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Medical Work From Evergreen's earliest days, we have desired to find ways to improve the health of the common people of Shanxi Province. The
Evergreen Medical Team began it's work in 1996 with the establishment of the "Cobbler Program" in Yangqu County. Cobbler's slogan was "putting shoes
on barefoot doctors." In other words, our aim was to equip doctors at the village level to provide the best possible medical care for their
patients. During the five years of the Cobbler Program, over 140 health care workers participated in one or more of our eight training courses. Currently, the work of the Medical Team has three main areas of focus: clinical care, public health, and medical training. Please click on the links below to learn more: Evergreen currently has four MDs, all board-certified in Family Medicine, working in two locations—Yangqu and Yuci. We do not have our own Evergreen clinics or hospital, but have chosen to work primarily within China's existing health care system. Here we see a wide range of patients, from peasant farmers to university graduates. Working in local hospitals and clinics has also afforded us the opportunity to develop long-term relationships with Chinese doctors and leaders in the Chinese health care system. Below is a brief description of each of the areas where we provide clinical medicine services. Yuci – Luxi Huifeng Community Health Center - China is developing a Community Health Center model for meeting the primary health care needs of urban residents. They are using Family Practice as the medical model upon which to build this health care delivery system.
Taiyuan – China Care Orphanage - In the summer of 2006, Evergreen doctors were invited by China Care Foundation to provide medical care to the orphaned children in their Taiyuan center. These children were abandoned because of medical problems such as cleft lip and palate or heart defects, which would be too costly for their parents to deal with. China Care provides funding for corrective surgeries and facilitates both overseas and in-country adoptions. Evergreen doctors make weekly visits to the center and are available to the China Care staff for phone consultation throughout the week. We've found this an extremely rewarding opportunity to care for "the least of these." The Samaritan Fund – Closely tied to Evergreen's clinical medicine work, Samaritan Fund was established to provide assistance for financially disadvantaged patients in order that they might recover, escape a cycle of poverty, and be able to contribute again to their family and community. Criteria for evaluating need of assistance are very specific. In an average year, about 30 patients are given financial assistance, with funds totaling about 40,000 RMB (US $5,000). In addition, the very tangible displays of grace and love bring about change, not only to the families assisted, but also to the doctors and nurses who care for them. Evergreen currently has two Public Health specialists, both in Yuci, and is involved in a wide range of public health work in both our Yuci and Yangqu areas. Micronutrient Deficiencies Project (Yuci) - Working with the Shanxi Medical University, Shanxi Children's Hospital and Yuci Women's and Children's Hospital, Evergreen Public Health specialists surveyed the nutritional, behavioral, and health status of 280 rural children aged 12-24 months and their mothers. The children's health status was reported to their parents and their village doctors to help them to better understand and improve the children's health situation. Lead Pollution Project (Yuci) - From a sample of local children, Evergreen Public Health specialists learned that over half of children ages 12-24 months have blood lead levels above the safe level. In order to find out the cause, we developed the “Lead Exposure Prevention Project” in collaboration with the local Women's and Children's Hospital. From the survey we found that burning coal in the home, infrequent hand washing, playing by a busy road and nutrition were important factors leading to lead poisoning in these children. As a result of conducting the survey, we have trained parents and village doctors how to reduce the possibility of lead poisoning in their children. Also, we are now providing “Lead Exposure Prevention” teaching for Yuci nursery school workers and parents.
