When we talk about access to healthcare in rural China, we often draw our attention to the patients. How can the rural population access better healthcare? Does the government build enough healthcare infrastructure for the poor? Can we make health services more affordable?
Most discussions of rural health services today are patient-centered. We often ignore the role of village doctors, who work in rural communities and practice medicine for the villagers.
In this story, I uncover today’s village doctors’ situation in China and explore how two generations of village doctors work together to promote rural health services.
As a part of the government’s scheme, many township health centers in rural China establish their own traditional Chinese medicine (TCM) clinic to provide services such as acupuncture, moxibustion, massage, scraping, cupping, and other related traditional medical skills.
Among all the TCM clinics, one small clinic in a rural town of Yunnan Province becomes really special. On each weekend, this TCM clinic turns to be a “free clinic”, as what local people call it. The free clinic runs by Dr. He, a 79-year-old TCM doctor who travels every week to this village clinic from Kunming, the capital city of Yunnan Province.
The free clinic charges no fees from the patients. Dr. He also doesn’t receive financial payback from doing this. Villagers from the surrounding areas all come for this great opportunity to treat their diseases by an experienced doctor from a big city. The number of patients per day in the free clinic started from a dozen four months ago, and it has reached more than sixty recently. Due to the large number of patients, Dr. He is also assisted by two young local TCM doctors who work at the township health center.
Nevertheless, why did Dr. He decide to run the free clinic while getting no financial benefits? What drives him to travel every week all the way to this town to treat patients?
Dr. He’s motive doesn’t come from nowhere. In fact, Dr. He grew up in this town but left when he was sixteen. When he heard the TCM clinic was established and two young doctors were hired to practice TCM, he was eager to join and teach his experience to the next generation of TCM doctors there. He told me, “this place has more than seven hundred years of history in practicing TCM. When I spend my childhood here, there were seven or eight TCM doctors. Now, there are only two. I cannot let TCM in this town continue going downhill.”
Dr. Yang is one of the young TCM doctors who help run the free clinic. She has practiced TCM for three years and always expected “an old expert” would come and train her medical skills. She told me, “when I heard an experienced doctor would come, I am so excited!” She waited for a long time and eventually Dr. He showed up. Dr. He teaches Dr. Yang skills while treating patients together, and he also compiles a series of prescriptions for different diseases, which serve as references for these two young TCM doctors.
The free clinic is a place not only for patients to get free treatment but also for two generations of doctors to interact. On one hand, Dr. He wished to pass on his TCM experience and knowledge to the young generation; on the other hand, Dr. Yang lacked access to better medical training and strived to learn from a more experienced doctor.
Indeed, these two generations of village doctors represent two separate historical phrases of practicing medicine, which also symbolizes the progression of healthcare in China. Dr. He started his medical career as a barefoot doctor in rural villages during the cultural revolution. Only a decade later, he obtained an associate degree in TCM and Western medicine from a medical school. Dr. He accumulated his medical experiences and practiced medicine even before he received formal medical education. And it was largely due to the lack of medical professionals in rural Chinese villages during the 1960s and 1970s.
However, the new generation of TCM doctors can only become medical professionals after formal medical education qualifies them. Dr. Yang went straight from a medical student to a village doctor in this TCM clinic.
To be a village doctor means that both responsibility and sacrifice have to weave into the heart of their life. When I first met Dr. Yang, I always thought she grew up in this town too, like Dr. He. However, it was not true. She told me that none of her family members lived here. Her daughter and her husband both live in Kunming, a mere 100 kilometers away from where she works.
As a village doctor, she works in almost a full schedule and seldom has a long vacation to spend with her daughter. Besides, the transportation is not so convenient. Every day, there are only two slow trains commuting between this small town to Kunming. She expressed her “regret” towards her daughter. She said to me, “my daughter always asks me why I don’t come home. Why I cannot spend time with her at the amusement park. I can only tell her that mommy needs to work…” I asked her whether she wanted to just stay to her daughter and husband. She said she thought about it before but she also felt “responsible for the villagers.”
For Dr. He, he continues practicing medicine at the age of 79. He carries the same responsibility as a doctor to pass on his long experience in TCM and contributes back to his own hometown.