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China Struggles to Provide Basic Health Care to Rural Residents

Infant mortality rates have dropped in China during the past two decades, but international health experts say that, despite the economic boom, general health conditions remain extremely poor - especially in rural areas where 70 percent of the population lives. VOA's Luis Ramirez reports from Beijing.

Between the 1949 Communist revolution and the transition to a market economy in the 1990's China made big strides in bringing health care to rural areas. The government hastily trained medics, known as barefoot doctors, to provide basic care to peasants.

In the past two decades, the government has closed public health care facilities and the rural poor have been faced with high fees for what little care is available to them.

The government spends 80 percent of its health budget on the cities, leaving only 20 percent for rural areas where most of China's people live.

Jim Murray works with Plan International, a children's advocacy group based in Britain that has operated in China since 1995. He says good quality health services are not accessible to rural residents.

"At the village level, in the 1960s and 70s, many of you know [there were] the heralded barefoot doctors. Well, their sons and grandsons today are still there, yet they do not have the same degree of effectiveness, we find, that their fathers and grandfathers have [had]."

Advocates say one problem is that doctors in rural areas earn very little. Rural medics get an average stipend of $65 a year, leading some to overcharge their patients.

China's health care system focuses on curing sicknesses rather than preventing them, because doctors here find that performing surgery and treating illnesses are more lucrative than providing annual check-ups and health education.

Murray says most of the rural residents with whom he works lack even the most basic knowledge of how to prevent disease.

"Research in the villages we worked in shows less than two percent of families adopt appropriate hygiene practices: whether it be washing; whether it be tooth-brushing; whether it be using boiled water," he said.

"This is an indicator for us that health awareness, because it is not being prioritized by the government, and we believe it should be, would be an impact on these levels of knowledge, attitude, and practices."

The government has responded to the pressure by boosting spending on health infrastructure. Beijing also has introduced a program to provide basic insurance for less than two dollars a year. But critics say coverage is limited to illnesses and injuries and has virtually no provisions for preventive care.