Chinese peasants encouraged to heal themselves

More striking is the regard for basic health and hygiene: smoking and spitting are commonplace, even among the doctors

Teresa Poole in Guanyindang, Hubei province, sees the effects of health cuts

Wan Liangmo, his head swathed in a grubby bandage and his arm connected to a saline drip, was not short of company as his wife described how he had ended up in Guanyindang township sub-hospital. Sitting on his bed or lolling around were half a dozen peasants, smoking and sometimes spitting on the dirty concrete floor.

Four days earlier Mr Wan's tractor had collided with a truck overloaded with straw and the drivers came to blows. The big question now was who would pay for Mr Wan's treatment. His wife said with some feeling: "It's difficult for us to pay." An irritated Mr Wan roused himself from his pillow to insist that there was no question the money would have to come from the other driver.

Before China's economic reforms in the early 1980s, medical care for rural farmers like Mr Wan was even more primitive - but at least it was free. These days the country's 900 million peasants get what they pay for. Government funding for rural health care has virtually collapsed, leaving patients to foot the bills. At the Guanyindang sub-hospital in 1994, patients' fees amounted to 1.12m yuan (£86,000) out of the annual budget of 1.36m yuan (£105,000).

Only children under seven, very poor farmers and old people received free services, said the hospital's director, Wang Yifa. Even in a relatively well-off area like Guanyindang, in central Hubei province, patients can be hard-pressed to afford medical care. According to Dr Wang, an appendix operation would probably cost 600 yuan (£46), "including bed and medicine and food, operation, electricity and water". Surgery to "take part of the stomach out" could be performed for less than 1,000 yuan.

This compares with an average monthly income in the township of about 1,200 yuan (£92).

In the cities it is different. Almost all urban employees are still provided with virtually free health care through their work- units. In the countryside, the disbanding of the commune system in the early 1980s raised living standards but also undermined the existing social-welfare structures.

"Because of the deterioration of most of the rural medical services, 80 per cent of the total population could be denied timely basic health service," said a recent article in the official Outlook magazine. Guanyindang sub-hospital serves a population of 46,000 but only nine of its 50 in- patient beds are occupied. This may be because the local farmers are extraordinarily healthy but more likely it is because many cannot afford to come for anything other than childbirth or accidents.

In this area, as elsewhere in rural China, when a farmer gets sick, his first port of call is the village "health-room", or clinic, usually staffed by two or three "countryside doctors" with only rudimentary training. If the problem cannot be solved, the patient moves on to a township sub- hospital, like the one in Guanyindang, and if he cannot find help there, he is referred to the district hospital. In Jiangling district, of which Guanyindang is part, there is one university-trained doctor for every 6,800 people.

At the village level there are sometimes co-operative health- care schemes to which the village collective and the individual farmers all contribute. "We encourage all farmers to join a co-operative health scheme," said Zhu Rong, director of Jiangling health bureau. The system is far from widespread, however. Otherwise, the only health cover is through the state insurance company but this is even rarer. Standards have improved with 15 years of economic growth in China but the basic level of treatment available to the majority of the population is still dire.

The present Guanyindang sub-hospital building is less than five years old but it already has broken windows, does not get cleaned and has draughty, unheated rooms that add to the atmosphere of neglect. More striking still is the disregard for basic health and hygiene: smoking and spitting are commonplace, even among the doctors, and the outdoor lavatories gape over open sewers.

Sitting in the reception-room with the hospital's senior staff, the question of qualifications naturally arose. What was the medical training of the hospital's director, Mr Wang? "No formal training," he said. And his deputy, Zhang Debing? "No formal training."

The chief specialist, Xu Daogong, trained at Chongqing Medical Science College for three years but only three others out of 79 "medical personnel" are fully trained doctors.

