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Sunday January 9, 2011

To the villagers, rural doctors are superheroes

BEIJING: Just thinking about hanging on a 400m-long zip line, swaying 50m above the roaring Nujiang River is scary, admits Li Jiasheng. But the 33-year-old rural doctor in Fugong county of Nujiang Lisu autonomous prefecture, Yunnan province, knows the zip line is the fastest way to reach Watuwa village, on the other bank of the Nujiang Great Canyons, for his house call.

Although he is from the Lisu ethnic group, Li, like most of the other locals, dreads it every time he has to ride the zip line.

“You could become fish food as soon as you fall,” says Li, who often has bruises on his legs and back from using the zip line.

Using a steel pulley and a hemp rope looped to the line, he puts his upper body through the loop and sits on it. He then hauls his medicine box over his right shoulder, steadies his trembling legs and takes a deep breath. After pushing hard against the rock face, he is on the other side of the canyon in less than a minute.

For many villagers living in remote parts of Yunnan, a rural doctor’s medicine box is all the access to health care they will ever have. For the doctors themselves, it means working long hours in bad conditions and for low pay.

As the only doctor servicing 11 villages in Lumadeng township, Li has been working round the clock for the past eight years, ministering to more than 1,700 people.

“My work is my life,” says Li, who lives next to his clinic, on call all day.

Li recalls how he once walked two days to take hepatitis B vaccine to a newborn baby in Ouludi village, on the top of a 1,800m-high mountain. The mountain roads were treacherously slippery and the howl of wild beasts in the dark frightened him out of his wits.

“I cried then,” says the man.

Unlike their counterparts in the cities, rural doctors are called upon to save lives with the most rudimentary of equipment and the most basic of knowledge acquired at “secondary medical schools”, which are like vocational schools offering specialised training in basic health care. To their patients, however, they are superheroes.

Once known as barefoot doctors, rural doctors are drawn from farmer families, and shoulder 40% of the country’s basic public health services.

The number of rural doctors stood at 995,000, and rural clinics at 633,000, by 2009. In Yunnan, where 94% of the land is covered by mountains, there are 33,241 rural doctors spread over 13,375 rural clinics.

He Guangcai, 31, a rural doctor from the Bai ethnic group in Baodeng village, Luobenzhuo township, Lushui county, has more than 10,000 villagers from eight nearby villages under his care. Fourteen years ago, after graduating from a three-year secondary medical school, the then 17-year-old took over from his father to become the family’s third generation of doctors.

He cannot recall how many pairs of shoes he has worn out going from house to house but does remember that in the past 14 years he has delivered 1,157 babies without any newborn or woman-in-labour dying.

He still cherishes what Qing Haiyu, a 19-year-old woman he saved from a difficult labour, told him: “The moment I saw you, I felt you would save me.”

Fellow villager Hu Sizhe, 36, recalls how she once accidentally took the wrong medicine and went into shock. He sucked out the medicine stuck in her throat and brought her back to life after a two-hour detoxification treatment.

“He is like my second parent,” says Hu, who never fails to present He with home-made ham every year during Spring Festival.

Like most rural doctors in Yunnan, till recently, He’s monthly subsidy was the same 60 yuan (RM28) he got when he first started work. His father too drew the same amount for more than 15 years.

He says he and his family have never been able to afford anything expensive over the years. When he started out, there were five other rural doctors with him but they all quit.

On March 8, 2003, He’s father, who had been working as a rural doctor for more than 30 years, died of high blood pressure and a stroke at 53. The family could not afford the 100,000 yuan (RM46,350) for a cure at a big city hospital. Even so, He decided to pursue the same career.

“I want to be like my father, who had won everyone’s respect,” says He, who made up his mind when he saw hundreds of villagers crying at his father’s funeral.

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