| 摘要: | 赤腳醫生是「文化大革命」期間的新生事物之一。許多新生事物後來被否定，但赤腳醫生卻擁有多面的評價，這與赤腳醫生政策的實施過程有關。 1965年毛澤東發下重要的〈六?二六指示〉，將醫療衛生工作放到農村去，大批城市的醫療人員下鄉培訓醫務人員。後來，他批示將〈從“赤腳醫生”的成長看醫學教育革命的方向〉這篇調查報告，發表在1968年9月10日《紅旗》雜誌第三期，促使文化大革命期間湧現出更多的赤腳醫生。此後，赤腳醫生正式成為全國的統稱。 其挑選對象來自於政治思想好、具備文化水準、身體健康、對衛生工作熱誠度高的貧下中農子女，以及知識水準較好的知識青年。培訓工作主要由公社衛生院、縣醫院、縣衛生學校和城市下鄉醫療隊負責，還要為赤腳醫生編寫各種教材。赤腳醫生經過3-6個月的培訓，學習基礎知識、農村常見病、預防、結合中西醫及政治思想。配合「合作醫療」制度，從事能力所及的醫療衛生工作，並參加勞動生產領取工分。以後，有計劃地進行多次複訓，逐步增進醫學基礎知識、處理常見病技術以及累積臨床經驗。 赤腳醫生發揮了結合中西醫、預防疾病、婦幼保健、縮小城鄉差距……等功能，暫時舒緩了農村、牧區偏遠地區落後醫療環境的壓力。但是，赤腳醫生短期草率的培訓過程，以及簡陋的醫療設備，如果使用方法不當，病患連最基本的生命保障權都沒有。再加上沒有正式考核制度的約束，甚至衍伸出草菅人命的悲劇。 在「文化大革命」結束後，赤腳醫生沒有完全被否定。因為這個聊勝於無、界限模糊、沒有正式執照的醫療衛生人員，在1960-1970年代中國初級衛生保健工作中，曾經擔負起疾病預防、為基層群眾服務及提供病人心理慰藉的任務。 關鍵詞：赤腳醫生、毛澤東、鄧小平、文化大革命、合作醫療 The Study on the Barefoot Doctors(1966-1976) Abstract The barefoot doctors are one of the newly emerged things during the Cultural Revolution. Many newly emerged things were denied later, but the barefoot doctors have various aspects of evaluation. This result is related to the implementation process of the barefoot doctors policy. Mao Zedong issued the important June 26 Directive to practice medical and health work in rural areas. A large number of urban medical professionals went to the rural areas to train medical personnels. Later on, the investigation report “ Observing the Direction of Medical Education Revolution from the Growth of the Barefoot Doctors” was directed to release on the third issue of the HONGQI magazine by Mao on September 10, 1968, which urged barefoot doctors to emerge in large numbers during the Cultural Revolution. Thereafter, the barefoot doctor became an official name national wide. The barefoot doctors were selected from the offspring of poor and low-middle peasants with moderate political thinking, high cultural standard, healthy body and passion for sanitation work, and urban youths with high knowledge standard. The commune health stations, the county hospitals, the county health schools and the medical teams from the city conducted the trainings. Various kinds of teaching materials were also compiled. The barefoot doctors learned basic knowledge, common diseases in rural areas, prevention, combination of western and traditional Chinese medical treatments, and political thinking through three to six months’ trainings. They cooperated with the “Cooperative Health” system, engaged themselves in medical and health work that they were able to do, and joined labor production to get salary. Afterwards, they received planned training many times to increase their basic medical knowledge, and to enhance their skills of treating common diseases and accumulate their clinical experience. The barefoot doctors displayed the functions of combining western and traditional Chinese medical treatments, preventing diseases, providing maternal and child hygiene, shortening the rural-urban disparity…etc. They temporarily helped release the pressure of laggard medical environment in the rural areas and the pastoral areas in remote districts. However, due to their short and hasty training and rough medical equipments, if they don’t operate properly, the patients will lose their basic right of living. Besides, the lack of formal assessing system may lead to the tragedy of treating human life as if it were not worth a straw. After the end of Cultural Revolution, the barefoot doctors were not denied completely because they fulfilled the tasks of preventing diseases, serving the grass roots and providing the patients mental comfort in the primary medical care work in China in 1960 ~1970 although they were not officially licensed and were not demarcated clearly. Keywords: barefoot doctors, Mao Zedong, Deng Xiaoping, Cultural Revolution, Cooperative Health |
