China Sends Barefoot Doctors into the Countryside

In 1968, China formally integrated a decentralized medical experiment into national policy, establishing what became known as the barefoot doctor system. Throughout the early twentieth century, rural populations had struggled with severe shortages of medical care, a reality little altered by the initial expansion of state-run clinics following the founding of the People's Republic of China. Most trained physicians remained concentrated in major cities, leaving the large majority of the population, who lived in agricultural communities, largely without access to modern treatment. Following Mao Zedong's 1965 directive criticizing this urban bias, the state began massively scaling up programs to train village residents as frontline medical workers.

The name originated among southern agricultural workers who tended rice paddies barefoot while simultaneously providing medical care. Recruits included young farmers, folk practitioners, and recent secondary school graduates chosen directly by their local agricultural communes. Because traditional customs often made rural women reluctant to seek examinations from male doctors, policy mandated that each village include a female practitioner, substantially improving access to maternal care and family planning. Trainees gathered at local hospitals and commune clinics for courses lasting from about three months to a year, where they studied basic anatomy, first aid, vaccinations, and the management of regional contagious diseases.