On loan, city doctors raise level of care

In a remote part of Xinjiang, a county hospital gets a professional makeover

In May last year, doctors told Awanisa Mahsut that she had a brain tumor.

After suffering a stroke, Awanisa, who lives in the southwestern part of the Xinjiang Uygur autonomous region, planned to go to Urumqi, the regional capital, for treatment, but she changed her mind when she heard there was an expert from Urumqi working at a local hospital.

Akbar Yalkun, 45, a neurosurgeon with more than 20 years' experience in Urumqi, gave Awanisa hope. One of 13 medics assigned to Pishan county, he provides medical support as part of an assistance program initiated by his home hospital in May.

The program aims to improve management and medical treatment at the smaller hospital by drawing on the experience of a team of doctors and administrators on loan from Urumqi.

"The treatment level of neurosurgery was quite low before I came. Few doctors can perform this kind of operation here," Akbar said. "If there are related conditions, patients generally need to be transferred to hospitals in big cities."

Awanisa's home - Pishan county - is one of the most impoverished and remote areas in Xinjiang. It lacks well-trained doctors, and the hospital doesn't have enough money to buy modern equipment. As a result, patients often find it difficult to get the care they need.

The poor medical service often means that seriously ill patients would rather spend more money and travel farther to Hotan or Urumqi to see a doctor, rather than receive treatment locally.

"One of my relatives told me that Dr Akbar, one of the best neurosurgeons in the region, is at the hospital in our county," Awanisa said. "I was relieved, not only because he was there, but also my insurance covered most of the treatment at the local hospital."

The operation was successful. At a follow-up consultation on March 1, Akbar told Awanisa she had fully recovered. The operation would have cost her at least 40,000 yuan ($6,000) in Urumqi, but she spent less than 10,000 yuan in her hometown.

In March last year, after investigating the Pishan county hospital, Manglek Syit, vice-chairman of the autonomous region, ordered the hospital in Urumqi to improve the healthcare situation in Pishan county.

"Before we came here, it could not be called a modern hospital. You could hardly tell the difference between the outpatient and inpatient departments," said Yerzat Yerzhan, an administrative staff member of the team. "To provide an effective healthcare system, the hospital needed to change from its registration office up."

The regional health commission arranged for the hospital in Urumqi to launch a program giving all-around help to Pishan county. Bahtiyar Kerem, a specialist in critical care, was one of the first doctors to arrive.

"Our team members normally live and work in Urumqi, but after learning about the medical conditions here, we came without hesitation," he said.

Hu Yanmeng, the newly appointed director of the county hospital and head of the assistance team, said, "It is not enough to send medical experts. We need to comprehensively improve the hospital's medical services, so we also brought management personnel."

Among the 13 people on the team are a director, an accountant and specialists in the medical, nursing, outpatient and logistics departments. Seven administrative staff members and six doctors were dispatched to different departments.

"Seven administrators will be replaced by new members after a year. It's six months for doctors," Hu said.

At the same time, the two hospitals signed an agreement covering specialists in other fields of medicine, including gynecology, pathology and neurosurgery, which makes it possible for other specialists from Urumqi to visit local patients if needed.

To help attract medical talent to an underfunded hospital in a rural area, the team made a priority of retaining the original staff and improving their medical capabilities.

A review of the program said that after the team took over, the hospital reformed its performance appraisal system and gradually improved the salaries of doctors, nurses and administrative staff. The pay increases were significant.

"In addition to treating patients, doctors from Urumqi need to train local doctors to ensure the people in Pishan county will continue to get better medical care after they leave," Hu said.

Doctors from the team taught local doctors, and the county hospital invited other experts from Urumqi to give medical lectures every month.

"I have done more than 50 surgeries since I came," Akbar said. "In addition, I have trained two local doctors who I believe will be able to perform neurosurgical operations independently soon. More patients like Awanisa will benefit from it."

Medical facilities in other impoverished counties in China are also improving.

According to the National Health Commission, more than 60,000 medical workers from top hospitals were sent to hospitals in impoverished regions last year to improve their management and medical treatment.

Commission figures show that 963 top hospitals have teamed up with 1,180 hospitals in 834 impoverished counties since 2016, enabling them to provide better medical service to residents.

"Only a few patients came to the county hospital before, but after nearly a year of effort, the residents gradually regained their trust," Hu said. "I hope more patients in poverty-stricken counties can get access to better medical services at their local hospitals."