Ma Wenfang, a 60-year-old doctor from Suliu village, Henan province, serves a local villager in his clinic on March 24. Xiang Mingchao / for China Daily

BEIJING - The world may be focusing on the safety of medicines during this year's World Health Day, which falls on Thursday.

But for Ma Wenfang, the most imperative medical issue facing China is enhancing the capabilities of rural doctors, who have worked at the grassroots for disease prevention and public health management.

A rural doctor with nearly 40 years of experience, Ma has been particularly concerned about the problems farmers - who account for more than half of the country's population - face when they become seriously ill.

"They can't afford to go to hospital even when they're seriously ill. Or they get themselves discharged from hospital before they've recovered," he recalled telling Premier Wen Jiabao face-to-face five years ago in the headquarters of the central government.

"Many had to wait at home to die," all because there was no medical care system for the farmers, said Ma, 60, a deputy of the 11th National People's Congress (NPC) and a farmer from Suliu village, Tongxu county of Henan province.

The words of Ma and other representatives from rural and medical communities helped speed up the national effort to establish a new rural cooperative medical care system in 2006, the beginning of the 11th Five-Year Plan (2006-2010) period.

Today, the new rural cooperative medical care system covers 96 percent of the rural population.

"Farmers not only go to hospitals but stay in hospital - if hospitalization is required - until they fully recover, because the new cooperative medical care system helps pay for a chunk of their medical bill," Ma told China Daily.

While farmers are enjoying the benefits, local hospitals have also expanded inpatient departments and upgraded diagnostic and treatment facilities.

One of the movers for change, Ma, however, said the medical reform is still inadequate because it has not enhanced the capabilities of rural doctors.

Before he came to Beijing in March for the annual NPC session, Ma visited 100 villages in Henan, Shandong and Hunan provinces.

Of the 100 rural doctors he interviewed, the eldest was 78 and the youngest 53. Although they have been in the medical service for an average of more than 43 years, they now make an average of 342 yuan ($52) a month.

As they approach retirement age, they don't have any pensions or safety nets to fall back on.

Because of their plight, very few young medical professionals want to take over their jobs, Ma said.

He said the public should be aware that rural doctors now perform public health services ranging from managing villagers' health files, vaccinations, prevention of infectious diseases and chronic diseases to taking care of children, pregnant women and new mothers, the elderly as well as people with serious mental problems.

Chronic diseases alone range from hypertension, diabetes, coronary heart trouble, cerebral-vascular diseases and physical handicaps to even cancer, Ma said.

However, some village clinics have started to disappear, Ma said. Rural healthcare is likely to suffer if the first line of public health defense is in tatters.

China had come a long way before instituting the current rural medical cooperatives.

Until the early 1960s, rural medical care remained almost non-existent. Ma's mother died of typhoid fever when he was 4. In 1962, his 8-year-old brother was also infected with typhoid fever.

To get his brother into hospital, he went door to door in the village, kneeling and begging for help.

"All families were poor then, but they all donated whatever they had, a penny, a cent. The largest bill was 5 jiao (8 cents)," he recalled.

With 169 yuan from neighbors, his family took his brother to a hospital in Kaifeng, the city closest to the village. But it was too late and his brother died a few days later in hospital.

In 1967, Ma went to a secondary medical school. After a year of training he returned to his home village to become a doctor, determined to repay his village neighbors and try whatever he could to give them medical treatment.

For more than three decades he managed a small clinic servicing more than 2,700 people in the rural community.

He remained on call almost 24 hours a day, seven days a week. He doesn't remember how many falls he had while trekking the dirt road in darkness to and from villagers' homes.

He charged very little.

"Farmers who go to see him for treatment usually pay 3 to 5 yuan for a visit," Yang Yan, who is writing a script for a television drama based on Ma's career, told China Daily.

He offers free medical services for the village's elderly who have no families, for children's vaccination, and for giving physical check-ups to villagers above 40 years old twice every year.

Ma's warm-hearted service has won him fame and respect in neighboring villages. He has received a lot of honors, such as one of the top 100 rural doctors in China.

Ma said his experience is shared by many other rural doctors who have made their share of great contributions to public health with little government assistance and under difficult conditions.

"They should be able to get a share of the benefits from the reforms today and open up the way for younger medical workers to follow in their footsteps," Ma said.

China Daily