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Development  The Establishment of the rural health service   Reform of the Medical and health care system  Maternity&Child Care
Disease Prevention and Treatment     Traditional Chinese medical (TCM) and Pharmacology

 

Development

After the founding of New China in 1949 the Chinese government put the emphasis of medical work on the rural health services, disease prevention and health care and giving a boast to traditional Chinese medicine. Great efforts were devoted to setting up medical and public health institutions. A nationwide public health network has now been basically formed and an adequate contingent of medical personnel has been established. China’s medical education system is complete, and a large group of medical experts has been trained. By the end of 1999, there were 310,000 public health institutions (including clinics) with 3.16 million beds, of which 2.93 million beds were in hospitals and clinics. There were 4.46 million medical personnel, including 2.05 million doctors and 1.25 million nurses. The public health institutions, hospital and clinic beds and medical personnel increased by 83 percent, 58 percent and 81 percent, respectively, compared with those in 1978.

The technical level of public health has improved greatly, and the management and supervision of medical work have been strengthened. An urban and rural medical insurance system combining state planning and fee paying has been established. Traditional Chinese medicine and Western medicine have been promoted simultaneously. The incidence of many epidemic diseases has dropped considerably, and some endemic diseases are now under control. Rural health work has been improved, greatly contributing to the overall health of the population. The average life expectancy of Chinese people, the death rate of infants and childbirth death rates have almost reached the levels of developed countries.

Development of Medical and Health Institutions, Hospital beds and Medical and Health Personnel

 Year 1949 1978 1985 1990 1998
 Medical & health institutions 3,670 169,732 200,866 208,734 310,000
 Hospital beds (1,000) 85 2,042 2,487 2,925 3,140
 Medical & health personnel (1,000) 505 2,464 3,411 3,898 4,420

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The Establishment of the rural health service Network

Of China’s 1.2 billion population, 900 million people live in the rural areas. The Chinese government has constantly paid great attention to rural medical and health work. Especially since the reform and opening started in 1978, further developing rural medical and health work to enable rural people to enjoy basic medical health care is one of the goals of China’s medical and health departments. Currently counties, townships, and villages are covered by a medical and health network. In 1998, China had 2,037 county-level hospitals, 50,600 township-level hospitals and 728,800 village clinics. About 89.51 percent of the country’s 730,000 villages have clinics. There were also 1.3276 million village doctors and paramedics, among whom 74.59 percent were doctors. A good foundation has been laid for realizing the World Health Organization’s goal of universal health care in China by the year 2000.

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Reform of the Medical and health care system

The current medical insurance system was based on the free medical care and labor insurance system established in the early 1950s, under which medical expenses incurred by workers and staff are covered by the state. This system has played an important role in guaranteeing the health of workers’ and staff members, promoting economic development and safeguarding social stability. In the wake of China’s economic development and the deepening of the economic reform, defects in this system have gradually emerged. The rapid increase in medical expenses has brought a heavy burden on the state and some enterprises. At the same time, a lot of medical resources have been wasted. But in the countryside, only a few well-off regions provide free medical care, while in other regions medical expenses are paid by the local people themselves. So reform of the medical services system is a matter of urgency.

The compensation mechanism of medical institutions has to be straightened out in the course of the reform of the medical and health care system for urban workers and staff. This means that the medical insurance system should be both socialized and localized. Medical expenses should be rationally allocated among the state, units and individuals. In the countryside, a cooperative medical service system should be further promoted and perfected. Organized and led by the government, the cooperative medical service system is run by the local people and subsidized by the state. Peasants take part in it voluntarily. The funds come mainly from peasant households, collectives and the state. In this way, basic medical services can be guaranteed in the countryside and the danger of rural people becoming impoverished because of illness can be averted.

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Maternity and Child Care

Since the founding of New China, the government has paid special attention to the medical and health care of women and children. Legislative and supervisory bodies to ensure women’s and children’s legal rights and interests have been established at the NPC and the CPPCC. Women and children’s work committees have also been established by the State Council and local governments. By the end of 1998, China had 2,724 maternity and child-care organizations, including 1,507 county-level ones, with a total of 73,000 medical technicians. A maternity and child-care network has been formed in both urban and rural areas.

