Forty-year-old farmer and doctor Han Xianyao has just registered for a
correspondence course in medicine in response to a government call and in a bid
to improve his medical expertise in treating his fellow villagers.
Han has been a village doctor for nearly two decades in Hongcheng Village, in
northwest China's Gansu Province. His medical knowledge and skills came from his
father - also a village doctor.
Village doctors like Han are usually descended from generations of medical
families. Another group of village doctors is made up of graduates from local
secondary medical schools who have returned to their home villages.
Village doctors are the most basic type of medical worker in China: their
simple homes are their clinics and they lack adequate medical equipment,
medicines and knowledge.
They were once prominent figures in the Chinese countryside from the 1950s to
the late 1970s. However, after China initiated the reform and opening-up policy,
they gradually withdrew from the medical sphere due to the rapid development of
township and county hospitals, which were relatively advanced and more favored
by villagers.
The situation even forced some village doctors to quit their profession and
turn to other trades, such as self-employed laborers.
But now village doctors are on their way back. "Things have changed. We have
won recognition from the government and villagers again," Han said.
The Chinese government shifted its focus to the medical and health care
system in the countryside after the SARS epidemic hit China in 2003 and
following the outbreak of bird flu.
The expensive medical care in rural China has become a major social problem.
A report by the Development and Research Center under the State Council, or
China's cabinet, shows that 37 percent of Chinese farmers who should go to
hospital refuse and 65 percent who should be hospitalized are not.
In 2003, China launched a new type of rural cooperative medical system, under
which the government and farmers combine to raise funds to help farmers afford
treatment for major diseases.
China's rural medical system is designed to achieve the following goals:
minor illnesses would be cured in the village, general diseases would be cured
in the township, major diseases would be cured at the county hospitals.
"The township and county hospitals cannot take all patients from local
villages, so my fellow villagers always come to me first when they fall ill,"
Han said.
In China, about 60 percent of the patients in the rural areas resort to
village doctors.
"To be good village doctors, we must improve ourselves first," Han said,
which is why he is hoping to gain a diploma in medicine. "It's a good thing and
it will bring benefits to others, not just to me," he said.
China has about 650,000 villages and 820,000 village doctors like Han,
statistics with the Ministry of Health show.
The Chinese government has pledged to invest more than 20 million yuan (2.5
billion U.S. dollars) in the countryside over the next five years to renovate
hospitals and village clinics and upgrade their equipment.
Meanwhile, "training village doctors and assistants" has been written into
the country's 11th Five-Year Program (2006-2010) for economic and social
development, and the central government has promised to regularly send urban
medical personnel to work in rural health facilities.
China has sent over 4,000 urban doctors since last June to help improve
medical services in underdeveloped rural regions, according to the Ministry of
Health.
The doctors, selected from 22 provinces and regions in central and west
China, have treated nearly one million out-patients and received about 34,000
in-patients in 600 counties nationwide and 350 township clinics in Gansu, said
the ministry.
"They not only bring benefits to rural patients but also professional
skills," said Han Keyin, deputy director of the Gansu Provincial Department of
Health.
Many provinces in China have also devised their own plans to increase
financial and training support for the village doctors.
In southeast China's Fujian Province, the local government has decided to
allocate 10 million yuan (1.25 million U.S. dollars) each year over the next
five years to let its 23,000 village doctors receive training at least once a
year.
From this year, Gansu will sponsor 20,000 in-service village doctors under
40-years-old, like Han Xianyao, to complete a secondary education course in
medicine.
In addition, Gansu will give 100 yuan (12.5 U.S. dollars) per month to every
village doctor from this year, which has also been practiced by the neighboring
Ningxia Hui Autonomous Regions and other provinces.
"The role of village doctors will be brought into better play once their
treatment and conditions are improved," the official Han said.