A Tale of Two Cities Supporting Xinjiang

They split into three teams, each consisting of a doctor, a nurse, and a guide, and drove an off-road vehicle with basic equipment to various grazing sites.

Aygul also brought her translation team to help solve the language communication problem.

At a grazing point, Zhou Yi witnessed a touching scene.

An elderly woman in her eighties, upon hearing that a doctor was coming, had her grandson lead her horse and travel more than ten miles to get there.

"My daughter said she felt anxious and couldn't sleep at night," her grandson said.

Zhou Yi performed an electrocardiogram on the elderly woman, and the results alarmed him—extensive anterior wall myocardial ischemia, with the possibility of a heart attack at any time.

"We need to go to the hospital right away," Zhou Yi said seriously.

The old woman shook her head: "No, I'm too old, it's time for me to go back to the grasslands."

Nurbahati walked over, squatted down in front of the old woman, and spoke softly in Kazakh for a long time.

Zhou Yi didn't understand, but seeing the old lady's expression change from resistance to hesitation, she finally nodded.

"What did you say?" Zhou Yi asked afterwards.

"I said, didn't you want to see your grandson get married?"

"Once the illness is cured, I can receive treatment for several more years."

Nuerbahati calmly said, "The herders' logic is simple: treatment must be meaningful."

They would rather not have it than prolong their suffering by just a few days.

But if they could see their grandchildren grow up, start their own families, and establish their own careers, they would be willing.

Zhou Yi seemed to be deep in thought. This is not only a medical issue, but also a cultural one.

The mobile screening lasted for two weeks, with the team visiting all seven regiments in the Tacheng region.

The furthest grazing area is inaccessible by car, so they have to carry their equipment and hike for two hours.

Little Ma cried from exhaustion: "Senior brother, this is too hard!"

Gulibaha patted her on the shoulder: "Girl, the herdsman is sick and has to walk a long way to see a doctor. What's this little distance for us?"

After the screening, treatment and follow-up became new challenges.

"We can't just finish the check-up and leave it at that; we need to establish health records and have regular follow-ups."

Seven days after the screening ended, Zhou Yi faced an unprecedented predicament with more than a thousand health records.

"Dr. Zhou, this is the complete list of patients who need to be followed up."

Gulibaha placed a thick stack of paper records on the table: "Ninety-two confirmed cases, one hundred and thirty-five suspected cases, and more than eight hundred high-risk individuals who need regular monitoring."

Xiao Ma added a harsher reality from the side: "There are only six of us."

Even if we follow up with twenty people every day, it would still take two months to visit them all.

And two months later—

He pointed out the window, "Most of the herders have moved to summer pastures, and all the addresses we recorded today are invalid."

Silence reigned inside the yurt.

Zhou Yi's finger slid across the tablet computer, which displayed his meticulously designed electronic health record system. This information technology solution, successfully implemented at a hospital in Dalian, boasts a user-friendly interface, comprehensive functions, and supports remote updates and real-time synchronization.

"We can enter the data into the system first, and then..."

Aygul said softly, "Dr. Zhou, the experts from the city hospital brought an electronic system with them when they came last time."

They stayed in the pastoral area for three days, but couldn't get a single file entered because there was no signal.

"So how did you do it before?" he asked the old veterinarian.

He took out a yellowed notebook, its cover so worn that the words were illegible.

"This is my archive."

Ahemaiti has high blood pressure and is prone to dizziness after migrating to new areas in the spring. He also likes to eat salty tea.

Bahaguli suffers from coronary heart disease and cannot travel long distances. Her eldest son works in the county town and comes back on the 15th of each month to deliver her medication…

Zhou Yi was examined closely.

"How can you guarantee accuracy if you remember it this way?" Zhou Yi couldn't help but ask.

"I don't guarantee accuracy, I guarantee accessibility."

The old veterinarian calmly said, "In large hospitals, medical records are written for doctors, and they need to be accurate and standardized."

On the grasslands, health records are written for patients; they need to be practical and easy to understand.

"So what's your suggestion?"

