Research On Cooperative Medical System And Barefoot Doctor(1955-1983)

Rural cooperative medical system rose in 1950-1960 when rural cooperatives was in climax, it was a medical and sanitarian safeguard system by which healthy crowd and ailing crowd helped or relieved each other in the range of villages, and it have made tremendous contribution to solve laggard visage of rural area lacking of doctors and medicine. At the beginning of establishment of the republic of China, the sanitarian status of the whole country was so bad and the whole country lacked of doctors and medicine, even worse in rural area; what' s more, because of the limit of economic progress and the power of wealth, the medical safeguard system only benefited the dwellers of towns and cities. The dwellers of villages spontaneously set up this cooperative medical safeguard system without any safeguard. This cooperative medical system was enforced and spread and barefoot doctor loyally enforced this system , which largely alleviated the status of lacking of doctors and medicine, made village dwellers get in time and acquire for basic medical sanitarian service , remarkably improved the healthy level of rural population , so this system was praised as "Chinese mode " by foreign experts which better solves the rural problems in developing country of huge population. But after 1980, cooperative medical system dismissed one by one because of all kinds of factors, the peasants in most of places returned back to pre-situation in which they saw doctors at their owns' expenses, so brought the side effect, namely, they didn' t go to see a doctor when they were ill, indisposition aggressively became serious , and they became poor caused by illness, thus seriously affected the health of peasants and the progress of rural area. Today, new cooperative medical system which the new government attaches importance to is pushing. Summarizing historical experience of cooperative medical system in the past benefits the healthy progress of new cooperative medical system.The first chapter firstly expounds the laggard medical sanitarian status of rural area at the beginning of establishment of the republic of China, reviews the reason that brought about this status and the countermeasure that the new government have taken. At the beginning of establishment of the republic of China, the sanitarian status of the whole country was very bad, even worse in rural area, and the distributing of health sources was seriously not even. The new government took active measures when confronted with this laggard status. Firstly, advanced "four principles" of sanitarian work to guide sanitarian construction of the whole country, next, integrated the exist rural sources to construct union cliniques, and sent the medical workers of cities to the rural area , thus alleviated the rural status of lacking of doctors and medicine. At the same time, the state strengthened the construction of medical sanitarian institutes in rural area, began to construct the third grade rural network of medical immunity and sanitation, which offered available medical sanitarian service for rural society and distinctively improved the status of lacking of doctors and medicine. The third grade rural network of medical immunity and sanitation and the rural cooperative medical system are tightly related, the former is the support system and actualized stage of the latter and offer the organization safeguard of system actualized for the latter, the latter is the basis for the former.The second chapter reviews the progress history and organization and management status of rural cooperative medical system and discusses the historical function of cooperative medical system and the outcome caused by the decline of this system. It rose in the climax period of rural cooperatives, developed during the cultural revolution, declined after the rural reformation of economic system. The organization and management of cooperative medical system carried through in the range of villages, its most distinctive function was to prevent and annihilate many infectious and endemic diseases, alleviate the rough plight of the peasants seeing the doctor, enhance the peasants' body diathesis, largely advance due life-span of rural dwellers, and to promote the social development. Its decline caused a series of ill aftereffect.The third chapter analyses the reason of rising and declining of cooperative medical system from multidimensional angle. Seen from history development cause of this system, its rising and declining are related to Chinese social transformation and "dualistic society" structural mode. It rises because of the variance of social economics and practical need of peasants, it can quickly spread in the whole country in a short time because of strong political mobilization and government' s outer intervention and its disaggregation is affected by change of political and economical circumstance. Of course, the decisive factor to the development of cooperative medical system is the ability to integrate social sources of centralized government and the Mao Zedong' authority. The reason why it can quickly be spread and popularized in such a short time is the strong support by central government and chairman Mao, and its disaggregation is related to government department who has changed the sanitarian route of Mao Zedong period.The fourth chapter expounds the history of appearance and course of barefoot doctor, reviews the reason of appearance of barefoot doctor phenomenon, and probes into the relationship between doctors and patients in cooperative medical system and the management and training for barefoot doctor. Barefoot doctor was loyal executors to this system and the laggard sanitarian visage was largely changed in rural area because of the arduous work of such a sanitarian group who was trained in rural basis on the spot. The appearance of barefoot doctor phenomenon was the outcome of central government who tried to solve the status of lacking of medical sanitarian sources in rural area and designed the Chinese characteristic system of rural pubic sanitation, and accordance with the practical need of rural dwellers of lacking of doctors and medicine. Central government attached importance to the work of management and training for barefoot doctor and education of morality (mainly embodied by political thought education then), furthermore, barefoot doctor worked in an acquaintance society, thus they could service for the peasants better and the relationship between doctors and patients was harmonious. Such a great barefoot doctor group consisted of millions of people throughout the whole country could be quickly trained in such a short time then, which had advisable experience and it can give reference to today' s training for rural doctors.The fifth chapter educes that development of rural medical system is largely related to political operation through a case study, namely, the course of cooperative medical system of a general village called SheShan. Rural medical system of this village rose in the period of rural cooperatives, and it was a spontaneous inner action; the rising and development of cooperative medical system was the outcome of outer intervention in the political and economic circumstance of the time. In the politicalized society space of the time, cooperative medical system was looked as one of positions where two class and two route battled. Cooperative medical system enforced the Mao' s route, so enthusiasm of cadre and crowd was high, furthermore, the production and existence of peasants depended on collectivity in the community system of the time, thus cooperative medical system could maintain and develop because of backing of community economics. With the disorganization of community economics and the disbandment of community system, SheShan village' s cooperative medical system disintegrated without outer intervention. We can conclude from the reason of rising and declining of this village that the extent of cadre and government' s attention to the rural problems directly influences developing status of rural society.Finally, in conclusion part the former cooperative medical system is comparatively searched with new cooperative medical system and it is concluded that some problems should be given attention in the development of new cooperative medical system. New cooperative medical system should integrate its conduct into the construction of public sanitarian system under the guidance of people—oriented conception, break the "dualistic society" bulwark between cities and countries, enforce medical safeguard mode of integrating cities with countries, develop civil medical insurance and equally ensure the health right of every citizen, only through these measures can social development advance better.