China’s Rural Medical Health-Care Reform


China with more than 1.3 billion population must be commended for its effort in providing health care even to the remote rural areas.

It’s by no means an easy task, reflecting the care & consciousness of the Central Government to do their utmost for the people who had contributed much to the victory of the Communist Party.

Now, it’s the political will & desire and financial resources, which China has plenty of, to bring about this needed medical reform of its health-care system for millions of rural folks.

 In the early years, China’s rural medical scene was covered by teams of “Barefoot Doctors”. Such doctors were in fact farmers who received minimal basic medical and paramedical training who worked in rural villages in the People’s Republic of China. Their purpose was to bring health care to rural areas where urban-trained doctors were reluctant to go. They promoted basic hygiene, preventive health care, and family planning and treated common illnesses. The name was derived from southern farmers, who would often work barefoot in the rice paddies.

In the 1930s, the Rural Reconstruction Movement had pioneered village health workers trained in basic health as part of a coordinated system, and there had been provincial experiments after 1949, but after Mao Zedong’s healthcare speech in 1965 the concept was developed and institutionalized. In his speech, Mao Zedong criticized the urban bias of the medical system of the time, and called for a system with greater focus on the well being of the rural population. China’s health policy changed quickly after this speech and in 1968, the barefoot doctors program became integrated into national policy. These programs were called “rural cooperative medical systems” (RCMS) and strove to include community participation with the rural provision of health services. Barefoot doctors became a part of the Cultural Revolution, which also radically diminished the influence of the Weishengbu, China’s health ministry, which was dominated by Western-trained doctors.(Wikipedia)

The New Rural Co-operative Medical Care System (NRCMCS) is a 2005 initiative to overhaul the health-care system, particularly intended to make it more affordable for the rural poor. Under the NRCMCS, the annual cost of medical coverage is 50 yuan (US$7) per person. Of that, 20 yuan is paid in by the central government, 20 yuan by the provincial government and a contribution of 10 yuan is made by the patient. As of September 2007, around 80% of the rural population of China had signed up (about 685 million people). The system is tiered, depending on the location. If patients go to a small hospital or clinic in their local town, the system will cover roughly 70-80% of their bill. If the patient visits a county clinic, the percentage of the cost being covered falls to about 60%. If the patient requires a specialist in a modern city hospital, the plan would cover about 30% of the bill.(Wikipedia)

The Government’s effort is further augmented by non-profit organisations, individuals & doctors themselves who undertake to provide free service. 

Receiving expensive medical treatment is a challenge for many people, particularly those from rural areas. Many have to travel from village to town, to big city hospitals in search of medical care. It’s both time-consuming and costly, besides not being able to find the right needed expert help.

But now, with this new ‘Doctors for Rural Areas’ initiative, doctors and other medical experts come to their communities. There are no fees and no waiting lists. The doctor-patient relationship is simple and direct.

A patient says, “The great thing is that, for us ordinary people, getting to see a doctor is easy. We’re happy because we don’t have to go to the towns or cities. But there are too many people here!”

Liu Yong, the founder of the ‘Doctors for Rural Areas’ scheme, also deputy director of the department of medical oncology, came up with this idea two years ago which won support from the hospital. He says providing practical help is a doctor’s duty.

Liu says, “I am concerned about health conditions at the grassroots. I work in a large city hospital, and although we see some farmers, the majority of rural people, especially in rural areas, don’t always get access to the treatment they need.”

After seeing a patient, a doctor will often give them their phone number so they can keep in contact. This isn’t a hospital requirement, the doctors do it out of care for the patients.


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Liang Jun of “Doctors for Rural Areas” scheme, says, “I’ve found that by providing these free clinics, we ensure people overcome the often expensive and difficult problem of getting to see a doctor. For me, it is a glorious thing.” Liu also says, “This work is helping me find a clinical focus for my future work. By combining my specialty with the needs of the people, I hope that I can really apply what I have learned. “

Zhang Peiying, president of Xuzhou central hospital, says, “We run ‘Doctors for Rural Areas’ in order to get medical care direct to the people. It’s also good for the doctors. It gives them a real sense of providing service to the community.”

Seeing a doctor in the rural areas is no longer a problem or a major challenge. The free clinics, medical staff are also bonding in a way that seldom happen in a doctor-patient relationship.

Crucial medical reform is truly happening

With professionalism & dedication growing!

Inward, Outward And Upward Looking

By P Chong

Tuesday, 6 July 1999

Of the nations in the world today, China stands out progressively tall and strong. It is as though the sleeping dragon is finally awakened. This appears to be the fear of the West, though an economically strong China is good commercially for all the trading nations in the West, politically China is deemed as great threat. It is feared that “once China stands up, it won’t topple or be toppled.”

In retrospect, China is undoubtedly the world’s greatest civilised nation over a continuous period of thousands of years – a civilisation undiminished & unbroken, unlike past civilisations like Egypt, Greece or the Romans. By any reckoning, China should have by now be far more advanced & superior than the rest of the world. Why not?

