From union clinics to barefoot doctors: healers, medical pluralism, and state medicine in Chinese villages, 1950–1970

This paper explores the dynamic differentiation and reorganization of healers within a plural medical system from the birth of the union clinics in the early 1950s to the popularization of barefoot doctors in Chinese villages in 1970. After 1949, the state started to mobilize individual medical practitioners to form union clinics that implemented a system of fees for services, individual accounting, self-responsibility for profits and losses, democratic management, and distribution according to each contribution. The union clinics became the township-level medical agencies following the establishment of county hospitals. These developments indicated the beginning of the dynamic differentiation of a plural medical system and formed the basic structure of the state medical system in 1950s–60s. Through the complete reshuffling of healers within the plural medical system, by 1970 barefoot doctors were embedded in the reorganized rural medical world of Chinese villages.