Grassroots medics battle harsh working conditions

Publish Time: 2021-08-09 Author: LI LEI From: CHINA DAILY

Chodron, a health worker at a hospital in Madoi, Qinghai, visits a senior as part of a free health check program. CHINA DAILY

Chodron, a health worker at a hospital in Madoi county, Qinghai province, has been advised to quit her high-altitude job to ease a persistent pain in her chest. However, her patients need her to stay.

Like many people on the arid Qinghai-Tibet Plateau, the 30-year-old has congenital heart disease and pulmonary hypertension, a type of high blood pressure that causes chest pains and shortness of breath.

Her symptoms have worsened with age. Doctors have advised her to move to the provincial capital, Xining, where she could be treated by specialists. As the city lies at a lower altitude, her conditions would also be eased.

Chodron, who like many ethnic Tibetans only uses one name, was born in Madoi, a sprawling, sparsely populated herding district at an altitude of more than 4,500 meters in Northwest China. She left her isolated hometown for college more than a decade ago.

After leaving a vocational medical college in Xining, she was one of a small number of graduates who opted to return to the plateau and become health workers. Her decision was partly prompted by the lack of competition in Madoi, which is known for its harsh working conditions.

There's no railway station, and the nearest airport is a five-hour drive away. Although the county is served by a newly built highway, the frozen ground means the speed limit is less than 80 kilometers an hour, which significantly increases journey times.

The isolation makes Madoi an expensive place to live because all supplies have to be shipped in.

After her return, Chodron married and had a child. "I cannot leave as I am not given an annual vacation," she said. "I can only leave when I am off-duty."

Due to a shortage of staff members, Chodron assumes multiple roles, which is common at grassroots hospitals. She oversees the pharmacy, manages the warehouse and operates the type-B ultrasonic equipment.

The harsh environment has led to a brain drain of doctors in a county four times the size of Shanghai but with less than 15,000 residents.

The altitude has taken a toll on the health of those medics who have stayed.

Liu Siren, vice-president of the Beijing Sixth Hospital and a cardiovascular expert, was one of about 300 doctors who recently traveled to Qinghai to help bridge a shortfall in quality healthcare.

He said the high altitude, poor oxygen concentration and year-round low temperatures pose challenges to people's health and cause a range of ailments, such as osteoarthropathy-a disease of the joints or bones-rheumatism, gout and deformed joints.

He explained that the low level of oxygen leads to a higher volume of red blood cells and thus thicker blood. Lack of oxygen during pregnancy can also cause congenital heart disease among newborns.

Liu would like to see the central government step up efforts to encourage young, capable medics and college graduates to come to Madoi and offer their services on a voluntary basis. Nyima Kyi is Chodron's colleague. The 27-year-old from Xining attended a medical university in Chongqing, and now she works in the hospital's scanning department.

She intends to use the experience she has gained at the grassroots level and Madoi's harsh working conditions to help her move to Xining, closer to her retired parents.

"I'm still working on it," she said.

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