In China, there are around 1.4 million doctors practicing in rural areas. They scatter through the entire country and provide medical service at 37,000 township and village-level health centers and 650,000 village clinics. While serving pretty much at the tail end of the medical industry, yet they are the closest to the patients. However, the majority of the public still perceive them as unprofessional and corny. This time, TMTPost’s 59th issue of Photo Gallery is taking us to get a glimpse of the life of a rural doctor in Xinxiang, Henan province. Perhaps through his perspective, the public will have a new understanding of the doctors in the countryside.
In 2000, Shi Jinfeng graduated from Medicine University of Henan Province’s Continuing Education College and started his internship at a city hospital. Originally, he planned to continue to work for that hospital, but he later returned to Anzhuang village as his father passed away, leaving the mother and grandmother at home needed to be taken care of. Anzhuang village belongs to Shizhai town of Xinxing city. Shi then took over his mother’s clinic in the village, who had provided her service for the villagers during her entire career as a rural doctor. Shi’s classmates, on the other hand, all stayed at prefecture-level or county-level hospitals. Such difference did upset Shi Jinfeng at that time.
The clinic has been promoted to a health center where Shi works now. In fact, this building belongs to Shi Jinfeng’s family. One third of the house’s space is in fact occupied by the health center. The medical business has always kept Shi busy. He was very exhausted in the beginning from daily busy schedule, but eventually grew out of it and got accustomed to the daily routine being a rural doctor. Shi didn’t stop learning after deciding to practice at a village clinic. At present, he has passed the exam of Certificate of Medical Practitioner and the general practitioner training.
19:52 pm, September 14th, 2017. A village took his son, who was having a fever, to Shi’s health center. Shi’s health center opens from six in the morning to ten at night. The morning and evening time are the peak hours for the health center, as villagers rush to see a doctor or purchase medicine. During a busy time, Shi Jinfeng would need to treat over a hundred patients a day. The reality is that there is no holiday for this rural doctor. Even when there is an urgent call from a patient at night, Shi would always respond and appear in the center.
Shi was tending a kid with a fever. The health center serves around 3,000 villagers, most of whom come here to get medical help for minor problems like a cold, headache, fever etc. This gives Shi Jinfeng tons of tedious works. He needs to pay close attention to anything that requires a diagnosis or medical attention in general. But he often feels powerless and exhausted when faced with different medical demands.
Shi Jinfeng was taking the ECG diagram of a patient who had a heart problem. This electrocardiogram device records the data and sends them directly to an Internet medical platform that boasts a large base of medical experts. With this Internet platform, experts are able to make a quick response and analyze the ECG diagram. Reading and analyzing ECG diagram is a very technical job that requires years of practicing experience to do well. To enhance the diagnosis accuracy, Shi Jinfeng purchased this device and system, which has helped him quite a lot at the health center.
In the village, many old people have diabetics and hypertension condition. When Shi first took over this clinic, there were only basic medical tools like echometer, thermometer, and sphygmomanometer. Eventually, the rising medical demands from the villagers could no longer be met by these three basic tools. Therefore, Shi Jinfeng poured out ￥70,000 to purchase medical equipment like biochemical analyzer and hematology analyzer etc. The biochemical analyzer Shi bought is half-automated, meaning Shi would still need to make the reagents himself. “It produces the same result as those fully automated ones at big hospitals, but it’s so much cheaper. For a small clinic like ours, it’s very cost-effective,” Shi said.
A construction worker fainted when he was working at a construction site in a neighboring village. He learned Shi’s reputation among the villagers and came to the clinic to have his condition checked out. “Health centers don’t usually have these because they are not standard equipment for the clinics of this level. But since I have them now, patients would no longer need to go all the way to the county to run tests,” Shi explained, saying that the equipment had provided convenience for both the villagers and himself.
A service fee of every health check program is displayed at the health center.
Shi Jinfeng wa giving a village an acupuncture treatment. In reality, village-level health centers deal with a large number of patients. With that comes great risk, especially for patients in critical condition. Such health centers might not be able to provide proper medical treatment for these patients due to the lack of proper equipment and enough professional staff, creating great risks for both the health center and patients. Although the health center now is relatively well-equipped, unexpected situations might still occur and bring troubles. This makes Shi Jinfeng extra careful over the years and continues to learn new knowledge.
