Impact of - IDL-BNC @ IDRC - International Development Research ...

In the past decade, tremendous efforts have been made to cope with this new
challenge. As acute pesticide poisoning is widespread among the rural population,
and because both curative and preventive medicines are concerned, its
control must depend on the general health-care system. Fortunately, the rural
primary health-care system remained active and was strengthened during this
time in areas around Shanghai. In particular, the peripheral health-service
units played an important role in the prevention of pesticide intoxication.
The peripheral health-care units, which operate at the subnational level,
consist of Health and Anti-Epidemic stations in township hospitals and infirmaries
in the villages. The latter are run by two or three rural health workers
(the "barefoot" doctors). They provide medical and health care to about 2 000
residents living within a 30-mm walking distance (or a 10-mm bicycle ride).
Most of the "barefoot" doctors have received 3 years of training in general
medicine and public health, including an internship in a county hospital. They
have passed county, city, and provincial examinations. Most have more that
20 years' experience practicing in rural areas.
The Health and Anti-Epidemic Station in the township hospital usually consists
of three to five staff with intermediate-level training in medicine and
public health. They serve the countryside mainly through instructing and
guiding rural-health workers. In addition, they are involved with infectiousdisease
control, vaccination programs, sanitary inspection of food and the
environment, health education, and industrial-health services, especially prevention
of pesticide intoxication.
There is also a Health and Anti-Epidemic Station in every county hospital,
which is responsible for public health and disease control. Industrial health is
usually the responsibility of 5-10 staff including several hygienists. This group
is in charge of implementing intoxication-prevention programs and promoting
the improvement of working conditions. The three levels cooperate with
relevant sectors and the community to form a medical-health network. They
communicate and integrate their activities through monthly meetings, common
programs, projects, and reports.
Usually the program for prevention of pesticide poisoning is led by the
municipal or provincial public-health authorities and implemented with the
participation of all three levels of the peripheral health-service units. Annual
meetings are held to summarize and evaluate the progress of the programs.
Strategies and plans for the next year, including points needing to be reinforced
and certain special research projects, are discussed. County-level meetings
are held once a year in May or June, before the time for pesticide
application. The chief physician of the county hospital frequently delivers
short lectures on the diagnosis and treatment of pesticide poisoning, particularly
with regard to new pesticides to be used in the area. Educational posters
and booklets are distributed to rural paradoctors free of charge.
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