The GCAT Project to sponsor Medical Clinics in Guizhou Province of China, with Amity Foundation - Part 1

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 padis, women working in the fields with babies strapped to their backs, all surrounded by interminable eerie swirling mists.

It is also an area that has experienced more than its fair share of natural disasters.  In the past year, the province has experienced floods, then drought, then a severe snowstorm, and currently forest fires.

In March 2008, I spent Project Week in Majiang, researching opportunities for our students to travel there in a group during China Week in November 2008.  GCAT (Global Concerns Action Team) has 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 kilometres without a mountain, and no three coins in any pocket”.

The Amity Foundation has therefore targeted this area for special help in four areas: (a) building 100 medical clinics to replace the present sub-standard facilities, (b) encouraging sustainability by supplying biogas facilities, and (c) assisting with emergency aid following the severe snowstorms in January this year, and (d) helping with strategic planning for the county’s future.  Amity works in close partnership with government officials and is always keen to help in ways that have expressed as needs by local people rather than imposing development solutions.

The focus of my visit in March 2008 was to study the health care needs of Majiang to prepare for the visit by a group of GCAT students in November. This page therefore represents a preliminary report on the GCAT medical clinics project, and an update will be posted after the visit by students in November 2008.  It is hoped that the first of the two GCAT-sponsored clinics will be finished at that time, probably to be located in a village called Gonghe.

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 an officer from Amity’s Hong Office (Tong Su) and LPCUWC Board Chairman, Mr Anthony Tong, in a meeting with local health officials of the Majiang County Health Bureau on Saturday evening, 8th March.  This meeting, which lasted almost two and a half hours, 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.  Dachong has been earmarked as the site of the first Amity-supported medical clinics.  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 gynaecological, 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 (including one by yours truly as well as the Vice-Mayor and the Head of Amity’s delegation), 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.

Our next stop was another village, 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 kilometres, 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 of Guangzhou, Shenzhen and Xiamen.  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.  All the village’s farming is subsistence (rice, corn and vegetables), and village’s only way of making money is to send its young people to the coastal cities for work.

We travelled to another village called Gubing.  The start of the visit was not auspicious.  To enter Gubing, one had to cross a very rough bridge comprising two metal pipes, which were very slippery in the rainy conditions on the day.  I almost managed to reach the far side of the bridge when the doctor in Gubing decided to offer me a polite helping hand.  Unfortunately, this meant we both lost balance and slipped over the edge, the doctor falling in the river and I falling half in the river and half on the bank.  This caused quite a commotion among the local people who were very gracious, even to the point of insisting that I accept a dry pair of socks.

My visit to Gubing’s clinic was therefore spent huddled over a bowl of hot coals, trying to dry my shoes and muddy clothes while at the same time listening to the doctor’s stories about health care in the village.  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 IOUs can amount to about 5000 RMB (US$700), which is more than the doctor’s annual income!

The doctor in Gubing seems to be fairly popular.  She does not keep regular hours, but works on a 24/7 basis.  Furthermore, 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 gynaecological issues.

We began our visits the next morning in a town called Jingyang.  The purpose of this visit was to learn more about the impact of the snowstorm and its aftermath.  For background on the snowstorm, you can click HERE to watch a video about the snowstorm in Majiang.

The visit began at the Party office.  We were told that after the snowstorm, there was a need to protect people from hunger, the cold, and disease.  The snowstorm resulted in severe losses in livestock, crops, forest trees, infrastructure such as electricity and water, and working age people who had left to find work in coastal cities.  The storm began on 27th January, and by 30th January the entire county was covered in a white sheet of ice.  By 12th February, there were no candles, batteries or salt to be found in any of the county’s markets.

Fortunately, there was a big influx of help (which is still arriving), including significantly 13 survivors of the Tangshan earthquake in 1976.  A generator supplied by the government allowed essential services to operate, including the bank, police, hospital and party headquarters.  Generators were also used to help people with the task of husking grains, without which many people would have starved.