Apart from apparent medical risks, Shi Jinfeng has been witnessing a harmonious doctor-patient relationship gradually forming. The center’s patients are villagers from the neighborhood. “I know them and they know me. They don’t have medical expertise and so they trust me. I put myself in their shoes and think about their well-being. I provide them with medical support and treat them well. And they appreciate and value my help too.”
Shi Jinfeng was preparing the medicine for a villager at the counter. Generally speaking, villagers have little knowledge of medicine. But they trust Shi. “We would only turn to injections and relatively more expensive drugs when it’s very necessary,” Shi told TMTPost, saying that practicing medicine is also a process of forming a good heart. “The patients entrust their health to you. So you need to think about their conditions on their behalf instead of pursuing your own economic gains.”
Shi seldom prescribes medicine for over two days for patients with minor problems like a cold and fever. “When you go to other hospitals, the doctor would usually give you an entire box of medicine,” Shi commented, believing that over prescribing is actually wasting the villagers’ money. In the picture, each piece of paper recorded the prescription for each dose. Six pieces of paper were the prescription for two days. Shi makes prescription in this way to make it more convenient for the patients to follow usage instruction because when the doctors only prescribe boxes of medicine to the patients, the patients would often get confused. “Many of my patients don’t understand the instruction manuals that come with the medicine. So I just put the medicines they need to take at a time in one bag. Then they wouldn’t use the medicines in a wrong way,” he said.
In the infusion room, two patients were having their infusions. In general, Shi Jinfeng would require patients that needed the infusion to stay in the health center, so that he could respond to urgent situations if they occurred.
When there are old people or patients that couldn’t really move around a lot, Shi Jinfeng would personally go to their house and provide service. An elderly with terminal esophagus cancer couldn’t really ingest any solid food. And after returning home from the hospital, she has been taken cared by Shi, who regularly comes to her home to perform infusion.
On September 13th, afternoon. Shi Jinfeng was at the village’s broadcast station, informing villagers who haven’t signed family doctor agreement to come to the health center to sign it. Besides the sit-in job at the health center, Shi is also responsible for 13 public health duties in the village.
Shi Jinfeng was preparing medicine for a patient, while his mother was sorting out some absorbent cotton aside. Shi’s mother had been a village doctor since the age of 18. She had helped deliver over several hundreds of babies during her practice. But when Shi’s mother was still exercising her practice, Shi didn’t really like doctors as all he could see was how busy his mother was. When Shi Jinfeng entered middle school, his father started to have liver issues, which eventually killed him after bringing him years of sufferings. That’s when Shi Jinfeng felt how powerless the patient’s families could be and that the importance of doctors. That’s why he decided to become a doctor. “After graduation, my mom was already at the retiring age. The health center of the village then would have no doctor there. I am a med school student, and I needed to take care of my family. So I just came back and took over. It was natural,” Shi Jinfeng told TMTPost.
Shi’s wife is an incredibly helpful assistant at work. Besides providing medical service at the center, she also helps out some basic works for Shi.
Near the health center, there were a few old people playing chess by the road. Most of the young population in the village has gone out for work opportunities, leaving the old and kids behind. There are very few people as young as Shi Jinfeng that are currently staying in the village.
A villager just came back from a hospital in the downtown expressed that in those big hospitals there is a lack of doctor-patient communication as everything is so fast. That’s why he took his X-RAY image that was taken in the hospital downtown to Shi Jinfeng for a treatment. Shi has been practicing medicine in the village for 17 years, during the course of time he has witnessed the gradual improvement of the medical conditions in the village. But he believes that the central government still needs to allocate more resources and funding to develop medical conditions in rural areas. “As a rural doctor, I also need to undergo a transformation. I need to continue to learn like the doctors in big hospitals. And when the resources we need do come to the rural regions, we would be able to better serve our patients and enhance public health here, and ease the burden on big hospitals,” Shi concluded.
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Translated by Garrett Lee (Senior Translator at PAGE TO PAGE), working for TMTpost.