The people who were chosen by their communities to become barefoot doctors studied anatomy, bacteriology, disease diagnosis, acupuncture, family planning, maternal and infant care, and traditional and Western medicines with teams of medical staff. All received a barefoot doctor’s manual – a comprehensive guide to the many health issues they were trained to treat.
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There is a great deal of potential for health care in a society by reflecting on how China’s barefoot doctors were trained, how they were organised and how they worked:
- though not fully qualified doctors, they had the possibility of becoming so
- their funding sources were both broad and local
- they focused on preventive care
- their role reduced health care costs
- qualified doctors were sent from the cities, as part of their social obligation, to work with them – in other words, social obligation was fundamental to Chinese health care.
- they used both traditional and ‘Western’ medicine
- they lived and worked as members of a community – they also farmed – thereby earning the trust of their community
- above all, they were motivated by a social ethic. When I discussed the barefoot doctors with a Chinese friend who was a doctor in Beijing she said ‘they came from a different time, more moral’
An herb grower teaches barefoot doctors about medicinal plants, Mount Huangshan, China, 1977
Doctors in Australia have been extremely reluctant both to give up any of their procedures to those less qualified and to accept a perspective on health care other than one consonant with their mantra of ‘evidence-based’ (so often shown to amount to pro-the drug industry and pro-surgery, and often amounting to the rejection of evidence), arguing a concern for patient safety.
The reluctance, even refusal, still, of Western doctors to have an wholistic approach to health care and medicine (contrary to all the evidence), to appreciate the relationship between how a person thinks and feels and the health of their body would be incomprehensible if one didn’t see the forms for surgery and all the little hand-outs from drug companies on their desks.
An equivalent of the barefoot doctors could form another level in the provision of health care not only in urbanised regions but particularly in sparsely populated areas – such as in Australia. It should not be a matter of either (the fully qualified professional)/or (none at all)
I have no doubt that the traditional methods and ways of thinking (communal and grounded in nature) of Australia’s Aboriginal people would have a great deal to offer in this regard.
Precisely because the ethic of the barefoot doctors represents an approach to health care contradictory to the nature of capitalism (socialist, not exploitative and profit-driven), the lessons they embody will most probably be lost on a capitalist West.
I understand that with the gradual loosening of economic constraints in China (a necessary but complex and delicate development that the Chinese have so far managed very well since a process of reform was initiated by Deng Xiaoping) the Western view of health care is also, most unfortunately, (re)gaining influence.
materialism, mysticism and art 
“Doctors in Australia have been extremely reluctant both to give up any of their procedures to those less qualified and to accept a perspective on health care other than one consonant with their mantra of ‘evidence-based’ (so often shown to amount to pro-the drug industry and pro-surgery, and often amounting to the rejection of evidence), arguing a concern for patient safety.
The reluctance, even refusal, still, of Western doctors to have an wholistic approach to health care and medicine (contrary to all the evidence), to appreciate the relationship between how a person thinks and feels and the health of their body would be incomprehensible if one didn’t see the forms for surgery and all the little hand-outs from drug companies on their desks.”
– So true! I think the Chinese traditional medicine takes a much stronger emphasis on an wholistic approach, that investigates treats and prevents the cause of the symptom, rather than focuses mainly on treating the symptom. I think this also reflects a deep philosophical difference between both approaches as you have correctly pointed out. The social ethics factor plays a big role, which I think stems from a great reverence in the Chinese culture for a higher and good ideal that connects everyone and everything in life. You are right to identify the conflict between this more wholistic approach and the individualist and selfish capitalist approach. Thanks Phil, a very interesting, inspiring and thought-provoking article. 🙂
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Hi Yi Ping Wang, thank you very much for your response and generous words, Best wishes, Phil
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You are welcome Phil, and glad to see someone like you who is capable of observing, contemplating and expressing perspectives that are interesting and valuable. Best wishes, Yi Ping
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Thank you, Yi Ping Wang. And I think the best hope for the future of the world is that everyone observes, contemplates and expresses their perspective – all different – and never accepts another (who is always so certain and eager to do so) providing them with it. It is the most difficult challenge. Best regards, Phil
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Just want to add that the same value differences reflected by the different approaches China and Australia take in the care of healthcare, also exists in other areas such as education and media.
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I take (and appreciate) your point. People in Australia talk about ‘the undermining of the public health system’ and the growth both in ‘private health’ (an oxymoron if ever there was one) and the costs of it; they talk about ‘the undermining of the public education system’ and the growth both in ‘private education’ and the costs of it, but what is taking place in both areas is that the nature of capitalism is becoming more overt, particularly as its post GFC crisis remains unresolved, if not is deepening (consider the implications of yesterday’s elections in Greece).
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