The old veterinarian unfolded a hand-drawn map of the pastoral area, with migration routes marked on it using lines of different colors.

"We need a dual-record system. One track is a paper-based health ledger that can be carried by the herders; the other track is an electronic database that facilitates statistical analysis."

"But how do we solve the signal problem?"

"Solve it in stages."

The old veterinarian moved his finger across the map. "The herders aren't completely isolated. They go to the market regularly, to towns to buy things, and to send their children to school."

In these areas with signal coverage, we can centrally input data.

"Yes! Just like puddles on the grassland, though they're not continuous, they're enough for the horses to drink all the way to their destination."

In the height of summer in July, the pastures at the foot of the Altai Mountains are dazzlingly green.

Hadanbatel was herding his sheep up the hillside when he suddenly felt a sharp pain in his chest and staggered, grabbing the saddle for support.

"Father!"

Upon seeing this, the sixteen-year-old son, Batel, hurriedly took out his mobile phone from his pocket to contact the veterinarian.

A broken voice came from the other end of the phone: "...location...symptoms..."

The walkie-talkie suddenly blared: "Dr. Zhou, Dr. Nuer, someone in the Halajun pastoral area is experiencing chest pain, suspected of a heart attack!"

Nurbahati has already led two horses out of the stable.

As he checked the medicine in the saddlebag, he said in fluent Chinese, "ECG machine, nitroglycerin, aspirin, oxygen cylinder, all ready. To cross the mountain pass, a horse is faster than a cart."

Zhou Yi glanced at the map and realized that to cross the Kizil Pass at an altitude of 3200 meters, the hiking section would be at least five kilometers long.

"Let's go!" He slung his medicine chest over his shoulder and mounted his horse.

The mountain road was steeper than I had imagined.

The simple electrocardiograph was housed in a specially made shockproof box, but at the third steep slope, the horse stumbled, and the box crashed heavily into the rocks.

"It's over."

When Zhou Yi opened the box, the screen was completely black, and no matter how he pressed the switch, nothing happened.

Nurbahati glanced at the sky: "There are still three kilometers left. We can't turn back."

Zhou Yi took a deep breath and pulled out a stethoscope from the bottom of the medicine box.

"This is it." He hung the stethoscope around his neck.

When the two men arrived, they were practically stumbling and crawling. Hadanbatel was already pale and breathing rapidly. His family members, gathered around in the tent, were all deathly pale.

Zhou Yi knelt on the felt rug, his stethoscope pressed against the patient's chest. The tent was so quiet that the bleating of sheep could be heard in the distance.

Heart rate 120, gallop rhythm... moist rales in the left lung...

Medication must be administered immediately: nitroglycerin sublingually, aspirin chewed and fed to the patient, and an oxygen mask attached.

The series of movements were fluid and seamless.

"Dr. Zhou, without an electrocardiogram, can you be sure?" Hadanbatel's wife asked, her voice trembling.

Zhou Yi pointed to his ear: "I've worked in cardiology for over ten years and heard the sounds of thousands of hearts. Your husband's heart is screaming for help right now."

Two hours later, Hadanbatel's chest pain subsided significantly, and his complexion regained its color. His first words upon opening his eyes were, "I...I'm still alive?"

Nurbahati replied in Kazakh: "Live, and you must live well from now on."

That night, a campfire was lit in Hadanbatel's tent, and herders arrived on horseback one after another.

More than thirty people were crammed into the small tent, with some even standing outside and peering through the gaps.

Nuerbahati stood up and said, "Fellow villagers, Uncle Hadanbatel's illness today is called acute myocardial infarction."

Our pastoral area's high-salt, high-fat diet, coupled with smoking and drinking, makes us very susceptible to this disease.

Zhou Yi then demonstrated cardiopulmonary resuscitation.

He made Nurbahati lie down as a model, pressing his hands together against his chest.

"Press like this, 100 to 120 times per minute, pressing down five centimeters deep."

Remember, the golden rescue time is only four minutes. By the time the doctor arrives, the person is already gone.

A young man raised his hand: "Dr. Zhou, how do we know if we have this disease?"