To ensure the health of women, the state has formulated the Law for Protecting Women’s Rights and Interests, Law on Maternity and Child Care, Labor Protection Regulations for Female Workers and Staff, and Provisional Regulations for the Health Care of Female Workers and Staff. New measures have been adopted for the health care of pregnant women and for safe child delivery to protect the safety of mothers and babies. A health-care program for pregnant women has been promoted, i.e. setting up a file at the beginning of pregnancy, regular examinations before delivery, nursing for endangered pregnant women, hospital delivery and post-natal visit. All these measures have greatly improved the quality of maternity and child care, resulting in a remarkable drop in mortality for pregnant women from the pre-Liberation15 per thousand to the present 0.619 per thousand.

Since the reform and opening policies were introduced at the end of 1978, the Chinese government has attached special attention to children’s welfare. The Program for the Development of Children in China in the 1990s and the Law on the Protection of Minors were formulated, providing a better environment for children to grow up, be protected and develop. At the same time, the Program for the Promotion of Breast Feeding was also formulated and the baby-friendly action was launched on a large scale. China has built 5,890 baby-friendly hospitals, and child mortality has dropped to 31 per thousand, from 200 per thousand before Liberation. Since the implementation of planned immunization for children in 1978, the development level and nourishment situation of Chinese children have kept improving.

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Disease Prevention and Treatment

Chinese public health departments at all levels conscientiously pursue the principle of putting prevention first. Active steps are taken to prevent and, if necessary, treat contagious, endemic, parasitic and other diseases. In the early 1960s China entirely eradicated smallpox, more than a dozen years ahead of the rest of the world.

In the 50 years since the founding of New China, epidemic prevention stations were established by governments at various levels all over the country, which have played an important role in disease prevention and treatment, and hygiene supervision. In 1998, epidemic prevention stations totaled 4,018, among which 1,696 were county-level epidemic prevention stations and 1,889 were specialized clinics and health stations.

In order to eliminate and control epidemic and endemic diseases, the Chinese government has issued a series of laws and regulations, such as the Law on the Prevention and Treatment of Epidemic Diseases, National Plan of Action for Eliminating Poliomyelitis by 1995, and Program on Eliminating Iodine-Deficiency Diseases by 2000. Active measures have been adopted for promoting immunization programs. Inoculation of children has successfully controlled the incidence of measles, polio, diphtheria, whooping cough and epidemic encephalitis B. The incidence of these diseases and the death rate of children from them have dropped greatly. At present, disease prevention and treatment and patriotic hygiene work are making great progress. As a result, the health of all China’s citizens has greatly improved since 1949, and the average life expectancy has increased from 35 to 70. Today, the main causes of death are malignant tumors, cerebrovascular diseases and heart diseases, which are typical causes of death in developed countries. Relevant research institutes and medical organizations are currently actively pursuing better methods for the prevention and treatment of these diseases, while monitoring the incidence and infection trends of epidemic diseases in both China and foreign countries. In the past 50 years marked achievements have been made in disease prevention and treatment in China. The Disease Control Department of the Ministry of Health won the special achievement prize for public health work awarded by the WHO in 1996.

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Traditional Chinese medical (TCM) and Pharmacology

Chinese medicine and pharmacology are important component parts of China’s splendid national culture. Chinese medicine and pharmacology have made tremendous contributions to China’s prosperity throughout the country’s history of several thousand years. They are noted worldwide for their outstanding curative effects, strong national character, unique method of diagnosis and treatment, systemic theories and vast accumulation of historical records and materials, making it common wealth of the medical treasure-house of mankind. Chinese medicine and pharmacology have shown great vitality for several thousand years. They are also a valuable complement to the modern techniques of medicine and pharmacology.

The origin of traditional Chinese medicine and pharmacology can be traced back to primitive society. Medicine was originally created in the struggle against Nature by the ancient Chinese. In the course of food gathering, they found that some food items could alleviate the symptoms of or cure diseases. That was the origin of TCM. When the ancient Chinese lit fires to warm themselves, they also found that heated stones and sand wrapped in animal skin or bark could reduce pain. Through repeated practice and improvement, moxibustion methods were gradually developed. In the process of using stone instruments they found that when a part of the body was hit by something, pain in some other part of the body might be relieved, and so stone or bone acupuncture needles were invented. After a long period of development, the theory of collateral channels took shape, and the technique of acupuncture treatment was perfected.

