Rural doctors in China; Free cancer screening; New TB vaccine; Do doctors have good cardiac skills?

by MICHAEL WOODHEAD

In a sign of the increasing concern about the demise of rural healthcare, China's 1.4 million rural doctors have now been given their own professional organisation.
Although it's not quite a trade union, the Chinese Medical Association has established a rural doctors section that will represent the interests of the many village doctors. The move is in response to the ageing of the semi-skilled workforce, most of whom lack medical degrees and have only high school education and a short training course on healthcare provision. According to the CMA, the new Rural Doctors Association "will assist the government to strengthen and promote rural doctor team building for the survival and development of rural medicine and safeguard the legitimate rights and interests of rural doctors."
Earlier this year Premier Li Keqiang acknowledged that it was important to retain doctors in rural areas, because their primary care role was "more effective than building a large hospital." The State Council acknowledged that rural doctors were the cornerstone of primary healthcare for hundreds of millions of rural residents.
However, most rural doctors are approaching retirement and younger people do not want to work in remote 'backward' areas in a role that is poorly paid and has few career prospects. Rural doctors by decree are paid the same salary as rural teachers - which is a pittance.Their miniscule pensions are an even greater cause for complaint.

Free screening programs for breast cancer and cervical cancer are to be developed nationally in China, according to the National Health and Family Planning Commission. The ministry said 48 million women in rural China had already received cancer screening interventions since 2009,  and there were now plans to increase promotion of screening services, co-ordinated by the All-China Women's Federation.

Despite studying medicine for seven years, China's junior doctors are unable to manage the basics of dealing with a heart attack, a study shows. A survey of 362 new medical graduates found they had little knowledge about basic cardiac diagnosis and resuscitation. Only about 50% of the doctors were able to identify common normal and abnormal ECG changes such as ventricular fibrillation. Likewise only half knew the basics of which drugs should be given for such conditions. The findings showed that many medical graduates were unprepared to manage the most common cardiac emergencies said researcher Dr Xi Huijun and colleagues from the Changhai Hospital, Shanghai.

China is leading the world in developing a new TB vaccine to replace the largely ineffective BCG vaccine against tuberculosis. At a TB vaccine conference held in Shanghai, researchers heard that a vaccine called Vaccae developed by an Anhui pharmaceutical company is in Phase 3 trials, whereas other candidate vaccines from other countries are only in the preliminary stages. Researchers said the vaccine would probably of most use in the elderly, who are expected to account for more than half of tuberculosis cases in the future.

Upgrade of rural health system breeds corruption

The upgrade of China's rural medical system is breeding corruption among heads of medical institutions in the country's remote areas.
Between 2009 and August of this year, the presidents of six rural health centers were prosecuted by the local procuratorate for taking kickbacks in the coastal city of Fangchenggang in south China's Guangxi Zhuang autonomous region, making it the biggest commercial bribery case in the city's medical system.
According to procuratorate documents, the suspects received kickbacks from pharmaceutical sales representatives worth 934,800 yuan ($152,496) when purchasing medical equipment such as Color B ultrasound machines in Fangchenggang, home to ten rural health centers.
The case was just one more in a series of similar cases in a corruption quagmire that has trapped several public officers working for the country's rural medical system.
In 2012, six health center deans in Guangxi's Luocheng county, a poverty-stricken county under the jurisdiction of Hechi city, were busted for accepting commissions while buying expensive medical equipment between 2008 and 2011.
Official documents show that the sales agents provided kickbacks to the centers' heads ranging from 10 percent to a staggering 25 percent in an attempt to increase sales.

Poor rural infants to be screened for PKU, thyroid and hearing disorders

China will start screening for three major diseases among infants in poor rural areas next month, said the National Health and Family Planning Commission here on Friday.
The free screening targets phenylketonuria, congenital hypothyroidism and hearing disorder and will cover about 490,000 rural newborns in 200 poverty-stricken counties of 21 provincial regions, said a commission statement.
Those who are diagnosed with the diseases will receive treatment and medical assistance from the state, according to the statement.
Phenylketonuria, also known as PKU, is a metabolic genetic disorder that can lead to learning disability, seizures and other medical problems. If patients can be diagnosed at an early age and get proper treatment, the symptoms may not develop and they can have a normal life.
Congenital hypothyroidism is another metabolic disorder under which an infant is born with a severe deficiency of thyroid function. Early diagnosis and treatment can prevent growth failure and mental retardation caused by the condition.
The central government will allocate a special fund for this program, 120 yuan (19 U.S. dollars) for each infant, the statement said.
Additionally, the commission will dispatch free dietary nutrition supplements to infants from six to 24 months in 300 poor counties so as to reduce incidence of anemia and stunting.
Source: China Daily