A doctor who travels through two eras

Wang Jin hadn't expected to be asked this, and scratched his head, saying:
“At least in our village, this situation exists. People basically don’t care when the elderly and children get sick. If there’s a folk doctor in the village, it’s better, as they can go up the mountain to collect some herbs themselves.”

For example, when we have a cold or fever, we'll gather Bupleurum to make a soup. If we have a sprain or bruise, we'll use some Chicken Blood Vine, both of which are herbs that can be found in the mountains.

If you can endure it, then endure it; if you can't, that's just how it is. They basically won't send you to the county hospital.

Our village is in Lalie Commune, 50 kilometers from the county seat, and there's still no road access. If someone gets sick, they can only be carried out in one of these makeshift sedan chairs.

Wang Jin pointed to the bamboo chairs and sedan chairs made by the mountain people themselves in the courtyard.

"Boss, think about it, 50 kilometers, and it's all up and down mountain roads. You can't possibly get to the county town in a day. Only landlords before liberation had the means to do that. Ordinary people don't have that kind of ability."

So when you say that we should build new village clinics in rural areas, that every village should have a barefoot doctor, and that farmers should have a place to get treatment when they are sick, I wholeheartedly agree. We farmers have suffered so much.

"If you, boss, are willing to set up a village clinic in my hometown, Lalie Commune, I'm willing to contribute a year's salary."

Upon hearing this, Huang Xiaoji quickly assured him, "Me too, I'm also willing to donate a year's salary."

Upon hearing this, Shan Guangming's eyes lit up instantly:
"Minister Lin, what do you mean?"

Lin Sanqi stopped hiding it. Anyway, with local veterans like Wang Jin around, he should be able to understand the real situation.

Moreover, piloting the barefoot doctor program in Andu County has another advantage: there are more than 50 veterans from Andu County, distributed in various communes, which will make it easy for Lin Sanqi to understand the true situation.

These veterans have no vested interests with their hometowns, so they are more willing to flatter their bosses and tell the truth, willingly acting as informants.

Lin Sanqi then continued:
"County Chief Jin, Dean Shan, the country is definitely going to promote the barefoot doctor system in rural areas nationwide. This is a mission, and it's not something to be discussed."

But don't worry, the government dares to promote barefoot doctors because it has a feasible method.

Just like the concerns that County Chief Jin just mentioned, I can answer them now. First of all, the financial investment is not too much. For example, barefoot doctors can open clinics in their own homes, and there is no need to build new hospitals.

If you don't have enough space at home, you can borrow a temple in the village, a house belonging to a landlord, or the village committee office, etc. You only need one or two rooms, and twenty or thirty square meters is enough.

At worst, we'll need to equip ourselves with some blood pressure monitors, thermometers, gauze, and other medical devices and small equipment. How much could that cost? Besides, these things will be provided free of charge by the higher authorities; your local area won't need to raise funds.”

Upon hearing this, County Chief Jin breathed a sigh of relief, thinking that as long as the county didn't have to pay for it, the more free things there were, the better.

Lin Sanqi also understood that if he wanted the local government to cooperate, he couldn't harm local interests; that is, he couldn't make the local government pay out of their own pockets, otherwise they would definitely object.

Lin Sanqi was actually prepared to pay for this himself.

After all, China cannot yet mass-produce equipment such as blood pressure monitors and thermometers. Even if it could, the output would be very low, since materials such as rubber are still controlled and China is completely dependent on imports.

But this was a piece of cake for China in 2016.

Being a manufacturing powerhouse isn't just talk. When orders for millions of blood pressure monitors are placed, there will be plenty of manufacturers ready to take them on, which will also boost domestic demand.

"In addition, you don't need to worry about doctors. This is the 'Barefoot Doctor's Handbook' compiled by Bao'an County."

Li Yujie handed the two small red booklets to County Chief Jin and Dean Shan.

"This manual is prepared for training village doctors. We plan to find a literate young man in each village, and after one month of training, he can start working and treating villagers."

If you encounter any diseases you don't understand, you can refer to this "Barefoot Doctor's Handbook." If you still can't handle a particular disease, you'll need technical guidance from your county hospital.

Dan Guangming flipped through the table of contents and glanced at the contents, his eyes widening in disbelief.

"Oh, this manual is great, it's wonderful! It's simple and easy to learn, and it's full of useful information."

