Xu Sanchun, Hu Danian
Liaoning Shihua University, No. 1, West Dandong Road, Wanghua District, Fushun 113001, Liaoning Province, China.
The City College of The City University of New York, 160 Convent Ave., New York, NY 10031, USA.
Endeavour. 2017 Sep;41(3):136-145. doi: 10.1016/j.endeavour.2017.06.004. Epub 2017 Jul 8.
Barefoot doctors were rural medical personnel trained en masse, whose emergence and development had a particular political, economic, social, and cultural background. Like the rural cooperative medical care system, the barefoot doctor was a well-known phenomenon in the Cultural Revolution. Complicated regional differences and a lack of reliable sources create much difficulty for the study of barefoot doctors and result in differing opinions of their status and importance. Some scholars greatly admire barefoot doctors, whereas others harshly criticize them. This paper explores the rise and development of barefoot doctors based on a case study of Shandong province. I argue that the promotion of barefoot doctors was a consequence of the medical education revolution and an implementation of the Cultural Revolution in rural public health care, which significantly influenced medical services and development in rural areas. First, barefoot doctors played a significant role in accomplishing the first rural health care revolution by providing primary health care to peasants and eliminating endemic and infectious illnesses. Second, barefoot doctors were the agents who integrated Western and Chinese medicines under the direction of the state. As an essential part of the rural cooperative medical system, barefoot doctor personnel grew in number with the system's implementation. After the Cultural Revolution ended, the cooperative medical system began to disintegrate-a process that accelerated in the 1980s until the system's collapse in the wake of the de-collectivization. As a result, the number of barefoot doctors also ran down steadily. In 1985, "barefoot doctor" as a job title was officially removed from Chinese medical profession, demonstrating that its practice was non-universal and unsustainable.
赤脚医生是大规模培训的农村医疗人员，其出现和发展有着特定的政治、经济、社会和文化背景。与农村合作医疗制度一样，赤脚医生是“文化大革命”中一个广为人知的现象。复杂的地区差异和缺乏可靠的资料来源给赤脚医生的研究带来了很大困难，导致人们对他们的地位和重要性看法不一。一些学者对赤脚医生极为赞赏，而另一些学者则严厉批评他们。本文以山东省为例，探讨赤脚医生的兴起与发展。我认为，推广赤脚医生是医学教育革命的结果，也是“文化大革命”在农村公共卫生领域的一项举措，它对农村地区的医疗服务和发展产生了重大影响。首先，赤脚医生在实现第一次农村医疗保健革命中发挥了重要作用，他们为农民提供初级医疗保健，消除地方病和传染病。其次，赤脚医生是在国家指导下将中西医结合的践行者。作为农村合作医疗制度的重要组成部分，赤脚医生队伍随着该制度的实施而壮大。“文化大革命”结束后，合作医疗制度开始瓦解——这一过程在20世纪80年代加速，直到随着去集体化而崩溃。结果，赤脚医生的数量也稳步减少。1985年，“赤脚医生”这一称谓正式从中国医疗职业中取消，表明其做法不具有普遍性且不可持续。
