thumb|A barefoot doctor performs acupuncture on a man

Barefoot doctors () were healthcare providers who underwent basic medical training and worked in rural villages in China. They included farmers, folk healers, rural healthcare providers, and recent middle or secondary school graduates who received minimal basic medical and paramedical education. These programs were called "rural cooperative medical systems" (RCMS) and worked to include community participation with the rural provision of health services.

Barefoot doctors became a part of the Cultural Revolution, which also radically diminished the influence of the Ministry of Health, which was filled with Western-trained doctors. Still, barefoot doctors continued to introduce scientific medicine to rural areas by merging it with Chinese medicine. There was also tension between proponents of traditional Chinese medicine and the scientific medicine that was gradually being introduced to the country. The new government prioritized healthcare, emphasizing preventive medicine and the integration of scientific approaches with traditional Chinese medicine. State owned union clinics operated by local doctors emerged as one solution to the shortage of rural healthcare, This concern was driven by the fact that 80–90% of China's population lived in rural areas. The directive is therefore considered the beginning of the formalized barefoot doctor system, with the goal of training one barefoot doctor for every 1,000 citizens.

Selected individuals

alt=man in robe holding various medical tools|thumb|A depiction of a Chinese country doctor, analogous to the folk healers who fed into the barefoot doctor system

The initial pool of barefoot doctors required no education or training as they were sourced from healthcare providers already working in rural areas as well as urban doctors. Other barefoot doctors originally worked as folk doctors and retrained to become barefoot doctors after the Cultural Revolution. Later, barefoot doctors had to have graduated from secondary school and then received three to six months of training at a county or community hospital. The PRC, during this time, collected many textbooks and medical training guides for barefoot doctors: including "treatment of common diseases, first aid, family planning, basic surgical skills, and human anatomy."

curing simple ailments that were common in the specific area. The barefoot doctors were integrated into a system where they could refer seriously ill people to township and county hospitals.

Barefoot doctors provided mostly primary healthcare services and focused on prevention rather than treatment. The village hosting the barefoot doctors and health aides funded the materials required for medical care. They also had an important role for disseminating information about birth control. As for costs to patients, these were not standardized and varied by village.

The barefoot doctor system was abolished in 1981 with the rise of Deng Xiaoping and the end of the commune system of agricultural cooperatives. This shift caused a privatization of the medical system, which marginalized barefoot doctors and their focus on preventive medicine and primary healthcare. In contrast, some doctors began to abandon their medical work causing the number of barefoot doctors to drop "from 1.5 million in 1975 to just over 1.2 million 1983." known as the New Rural Cooperative Medical Scheme, Households themselves also contribute a fee of 10 Renminbi. Moreover, the success of the barefoot doctor model demonstrates that many diseases in poor countries can be prevented and solved without significant financial resources or technological transformation. Public health improvements attributed to the barefoot doctor system are numerous. Nationwide, Chinese citizens were living longer, with an " [increased life expectancy] of 35 to 68 years" and infants were more likely to survive, with an infant mortality drop "from 200 to 34 deaths per 1000 live births". which lauded the benefits of primary care, as seen in the barefoot doctor system, was signed unanimously. This was hailed as a revolutionary breakthrough in international health ideology - it called for local communities participating in deciding healthcare priorities, called for an emphasis on primary and preventive healthcare, and most importantly sought to link medicine with trade, economics, industry, rural politics and other political and social areas.

The resurgence of interest in preventive medicine, primary healthcare, and holistic approaches to social welfare worldwide is leading to positive revisitations of the legacy of barefoot doctors. Political restrictions against discussion of the Cultural Revolution in China, however, limit the extent of this debate in China itself.

International development with NGOs

thumbnail|60px|right|MAPD's logo

In 1977, Jean-Pierre Willem created an international humanitarian apolitical non-governmental organization of doctors called ' (MAPD) in France. The name of the organization means "barefoot doctors", an homage to the barefoot doctors of China. Volunteers work in Burundi, Colombia and Southeast Asia with local healers to develop "medical garden" for herbalism and make essential oils for gemmotherapy. In 1999, Jean-Claude Rodet became the first president of Médecins aux pieds nus Canada, working with Mark Smith in the United States. This NGO leads ethnobiological missions based on "proximity, prevention and humility".

See also

  • Health in China
  • Healthcare in China
  • Barefoot lawyer
  • Medical missions in China
  • Heilpraktiker a category of alternative health workers in Germany and Switzerland
  • Barber surgeon a historical category of health worker in Eastern Europe
  • Feldsher
  • Nurse practitioner

References

About this Collection | Country Studies | Digital Collections | Library of Congress

Further reading

Primary sources

Several versions of the Barefoot Doctor's Manual exist. They generally cover basics of Chinese and Western medicine, preventive care, identification of medicinal herbs, and CBRN defense (related to the ' slogan).

  • (translation of Hunan edition)
  • NPR Article: Health for the Masses: China's 'Barefoot Doctors
  • Chinese posters of barefoot doctors