Reinterpreting the Role of Traditional
Chinese Medicine in Public Health in
Rural China in 1970s
Xiaoping Fang, Ph.D.
University of Technology, Sydney
12:30-2:00pm, 13 March, Wednesday
The Global Health Histories seminar series
The World Health Organization (WHO)
Age Distribution of Barefoot Doctors (Unit: Person)
• Sources: The barefoot doctor survey in Hangzhou Prefecture conducted from 2003 to 2005; Xiaoshanxian weishengju [Xiaoshan County Health Bureau], “1971 nian eryue tuijian qu hangwei xuexi mingdan” [The Trainee List Recommended to Study in Hangzhou Health School in February 1971], XSA, Vol. 25-1-38; Huanshan renmin yiyuan [Huanshan People’s Hospital], “Fuyangxian chijiao yisheng fuxun dengjibiao” [Registration Forms for Fuyang County Barefoot Doctor Re-training Class], October 1978, FYA, Vol. 74-3-29; Gaoqiao renmin yiyuan [Gaoqiao People’s Hospital], “Qingyunqu 1981 nian diyiqi chijiao yisheng peixunban huamingce” [Roster of the First Barefoot Doctor Training Class in Qingyun District in 1981], April 9, 1981, FYA, Vol. 74-3-29; Sandunzhen zhongxiyi jiehe yiyuan [Sandun Township of Integrated Chinese and Western Medicine], “Sandunzhen xiangcun yisheng qingkuangbiao” [Roster of Village Doctors in Sandun Township, Hangzhou City], January 17, 2005, SDA.
0
2
4
6
8
10
12
14
16
18
20
Number
Percentage of Woman Barefoot Doctors in Hangzhou Prefecture,
1968-1985
Sources: Hangzhoushi weishengzhi, pp. 84-87.
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
1974 1975 1976 1977 1978 1979 1980 1981 1982
Female
Male
Educational Backgrounds of Barefoot Doctors
in Selected Years and Comparison with Villagers (Unit: 100%)
Period College High School Primary School Illiterate
Senior Junior Senior Junior
1978 0.00 24.1 44.8 18.9 12.0 0.00
1981 0.00 15.5 46.7 24.4 13.3 0.00
Average 0.00 19.8 45.7 22.65 12.65 0.00
1982 rural census 0.08 3.77 15.85 40.59 39.85
Sources:
•Barefoot doctor survey in Hangzhou area conducted from 2003 to 2007;
•Huanshan People’s Hospital, “Fuyangxian chijiao yisheng fuxun dengjibiao” (Registration Forms for Fuyang County
Barefoot Doctor Re-training Class) (October 1978), FYA. vol. 74-3-29;
•Gaoqiao People’s Hospital, “Qingyunqu 1981 nian diyiqi chijiaoyisheng peixunban huamingce” (The First Barefoot Doctor
Training Class Roster in Qingyun District in 1981) (June 10, 1981), FYA vol. 74-3-29.
•Zhongguo renkou: Zhejiang fence (Population of China: Zhejiang) (Beijing: Zhongguo caizheng jingji chubanshe, 1988), p.
348.
Barefoot Doctor Textbooks and Journals 1969-1981
Collected by National Library of China (Unit: book)
Sources: National Library of China website.
0
1
2
3
4
5
6
1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981
Books
Journals
Barefoot Doctor Xu Peichun’s Reading List
Book Place & Time Way of obtaining
Textbook for Rural Health Workers Hangzhou 1966 No indications
Common Medicine Dosage for
Child
Shanghai 1966 bought on May 24, 1969 in Fenkou
District training class
Preventing Respiratory Infectious
Diseases,
Hangzhou 1970 Pamphlet distributed from the above
Common Chinese and Herbal
Medicines in Zhejiang Province
Hangzhou 1970 Bought at District June 26 Mao Zedong
Thought Study Class in July 1970
Pesticide Usages and Poisoning
Prevention
Hangzhou 1971 No indications
Manual for Health & Epidemic
Prevention
Hangzhou 1974 Awarded by Chun’an County Health &
Epidemic Prevention Station in June 1976
Common Medicines Used by
Barefoot Doctors
Shanghai 1975 Awarded by Hangzhou Prefecture Health
Bureau in June 26, 1976
Population Must Be Controlled Hangzhou Pamphlet distributed from the above
Sources: Supplied by barefoot doctor Xu Peichun, March 2004.
The Knowledge Structure of Candidates
for the Excellent Village Doctor Award in China, 2005 and 2010
Category
2005 2010
Time of becoming barefoot doctors
Total Before 1983 After 1983 Total
Number % Number % Number % Number %
Western 94 64.8 38 69 132 66 147 73.5
Chinese 36 24.8 15 27.2 51 25.5 51 25.5
Integrated 13 8.9 2 3.6 15 7.5 1 0.5
Mongolian 1 0.7 0 0 1 0.5 - -
Tibetan 1 0.7 0 0 1 0.5 - -
Chinese-Tibetan - - - - - 1 0.5
Total 145 100 55 100 200 100 200 100
Source: Zhonghua renmin gongheguo weishengbu [The Ministry of Health of the People’s Republic of
China], http://www.moh.gov.cn/moh (access June 20, 2005); “2010 nian quanguo youxiu xiangcun yisheng
houxuanren mingdan” [List of Candidates for the Excellent Village Doctor award in 2010], Jiankangbao
[Health Bulletin], November 30, 2010 (accessed May 28, 2011).
