The first time An Ayue, a renowned Beijing-based surgeon, went to Xinjiang Uygur Autonomous Region, northwest China, was in 1985, on a joint training program. Organized by the China Academy of Chinese Medical Sciences (CACMS) and the regional government, the program brought medical experts to the region to improve the capacity of the local hospitals and doctors.

An was assigned to train three doctors in proctology and give lectures in different hospitals. He remembers the paucity of equipment he saw at that time. "I had only a pair of scissors and a pair of forceps. Even a minor illness was difficult to treat," he said.

When he went to the city of Turpan in east Xinjiang from regional capital Urumqi by train, it took a whole day though the distance was just about 150 km. Today, with better connectivity, the journey takes only one hour.

Although An is a colon and rectal surgeon, during his Xinjiang stay, the locals would come to him with all kinds of health problems, thinking because he came from the capital he was a wizard who could cure everything.

When he was working with a hospital in Turpan, a couple came to him with their baby, who cried incessantly. An found the baby's fontanels—the soft spots between skull bones that close after a certain age—had not done so. So he suggested they give the tot calcium supplements to hasten the closure. "They had never heard of health supplements such as calcium tablets and cod liver oil and didn't know where to get it. So I told them to roast eggshells, grind them into a fine powder and put the powder in the baby's milk," An told Beijing Review.

Months later, he heard the baby had recovered. The news was given to him by the hospital's dean, who had to go to Urumqi to make the call. In the 1980s, telephones were rare in China. Xinjiang households began to have telephones in the 1990s. Today, smartphones are in wide use.

Shortage of professionals

"There was a shortage of medicines and doctors everywhere in Xinjiang and a shortage of medical facilities," An said.

The Xinjiang authorities later launched a partnership program with their doctors going to Beijing for further training. After An returned to Beijing, his hospital partnered with Xinjiang's regional health department from 1988 to 1989 to train doctors from Turpan and another area.

"The doctors [from Xinjiang] really worked hard in Beijing," An said. Besides their medical training, the doctors, who were from ethnic minority groups and could not speak standard Chinese well or at all, also learned the common language. Within three months, they could speak it fluently. An remembers they would carry dictionaries with them and quickly flick through the pages during the training sessions if the teachers used unfamiliar terms.

An kept going back to Xinjiang and witnessed the huge medical development that was taking place, particularly in the hardware. However, there was still a shortage of well-trained medical staff in county-level hospitals in the region. While medical services in Urumqi are on par with those in major cities such as Beijing and Shanghai today, the county-level hospitals, though they have modern buildings and the latest medical devices, had few technicians who knew how to operate those state-of-the-art machines.

Local doctors said the communication gap was one of the main reasons skilled operators are rare in county-level hospitals. A large proportion of the healthcare personnel there are from ethnic minority groups. Due to their lack of proficiency in standard spoken and written Chinese, they find it difficult to upgrade their knowledge and skills.

The Xinjiang authorities, aware of the problem, have been trying to address it for a long time, encouraging the people to learn other languages. In the 1980s, the then Chair of the regional government, Tonur Dawamat, said in an interview with Beijing Review that if Uygurs spoke only the Uygur language, their power of communication and knowledge would be extremely limited. But if they spoke standard Chinese and other languages, their scope would vastly improve. "That is why we encourage ethnic minority people to learn not only standard Chinese but also English, Russian, French, Arabic and whatever [language] they are interested in," he said.

Unbalanced development

An, who is now with the Beijing-based Wang Jing Hospital of CACMS, is a member of the 13th National Committee of the Chinese People's Political Consultative Conference, the top political advisory body. This identity has given him greater insight into medical conditions in the country.

Unbalanced development remains a serious problem in Xinjiang. In 2017, about 41 percent of China's total population were living in rural areas, according to the National Bureau of Statistics. However, in Xinjiang, 60 percent of the local population lived in rural areas as recently as in 2017. Therefore, county-level hospitals have a key role to play in early identification and treatment of diseases and need to have their capacity improved.

For that, An has proposed a medical training program for students who would be going to high school or college, want to be a doctor and are willing to serve in underdeveloped areas, including in Xinjiang.

He has also proposed free education and subsidies including accommodation expenses during the training period for students from these areas who agree to work in their home counties for some time after graduation.

"This way, we could address the talent shortage in county-level hospitals," he said.

Local doctors who want to improve their skills can take part in training programs meant especially for county-level hospitals.

The Central Government has allocated 78.3 million yuan ($12 million) for healthcare training in Xinjiang in 2021. 

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