Suggested Topics
Start your day with The Independent, sign up for daily news emails
PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
ebooks
ebooksA year of political gossip, levity and intrigue from the sharpest pen in Westminster
News
Lena Dunham posing for an official portrait at Sundance 2015
people
Arts and Entertainment
Under the skin: Sarah Kane in May 1998
theatreThe story behind a new season of Sarah Kane plays
Arts and Entertainment
Preening: Johnny Depp in 'Mortdecai'
filmMortdecai becomes actor's fifth consecutive box office bomb
Sport
Bradford City's reward for their memorable win over Chelsea is a trip to face either Sunderland or Fulham (Getty)
football
News
Lars Andersen took up archery in his mid thirties
video
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Recruitment Genius: Warehouse Operations & Logistics Manager

£38000 - £42000 per annum: Recruitment Genius: One of the UK's best performing...

Recruitment Genius: GeoDatabase Specialist - Hazard Modelling

£35000 - £43000 per annum: Recruitment Genius: Our award-winning client is one...

Recruitment Genius: Compressed Air Pipework Installation Engineer

£15000 - £21000 per annum: Recruitment Genius: This leading provider of Atlas ...

Recruitment Genius: Operations Coordinator - Pallet Network

£18000 - £20000 per annum: Recruitment Genius: Opportunity to join established...

Day In a Page

Woman who was sent to three Nazi death camps describes how she escaped the gas chamber

Auschwitz liberation 70th anniversary

Woman sent to three Nazi death camps describes surviving gas chamber
DSK, Dodo the Pimp, and the Carlton Hotel

The inside track on France's trial of the year

Dominique Strauss-Kahn, Dodo the Pimp, and the Carlton Hotel:
As provocative now as they ever were

Sarah Kane season

Why her plays are as provocative now as when they were written
Murder of Japanese hostage has grim echoes of a killing in Iraq 11 years ago

Murder of Japanese hostage has grim echoes of another killing

Japanese mood was against what was seen as irresponsible trips to a vicious war zone
Syria crisis: Celebrities call on David Cameron to take more refugees as one young mother tells of torture by Assad regime

Celebrities call on David Cameron to take more Syrian refugees

One young mother tells of torture by Assad regime
The enemy within: People who hear voices in their heads are being encouraged to talk back – with promising results

The enemy within

People who hear voices in their heads are being encouraged to talk back
'In Auschwitz you got used to anything'

'In Auschwitz you got used to anything'

Survivors of the Nazi concentration camp remember its horror, 70 years on
Autumn/winter menswear 2015: The uniforms that make up modern life come to the fore

Autumn/winter menswear 2015

The uniforms that make up modern life come to the fore
'I'm gay, and plan to fight military homophobia'

'I'm gay, and plan to fight military homophobia'

Army general planning to come out
Iraq invasion 2003: The bloody warnings six wise men gave to Tony Blair as he prepared to launch poorly planned campaign

What the six wise men told Tony Blair

Months before the invasion of Iraq in 2003, experts sought to warn the PM about his plans. Here, four of them recall that day
25 years of The Independent on Sunday: The stories, the writers and the changes over the last quarter of a century

25 years of The Independent on Sunday

The stories, the writers and the changes over the last quarter of a century
Homeless Veterans appeal: 'Really caring is a dangerous emotion in this kind of work'

Homeless Veterans appeal

As head of The Soldiers' Charity, Martin Rutledge has to temper compassion with realism. He tells Chris Green how his Army career prepared him
Wu-Tang Clan and The Sexual Objects offer fans a chance to own the only copies of their latest albums

Smash hit go under the hammer

It's nice to pick up a new record once in a while, but the purchasers of two latest releases can go a step further - by buying the only copy
Geeks who rocked the world: Documentary looks back at origins of the computer-games industry

The geeks who rocked the world

A new documentary looks back at origins of the computer-games industry
Belle & Sebastian interview: Stuart Murdoch reveals how the band is taking a new direction

Belle & Sebastian is taking a new direction

Twenty years ago, Belle & Sebastian was a fey indie band from Glasgow. It still is – except today, as prime mover Stuart Murdoch admits, it has a global cult following, from Hollywood to South Korea