Chinese health care reformers aim to help rural areas but face hurdles

About 5,000 general practitioners will be trained, and hospitals built or renovated in all 129 counties. Chen warns that funds are very limited. "We want do things, but our money is very little — that's Yunnan's characteristic," he told reporters in early April.

Farmer Li has not yet heard these latest promises, nor has her local doctor, Ma Jingliang. With the mud of spring planting still on his trousers, Ma unlocks his simple clinic in Mengpin village on a recent afternoon.

"I wish I could be a full-time doctor," says Ma, 45, from the Yi ethnic group, who received basic medical training at regional hospitals but is not a qualified physician. "I'm often tired after a day's work, but I have to serve the people," he says. "I don't do it for the money!" he adds with a laughs

To open the clinic six hours a day, Ma earns $7.30 a month from the local health bureau and makes an additional $15 from drug sales, mostly to treat colds and pneumonia.

"He's a good doctor. He has culture and knowledge, and he'll give you an injection or drugs and let you pay later," says Shi Yuqing, 25, a Yi farmer tending rice fields. A basic, state-run rural insurance plan reached the region last year, but Ma says many patients owe him for a year or two, even on small sums such as $1.50.

Three miles away, in the township of Panjihua, physician Xiao Yunhong worries the new funding will get stalled at the county level and fail to trickle down to help his clinic.

"We are the frontline of health care and can stop people traveling to the cities for treatment, which is one of the government's main aims," he says.

To accomplish that, Xiao says he needs more and cheaper drugs — and better personnel. The county in 2006 assigned 18 staff to his clinic, "But there were only funds for six in an area of 18,000 people, and we lack expert knowledge," he admits.

Shopkeeper Li Xia wishes that expert help had been available in 1996, when her son was born in Xiao's clinic. Li's father, an exorcist who practiced the Hani's polytheistic religion across several villages, warned that he was born at the wrong time, Li says.

"I didn't believe him then, but now it seems he was right," she says. Tian Xiang was diagnosed with hydrocephalus, or "water on the brain," that caused physical and mental disabilities. His grandfather tried chanting rituals to drive out the bad spirits.

His mother has tried, without success, to seek more scientific treatment, and to get a disability allowance. "You have to pay through the back door to get any service here, but we lack the money. And the doctors in this province are not expert enough anyway," Li says.

Li Rui, however, is one lucky little boy.

Chinese Premier Wen Jiabao chanced upon the 2-year-old when visiting the Tianjin train station in February. His parents were returning home after exhausting their savings on Li's treatment for leukemia. Wen was able to get the youngster free care in Beijing that saved his life.

Most are not as fortunate. Since 2005, the Chinese Red Cross Foundation has helped just 10% of the 4,000 children with leukemia who applied for funding — out of 2 million children in China with the disease, according to the state-run Xinhua News Agency.

Some patients have taken matters into their own hands. Wei Qiang set up a do-it-yourself kidney dialysis clinic in the capital's outskirts.

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