Trip to Guizhou: What an Experience in Majiang!

Stephen Codrington, principal of Li Po Chun United World College in Hong Kong, accompanied Amity staff to one of the poorest provinces of China: Guizhou. Here, people are in desperate need of better healthcare. The trip took place immediately after the 2008 snowstorm disaster. His experiences led Mr. Codrington to involve his school in fundraising efforts for Amity’s “100 Village Clinics for Guizhou” project. The following is an excerpt from his diary.

You will never find Majiang in a tourist guide to China. Indeed, you would need a very detailed map to locate it. And yet this poor rural country in eastern Guizhou province is the quintessential Chinese landscape of steep limestone hills cut by fast-flowing rivers, terraced farmlands and wooden houses, water buffaloes sloshing through rice paddies, women working in the fields with babies strapped to their backs, all surrounded by interminable eerie swirling mists.

I have just spent a week in Majiang, researching opportunities for our students to travel there in a group. The service group that I lead at the College, GCAT (Global Concerns Action Team) has just raised the funds to sponsor the construction of two medical clinics in Majiang in support of a campaign by the Amity Foundation to build 100 medical clinics in this very poor, deprived, rural area.

Majiang has been classified by the Chinese government in Beijing as a ‘Poverty County’. Indeed, the whole of Guizhou is one of China’s poorest provinces – as the saying goes, Guizhou is a land where there are “no three days without rain, no three kilometers without a mountain, and no three coins in any pocket”.

The focus of my visit was to study the health care needs of Majiang. It is hoped that the first of the two GCAT-sponsored clinics will be finished at that time. In order to gain a clear understanding of the program, I joined a team from Amity’s headquarters in Nanjing headed by Zheng Ye, supported by Tong Su from Amity’s Hong Office and Anthony Tong, LPCUWC Board Chairman, in a meeting with local health officials of the Majiang County Health Bureau. This meeting was a very useful opportunity for me to gauge the enthusiasm of both the local officials and the Amity Foundation for the medical clinics project – the enthusiasm of both sides was infectious to say the least.

The next morning, in steady rain, we visited Dachong village in Majiang County. Our visit began in the old clinic, and once we saw the leaking roof, bare earth floor, open cabinet used for storing medical supplies and damp, unhygienic conditions, we quickly appreciated the need for the new clinics. Fortunately, that building had been replaced by a newer, temporary building after the snowstorms, and although inadequate, it was a vast improvement on the old clinic. The clinic was staffed by a husband -and-wife team, which worked well as many of the medical issues dealt with at village level are gynecological, and women always refuse to be seen by a male doctor.

The highlight of our visit to Dachong was the laying of the foundation stone of the first Amity clinic. This was quite a prestigious occasion by the standards of a remote rural village, with speeches, presentation of banners, ceremonial turning of the earth, fireworks and so on, all under steady rain that I was told was a very positive omen – in springtime the farmers need rain for the seeds to sprout, and the rain meant that the seeds of the new clinics would sprout and blossom in the times ahead.

No bed for an IV

Our next stop was Xuetou. This was a larger village with a population of about 13,000 people. The current clinic was abysmal, being so small that there was no room even for a bed to handle intravenous drips (which seem to provide the entire foundation of Chinese rural health care). Consequently, the doctor in Xuetou does most of his work as house calls, carrying with him a Cultural Revolution era Barefoot Doctor’s kit box. Because of the clinic’s location, some of the doctor’s house calls require a walk of up to 5 kilometers, which can take about 3 hours in the difficult terrain of Xuetou.

Like many of the villages in Majiang, and indeed Guizhou province, Xuetou is depopulating as young men leave in search of work in the coastal cities. This means that more and more women have to do the farming work, and it also creates a potential problem of the spread of AIDS when the men return.

Paying with IOUs

We traveled to another village called Gubing. The clinic in Gubing is one of the busier rural clinics, seeing up to a dozen or so patients per day. Like the other clinics we visited, the level of equipment was extremely basic, including a coat hanger on the ceiling to hold the intravenous drips. The doctor’s monthly salary was just 400 Renminbi Yuan per month (US$56), comprising 120 RMB (US$16.90) per month from the government, the balance being on the profit made on medicines sold – all visits for basic medical issues are free to the patient. Even so, many people in the village cannot afford treatment (because of the cost of the medicine), so the clinic works on an IOU system. Over the course of a year, the debts can amount to about 5000 RMB (US$700), which is more than the doctor’s annual income!

Working 24 hours a day

The doctor in Gubing seems to be fairly popular. She does not keep regular hours, but works 24 hours seven days a week. If patients come at meal times, they join her family for lunch or dinner. The most common problems she deals with are arthritis, high blood pressure, hepatitis B, tuberculosis and gynecological issues.

Logs propping up the walls

Another village we visited was to Daping, a cluster of several hamlets spread over several square kilometers. In that village, we witnessed taps that still have no water in them, and many of the village residents carrying buckets of water on shoulder poles from a water source an hour and a half’s walk away.

The visit to Daping also included the medical clinic. Although this clinic was a little larger than some – it did have enough room for a bed – the building was in a sorry state following the snowstorm, and the walls had to be propped up by two logs to prevent the building falling over. The clinic was extremely basic, but the young doctor, trained with financial assistance from the Amity Foundation, was remarkable for his optimism.

A cleaner village

Our final stop for the day followed a long drive to a Han nationality village called Nabai. Nabai is the centre of a biogas project sponsored by the Amity Foundation, which is trying to encourage sustainable environmentally-friendly energy use. A total of 52 underground tanks were built in the years following 2004 in which a mixture of pig manure and human excrement was fermented to produce biogas to fuel small gas stoves and household lights.

The tanks need cleaning out every two years or so, but the sludge is a very useful fertilizer for the fields. Several members of our team noted how the biogas project seems to have resulted in a much cleaner and tidier town than many of the others we had visited.

As you have probably gathered, I was deeply impressed with my experience in Guizhou and the work of Amity Foundation there. I am really looking forward to working with Amity to develop the trip for my students in November this year, as I think they can learn a great deal as well as contribute a great deal in this economically needy but culturally rich and sensationally hospitable little-known region.