Basic Healthcare: 100 Rural Clinics for Guizhou

by Anthony Tong

Most people in the countryside of Guizhou Province have only one choice when they need to see a doctor: visit a small village clinic run by a rural health worker. These health workers often live in the same rooms where they deliver their services. They provide check-ups and treatment of patients on the same bed where they or their family members sleep at night. The clinics often have mud floors and wooden walls. This is not what one expects from hygienic treatment facilities. Working conditions of village doctors have been so poor that many of them have left their villages to work in cities, where they can realize much higher incomes.

The importance of infrastructure

We at the Amity Foundation are convinced that with the proper infrastructure – clean and hygienic clinics which are separate from health workers’ living quarters – health workers will be able to serve more patients, feel less vulnerable from infections, take more pride in their work, bring in higher incomes and feel motivated to stay in their villages, serving their communities in the long run. Villagers, too, will directly benefit from more hygienic surroundings and enjoy better care.

The Amity Foundation has therefore committed to the building of 100 clinics in rural Guizhou Province as part of the Clinton Global Initiative (CGI). This commitment is designed to improve the level of health services offered in villages in the Chinese countryside. The clinics will be constructed through a public-private partnership arrangement. Amity hopes that the clinics will serve as a model for the state to consider for replication. 170,000 villagers, many of them from ethnic minority groups, will benefit once this commitment to action is completed. More than half of the beneficiaries are women and children.

The clinics we are planning to build take account of the current government standards and can effectively meet the needs of the villagers. Moreover, following our commitment to ensure sustainability, Amity focuses on supporting those health workers who have already received medical training by the Amity Foundation in the past.

Proof of concept

Guizhou is one of China’s least economically developed provinces and under the country’s decentralized fiscal system, the provincial government does not have sufficient resources to build all the clinics in rural areas in the foreseeable future. The Amity clinics will serve as a proof of concept, demonstrating how affordable health services can be delivered even under very difficult circumstances. We hope that in the longer term, our model will be taken up by the government to provide better primary health care in the whole province.

This is the first time for Amity to build clinics in clusters. In the past, we responded to requests from various provinces. While this has worked well for individual villages and Amity has had plenty of opportunity to gain experiences in this field, there is still room for improvement in terms of long-term and comprehensive impact.

Partnership

Amity has chosen the three counties of Majiang, Jianhe and Cenggong because of their acute needs and their proactive approaches in solving primary health care problems. Local authorities have been very forthcoming and are willing to engage in meaningful, long-term cooperation with the Amity Foundation.

The Health Bureau of Guizhou Province is helping to identify the locations according to the relative needs of individual villages. The design of the clinics is both based on national standards and has benefited from the expertise of Hong Kong practitioners. Amity will put up the equivalent of US$ 6,450 for each clinic, while the local communities will top this up to the full cost of constructing clean and hygienic clinics.

Implementation strategy

During the first stage of the clinics project (April to November 2008), Amity’s Hong Kong office focused on the raising of initial funds and planning. Construction of clinics and fundraising will go on through 2013. Estimated total project costs are US$ 645,000, with first-year costs at US$ 129,000. The Amity Foundation’s Hong Kong office has so far raised funds totaling US$ 90,300. We hope to be able to raise the remaining funds by 2013.