China: Targeting assistance to rural populations

Many medical professionals have left rural areas; the poorest people cannot pay for the health care they need. MSF continues to provide basic care and tuberculosis (TB) treatment to some of the most vulnerable people. In Guangxi province, MSF focuses on quality and access to care for Miao, Dong and Yao minority people in Danian and Gongdong. A health economist has worked to increase MSF understanding of how the local health system functions, its cost and its acceptance by the local people. This has led to more targeted training and better follow-up of a network of village doctors. MSF has also begun training midwives in Gongdong. Treating TB is an important part of MSF work in Guangxi. From 1999 to mid-2002, around 200 patients were treated. In Shaanxi province, MSF provides medical care and social support for 45-50 children at a public welcome center in the city of Baoji. Transferred from detention after being picked up on the streets, these children - mostly boys aged from 4 to 17 - also receive food and educational assistance. An integrated water supply and hygiene promotion program initiated in early 2001 continues to improve public health in poor villages in Kashgar prefecture in Xinjiang Uighur Autonomous Region. MSF is now looking at ways to become involved in AIDS prevention, care and treatment both here and in Henan province. MSF is phasing out some projects after reevaluating its work in several regions. Since 1993, MSF has attempted several basic care projects in Tibet Autonomous Region and has also helped Tibetans affected by Kashin-Beck or Big Bone disease, a painful progressive joint disease. However, it has found it impossible to work either within the collapsing public medical system, or independently, and stay close to people in need. MSF has thus decided to end its existing projects in Tibet by the end of 2002. A TB program in Nujiang prefecture of Yunnan province closed in June 2002. MSF was only able to achieve a 50-60% cure rate (the target was 85%) after treating 355 patients since 1999. Work to increase AIDS awareness and promote prevention among high-risk groups in Liangshan prefecture of Sichuan province and in Yunnan province also ended in summer 2002. MSF was forced to cease work in North Korea in 1998 because of lack of access to people in need and lack of independence to carry out its programs. MSF continues to decry the abysmal conditions and state of famine within North Korea and the disappearance and manipulation of food aid given by donor countries. MSF is also supporting North Korean refugees in China through a local network of assistance. In a statement before the US Congress in May 2002, MSF urged the Chinese government and the United Nations High Commissioner for Refugees to ensure protection and assistance for North Korean refugees in China. MSF has been working in China since 1988. Staff: 37 Volunteers: 120