Pan Feng tests a man's blood pressure at her clinic in Lugoutang village, Guizhou province.[Photo provided to China Daily]
Rural doctor overcomes incredible obstacles to care for those who need her, report Wang Qian in Beijing and Yang Jun in Guiyang.
Finding a doctor for her mother, who had chronic pulmonary heart disease, was not easy for Pan Feng in the 1980s. It meant a walk of more than 10 kilometers from her home to the nearest health center in Getang, a mountain village in the Qianxinan Bouyei and Miao autonomous prefecture in Guizhou province.
"That was when I wanted to be a doctor to make medical care more accessible in the countryside," the 53-year-old Pan says. Since becoming a rural doctor in 1999, a profession with a shortage of practitioners, she has played an important role in keeping the community healthy and reducing the healthcare gap between the rural and urban populations.
On Aug 17, Chinese Doctors' Day, Pan was awarded the Chinese Physician Prize, the highest honor the nation's medical workers can receive, for her dedication and long service to the village. Besides her, 78 recipients received the title this year.
"I consider myself very fortunate to get the honor, because there are many village doctors who have done a great job and I am just one of them," Pan says.
The latest data from the National Health Commission shows there were about 1.15 million doctors providing care for rural residents as of last year, down by around 100,000 from 2012, despite all the efforts to get more doctors into rural practice by the authorities.
Pan knows that meager salaries and bleak promotion prospects have led to fewer doctors willing to practice in the countryside, but she doesn't regret her choice.
A patient (left) with gallstones comes for medicine and a checkup at Pan's clinic.[Photo provided to China Daily]
"It is a valuable career to bring healthcare services to more people in villages," Pan says.
Until 2018, she was the sole physician for eight nearby villages, inhabited by more than 20,000 people. Every day, the doctor receives about 30 patients on average. She has to be a general practitioner and, consequently, is required to always be on call.
Over the past two decades, she has carried her medical kit and rushed to patients' houses whenever needed, regardless of the arduous route or rough weather.
Her clinic was moved to Lugoutang village and two more doctors, including her husband, joined.
In early 2020, faced with the sudden outbreak of COVID-19, Pan and her team were in charge of healthcare services for 4,425 people in Lugoutang village. Every day, they visited the residents' homes, checking temperatures, distributing medicine to tackle colds and telling villagers how to prevent COVID infection.
Healthcare for more
Born in Getang village, about 1,430 meters above sea level, located halfway up a mountain in Guizhou's Anlong county, Pan still has fresh memories about how difficult it was for villagers to see a doctor. Her mother suffered for years with chronic pulmonary heart disease and every week since Pan's junior high school, she would take her along the mountain road to the nearest health center, over 10 km away.
She attended a local nursing vocational college in 1995. As one of the three outstanding graduates among the total 300 students in 1998, it was recommended that Pan continue her study at the Zunyi Medical University.
However, things didn't go as expected. When she was ready to register at the university, she got a call from her family, saying that her mother was dying. She gave up the opportunity for further study and returned home to care for her mother in her last days.
After her mother's funeral, she continued her study at the department of obstetrics and gynecology in the Qianxinan People's Hospital in Xingyi, Guizhou.
While on her way to visit "empty-nest" seniors, Pan stops to talk with a woman who lives by herself.[Photo provided to China Daily]
When her studies ended in 1999, most of her classmates pursued a medical career in the big city, but she went back home and became the only doctor in the village.
Starting from scratch, Pan had to spend hundreds of yuan to rent and renovate a village house and converted it into a health center with two beds for patients. Before opening, a man came to Pan asking her to help his wife, Yang Datuan, who was having trouble during childbirth.
She clearly remembers the date-Feb 24, 1999. When she entered Yang's home, it was a horrible scene-some of Yang's family members were lifting a stone quern, used for grinding corn, to put it on Yang's belly.
"It was the first time I helped a woman give birth and the situation frightened me. I immediately shouted at them to stop," Pan recalls.
It took her nearly an hour to ensure that both Yang and her baby were healthy and safe. The experience reinforced her decision to become a rural doctor.
"In remote villages, every delivery can be risky, because most pregnant women don't want to go to the hospital and they don't come to me until the last moment," the doctor sighs. In the past 23 years, Pan has helped more than 1,200 women safely deliver healthy babies.
Besides the pregnant women, Pan has paid special attention to the health of the "empty-nest" seniors, who live by themselves.
With her husband passing away and her son diagnosed with night blindness, 58-year-old Yang Zhongfen had mobility problems after a brain infarction or obstruction. Pan took Yang for acupuncture twice a week free of charge for two months until she got better.
She helps set up medical records for villagers and pays regular visits to people at their home, taking time to talk with them.
Challenges ahead
According to her observations, most rural doctors in Guizhou face serious challenges, such as heavy workload, aging issues and low salaries.
Pan knows her own contribution is limited and calls on more people to raise awareness about rural healthcare. The good news is that starting this year, rural doctors in Guizhou got an additional subsidy of 200 yuan ($29.2) every month from the local government.
"The policy is an encouragement for rural doctors facing a harsh natural and working environment, but there is still a lot to improve in the rural healthcare field," Pan says.
On the national level, China has enrolled 70,000 medical students to serve the population in rural areas and 35,000 of them have already practiced in the countryside, according to the National Health Commission.
In February, the State Council, China's Cabinet, launched a guideline focusing on the modernization and vitalization of rural areas for the 14th Five-Year Plan period (2021-25). Improving rural healthcare is one area emphasized in the policy.
It says that doctors earning degrees from vocational colleges will be encouraged to work in rural areas, while some large hospitals will be required to help improve the services of rural clinics by sending doctors there or organizing diagnostic tours to such areas.
Nationwide, the country is expected to have 16 million medical workers by 2025, according to the commission. The number was close to 14 million last year.
For Pan, besides the duty of a physician, being a rural doctor has its rewards-being part of the local community and staying connected with patients, who are more like her friends.