Hypertension Project (Yuci) – Evergreen Public Health specialists conducted blood pressure screening and community surveys, and discovered that most people in our community, including some patients with high blood pressure, have limited understanding of hypertension. One third of our project attendees wanted to attend a regular health education program in their community, though they have never attended this kind of training before. Thus, we began providing regular health education for our community. We collaborate with the Luxi Huifeng Community Health Center for this project. Village Health Education Project (Yangqu) - For most of the rural population of Yangqu County, reliable information on common health problems is sorely lacking. Thus, beginning in November 2006, the Yangqu Medical Team began working in cooperation with the Yangqu Department of Public Health to provide both prenatal and general health education in twenty villages in Yangqu County. In the process, we will be training a handful of village doctors to run interactive classes and use other effective means of providing reliable health information to the people they serve. From the first, the Evergreen Medical Team has endeavored to provide opportunities for training for those we work alongside in China. To some degree, training permeates all aspects of our clinical and public health work. Several specific areas in which we provide medical training are described below. Family Medicine - The Chinese Ministry of Health has mandated that all provinces in China begin training Family Medicine doctors, and that 30% of all physicians in China receive this training by the year 2015. They have also set a goal to have effective community based health clinics in place and working in county and urban centers by 2010. The provincial level Public Health Bureau has asked Evergreen to participate in the clinical training of these doctors. The first formal Family Medicine training in Shanxi began in September 2001 with a class of 34 students. Evergreen's board-certified Family Medicine physicians have participated each year since 2001, providing training for both doctors and nurses, both practicing physicians as well as clinical teachers. Social Work - From our years of experience with the Samaritan Fund, as well as the RED Team's scholarship programs, it became clear that we needed skilled social workers to be involved not only with our patients, but also in many of Evergreen's other projects, to enhance effectiveness by finding community resources and improve communication skills with those whom we are serving. Currently, we are providing training for several members of our staff in this area. Practicums - In evaluating ten years of medical training, it was clear that the most effective training occurs on an individual level. Thus in both Yangqu and Yuci, the Medical Team offers opportunities for both “exposure” training, in which practicing doctors can come for one week to understand the scope of primary care, and “practical” training, in which students and recent graduates can spend 4-6 months working alongside our doctors to learn clinical skills, relevant knowledge, and appropriate attitudes.
CME (Continuing Medical Education) - The Evergreen Medical Team offers lectures by specialists from Taiyuan, as well as occasional specialists from
overseas, on a regular basis at Yangqu County Hospital. This gives local doctors increased opportunity to stay abreast of Medical Student Rotations - Many medical students and medical residents from Western countries contemplate devoting their careers to serving in another country, as Evergreen's doctors have done. To help them understand what this is like, we offer two or three students each year the opportunity to work alongside our doctors for 1-2 months; often they receive academic credit for this as a medical school rotation. Not only do they have the opportunity to see what we do, but they also contribute to our work by completing a project related to their interests and designed to serve our patients. A functional level of Mandarin Chinese is a prerequisite for participation in this program. Short-Term Medical Experts - Evergreen periodically serves as a liason between several of the large hospitals in Taiyuan and medical specialists from other countries. We have been privileged to have faculty from such places as Johns Hopkins School of Medicine and the Mayo Clinic come to provide classroom, bedside, and/or surgical teaching at provincial level teaching institutions in Taiyuan. We have also been privileged to have a number of practicing clinicians from the West with special interest in the Medical Team's work come for short periods to work and teach alongside Evergreen doctors at the county level. Both the visiting experts and the host hospitals have profited from this type of academic exchange. Over 30 experts have come over the past ten years. |
Our Work > Medical
Cobbler
was followed by the Well Baby Program, which ran from 1996 to 2004, and resulted in the care of over 4000 children and the training of over 80 workers.
One tangible result of Well Baby was a 38% decline in the incidence of rickets in our project townships. Our third major program was Antenatal, designed
to equip village and township midwives to provide quality care to pregnant women. Antenatal ran from 2001 to 2005, and resulted in improved medical
skills for the 16 doctors we trained, as well as improved care and better outcomes for the 430 women and infants served. In 2003, we expanded our work
into a second area, Yuci, serving a more urban population. 
Yangqu – Yangqu County Hospital - Evergreen's work in Yangqu County centers around the outpatient department of Yangqu County
Hospital. Evergreen doctors see a wide range of patients with acute illnesses such as TB to chronic conditions such as diabetes and hypertension. Over half
of the patients we see are established long-term patients for whom we provide ongoing care. In addition, Evergreen doctors also provide home visits for those
patients who have difficulty coming to the clinic. 
TB Project (Yuci) - China carries the second heaviest burden of TB in the world. DOTS (Directly Observed Therapy-Short course) has proven to be one
of the most effective and efficient methods of public health intervention. In order to understand the relationship between health consciousness and health behavior, we
surveyed 29 TB patients in the Yuci area in 2004. By comparing the health beliefs of patients adhering to treatment with patients who did not complete their course of
treatment, we discovered several factors leading to non-adherence. As a result of the survey, Evergreen now serves as an advisor for the local Center for Disease Control
to further improve the success of DOTS in Yuci. In addition, we are providing regular training for all the doctors who are responsible for conducting DOTS in Yuci. 
current developments in medicine, in the hopes
that this will translate into better overall patient care. 