The basic theory of TCM shows its unique understanding of the zang-fu organs, meridians and collateral channels, qi, blood and body fluids, and pathogeny. The diagnostic method of TCM consists of the “four examination methods” and the differentiation of symptoms. The former refers to visual inspection of the complexion, auscultation, reading the pulse and directly asking about the patient’s conditions. The differentiation of symptoms means after the actual circumstances are gathered through these examinations and analyses, the proper method of treatment is induced. TCM pharmaceutical treatment is often accompanied by acupuncture, massage therapy and qigong (breathing exercises).

The Yellow Emperor’s Canon of Medicine, the earliest and most comprehensive medical classic from both the theoretical and clinical standpoints, was compiled more than 2,000 years ago, and laid a theoretical foundation for TCM. Later, other authoritative medical books appeared, such as the Classic of Difficulties, Treatise on Febrile and Other Diseases and Causes and Symptoms of Diseases. Shen Nong’s Materia Medica is the earliest known pharmacopoeia in China. The Materia Medica of the Tang Dynasty was the first pharmacopoeia published by the government in ancient China, as well as being the earliest state pharmacopoeia in the world. The Compendium of Materia Medica compiled by Li Shizhen of the Ming Dynasty contains details of 1,892 kinds of herbs and 10,000 prescriptions.

Since the founding of New China in 1949, the government has paid great and consistent attention to the development of TCM. In 1986, the State Traditional Chinese Medicine Administration was established. Two years later, the name was changed to the State Traditional Chinese Medicine and Pharmaceuticals Administration. A series of policies, principles and regulations have been formulated to promote the development of TCM and pharmacology. At the same time, higher and secondary TCM education has developed gradually. Regular education and other kinds of education, such as correspondence and night school courses, as well as teach-yourself programs have trained a lot of TCM personnel. A fairly comprehensive TCM pharmaceuticals industry has been basically completed. As China develops its modern medical system, active efforts are being made to synthesize Western and Chinese techniques and theories, with emphasis on the respective strengths and weaknesses of both approaches. Chinese medicine, Western medicine and integrated Chinese and Western medicine exist side by side. Medical workers working on the integration of Chinese and Western medicine have done a lot of research work on the basic theories and principles of treatment of TCM with advanced techniques and modern methods. For example, scientific annotations have been made on the principles of the zang-fu organs, stasis of blood and acupuncture. Great achievements have been made by China in the five fields of fractures treatment, acute abdominal diseases treatment, acupuncture anaesthesia, replanting of broken limbs and extensive burns treatment, the former three being the result of combining Chinese and Western medicine techniques.

In recent years, great successes have been made by using combined Chinese and Western techniques to treat cardiac and cerebral vascular diseases, immunological diseases, tumors, fractures and some other diseases. New progress has been made in the investigation of folk prescriptions, in planting and processing herbal medicines and in the development of drugs. Consequently more and more diseases can be treated by TCM methods. TCM can ensure quick recovery for patients suffering from acute abdominal diseases without the need for surgery. Acupuncture treatment and acupuncture anaesthesia are now used in 120 countries and regions throughout the world. In 1987, the World Acupuncture and Moxibustion Union was established in Beijing, with nearly 100 countries and regions participating, giving a total of more than 50,000 members. This is the first international academic organization with its headquarters in China and with China as its chairman. An international qigong conference was held in Beijing in 1989, with 29 countries and regions participating. In 1991, China organized an international conference on traditional medicine and pharmacology, and a Beijing Declaration was drafted by the several dozen countries which participated. At present, China carries out academic exchanges with more than 100 countries and regions throughout the world.

Following the popularization of the use of natural medicines and non-medicinal treatment in foreign countries, people all over the world have become more interested in TCM and pharmacology in recent years. Cooperations in TCM and pharmacolgy are increasing day by day. Cooperative relations have been established between China and Japan, the United States and Germany. In addition, seven traditional medicine and pharmacology centers have been established in China by the WHO. The number of foreign students who come to China to study TCM ranks first among those studying natural sciences in China. An agreement has been reached to run a TCM school cooperatively between Beijing University of Traditional Chinese Medicine and a British national university. It will be the first regular university in Britain, and even in Europe, to teach TCM. Japan and the Republic of Korea (ROK) also have TCM schools. France, the United States, Italy, Australia and some other countries have established TCM colleges or acupuncture and anaesthesia colleges, and Munich University in Germany has its Institute on the Theory of Traditional Chinese Medicine.

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