Barefoot Doctors

The barefoot doctor program was a government-initiated program started during the 1960s to train local village doctors in the basic medical services necessary to treat common ailments such as cuts, bruises, and the common cold. Originally trained through an apprenticeship format, an analogous program exists today as a standardized, 3-year school. The government has initiated a number of changes that have generally brought about positive changes; replacing the old fee-for-service payment style with a decent standardized wage, and even providing funds to erect proper clinics for some doctors, allowing them to relinquish the need to work the fields and focus entirely on their medical work.

All that’s according to the people from the Fred Hollows Foundation I was traveling with. Wikipedia mentions nothing about the 3-year school, the standardized wage, and the federally supported clinics (so you know you have to watch out). From its point of view, the barefoot doctor program peaked in the 60s but was abolished in 1981 with the end of the commune system in rural China.

Nevertheless, the barefoot doctor program during its time is generally seen as a great success, alleviating the burden on many higher-level hospitals and specialized doctors and providing an assessable first line of defense against medical ailments for villagers. One of its key strengths lie in the deep local connection between the barefoot doctors and the villagers they served. Being from the village, these doctors knew closely the situation and needs of their neighbors, and in turn received a great deal of trust that’s often withheld from outsiders.

The barefoot doctors carried out other services as well; they could give shots and vaccines, keep handwritten patient records, and register villagers to receive insurance. They also were and still are an important method of promulgating information.

As the students at Zhongshan Medical School told me, in China there is no primary physician system, no group of doctors to address basic medical issues for a set population of patients, and no thus no standard, integrated, and consistent source of patient education and health promotion. Attempts to set up such a system, they say, have all met with abysmal failure.

It seems to me, however, that the makings of such as system are already in place, a group of medical personnel that serve roughly a similar purpose. Why not expand upon a program that has already been hailed as a success?

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