Average Number of Medical Staff Members in Commune Clinics (or Union
Clinics) of Selected Counties within Hangzhou Prefecture (Unit: person)
County 1950s 1960s 1970s 1980s
Fuyang 5.3 5.7 9.6 12.9
Xiaoshan 5.3 6.15 10.4 16.5
Lin’an 5.2 6.6 10.8
Hangzhou Prefecture 6.12 12
Average 5.3 14.7
National average 5.8 13.9
Sources: Xu, Fuyangxian weishengzhi, 68–69; Xiaoshan weishengju, Xiaoshan weishengzhi, 54–56;
Lin’anxian weishengzhi bianzhuan weiyuanhui, Lin’anxian weishengzhi, 107–16; Hangzhoushi weishengju
[Hangzhou Prefecture Health Bureau], “1965 nian weisheng shiye zonghe baobiao” [Comprehensive
Statistical Health Work Form in 1965], HZA, Vol. 87-3-262; “Hangzhou diqu nongcun shengchan dadui
shengchandui weisheng zuzhi qingkuang” [Survey of Health Organizations in Production Teams and
Production Brigades in Rural Areas of Hangzhou Prefecture], 1975, HZA, Vol. 87-3-302; “Hangzhou diqu
nongcun shengchan dadui shengchandui weisheng zuzhi qingkuang” [Survey of Health Organizations in
Production Teams and Production Brigades in Rural Areas of Hangzhou Prefecture], 1976, HZA, Vol. 87-3-
307; Zhongguo weisheng nianjian bianweihui [Editorial Board of China Health Yearbook], ed., Zhongguo
weisheng nianjian 1983 [China Health Yearbook 1983] (Beijing: Renmin weisheng chubanshe, 1983), 57.
Percentage of Chinese Medicine Doctors in Commune Clinics (or Union Clinics) of
Selected Counties within Hangzhou Prefecture (Unit: Percentage)
County 1950s 1960s 1970s 1980s
Xiaoshan 59% 29.45% 29% 19.4%
Lin’an 60.6% 47.33% 26.4% 22.7%
Yuhang 71.5% 50.6% 34.9% 17.9%
Seven counties 48.6%
Average 63.7% 30% 20%
Sources: Xiaoshan weishengju, Xiaoshan weishengzhi, 54–56; Lin’anxian weishengzhi bianzhuan
weiyuanhui, Lin’anxian weishengzhi, 116; Yuhangxian weishengju weishengzhi bianzhuanzu, Yuhangxian
weishengzhi, 80; Hangzhoushi weishengju, “1965 nian weisheng shiye zonghe baobiao,” HZA, Vol. 87-3-
262.
Average Number of Barefoot Doctors per Commune Clinic in Selected Counties
within Hangzhou Prefecture during the 1970s (Unit: person)
County Average Maximum (Year) Minimum (Year)
Fuyang 28.9 36.5 (1977) 23.5 (1973)
Chun’an 24.7 33.7 (1976) 16 (1973)
Jiande 23.5 53 (1970) 12 (1975)
Average 25.7 41.6 13.8
Sources: Xu, Fuyangxian weishengzhi, 73; Hangzhoushi weishengju hangzhoushi weishengzhi
bianji weiyuanhui, Hangzhoushi weishengzhi, 87; Chun’anxian jihua weiyuanhui [Chun’an
County Planning Commission], Chun’anxian guomin jingji tongji ziliao, 1949–1978 [Statistical
Data of Chun’an County’s National Economy, 1949–1978] (Chun’an, 1980), 333–46; Yan,
Jiandexian yiyao weishengzhi, 70.
Prices for Major Western Medicines in Hangzhou Prefecture, 1953–1984
(Unit: RMB)
Medicines Specification Unit 1953 1957 1965 1969 1984
Penicillin 0.2 million bottle 1.12 0.83 0.31 0.25 0.14
Streptomycin 1 million bottle 2.84 2.15 0.62 0.43 0.28
Antondin 10x2ml box 0.94 0.78 0.80 0.61 0.69
Analgin 100x0.5g bottle 10.66 5.54 2.50 2.30
Tetracycline 100x0.25g bottle 170.13 18.13 6.00 3.50
Terramycin 100x0.25g bottle 177.88 10.25 4.38 2.50
Chloromycetin 100x250mg bottle 74.56 20.72 6.72 5.00
Sulfapyridine 1000x0.5g bottle 73.73 72.87 74.16 34.80 28.0
Sulphaguanidine 1000x0.5g bottle 17.00 16.72 15.00 14.17 13.0
Sources: Hangzhou yiyao shangyezhi bianzhuan weiyuanhui, Hangzhou yiyao shangyezhi, 254; Zhongguo
yiyao gongsi, Zhongguo yiyao shangye shigao, 274.
