Barefoot doctors (Chinese: ???? pinyin: chìji?o y?sh?ng) were farmers who received minimal basic medical and paramedical training and worked in rural villages in the People's Republic of China to primarily bring health care to rural areas where urban-trained doctors would not settle. They promoted basic hygiene, preventive health care, and family planning and treated common illnesses. The name comes from southern farmers, who would often work barefoot in the rice paddies. There were scattered experiments with this before 1965, but with Mao's famous 1965 speech about healthcare it became institutionalized, and 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.

Training

The barefoot doctors usually received about six months of training, though training length varied from a few months to one and a half years. Training was focused on preventive medicine and curing simple ailments that were common in the specific area. An important part of the Cultural Revolution was xiaxiang (a movement of sending intellectuals, and in this case doctors, to serve in the countryside). They would live in an area for half a year to a year and continue the education of the barefoot doctors. About a fifth of the barefoot doctors later entered medical school.

Work

Barefoot doctors acted as a primary health-care provider at the grass-roots level. They were given a set of medicines, Western and Chinese that they would dispense. Often they grew their own herbs in the backyard. As Mao had called for, they tried to integrate both Western and Chinese medicine, like acupuncture and moxibustion. An important feature was that they were still involved in farm work, often spending as much as 50% of their time on this - this meant that the rural farmers perceived them as peers, and respected their advice more. They were integrated in a system where they could refer seriously ill people to township and county hospitals.

End of barefoot doctors

The barefoot doctor system was abolished in 1981 with the abolishment of the commune system of agricultural cooperatives. The barefoot doctors were given the option to take a national exam, if they passed they became village doctors, if not they would be village health aides.

Historical legacy

The system of barefoot doctors was among the most important inspirations for the WHO conference in Alma Ata, Kazakhstan in 1978 where the Alma Ata Declaration was signed unanimously. This was hailed as a revolutionary breakthrough in international health ideology - it called for local communities participating in deciding health care priorities, called for an emphasis on primary health care and preventative medicine, and most importantly sought to link medicine with trade, economics, industry, rural politics and other political and social areas.

See also

• Public health in the People's Republic of China

References

http://lcweb2.loc.gov/frd/cs/china/cn_glos.html

External links

• http://www.npr.org/templates/story/story.php?storyId=4990242 NPR Article: Health for the Masses: China's 'Barefoot Doctors

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