To the elderly in Tuanjie, a remote village in the northern edge of Hunan Province, it’s considered a big event in the community whenever the County Hospital of Traditional Chinese Medicine holds disease education and free consultations. On this day, the village cadres and the doctors in the village clinic go door-to-door to send out notices, inviting the elderly to gather at the village clinic.
Luo Zan, Chief of Publicity and Expansion Department of Anxiang County Hospital of Traditional Chinese Medicine, remembers a 92-year-old patient with severe vision loss who was not aware that he had cataracts for nearly two years. After the doctor’s explanation, his family took him to the County Hospital of Traditional Chinese Medicine to undergo cataract surgery. In that free clinic consultation, there were eight other cataract patients from Tuanjie Village, just like him. They had also learned about their own cataract conditions and received surgical treatment at the hospital and regained their clear vision.
“Village doctors are usually the first point of contact for most patients aged 70 and above. By improving the knowledge and awareness of village doctors, patients will have a higher chance of early diagnosis and treatment,” says Zan.
With an aging population, it’s important to strengthen the diagnosis and treatment capabilities of grassroots medical institutions and medical workers and promote the prevention and treatment of common diseases. This is the goal of the “Community Health Worker (CHW) Capacity Building for Elderly Common Disease in China” project initiated in 2021 by the China Primary Health Care Foundation and supported by the Johnson & Johnson Foundation.
Promoting preventive care by making healthcare more accessible
Most of Zan’s patients are aged 70 to 90. They generally suffer from coronary heart disease, stroke, cataracts, COPD and other diseases. However, due to lack of disease knowledge, the elderly usually come to the hospital for treatment only when their conditions have reached critical stages.
“If these elderly people can get a timely diagnosis in the rural hospital, they can come to the county hospital for treatment earlier, reducing their financial and physical burden,” Zan adds.
Zhang Yansong is a general practitioner at the Beijing Baizhifang Community Health Service Center. More than 90% of the residents in her community hospital are elderly. On outpatient days, she sees more than 70 patients on average, not only to deal with the diagnosis and treatment of various common diseases, but also working on disease prevention and seeing residents for traditional healthcare. Yansong participated in a public welfare project for capacity building in the prevention and treatment of common elderly diseases in the community. At the event, three clinical experts conducted professional training on common diseases of the elderly such as atrial fibrillation and cataracts.
For Yansong, inviting the clinical experts was very beneficial in improving the general knowledge of doctors. As community doctors are converted from internists, they were only trained to handle the responsibilities of general practitioners. These community doctors often lack knowledge in disease fields such as ophthalmology and cardiology. However, through professional training, Yansong has gained a deeper understanding of the diagnosis of these related diseases, which will help her achieve timely diagnosis and early treatment when facing elderly patients in the community.
“In the past, I thought that problems such as cataracts and atrial fibrillation should be solved by specialists, and general practitioners only need to manage conditions such as hypertension and diabetes. But in fact, the early prevention of these common diseases of the elderly is also one of the responsibilities of community doctors,” Yansong shares.
Yansong recalls receiving an elderly patient who came to the center for treatment due to palpitations and discomfort. She diagnosed him with paroxysmal atrial fibrillation and immediately contacted and referred the patient to a tertiary hospital, where radiofrequency ablation was performed. Due to accurate diagnosis and timely treatment, the patient recovered and was discharged from the hospital within a week.
Helping patients age in a healthy way
According to the latest data from the National Bureau of Statistics, in 2022, there were nearly 980,000 grassroots medical and health institutions across the country of China, including 34,000 township health centers, 36,000 community health service stations and 321,000 outpatient clinics. There are a total of 588,000 village clinics, an increase of 2,210 compared to the previous year. These clinics were widely spread over streets, communities, towns and villages. According to a recent survey, 90% of families can reach the nearest medical point within 15 minutes.
The development of public welfare projects for the prevention and treatment of common elderly diseases in the community has injected new power into the promotion of healthy aging. It is reported that since the launch of the public welfare project, more than 80,000 community health workers have been trained in the prevention and treatment of atrial fibrillation and cataract diseases through a combination of online and offline forms, and more than 1.86 million people have benefited.
With the continuous promotion of the project, the concept of early diagnosis and early treatment of common elderly diseases has been popularized in more grassroots, and more grassroots medical workers have gathered to protect the health of the people around them.
“Today, Anxiang County Hospital of Traditional Chinese Medicine adheres to the concept of ‘not treating the disease only when it happens, but treating the disease before it.’ The concept has gradually become popular in rural areas,” Zan says.
For Yansong, being a community doctor is her constant choice. “During close contact with ordinary people, they are willing to share about their family affairs or their own illness, and I am happy to be their companion. I will help these patients with my heart, so that they can be healthy, not only to lengthen their lifespans but also increase the quality of their lives. This not only makes patients happier, but it allows me to also realize my true-life value.”
This article was translated and adapted, with permission, from the piece “China Doctors’ Day: The first line of defense in the battle to protect aging health,” originally published by China News Weekly on the Weixin social media platform on August 19. The original article in Chinese is here.
The Johnson & Johnson Foundation is a registered charitable organization that reflects the commitment of Johnson & Johnson to create a world without health inequities by closing the gaps between communities and the care they need. Funded solely by Johnson & Johnson, the Foundation operates worldwide as Johnson & Johnson Foundation US (founded 1953) and Johnson & Johnson Foundation Scotland (founded 2007). These independent entities support both global and in-country partnerships and community-led initiatives to champion health workers, especially nurses and community health workers, and advance access to quality healthcare.