Vaccines in Four Selected Counties in Hangzhou Prefecture, 1949–1970
Vaccine Year of first inoculation
Smallpox 1950
Typhoid, paratyphoid 1950
Bubonic plague 1952
BCG 1952–1957
Diphtheria toxin 1952–1954
Pertussis 1954
Epidemic Japanese b encephalitis 1957–1958
Anthracnose 1960
Diphtheria, Pertussis, Tetanus
(DPT)
1961
Dysentery bacteriophage 1961
Polio 1962
Para-cholera 1962
Leptospirosis 1961–1966
Measles 1967–1970
Epidemic cerebrospinal
meningitis
1970
Sources: Yan, Jiandexian yiyao weishengzhi, 141–42; Lin’anxian weishengzhi bianzhuan weiyuanhui, Lin’anxian
weishengzhi, 257; Xu, Fuyangxian weishengzhi, 15–16, 173–77; Xiaoshan weishengju, Xiaoshan weishengzhi, 139–79; Qian
Xinzhong, Zhongguo weisheng shiye fazhan yu juece [Health Development and Decision Making in China] (Beijing:
Zhongguo yiyao keji chubanshe, 1992), 850–86; Huang Shuze and Lin Shixiao, eds., Dangdai zhongguo de weisheng shiye
[Health Development in Contemporary China], Vol. 2 (Beijing: Zhongguo shehui kexue chubanshe, 1986), 291–343.
Incidence Rates of Notifiable Infectious Diseases in Hangzhou Prefecture
and Zhejiang Province, 1949–1990 (Unit: 1/100,000)
Sources: Hangzhoushi weisheng fangyizhan, Yiqing ziliao huibian,1950-1979, 12; Zhejiangsheng weisheng fangyizhan [Zhejiang Province Sanitation and Epidemic-Prevention Station], ed., Zhejiangsheng yiqing ziliao huibian, 1950–1979 [Compiled Data of Epidemic Diseases in Zhejiang Province, 1950–1979] (Hangzhou: Zhejiangsheng weisheng fangyizhan, 1982), 1–4; Zhejiangsheng yiqing ziliao huibian, 1980–1989 [Compiled Data of Epidemic Diseases in Zhejiang Province, 1980–1989] (Hangzhou: Zhejiangsheng weisheng fangyizhan, 1994), 7.
0
1000
2000
3000
4000
5000
6000
Hangzhou
Prefecture
Zhejiang
Province
Mortality Rates of Notifiable Infectious Diseases in Hangzhou Prefecture and
Zhejiang Province, 1949–1990 (Unit: 1/100,000)
0
10
20
30
40
50
60
70
80
90
Hangzhou
Prefecture
Zhejiang
Province
Fatality Rates of Notifiable Infectious Diseases in Hangzhou Prefecture and Zhejiang
Province, 1949–1990 (Unit: Percentage)
0
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
1.8
2
Hangzhou
Prefecture
Zhejiang
Province
Gathering and Planting of Medicinal Herbs in Cooperative Medical Stations in
Hangzhou Prefecture, 1976
County
Production Brigades
Total
number
Brigades with a cooperative medical service
Total
number
Gathering and planting of
medicinal herbs
Area of medicinal herb fields
Total number % mu
Per brigade
Xiaoshan 750 736 165 22.41% 212 1.28
Yuhang 550 550 165 30.00% 473 2.87
Lin’an 636 581 180 30.98% 80 0.44
Tonglu 407 407 163 40.04% 98.9 0.61
Fuyang 589 451 292 64.75% 60.47 0.21
Jiande 515 492 281 57.11% 200 0.71
Chun’an 852 815 463 56.80% 307 0.66
Average 43.16% 0.97
Source: Hangzhoushi weishengju [Hangzhou Prefectural Health Bureau], “Nongcun chijiao yisheng
weishengyuan jieshengyuan qingkuang” [Statistical Data of Rural Barefoot Doctors, Health Workers and
Midwives], 1976, HZA, Vol. 87-3-307.
Expenditures on Different Kinds of Pharmaceuticals in Jiande County, 1961–1983
(Unit: RMB 1000)
Source: Yan, Jiandexian yiyao weishengzhi, 110–11.
Materia Medica Consumption Per Capita
in Jiande County, 1960–1983 (Unit: jin or 500g)
Source: Yan, Jiandexian yiyao weishengzhi, 110–11.
Materia Medica and Chinese Patent Medicine Consumptions
in Three Counties of Zhejiang Province, 1961-1978
Materia Medica and Chinese Patent Medicine Consumptions
in Three Countries of Zhejiang Province, 1970-1987
Top ten medicines consumed per capita in Jiande County throughout the 1970s
Rank Pharmaceuticals
1 tetracycline
2 penicillin
3 Terramycin
4 Gastropin
5 piperazine citrate (for repelling ascarids)
6 anti-pyretics
7 painkiller tablets
8 Anlagin
9 ephedrine tablets
10 syntomycin
Source: Yan, Jiandexian yiyao weishengzhi, 110–11.