20 Summer Days In China by Betty Blunden (1974)

27 August

In Shenyang. A fine warm day. Our outing for the morning was to the hospital that was attached to the Liaoning Medical College. From my diary: “There was no college of medicine in Shenyang under the old society. Under the leadership of the Communist Party of China and Chairman Mao this College was established in 1958 and there was this one hospital. After the Cultural Revolution three subsidiary hospitals were set up in the rural areas. originally the teaching staff numbered 500. It was now 1500. There are two departments, Chinese Medicine and Chinese Pharmacology. There is also a basic course in medicine and Chinese Medical Research is being done at the Institute. The teaching of students is combined with productive labour, culture and social conscience. Western doctors come to this hospital to learn Chinese traditional medicine.

“Research is being done in recurring diseases. Before 1949 there were 3,000 beds. Now 4,000 beds and 2,000 out-patients are treated each day. The three rural hospitals each have 100 beds and treat between 2 and 300 out-patients a day. They serve the peasants.”

We were taken to the dental clinic for a demonstration of acupuncture used as analgesia. This form of analgesia was useful in both cities and the country. There was little bleeding after a tooth was extracted. We saw a tooth extracted from a young man then a girl. The dentist applied pressure with thumb and forefinger to a spot on the cheek and on the jaw for exactly one minute, then the tooth was drawn. No pain and practically no bleeding. It cost the patient 30 cents — 10 cents Australian.

We saw a case of chronic tonsilitis in a little girl about ten years old, being treated. We did not see the acupuncture analgesia being given so do not know where the needles were put. But the child had no fear and opened her mouth so a small hot spoon-like instrument could be applied to the infected area to cauterize it. Quite astonishing.

We went to another room for rheumatic patients where we watched a young woman being treated. Two needles were put in her shoulder and pushed down just under the skin for about six inches. (This was too much for Gisela and she fainted The patients usually needed seven treatments.

A patient being treated for high blood pressure had two tiny needles put in each side of her spine above the waist. They were covered with Elastoplast, left for two days during which time the patient could go back to work. This treatment was repeated 3 or 4 times. I don’t remember at what intervals of time. The blood pressure was usually normalised. Generally it was a permanent cure, but the condition may recur in a few years time and the patient would return for further treatment.

Acupuncture worked well with diseases of the nervous system, nervous headache and tension. Pneumonia was treated in this hospital with herbs.

After graduating from middle school young people spent the next two years working in the country, a factory or the PLA. If they wished to study medicine their application was first discussed by their fellow workers, then by “upper orders” which we now knew meant the Communist Party, then in the College. Before the Cultural Revolution training was for six years of which one was spent in the hospital. Medical students were unwilling to serve as nurses in the wards, and when qualified some were often capable only of “giving orders and writing prescriptions”. After the Cultural Revolution the course was reduced to three years and students combined theory with practice. They studied theory in the mornings and worked in the wards with the nursing staff in the afternoons. Before the Cultural Revolution many doctors were unable to give injections. Now they learnt all these skills. After three years study the students went to the country and the quality of the graduates was higher than under the previous system of training. “Chairman Mao had taught us to combine Traditional and Modern medicine. A combination is best. We are encouraged to combine techniques, to pay attention to hygeine, reduce diseases and improve physique.”

In the Province health services are in five categories.

Provincial Health Bureau and Provincial Hospitals.

Municipal Hygeine Bureau and Municipal Hospitals.

Country level — Brigade stations. They have beds and treat out-patients.

Commune level.

Local committee level — Street health stations.

Four times a year a campaign is launched to clean all areas. It is a “National Patriotic” Campaign, and covers houses, factories and all institutions.

The barefoot doctors come to study for two months and then return to their provinces. Later they would return to the hospital for further study. Before the Cultural Revolution most graduates were unwilling to go to the country. Now it is different. The students come from the workers, peasants and soldiers and are glad to return. Some had to be persuaded to stay in the College and teach. Doctors were taught to “serve the people” and “solve practical problems”.

There were no examinations. The young doctors go to factories and the country and prove they are competent and there was no longer the need to do a year as an intern.

Medical treatment was free for the workers and their families pay half price. In the country everyone pays 50 cents a year and that pays for everything. The State Government covers the cost of preventative campaigns. Already bubonic plague, cholera, venereal diseases had been eliminated, and snail fever was almost exterminated. It still existed in parts of Southern China along the Yangtse.

We asked questions about salaries. A new graduate gets 56 yuan a month. Doctors from the old society who still wished to work were honoured. They would receive 200 yuan a month. We often asked about salaries in the various establishments that we visited and I think this salary for an ‘old’ doctor was the highest ever quoted.

Before we left we were taken to a botanical museum on the top floor of the hospital. Here were displayed thousands of dried herbs, mounted behind glass and classified. They covered the walls and the many screens that divided up the area. All students studied these specimens so that they could be identified in the field and gathered. I understood that ‘everyone’ gathered herbs for the hospitals. The famous Ginseng was pointed out to us. It looked rather like a turnip to me, the section from under the ground being the valuable part. The specimen in the museum was about 15 inches long and we were told that it would take 100 years to grow that big.

We had had a wonderful morning, medical treatment being close to everyone’s heart. But for the four doctors in our party it had been tremendous. About half a dozen of the senior staff had welcomed us and stayed with us to answer our questions. Arthur, one of our doctors, walked out of the hospital, waving his hands and saying very quietly and happily “It is socialist medicine. It is socialist medicine.”