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Village Doctors Fill Breach in HIV Prevention, Control

Villages are where 70 percent of China's HIV and AIDS cases are found, so it's little wonder that a pilot project to fight the epidemic has its roots in rural areas of southwest China's Yunnan Province.

Started by the local governments in Dehong Dai and Jingpo Autonomous Prefecture in the province in May, the project has made progress despite challenges.

In five villages in Longchuan and Yingjiang counties, a comprehensive prevention-and-treatment program is in place which includes public education, HIV testing and consultation, high-risk activity intervention, treatment and social projects.

Village doctors typically farmers who are given basic training in healthcare and are paid a nominal sum have become the main force behind the project, said Teng Yun, director of the HIV/AIDS Control Center in the prefecture.

In the two counties, which border Myanmar, about 80 per cent of the HIV/AIDS victims were infected after using contaminated hypodermic needles while taking drugs.

Since 1989, when the first case was found among drug abusers in Longchuan, the virus has spread from seven villages to 214, infecting 1,865 people. Therefore, the government has taken a new approach by sending health workers to the villages, instead of being based in counties or towns.

In the spring of 2003, the central government launched a nationwide campaign for comprehensive control in dozens of counties where the epidemic was considered serious.

Free services, such as testing for HIV, treatment and education, are provided.

"However, our workers and doctors, who are based in the town centres, are too far away from the rural sufferers," said Mei Hongying, director of the Longchuan HIV/AIDS Control Center.

"The (Yunnan) project lets village doctors play a vital role in helping the villagers fight against the deadly virus," Mei said.

In the past two months, local doctors gave free HIV tests to people aged 15-60 in the two pilot villages in Longchuan.

They are trained in intervention work, such as handing out condoms and instructing patients how to take medication correctly, Mei said.

"We can do it because we are their neighbors, familiar with all their problems," said Yin Zuluan, a 34-year-old village doctor of Guangsong village. "The villagers trust me."

However, the pilot project has also encountered problems.

For instance, most village doctors each get a salary of less than 100 yuan (US$12) a month, Mei said, and many of them do not have a chance to receive advanced training.

Generally there are only one or two doctors per village.

"It is very hard for me to provide follow-up service and do intervention work among all the families, many of whom live far in the mountains," said Luo Lu, a village doctor in Longchuan.

"Many poor villagers," Yin added, "cannot afford the bus fare for the trip."

(China Daily October 27, 2005)

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