As an administrative leader, County Chief Jin obviously has more to consider:
"Minister Lin, even if village clinics are all set up, how will we solve the problem of medication? Look here, it says here that you can take cefuroxime orally, one tablet at a time, twice a day."

What kind of drug is this cefuroxime? We've never even heard of it, let alone know where to buy it. Even if we could, whether we have the financial means is another big problem.” Lin Sanqi took a deep breath, feeling a tightness in his chest.

In the 1960s, whenever he raised a question, it would lead to countless problems. It was truly an era of having nothing and being extremely poor.

"You don't need to worry about the medicine; it's divided into traditional Chinese medicine and Western medicine."

As for traditional Chinese medicine, it is all noted in the "Barefoot Doctor's Handbook" and there are also illustrations. Village doctors can pick Chinese herbs themselves according to local conditions to treat diseases.

(Each region has a different version of the Barefoot Doctor's Manual, after all, there are regional differences in Chinese herbal medicine.)

As for Western medicine, when your county establishes a pharmaceutical company, the first batch of Western medicine, including the cephalosporin you mentioned, can be supplied to you on credit by our Bao'an County Pharmaceutical Factory.

After you receive the Western medicine, the barefoot doctors in each village can purchase it from your newly established county pharmaceutical company. Once you receive the money, you can then transfer the payment to our Bao'an County Pharmaceutical Factory.

This is equivalent to us lending you some start-up capital.

But there's a prerequisite: debts must be repaid, and finances must be clear and transparent, able to withstand audits.

If any county receives the medicine but doesn't make payment, we'll blacklist that county and stop supplying medicine to them. Don't say Bao'an County is heartless then.

Upon hearing this, County Chief Jin slammed his fist on the table:
"Minister Lin, what else is there to say? We'll start the pilot program right away, and begin the barefoot doctor training program immediately. Rest assured, on behalf of the W County government, I fully support this new policy."

At this moment, Dean Shan stroked his chin, thinking of another question:
"Minister Lin, let's not talk about distant things, let's just talk about our county hospital. Why is it so small? Besides the lack of medicine, the main problem is the lack of doctors, because their income is unstable and not guaranteed."

Conversely, if every village were to have a barefoot doctor, how would their income be guaranteed? After all, everyone needs to eat; they can't treat patients while starving, can they?

County Chief Jin calmed down, then became somewhat frightened.

With over 200 villages, there would be more than 200 barefoot doctors. Add to that the 25 commune clinics, and even if each commune had 3 doctors, that would still be 75 people.

In total, the county would have to pay the salaries of about 300 medical staff, a burden that Andu, an impoverished county, could not bear.

Lin Sanqi already had a solution to Dean Shan's question.

"The barefoot doctors' income is divided into three parts. County Chief Jin, rest assured, it will absolutely not increase the burden on your local government."

Conversely, if barefoot doctors' income increases, your local government will not be allowed to find various reasons to take away their hard-earned money.

County Chief Jin blinked. "Minister Lin, why is it divided into three parts?"

Lin Sanqi counted on his fingers and said:

"First, barefoot doctors did not provide free medical care. Each farmer had to pay a 5-cent registration fee. All medicines were allowed to be sold at a 15% markup. In other words, no matter how much money was earned, it belonged to the barefoot doctor personally."

Secondly, for villages with poor conditions and few villagers, barefoot doctors adopted a "part-time work, part-time medical practice" model, where they could continue to work in the fields to earn work points and treat patients in their spare time.

In fact, the original model of the 'rural medical cooperatives' in the 1960s and 70s was:
Each year, each villager pays a few cents, and when they need to see a doctor, they only need to pay a small registration fee, and they can get medicine for free.

However, one negative consequence of doing this is that barefoot doctors receive the same pay for whatever they do, so they lack motivation. In fact, if there are many patients, barefoot doctors will even lose money.

According to Lin Sanqi's model, the more patients a barefoot doctor has, the higher their income will be, thus maximizing their work enthusiasm.

At the same time, barefoot doctors are among the highest-paid people in rural areas. Could this encourage more educated young people to become barefoot doctors?

This is what constitutes a virtuous cycle and sustainable development.

"As for the third source of income, Bao'an County has decided that each barefoot doctor will receive a subsidy of 120 yuan per year, which will be temporarily borne by the Bao'an County finance department. The subsidy will be provided for five years initially." (End of Chapter)