Health and Wealth

By Sudeshna Sarkar

When the news came on November 23 that absolute poverty had been eradicated in China with the nine last-mile impoverished counties almost tripling their income from the national poverty line， there was a sense of achievement in the country. As for me， I have a personal angle in this.

You see， these nine counties are in Guizhou， the province in southwest China that struggled with the largest indigent population. I was scheduled to go there in October as part of a team to look at the remarkable institutions and individuals there that had helped ferry over 9 million people in the province to stable incomes since 2012.

One of our destinations was the Jishikang Hospital， a private healthcare institution in a once deeply impoverished village. I was told it gets patients from other provinces as well.

Besides jobs， education and infrastructure， medical care has been a critical element in the fi ght on poverty. An article in the London-based International Journal for Equity in Health by three Chinese authors in March gave a succinct outline of the link between illness and poverty.

“Poverty and ill-health are generally believed to have a bidirectional causality relationship， and poverty-led diseases disproportionately affect extremely poor populations and contribute to a vicious cycle of poverty because of decreased productivity led by long-term illness and disability，” stated the article， Health， Income and Poverty： Evidence From Chinas Rural Household Survey.

It was based on a survey of over 29，000 poor households in rural areas， which found 51.63 percent of the respondents attributed their poverty to illnesses suffered by one or more household members. Over 60 percent of the households had at least one patient and more than 25 percent with ill members could not afford expensive medical expenses.

The authors attributed most rural illnesses to living in “unhealthy environments without decent shelter， clean water or adequate sanitation… lack of competent medical personnel in poor communities…and low-quality care.”

It gave a new perspective to the governments initiative to relocate entire villages into new residential communities or rebuild their houses and the drive to clean up the major rivers and water sources. Besides， there have been reports of 80，000 healthcare professionals being deputed to impoverished areas to build up the capacities of the local hospitals there.

Our web editor Li Nan had met several such doctors in Tibet Autonomous Region in southwest China. Three of them came from Shanghai last year to work in the Xigaze Peoples Hospital for three years. One of them， Lou Jianing， had left his wife recuperating from cancer at home. Yue Fei had left his young son at home. A third， Zhou Jian， soldiered on during the Spring Festival holiday， the time all Chinese families reunite. While worried about their families， these doctors were buoyed up by the fact that the hospital could now perform surgeries it wasnt equipped to earlier.

I was told that for 80 percent of the people， medical treatment is only 15 minutes away， thanks to the development of primary clinics and hospitals in villages， counties and townships.

However， that was mostly read and heard from others. My own personal experience of receiving medical care happened in Sanya， the sunny city in Hainan Province， south China. I had developed a nagging pain in my right arm that worsened in Sanya and I thought it would be a good idea to see a doctor.

Tryst with TCM

I chose a community hospital and made a phone call for an appointment. Then we arrived there. The receptionist took my blood pressure and asked me what my problem was， then sent me upstairs with a note. I opted to have a traditional massage followed by moxibustion.

Wang Xiaodong， the 31-year-old doctor， a graduate from Shaanxi University of Chinese Medicine， had magic fingers. He kneaded all the aching pressure points on the back of my neck， shoulders and upper arms with the right degree of pressure and though at times I wanted to scream due to the pain， it was also， perversely， most satisfying. After the massage ended， though it still hurt to extend my arm laterally， at least I could lift it up.

Then moxibustion followed. This was so comforting and pampering that I wanted to go to sleep on that nice clean bed in that warm room. The doctor lit a coil made of herbs that looked like a fat white cheroot and kept moving it near my arm， close and closer until I could feel the heat from the coil on my flesh. When the heat became intense and I thought the fl esh would burn， he would deftly withdraw the coil.

The doctors also suggested a followup course of acupuncture but since I am a coward， I professed not to have much time， being on a work trip. I also sidestepped their suggestion of cupping， which would involve heating cups and putting them on pressure points， but I made a mental note to try out the massages by blind masseurs once I reached Beijing.

After I changed back into my clothes， a smiling nurse gave me a delicious cup of steaming herbal tea and my bill. I was pleasantly surprised to see that the two massages， which together were over an hour， and the consultation cost only 100 yuan （$15.21）.

However， I was also unpleasantly surprised to see three of my colleagues， tempted by my exclamations of pleasure during the massage， had thrown themselves on the bed and chair I had vacated， getting themselves a similar massage！

Parting gift

However， that was not the end of my medical care experience in Sanya. There was an additional unforeseen mishap on our last day， when we had finished our work and were ready to go back. Something went into my eye and for about an hour， it became a fountain， spouting water non-stop. I just couldnt open it due to the burning sensation.

We went to the airport like that and were told there was an emergency clinic on a lower fl oor. When I fi nally groped my way to it， the young doctor who opened the recalcitrant eye wide with fi rm fi ngers and shone a torch into it had the same magic fingers as the doctor at the community clinic. She administered a drop， gave me the little phial to keep， and said whatever it was that had been bothering me was gone

and I would be all right soon.

Halfway into the flight the tears stopped and my eye opened magically once again. That little excursion cost me 5 yuan （$0.76）. I remember an American colleague going to a hospital in Beijing after a shoulder problem and understood why she couldnt stop raving about how inexpensive it was， especially after American standards.

I want to add a footnote to my medical story in China. In the last fi ve years， 10 million people who fell into poverty due to illness had been rescued. In 1998， China initiated a healthcare reform to build the worlds biggest basic health insurance system， which today covers 95 percent of the population. By the time this year ends， I hope the remaining 5 percent of the population also come under the safety net.