Peking has banned the publication of medical journals since 1968, and if the authorities compile comprehensive statistics, they arc unknown in the West. But when a handful of American physicians and scientists followed the table tennis players last year, expert outsiders got a good look at how Maoist medicine is being practiced today. TIME interviewed four of the doctors: Paul Dudley White, the Boston cardiologist; Samuel Rosen, a Manhattan ear specialist; E. Grey Dimond, provost for the health sciences at the University of Missouri's new Kansas City School of Medicine; and Victor Sidel, head of the department of social medicine at Montefiore Hospital in New York. Their stays ranged from two weeks to a month, the most recent in September. On balance, all four were favorably impressed with what they saw in the cities and the countryside. Their appraisal:
The Communist regime made an early policy decision to marshal all medical manpower for two basic missions: to make some sort of care available to the entire population and to drill the people into becoming active participants in public health campaigns. This approach consciously downgraded advanced research in pure science and exotic new techniques such as heart transplants. Clinical treatment and preventive measures monopolize Chinese medicine.
Barefoot Doctors. Training has been reorganized to meet these goals. The classical six-year curriculum has been cut in half. Each of the three years is punctuated by periods of military training, manual labor and political indoctrination. Before graduation, the students also get a good deal of on-the-job experience, and training includes Western medicine and the traditional Chinese arts of acupuncture and herb treatment. As a result, China is turning out far more doctors than in the past. Overall figures are not available, but there are some indicators. In the four decades prior to the Communist takeover, Sidel reports, First Peking Medical College had just over a thousand graduates. Since 1949, there have been more than 10,000. Despite the speedup, Sidel says, "the Chinese are the first to admit that they are still limited in manpower and resources."
They partly offset the shortage with the use of paramedics, who are called "barefoot doctors" in rural areas and "Red Guard doctors" in the cities. They are peasants, housewives and factory workers who divide their time between their regular jobs and medical duties. Based in commune dispensaries or urban "lane clinics," the paramedics get little formal training; they learn by watching and listening to physicians.
The barefoot doctor's basic assignment is to know his co-workers and neighbors intimately, keep immunization records on each individual assigned to him, keep track of the contraception methods used by each woman in his jurisdiction, and arrange for consultation with a real doctor when necessary. The government has been heavily promoting birth control and immunization against contagious diseases; the barefoot doctor is the grass-roots salesman of these programs.