Being severely ill is far more of a worry for Chinese farmers these days, even compared with floods and other natural disasters. Families have often plunged into chronic poverty simply because one member had suffered from a serious illness and cost them a fortune.

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Shanghai Star

The worst scenario for the current SARS epidemic would be if it stormed into China’s vast rural areas. This is because the countryside, home to some 80 per cent of China’s population, is simply lacking in some basic medical facilities and totally unable to fight such a highly contagious disease.

Chinese farmers were the first to benefit from the reform and opening-up drive in the 1980s when their income swelled much faster than urban dwellers. But during the same transition period to a market economy, the rural medical co-operative system that the late Chairman Mao Zedong fought so hard to establish in the 1960s and 1970s was mostly destroyed. There are no more free clinics and “barefoot doctors” serving the people with heart and soul.

It’s important to remember that these “barefoot doctors” - those paramedics trained by doctors sent from urban hospitals - and the rural medical co-operative system made a great contribution to controlling rural epidemics, bringing down child mortality and improving life expectancy in the 1960s and 1970s.

The system was lauded by the World Bank and the World Health Organization (WHO) as a role model for other developing countries.

Nowadays, seeing a doctor in mostly privately run clinics is usually too expensive for Chinese farmers. While urban dwellers still have their medical bills subsidized by the State, most rural people would not go to hospital until they become gravely ill. An ailment that could have been easily cured at an early stage can often develop into a fatal illness if left untreated.

Being severely ill is far more of a worry for Chinese farmers these days, even compared with floods and other natural disasters. Families have often plunged into chronic poverty simply because one member had suffered from a serious illness and cost them a fortune.

According to statistics, Chinese farmers now have less than one third of the country’s medical services, while urban dwellers, who account for less than 20 per cent of the population, enjoy the other two-thirds.

This is reminiscent of the situation Mao spoke of on June 26, 1965 when he said the Ministry of Health should be changed into the “Ministry of Urban Health”, or “Ministry of Health for Pampered Urbanites”.

Fortunately this plight of our rural fellows has been recognized by both the government and health workers. Efforts are being made to restore a rural medical co-operative system. The daunting task is to have a new system covering all the countryside by 2010.

To solve the current SARS crisis, the government has also vowed to provide free treatment to SARS patients who come from the countryside, including the tens of millions of migrant workers now working in cities.

But without an effective rural medical network, fighting rural epidemics would probably need double or treble the effort.

The destruction of the rural medical co-operative system is certainly a hard lesson that we have learned.

weihua_chen@yahoo.com