The Lost Generation: “Barefoot Doctors” in Post-reform China

ABSTRACT: In the 1960s and 1970s, China’s barefoot doctor system was acclaimed worldwide for providing inexpensive and equally accessible medical care for rural populations. In the 1980s, with the advent of market reform, the barefoot doctor system came to an end. Many barefoot doctors either became private doctors or gave up medical practice. More than three decades have passed since this dramatic change, and barefoot doctors seem to have been forgotten. However, the legacy of the barefoot doctor system is still felt in the hardship of aging former barefoot doctors who now find themselves pensionless. Based on ethnographic research in a county in Sichuan Province from 2011 to 2012, this article explores the experience of a group of former barefoot doctors to observe their transition in post-reform China, and their struggle for payment, pension, and status in recent years. It records the change these doctors experienced from barefoot doctors working under very difficult conditions in the collective era, to individual doctors in the market era who struggle with qualification requirements, market competition, and selfsupport, to the newly ambiguous status of village doctors, who constitute an important part of the primary health care network but are still marginalised in the health care system.

KEYWORDS: barefoot doctors, payment, pension, health care, rural China.