There were many stories of people rising to the occasion and helping one another.  One remarkable story involved a huge tree that fell on a house in Maocao, smashing a bedroom and killing a woman in her 70s, and injuring her 14 year old granddaughter.  The girl was already an orphan, as her mother had died when she was 2 and her father had been killed in a car accident when he was travelling to a coastal city in search of work (before the snowstorm).  The girl had severe back injuries and was carried down the icy slopes from the village by a party official who was in Maocao that night helping with relief efforts.

One of the main lingering impacts of the snowstorm is that many homes still have no running water.  This is because the snowstorm snapped many of the cheap plastic pipes that were too close to the surface, and now thousands of people are still having to carry water to their homes, often from water sources that require several hours of walking.  While we were there, we met a doctor from France who is working with Médecins Sans Frontières (MSF) to restore water supplies in one village; he said that they really need to perform the same work in 6 other villages also, but the funds required (200,000 RMB, or US$28,000 per village) are simply not available.

We followed up this information by visits to several villages affected by the snowstorm.  Our first visit was to Daping village, a cluster of several hamlets spread over several square kilometres.  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 (making a three hour return trip to obtain just two buckets of water).  I was intrigued to see that each bucket has a cabbage leaf floating in it; I was told this helped prevent the water splashing too much, and without it about half of each of bucket of water might be lost through spillage.

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.

Our next stop was Jingyang village, situated quite close to Jingyang town.  Several of the buildings here was also badly affected by the snowstorm, including one wooden building that had been standing for 200 years.  As a result of the snowstorm, however, it had now developed a lean and was being propped up by a few logs.  It was remarkable experience to be invited inside this home, and even invited upstairs (or up-ladder to be more precise) and see at first hand the extremely basic living conditions experienced by farming families in Guizhou.

From Jingyang village we took a half-hour uphill drive to a village called Maocao.  At 1100 metres, this village was particularly affected by the snowstorm, and upon arrival we were struck by the devastation to the trees surrounding the village, with huge branches ripped off downwards and some huge trees toppled altogether.  This was the village where the grandmother had been killed as the tree fell on the house, and it was a sobering experience to walk into what was left of the home and see the destruction of what used to be a grandmother’s bedroom.

Over lunch back in Jingyan township we had the privilege of meeting the girl who had lost her grandmother.  The girl, Yang Xu, is a bright-eyed 14 year old Miao who is in Secondary 2 and is now living in the boarding quarters of the Jingyang Middle School.  It was very sad to hear her ask “Why do all bad things happen to me?”.  Her future education looks bleak without any means of financial support, and so I am hoping that GCAT and Amity Foundation can work together to try and provide some finances to assist the girl’s secondary education.

Our next stop was a more remote Miao village called Changzhong.  Set in beautiful terraced hills, the local people in Changzhong had heard that the Amity group was coming to visit, and so as a special welcome, the men and women arrived at the clinic in Miao national dress and performed several dances in he street.  This was an unforgettable experience as the local people also presented small gifts of hand-woven belts and hand-made inner soles for our shoes.  The clinic itself was extremely basic, like the others we had seen, highlighting the need for Amity’s “100 clinics for Guizhou” campaign.

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, which is used 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 fertiliser for the fields.  All in all, this was a very impressive project, and several members of the 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.

After an early 7 am departure, our final morning in Guizhou was spent at a hilltop Miao village called Bala, situated near Kaili to the east of Majiang.  The residents of Bala have developed their village into a fascinating eco-tourism venture, using their culture to develop an income source from visitors that showcases their culture on the one hand, but dos not divert them away from their farming activities on the other.  Our visit included some spectacular Miao dances as well as a wander around this fascinating village.  If Guizhou has difficulty in raising outside income, then locally managed sustainable tourism based on the region’s cultural richness is an option worth exploring for the future.

As you have probably gathered, I was deeply impressed with my Project Week experience in Guizhou and the work of Amity Foundation there.  I am really looking forward to working with Amity to develop the China Week 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.

If you haven’t already done so, you can access galleries of images of all the places mentioned on this page by clicking HERE.


Key Links:


Read about my third trip to Guizhou in October 2009 by clicking HERE


Read about my second trip to Guizhou in November 2008 by clicking HERE