang was shocked to find that no child receiving a consultation - more than 1,000 during her tenure - ever survived. Such children would eventually be placed in a ''waiting-for-death'' room before they died.
In her first US appearance last week, Zhang described how her outrage over the practice propelled her down a four-year road of organizing petitions, detailing abuses with fellow doctors, and pressing for action by everyone from Shanghai City Council members to the then-Communist Party secretary in Shanghai, Wu Bangguo, who is now a vice premier of China.
Zhang - who became an international whistleblower earlier this month after Human Rights Watch/Asia issued a report based on her findings at the orphanage - also offered details on what she said was a practice of withholding food from the orphans in order to select the healthiest for potential overseas adoptions.
''Any real doctor going into a place like that would immediately have conflicts,'' said Zhang, who was fired in 1993. ''It went against medical ethics, against my conscience. As a mother, you can't take it and you want to do something.''
Zhang's records, documents, and photographic evidence of abuse and neglect at the Shanghai orphanage provided the basis of ''Death by Default,'' a 394-page report by New York-based Human Rights Watch that describes what it says is a China-wide policy of ''fatal neglect'' of abandoned children.
Zhang said she thought at first that officials would press for change. ''I had total confidence the government would intervene once it knew what was going on .... The process of disillusionment took a long time,'' she said.
Chinese authorities vigorously denied the report, saying it was ''totally without foundation.''
Human Rights Watch officials admit it is impossible to put together a statistically accurate account of orphan treatment across China. But based on the Shanghai example, other testimony of journalists and doctors, and government documents, the human-rights group charged that ''the majority of abandoned children admitted to China's orphanages were dying in institutional care.'' Some 60 percent of the children placed in orphanages die during the first year, the group asserts.
In addition, Human Rights Watch/Asia said that two of Zhang's colleagues were detained late last year in what appeared to be an effort to intimidate critics of the government's management of the orphanages, according to a Reuters report. One, a former member of Shanghai's legislature who pressed for an inquiry into the allegations, has been held without formal charges since November. Another supporter of Zhang's was detained for seven weeks and then released.
Police also said last week that Zhang's brother had been detained - and later released. Zhang said in Boston that he was under a kind of house arrest.
But in an apparent shift in its dealing with the fallout from the report, the Chinese government agreed Jan. 22 to work with UNICEF to train workers and help set management standards in Chinese orphanages.
Kit Munro, a co-author of the report who accompanied Zhang to Boston under the auspices of the Physicians for Social Responsibility, said he is not accusing China of a policy of murder: ''We accuse them of a policy of lethal neglect.''
When asked why she repeatedly raised the issue with authorities despite the risks involved, Zhang said it was a ''question of what interest do you serve? Do you put your own career first? Or your family? Or your own welfare? Or is it these children? How brave are you? You have to be ready for constant trouble and persecution. You have to be prepared to withstand trouble for a long time.''
Photographs of the abuse were taken by Ai Ming, a slightly handicapped young man raised at the orphanage. In Boston, Mr. Ming said he had heard from other children about the morgue, and he started to watch the door to the ''waiting-for-death room.'' If it was locked, he said, a child was inside.
Once, when the door was unlocked, he entered and undid the window latch. He borrowed Zhang's camera, and when the door was locked again ''I waited until everyone was asleep, and climbed through the window.''
Zhang said that the orphan policy is not due to lack of doctors, money, or food. It is a human-rights problem, she said.
Some American academics criticized the Human Rights Watch report, saying that China as a whole cannot be judged based on the practices of one Shanghai orphanage.
Zhang and Mr. Munro agree with that assessment - but only in that they say the policy of fatal neglect is worse than their report can verify. ''The Shanghai Institute ... gets UNICEF and other Western aid,'' said Zhang in an animated tone. ''You can imagine what the conditions are like in rural provinces like Xinjiang.''
The report includes the Civil Affairs Statistical Yearbook, a rare, 1989 internal government document. It lists the orphanage death rate for each province, based on the rate of admissions.
Even in wealthy Guandong province, 41 percent of incoming children die in the first year, according to the yearbook. In Fujian province, 106 children were admitted to orphanages in 1989, and 106 died.
Among those meeting Zhang in Boston was well-known Lutheran theologian Krister Stendahl of the Harvard Divinity School. ''I believe the data,'' he said. ''This seems like the darkest bottom of China's population policy. There is a triage process among the abandoned, and it is a good thing to bring that to attention.''