From "Barefoot Doctor" to "Village Doctor" in Tiger Springs Village: A Case Study of Rural Health Care Transformations in Socialist China

Abstract

During the 1970s, a wave of publications emerged in "the West" on the dramatic Cultural Revolution developments which were taking place in rural health care in the People's Republic of China. The PRC's model became internationally renowned in public health and health development circles, and served as the inspiration for the World Health Organization's Primary Health Care initiative. In the early to mid-1980's, however, with the advent of post-Mao political and economic changes in the PRC, specifically rural decollectivization, it was feared that the fate of rural health care in China was seriously threatened. Since the early 1980s, a number of additional scholarly publications have addressed the changes in rural health care in the post-Mao PRC. This article contributes to the ongoing discussion about rural PRC health care by illuminating some of the discrepancies between the policies upon which much of the debate has been based and the actual ways in which the policies were played out "on the ground" as reflected in a case study of one rural area of the PRC. Several key points about the practice of rural health care both during and after collectivization are addressed, as are a number of other concerns, including the financing of rural health care, its relative emphasis on prevention and primary care versus curing and secondary and tertiary care, issues of villagers' access to health services, issues of training and/or professionalization of village health practitioners, and issues of relative emphasis on Chinese versus Western medicine.