44岁的何万里去年4月来到捧当乡，这位来自珠海的全科医生如今想到爬山还是有点害怕。这10个月来，背上b超机、心电图机，爬上一天山路去给村民们体检看病已成为他的工作日常。 何万里是珠海驻怒江医疗帮扶队的第六批成员，在捧当乡卫生院，他和本地医生一起，担负着危重症急诊转诊、上山送诊体检、健康宣讲等最为核心的医疗工作。此外，作为来自大城市、临床经验最为丰富的医生，他还承担着培训当地医生，提高乡镇卫生院医疗技术的重任。 After six months in his new post, He Wanli still hasn't gotten used to all the climbing the job requires. The 44-year-old general practitioner built his career in Zhuhai, a port city facing the South China Sea and famed for its sandy beaches and startup culture. But in early 2020, he packed his bags and traveled some 2,000 kilometers to the deep highlands of Yunnan Province. His journey westwards was not some kind of reverse migration or a form of escapism from the pressures of urban bustle. One doesn't simply happen on the little town of Pengdang. Gongshan County, where Pengdang is located, is so far-flung that it's faster to get to Myanmar from there than to drive to a major Chinese city. The only way in and out of the area is a two-lane road stretching for hundreds of kilometers along the length of a valley. The route is sandwiched between precarious slopes prone to landslides on one side and the violent torrents of the Nujiang River, ominously known as the Angry River, on the other. The doctor was dispatched by his hospital to help get health care at the grassroots level up to snuff as part of China's campaign to purge extreme poverty in the countryside. For those who have little in life, good health is their greatest asset. A chronic cough or nasty infection could mean the difference between a lifetime of penury and a future of possibilities. 在泥泞中攀爬送诊 65岁以上老年人免费体检是贡山县医疗扶贫年度重点工作，范围覆盖到最偏远的高山村庄。Nadim加入医生们的队伍前往山上的娜沟洛小组给老人们看病。 娜沟洛小组如今还居住着20多户人家，多数是习惯生活在山上的老人。 这一天，身负数斤重的医疗器材，医生们在大雨和泥泞的陡坡上攀爬，负重前行了数小时，整个医疗队严重体力透支，然而在一年大部分时间都是雨季的贡山，这样的情景几乎已是常态。 “这些村民住在高山之上，与世隔绝，也就意味着与一切医疗资源隔绝。因而，去为他们做体检，保证他们的健康至关重要。” Nadim说。 The shifts at the hospital are mostly quiet and visitors are few. It's a welcome change for the city doctor from the characteristically crowded hallways and throngs of patients at urban hospitals. But the job in the countryside entails venturing outside the gates for house calls, a duty that in this alpine area requires strong legs – something Zhuhai's Dr. He is still working on. On a gloomy October morning, I joined a team from the hospital on a hike to a small hamlet perched on a mountaintop and only accessible on foot. We navigated winding dirt paths that turned skywards and which relentless rains had rendered slippery and muddy. To make things more challenging, the hospital staff had to carry medical equipment and snacks on their back. The team was carrying out their annual health checkup for people over the age of 65, a free service that's part of the local poverty reduction campaign. As doctors explained, the consultation helps paint a detailed image of the health situation of seniors and enables the detection of health problems that would otherwise go unnoticed. In a house that was temporarily turned into a clinic, old villagers, back bent from years of working the land, thronged in to get examined. Most were healthy, with the exception of a few showing symptoms of hypertension and one with uneven heartbeats that required further investigation at the hospital. “烂到骨头就会少一条腿” 医疗队在给老人们做完集中体检之后，又前往一些没能来参加检查的人家探访。这几户老人一户因患严重白内障几近失明，一户老人腿上有一个很深的伤口，还有一户老人中风在家。 医疗队走过最艰难的路，到达一栋如置身在仙境中的木屋。在高山陡坡之巅，一个腿坏掉无法行走的老人躺在床上。伤口已经化脓，上面似乎覆盖了一些草药或者是泥沙。 “他最坏的结果不是截肢，烂到骨头里甚至会造成生命危险。”何医生说。 看着躺在床上接受紧急治疗的老人，Nadim内心震荡。这些生活在山上的老人们太过坚韧，也太过脆弱。他们接受自然给予的一切，也承受一切。在高黎贡山之上，毫无声息、日复一日地等待。 “大山里的人们，长在山上，皈依山上，他们也看得很平淡，”何医生告诉Nadim。 然而大山上人们的坚韧，对生死的淡然，其间或许也隐藏着与生俱来的自然环境带给他们的限制和无奈。 At a neighbor's place, the team treated a man for a deep leg wound that had festered. The procedure was done under the flashlight of a mobile phone that I shone at the gash while trying to look away from the hair-raising sight of dried blood and oozing pus. We later got to know that the man's son had thought the injury wasn't serious enough to warrant the troublesome trek down the mountain. Our timing couldn't have been more perfect. It also couldn't be any clearer that visits like this are crucial for those who can't make the short trip to the hospital. 改变正在上演 如今在捧当乡，像娜沟洛小组的老人们那样生活在偏远山顶的已是少数。大部分村民居住在更为宜居的村庄里。人们有较好的渠道前往村医诊所或乡镇卫生院看病。 捧当乡卫生院如今每天接待30名左右的病人，人虽然不多，但医生们几乎每月都要下乡或者前往村医室开展工作，十分忙碌。 情况在一天天转变。2019年底，怒江州实现了全州贫困人口100%参加医保，如今贫困户在捧当乡卫生院就医可以得到高达95%的报销，在县城医院报销比例也达到了90%。捧当乡卫生院的医务人员从最初的7、8人，壮大到如今的32、33人，医疗资源和团队都在一步步增强。 “虽然资源很少，但你们做得很多，你们真的辛苦了。有你们的专业精神、奉献和爱心，我相信村民们会越来越好。”Nadim说。 Despite the many inconveniences the team didn't seem to mind their daunting duty. They did the job with competence, cheerfulness and utmost care undeterred by the pesky rain and malfunctioning gadgets. They took their time answering medical questions, punctuating their consultation with lighthearted humor and concerned appeals for follow-ups at the hospital. Not even the fading daylight could get them to rush things. A medical career is nothing short of a status symbol but the health care workers in Pengdang seem to care little about the perks that come with the title. They go about their job with a can-do attitude and make do with the limited resources at hand. Here, the most basic health services are provided with the most basic quality of a good doctor: empathy.