A short walk from billionaire Stanley Ho's extravagant Grand Lisboa casino stands the faded pink exterior of the Conde S. Januário, Macau's only public hospital.
Inside, bathroom tiles are stained and paint peels off the walls along the corridors where patients queue to be examined by busy medical staff. The hospital, built in the 1980s, serves the former Portuguese colony's more than half a million residents.
A new hospital is planned, but won't open until 2019. By then, Macau is expected to have added another six glitzy casinos to the three dozen that already make it the world's betting capital, as Las Vegas mogul Steve Wynn and others continue to bet on the only place where Chinese can legally gamble.
Life in Macau, a southern Chinese enclave one third of the size of Manhattan, is geared to gambling, which brings in revenue of more than $33 billion and accounts for more than 40% of GDP. There are more than four times as many gambling tables per 1,000 residents than hospital beds.
To many who live in what is both the world's most densely populated territory and fastest growing economy, the priorities are all wrong.
"It's unacceptable. These facilities are a joke. This is the main hospital in Macau," said Simon, who has lived in Macau for five years and works in the hotel industry, as he wheeled his toddler up and down in a narrow car park waiting for his wife.
Macau last year attracted 28 million visitors - more than the population of Australia - and while the gambling industry has boosted general living standards over the past decade, residents say the development of social infrastructure, including healthcare and transport, has lagged behind.
A fleet of nearly 2,400 brightly coloured casino buses shuttles visitors who commute en masse, stretching Macau's overburdened transport network, causing gridlocked streets and an increase in traffic accidents. This month, one Macau legislator pressed for a limit on the number of shuttle buses. A driverless light rail transit network is in the works, but isn't expected to be up and running until at least 2015.
Property prices have risen by half since last year, industry data show, and surging food prices mean daily groceries for Macau locals cost close to double what people pay in Hong Kong, the international financial hub an hour's ferry-ride away.
"I do see the inequality and the property price increases. Most importantly, I see the inequality gap is widening more and more compared to two years ago," said Larry So, a Macau-based political analyst.
Thousands of Macau residents have taken to the streets this month to call for more welfare measures, more public housing and more action to check inflation. Macau does also have a private hospital, a university hospital and several health clinics.
In comparison, greater Las Vegas, Macau's main rival as a gambling hub, has roughly the same population, more than 150 casinos and at least 15 hospitals with at least 90 beds or more.
HAND-OUTS NOT ENOUGH
Macau's government routinely gives residents annual "wealth share" cash handouts, raising this year's allowance to 7,000 patacas, to try to stem public discontent. Last week, the government approved measures to tackle the overheated property market, but industry watchers say it is unlikely to bring down prices to affordable levels.
Juliet Risdon, director at JML Property in Macau, said that despite new housing supply such as the 19,000 subsidised home-ownership and social housing units due to be ready by the end of the year, overall new property supply was relatively short.
"I think it's very disappointing as a long-term resident of Macau, for my friends and colleagues here, that they are continually in a position where they cannot buy property," she said, adding that potential residents were frustrated about the small size of the new units and the exorbitant one-off cost of a car park berth, which has hit 1 million patacas (around $125,000) near one of the new low-cost housing developments.
The quality of housing is also under scrutiny, with some 200 residents evacuated from their apartment in the north of Macau's peninsula earlier this month after cracks appeared on the walls of the 30-storey structure.
HOOKED ON GAMBLING
Macau's transition from tranquil fishing village to casino boomtown has seen dependence on the gambling industry grow despite the government's efforts at diversification, said Jose Pereira Coutinho, a Portuguese legislator in Macau who heads the Civil Servants Association.
"There is no diversification of industry. We are too much dependable on gambling, so if something happens in mainland China, something bad, like SARS (Severe Acute Respiratory Syndrome) and people stop coming over to Macau, then the economy is in a mess," he said.
Small and mid-sized businesses struggle to survive, with many forced into bankruptcy in recent years, while others grapple with rising rents and skill shortages as graduates head straight to the casino industry where salaries are more than double.
Bobo Chan, a 26-year-old Macau university graduate, stopped working in the Sands Macau casino last year after she felt unable to cope with the lengthy overnight shifts in VIP rooms and the smoke-filled environment.
Chan, who now works for the Civil Servants Association, said that while she was able to switch industry, both her parents still work at the Sands Macau casino, with her mother on shifts from 8 p.m. until 4 a.m. most nights. While new casinos create opportunities for young people, Chan said the government is too focused on using gambling revenues to benefit Macau.
"There are already so many casinos in Macau. I think they had better put the money in education. I remember many years ago people came to relax, but now so many mainlanders come to Macau just to gamble," she said.
The social implications are taking their toll on residents, too, with local media reporting a 30 percent increase in the number of those seeking treatment for mental health problems in the past few years.
Some hope a change of leadership in China will help shift the political agenda in Macau.
"Let's hope when Xi Jinping becomes president something changes here in Macau. I don't know ... I hope so," said Coutinho, referring to the man widely touted as China's next leader.