NGOs flex their muscles to bridge the urban-rural rehabilitation divide

Charities and hospitals are working hard to reverse an imbalance in the supply of services between cities and less-developed areas, as Li Lei, Li Xueqing and Huo Yan report from Fuping county, Shaanxi.

The provision of physical rehabilitation and restorative care services has been expanding nationwide since 2008, when the central government decided to include them in the basic healthcare insurance system.

However, despite the developments of the past decade, supply is being strained by rising demand from the nation's 85 million registered disabled citizens, people who require assistance in the wake of surgery or other illnesses, and the rapidly aging population.

The imbalance between supply and demand is most acute in the vast rural areas, where rehab facilities are rare but disabilities resulting from strokes and farming accidents are common.

Operation Concern, a charity in Hong Kong, is among the groups attempting to reverse the urban-rural shortfall by sending orthopedic surgeons and physical therapists to the countryside and funding surgery for the rural poor.

Beneficiaries

Zhang Jinjin, from Fuping county, Shaanxi province, is one of thousands of people benefiting from the program.

The 32-year-old has had three consultations with Leung Ping-chung, a surgeon and university professor from Hong Kong who founded Operation Concern. Leung gained fame in the 1970s when he grafted a toe onto a man's hand to replace a finger that had been severed in an accident. It was the first time the procedure had been carried out in the city.

Zhang worked at an electronics factory in Shenzhen, Guangdong province, until 2014, when she became so ill she could hardly walk. She returned to Fuping, and was diagnosed with progressive muscular dystrophy - a degenerative disease in which the skeletal muscles waste away, leading to complete immobility.

Now, she lives with her mother and survives on State benefits. Daunted by the disease and high medical costs, Zhang almost abandoned treatment. In 2015, though, she learned about the financial support Operation Concern offers to rural residents who require physical rehab, and turned to it for help. The amount each patient receives varies according to their illness and circumstances.

Hearing that Leung was visiting Fuping County Second People's Hospital, Zhang successfully applied for a consultation. Following a physical examination, Leung decided to have Zhang fitted with a specially made spinal brace and asked her to follow an exercise program devised by rehab professionals.

The brace enables Zhang to stand upright and perform the exercises, which are designed to slow the progress of the disease. "I would have been confined to a wheelchair and died a gradual death if Professor Leung hadn't helped me with the spinal brace," she said.

More than 5,000 rural patients have received rehab assistance from Operation Concern since it was founded 25 years ago. Moreover, the charity has also provided training sessions in Hong Kong for more than 200 rural doctors from the mainland, with some of the courses lasting as long as six months.

Statistics supplied by the China Disabled Persons' Federation show that rehab services are gradually expanding from cities to rural areas, where 75 percent of those in need reside.

However, these services and related facilities are still luxuries in rural areas, and that could have huge consequences, according to Kwok Wai-leung, associate professor at the School of Medical and Health Sciences at Tung Wah College in Hong Kong.

"In rural China, there are large numbers of elderly stroke patients who become bedridden as a result of a lack of rehab exercise and guidance," said Kwok, who joined Operation Concern in 2013. He added that the situation is a slight on patients' dignity, can cause mental health issues and adds to the burden on family members.