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In the path of the trailblazing barefoot doctors

  • Source : China Daily Author : Time : 11/04/2019 Editor : Tenzin Woebom

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    Women in Tuoding township in the northwest of Yunnan province attend a health knowledge lecture. [Photo provided to China Daily]

     

    Well-trained medical professionals are picking up where those who were both farmers and physicians left off.

     

    For many decades health workers in villages throughout China have spent most of their work time as farmers even as they have maintained a certain level of medical knowledge and skills allowing them to give basic treatment to ill neighbors from time to time. They were called barefoot doctors.

     

    Now a system covering rural areas throughout the country in which a family physician is designated to serve particular people is ensuring that rural dwellers have access to a much more reliable standard of healthcare.

     

    Better skilled and equipped general practitioners, nurses and village health workers, some of whom used to be barefoot doctors, are included in the system, in which villagers receive home visits when they are in need of care.

     

    They are also obliged to give regular health checks and lectures to help villagers cultivate healthy living habits.

     

    Wugyan Tsering, a licensed doctor, and his team of four have been assigned as family physicians to more than 400 people in the village of Niansa in Tuoding township in the northwest of Yunnan province.

     

     

    The villagers line up at the entrance of the township health center as well as inside the waiting room for free checkups. [Photo provided to China Daily]

     

    It is this team that villagers will turn to when they realize that their condition is beyond self-help.

     

    Hundreds of villagers are scattered throughout the mountains, and it is particularly difficult to complete family physician duties on rainy days. Landslides destroyed bridges and damaged some parts of the road late last year, and the impact on transport is still being felt.

     

    Often when Wugyan Tsering treats patients he dispenses medicines, gives infusions, administers oxygen therapy and occasionally undertakes cardiopulmonary resuscitation.

     

    If a patient is severely ill, he provides basic treatment before transferring the patient to a larger hospital in the city of Shangri-La, about 100 kilometers away, or in Lijiang, about 200 kilometers away, the latter being ideal because of its lower altitude.

     

    In the meantime, an ambulance from the city can be on the way, preparing to pick up patients halfway.

     

    Wugyan Tsering says that for years he has paid for some patients' costs out of his own pocket, given that many elderly, impoverished patients have been unable to afford the full cost of their care.

     

     

    The villagers line up at the entrance of the township health center as well as inside the waiting room for free checkups. [Photo provided to China Daily]

     

    Though he has been married for 15 years, he and his wife have always lived apart. She now lives in a rural community doing work that aims to eradicate poverty. They have two sons, one of whom has been living at school since the first year of primary school, and the other who is cared for by Wugyan Tsering's mother at home.

     

    Yu Guihua, a village health worker for 24 years, has witnessed the improvement of healthcare services in Tuoding village, in the homonymous township, over the decades.

     

    Prophylactic vaccination can now be given every month instead of four times a year, as was the case 25 years ago or so, when Yu graduated from a secondary medical school. The main road had then yet to be sealed, and Yu really did have to live up to the name of barefoot doctor, traveling great distances, including climbing mountains, and carrying equipment and other items as she visited villagers in their homes to administer vaccinations.

     

     

    The villagers line up at the entrance of the township health center as well as inside the waiting room for free checkups. [Photo provided to China Daily]

     

    Nowadays the healthcare workers can even provide regular antenatal care and prescribe a much wider range of medicines.

     

    Wugyan Tsering says that those working in medicine in the township are relatively well paid, but it is still difficult to retain such talent. Of 10 of his classmates when he did a medical internship in Kunming 20 years ago, only three remain in the field, and he is the only one working in the countryside, he says.

     

    After graduating from secondary health school in 2001 he was unemployed for a year, then worked in a pharmacy for two years, and then in the ticket center of a nearby tourism spot for seven years.

     

    He then returned to medicine, spurred by a local government policy aimed at tackling the shortage of rural doctors.

     

     

    Yu Guihua (right) helps translate the local ethnic dialects to Mandarin. [Photo provided to China Daily]

     

    Several qualified young people have joined the team recently, enabling staff to finally have a regular day off every week since last year, and two more will join the team in a year or two.

     

    However, people tend to retire earlier in plateau regions such as Tuoding township, and many qualified people are keen to seek opportunities in larger hospitals in the cities, exacerbating the problem of doctor shortages.

     

    Yu says her job is highly stressful, and she particularly fears the risk of medical accidents, and the possible indemnity and disputes.

     

    Unlike in the case of licensed doctors, it was not until April that the government of Dechen Tibet autonomous prefecture, to which the township belongs, adopted a policy aimed at improving village health workers' remuneration and setting out their pension and health insurance benefits.

     

    However, Yu says she feels luckier than her fellow villagers although it is hard to be a medical worker at the grassroots.

     

    "People respect us. On hearing my patients say 'Oh doctor, you're here', all the exhaustion slips from my mind."

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