Of the many reasons why China did not progress beyond its initial lead in technology & discovery, the main cause of which can largely be attributed to its inward looking policy . . . viewing all territories beyond the Great Wall of China & its boundaries as barbarian nature. This nationalistic pride & closed door policy led to its seclusion, totally depriving itself from from the interchange of ideas and exposure to new scientific developments & industrial growth. While China lavished in its culture, philosophy & essentially non-materialistic form of development, it began to lag behind the West in terms of economic industrial growth. In preserving its civilisation from being tainted by corruption, disruption & deterioration, it never knew new growth, developments & discoveries elsewhere in the whole wide world. The “Middle Kingdom” realised too late the encroachment of other nations upon its shores & territories. Countries like Britain, Portugal & Japan were making inroads into China through modern superior arms of war instead of its age-old “kung-fu”.

To grow, to progress is to change. Sentiment must give way to progress. There is no room for inhibition to changes. Change needs to take place before growth ^& progress can be attained. It’s attitude more than aptitude that scales the altitude. Mr. Lee Kuan Yew, the great former prime minister of Singapore, is credited for the great strides achieved by the City State. His visionary ideas have no room for inhibition to change or any hindrance.

Now, what a change has come about as a result of Deng XiaoPing‘s visionary concept of “Xiang Qian Zou”. In Mandarin, it means “Forward Move”, but by replacing the middle word with similar pronunciation, it becomes “Moving Forward with Money”. This started a great frenzy for the Chinese striving for monetary progress in all spheres of work & life.

Capitalistic way of life does have its price. Greed always breed a profound loss of goodness in mankind. Simple honesty, truth, kindness & compassion are lost in the process. The dollar sign etched prominently on the foreheads of goal-getters. It is evident to an outside observer that the whole civilisation is transforming overnight. China, in its forward economic stride, has done away with its traditional large families, and its door is wide open to the corrupt western way of life. There is a price to be paid, for consequential results cannot be avoided.

We are not about to discuss the forward march of China & the loss of a whole generation of tradition, custom, simple courtesy & good manners, which come about as a result of its Cultural Revolution.

We want however, to draw a comparative study between China and the United States of America, which has only a history of some 200 odd years, and yet progressively more advanced. Why is this so? The irony of this is even more profound when we compare US with Great Britain – the tag of British “greatness” pales in significance. And to think America started as a colony of Britain! What then is the significant attributable factor?

This factor is spelt out very clearly when we look at the green bag note. It says very clearly: “In God We Trust”. It is this upward and outward attitudinal outlook that made all the difference between Britain & the US, and China & the US. The American look upward to God for all its needs & provisions since the first Pilgrim Fathers stepped on the shore of the new continent. Because of its explicit trusting the Lord, America has been greatly blessed and it prospered beyond the realms of the other nations with similar history or longer history.

Apart from this upward attitudinal outlook, it practises an outward outlook beyond its shore and adopt an open door policy in the many aspects of its economy. In so doing, it was to absorb and gain both from within and without the world the wealth of knowledge towards its rapid advancement.

On the personal front, the individual musty avoid being inward looking. The classic example is drawn from the Pharisees, the elite Jewish ruling council, highbrowed, stiff-necked & self-centred in character. They rejected Jesus as the Messiah (the Jews’ promised deliverer) and till today they are still awaiting His coming. Ever wonder re the p,light of the “wandering Jews”? Being persecuted and hated wherever they are? It is without doubt God’s punishment of the Jews for crucifying Christ on the cross! Not until the Jews find their roots in the Messiah Jesus, will their wandering stop!!

In Matthew 23:13, it reads: “Woe to you, teachers of the law and Pharisees, you hypocrites! You shut the kingdom of heaven in men’s faces. You yourselves do not enter, nor will you let those enter who are trying to.”

Verse 27:Woe to you, teachers of the law & Pharisees, you hypocrites! You are like whitewashed tombs,which look beautiful on the outside but on the inside are full of dead men’s bones & everything unclean. In the same way,on the outside you appear to people as righteous but on the inside you are full of hypocrisy and wickedness.”

Verse 39 concludes with this: “For I tell you,you will not see me again until you say “Blessed is he who comers in the name of the Lord.”

How prophetically true what Jesus said. Until & unless the Jews find repose in Jesus, their perils will not be over!!

In John 14:6, the terminology is always on the personal basis: “I am the way and the truth and the life.” Jesus has given us the road map guiding us upward to heaven, and to stay in the centre of God’s will. You need not worry about tomorrow and trust Jesus to guide you one day at a time, and to follow him even though you don’t know the way. No other road map is required.

Abram followed one day at a time. He walked by faith and not by sight. As in genesis 12: 1 -5, we read:

The LORD had said to Abram, “Leave your country,

your people and your father’s household and go to

the land I will show you.”

“I will make you into a great nation and I will bless

you. I will make your name great, and you will be

a blessing. I will bless those who bless you, and whoever curses you I will curse; and all the peoples on earth will be a blessed through you.”

So Abram left, as the LORD had told him; and Lot went with him. Abram was seventy-five years old when he set out from Haran. He took his wife Sarai, his nephew Lot, all the possessions they had accumulated and the people they had acquired in Haran, and they set out for the land of Canaan and they arrived there.”

Abram (whose name was changed by God to Abraham) is the classic example of the principle of “walking by faith, rather than by sight . . . one day at a time”. In walking with the LORD, ourselves must be erased, the LORD must be raised. There is a definite attitudinal shift from self-centrednerss to God-cent redness.

In John 15:5 it says: “I am the vine; you are the branches. If a man remains in me and in him, he will bear much ruit; apart from me you can do nothing.”

Thus the way to be is: inwardness to upwardness. Amen.

The above account is in essence the salient points of a religious message

first delivered in a Sunday church gathering in July 1999.