The story appears on

Page B1

September 28, 2011

GET this page in PDF

Free for subscribers

View shopping cart

Related News

Home » Feature

New regimen for rural health

BAREFOOT doctors were the linchpin of China?s old state-supported health care system, but the remake of the system now calls for one clinic in each village.

Yu Bing, a 40-year-old village doctor in southwest China, is on call 24 hours a day to provide medical treatment and advice and carry out water and other checks to prevent epidemics in his mountainous home.

òIt isn?t rare for me to be awakened by patients at two or three in the morning,ó says Yu, the only doctor in the remote village of Suichao in Hezhang County, Guizhou Province.

Yu is constantly busy but says he?s content when he compares his past job as a òbarefoot doctoró with his current work in the village clinic.

Yu?s office, a 60-square-meter cottage, contains a consulting and diagnosis room, a therapy and treatment room and a pharmacy. It also contains basic medical equipment and instruments.

òMy family used to dine, sleep and treat patients in the same cottage, and like all the other barefoot doctors, I only had three medical instruments in the past: a blood pressure cuff, a stethoscope and a syringe,ó he says.

The barefoot doctor?s cottage has been refurbished and turned into a real clinic with government funding as part of a nationwide effort to improve the rural health-care system.

Yu is one of more than 1 million village doctors providing basic medical services to nearly 700 million Chinese farmers. A majority of them began their training as barefoot doctors.

Barefoot doctors were an essential part of an extensive health-care system promoted by late Chinese leader Mao Zedong. The number of barefoot doctors was officially placed at 1.46 million in 1980.

The name came from the medics? appearance ? they looked like farmers and that?s what most had been. Despite lack of professional training, they provided basic medical care for China?s huge rural population during the country?s planned economy era, when 90 percent of the population enjoyed life-long, government-subsidized health care.

The system started to collapse in the early 1980s with the end of the collective economy and beginning of market reforms in rural areas, according to Chen Xiwen, deputy director of the Leading Group on Rural Work of the CPC Central Committee.

Farmers could not afford the surging medical expense when subsidies were cut in market reforms and the user-pays system was introduced.

Rural medical facilities lost government funding and many had to close. Thousands of barefoot doctors lost their jobs.

As a result, rural China experienced a vast shortage of doctors and medical facilities.

The Chinese government has been trying to improve health-care services in rural areas through a new program called òone clinic in each villageó or òone village doctor for every 1,000 farmers.ó This conforms to health guidelines released by the General Office of the State Council in July.

To improve village doctors? living conditions, the government plans to improve their subsidies and income. A pension program is expected to be launched soon, according to the guidelines.

In addition, special funds have been set up in many provinces and regions to purchase medical equipment and provide professional training to village doctors.

òWe farmers like village doctors because they are always there to help and they are familiar to us,ó says Zhang Zhihe, a farmer in Lishan Village in eastern Jiangxi Province.

Without a village doctor, he would have to travel for an hour to get to the township hospital, he said.

Zhang Xingde has been practicing in Lishan Village for more than 40 years. Today the 63-year-old barefoot doctor-turned-clinic head cannot figure out whether he is a private doctor or a doctor under the government health system.

He said he struggled to be an independent doctor in the village, even after the government gave up the extensive health care system in 1980s.

In the early 1990s, village officials persuaded him to turn his private clinic into the village clinic though the government did not invest a penny.

Through his own initiative, Zhang took responsibility for providing health care and epidemic control for the whole village.

òIn the early 1970s and 1980s, many farmers volunteered to be trained as barefoot doctors even though medical facilities and funds were scarce. Doctors enjoyed relatively high social status,ó Zhang recalls.

Zhang?s son, Zhang Hua, graduated from Jiangxi Medical College in 1988 and then followed in his father?s footsteps. He gave up an opportunity to work in a city hospital and returned home to help his father in the village clinic.

òWith increasing government funding, the environment and facilities in many village clinics have begun to improve, and they will attract more medical students in the future,ó says the elder Zhang, adding that he hopes the younger generations of village doctors would provide more professional medical care to farmers than barefoot doctors like him.


Copyright © 1999- Shanghai Daily. All rights reserved.Preferably viewed with Internet Explorer 8 or newer browsers.

沪公网安备 31010602000204号

Email this to your friend