A village doctor's journey on horseback to care for herders

Shiliuyun-Xinjiang Daily (Reporter Su Luping) news: On May 14, a fresh snowfall dusted A'ershan Village in Narat Town, Xinyuan County, Ili Kazak Autonomous Prefecture, northwest China's Xinjiang Uygur Autonomous Region.

Villagers came to the village clinic one after another to get medicine. Amangul Dawlethan, the village doctor, sat at her desk. She examined her patients and wrote prescriptions as she went.

A thick stack of health records lay on the desk. She knew exactly what medicine each person took and when they needed a follow up.

Every year in late May and early June, when the snow melted and the grass grew, herders in A'ershan Village would take their livestock up into the mountains for the summer grazing season. It was the busiest time of the year for them, and the time when Amangul worried the most.

A'ershan Village sits at the eastern edge of Narat Grassland. Its 1,520 households, home to 4,503 people, are scattered across the mountains. The farthest yurt is more than 30 kilometers from the village clinic. Vehicles cannot reach it. The only way is on horseback.

In 1998, Amangul graduated from a health school and returned to her hometown with a medicine box to work as a village doctor. In 2010, she was transferred to A'ershan Village and made her home on the grassland. Wherever the herders moved their livestock, she moved her clinic.

Over 28 years, she has gone through three horses and worn out countless pairs of boots. Her total travel distance has exceeded 50,000 kilometers.

"The roads here are carved out by horses' hooves," she said.

In winter, temperatures drop to minus 30 degrees Celsius. Snow rises to the belly of her horse. Ice formed hard shells around her trouser legs. In summer, after heavy rain, the mountain trails become slick. Her horse nearly slipped into a ravine several times.

She never complains. "If my phone rings, I go. No matter the hour," she said.

Alimbek Saparkhali, 90, has been bedridden for nearly ten years. Rheumatoid arthritis made it difficult for him even to sit up.

The first time Amangul visited, the old man waved his hand. "My illness can't be cured," he said.

She did not say a word, just knelt down, gently massaged his stiff knees, took out her acupuncture needles and carefully located the pressure points. "Let's just try once, uncle. Tell me if it hurts," she said.

Since then, she has visited him three times a month without fail. In spring, she brought herbal patches. In winter, she warmed her stethoscope with her hands before examining him.

She cared for him like a daughter, asking about his health and how his livestock were doing.

The old man told everyone he met: "Amangul is dearer to me than my own daughter."

Amangul keeps her phone on 24 hours a day. Every villager knows her number.

In the past, her worst fear was emergency cases.

"When a herder had a fever, I could only give them medicine and tell them to go to the town clinic if they didn't get better," she said. "When old people were suffering from chest distress and shortness of breath, I had nothing but chest auscultation to rely on. I could not do much else. Back then, I felt like I was barely a qualified doctor."

Two years ago, the "Walking Hospital" health project was launched in A'ershan Village. It put portable ultrasound machines, electrocardiogram devices and biochemical analyzers into her medical bag. From then on, the village doctor carried a mobile emergency room on her back.

Last winter, Halmurat Abdurehman collapsed on the mountain trail during the spring livestock migration. He was gripped by sudden chest pain. His family called Amangul in a panic.

She hung up, grabbed her portable electrocardiogram device and headed into the mountains, fighting through wind and snow.

The wind and snow stung her face. Her horse's hooves slipped. She gripped the reins tightly and leaned forward.

By the time she reached the yurt, Halmurat's face had turned purple. He was curled on a wool blanket, clutching his chest.

Amangul knelt beside him and opened her medical bag. She took out the electrocardiogram machine, placed the electrodes and started it. The waveform on the screen showed abnormalities. The data was uploaded instantly.

Within seconds, a specialist at the county hospital replied. "Acute heart attack. He needs to get to the hospital immediately," the message read.

She calmed the patient while calling for an ambulance. When the ambulance arrived, the paramedics assessed him, gave him oxygen and started an intravenous line.

Halmurat was carried onto a stretcher. The ambulance raced toward the county hospital.

After he recovered, Halmurat sent her a silk banner with words of gratitude. "The lifesaver on horseback," it read.

Amangul shook her head. "It was not because of me," she said. "It was because of the equipment. And because of the government's good policies."

Today, her medical bag always holds new tools. Blood pressure readings from hypertensive patients are recorded directly into their digital health files. Ultrasound results from prenatal checkups are sent instantly to obstetricians at the county hospital. Parents can check their children's vaccination records with a simple scan.

Every one of the 4,503 herders in the village now has a digital health file.

On her busiest day, she saw nearly 50 patients. She worked from early morning until late at night. Her voice grew hoarse, but she still smiled as she gave the last patient instructions on what to do.

Today, the family doctor contract signing rate in A'ershan Village is 100 percent. Patient satisfaction is above 98 percent.

Over 28 years, Amangul has missed countless family gatherings.

On her child's birthday, she promised to fly a kite with him. But a pregnant woman in the village went into labor. She handed her child the gift and rode off. She returned home late at night. Her child had fallen asleep with the kite clutched in his hand.

Her husband asked her, with a voice full of concern, "Can't you take a single day off?"

She held her child close and said nothing.

But she cannot stop.

In spring, herders hand her cups of freshly brewed milk tea. In winter, they bring her sturdy horses to ride when the snow is deep.

Children run up to her as soon as they see her. "Auntie Amangul," they call out.

The May snow will soon melt away. In a little over ten days, the herders will take their livestock up into the mountains for the summer grazing season.

Amangul is calling every household. "Is your medicine ready? Come back for one more blood pressure check before you leave," she said.

Twenty eight years have passed. Gray hairs have appeared at her temples.

She said, "As long as the herders need me, I will stay on horseback."

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