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Village doctors have dramatically improved access to health care in China's rural communities over the last few decades. Cui Weiyuan reports.
China's barefoot doctors were a major inspiration to the primary health care movement leading up to the conference in Alma-Ata, in the former Soviet Republic of Kazakhstan in 1978. These health workers lived in the community they served, focused on prevention rather than cures while combining western and traditional medicines to educate people and provide basic treatment.
Dr Philip Lee, then a professor of social medicine at the University of California in San Francisco, wrote glowingly in the Western Journal of Medicine about China's primary health care system after visiting the country in 1973 as part of a United States of America (USA) medical delegation. He said prior to the founding of the People's Republic of China in 1949, epidemics, infectious disease and poor sanitation were widespread. "The picture today is dramatically different ... there has been a pronounced decline in the death rate, particularly infant mortality. Major epidemic diseases have been controlled ... nutritional status has been improved [and] massive campaigns of health education and environmental sanitation have been carried out. Large numbers of health workers have been trained, and a system has been developed that provides some health service for the great majority of the people."
Dr Zhang Zhaoyang, the deputy director general of China's Department of Rural Health Management, says the barefoot doctor scheme had a profound influence on the Declaration of Alma-Ata. "WHO research in the 1970s found problems relating to the health-cost burden and unequal distribution of health resources. To try to solve the inequality, it did research in nine countries, including four cooperation centres in China. China's experience inspired WHO to launch the health for all by 2000 programme."
Zhang says the barefoot doctor scheme, initiated by central government but largely administered locally, had its origins in the 1950s. "The name barefoot doctor became popular in late 1960s after an editorial in the People's Daily by Chairman Mao in 1968," he says. "The name 'barefoot doctor' originated in Shanghai because farmers in the south were often barefoot working in the paddy field. But China's village doctors had been there long before. In 1951, the central government declared...