In the mountainous regions of China, the healthcare challenges faced by rural communities are starkly illustrated by David Wei's ordeal. The 60-year-old had to carry his nephew on his back for 3 km (1.9 miles) after the younger man suffered a heart attack, waiting 90 minutes for an ambulance to arrive. Despite improvements in infrastructure, his nephew passed away during a second cardiac arrest due to delayed emergency response.

This incident highlights the urgent need for accessible healthcare in rural China, where approximately 120 million people aged 60 or older face significant challenges. Experts warn that addressing these disparities is critical as China's aging rural population grows.

China's development model faces a dilemma: prioritize urban industrial growth or invest heavily in rural healthcare. Critics argue that neglecting welfare in low-income rural areas risks long-term demographic and economic consequences, as seen in declining rural life expectancy and increasing poverty levels.

Despite significant progress in rural healthcare since Mao Zedong's era, where "barefoot doctors" were the norm, the system remains overburdened. Rural doctors like Xiang in Hunan Province struggle with limited resources, heavy workloads, and low pay—earning just 1,000 yuan ($137) monthly while performing multiple roles.

Meanwhile, urbanization continues to drain talent from rural areas. National Health Commission data reveal a 42% drop in rural doctors over the past decade, while urban doctor numbers have nearly doubled. Medical students cite the significant pay gap as a major deterrent, with urban salaries often ten times higher than rural ones.

The Chinese government aims to narrow the rural-urban healthcare gap by 2035, partly by offering free tuition for medical students who agree to work in rural clinics. However, attracting talent remains a challenge, with young doctors often viewing rural placements as temporary before seeking better opportunities elsewhere.

With healthcare spending at just 7.2% of GDP—well below Japan and South Korea—high local government debt limits China’s ability to boost investment. Experts stress that failing to address rural healthcare needs could exacerbate economic inequality and deepen the demographic crisis.

For rural communities like David Wei’s, where clinics are scarce and poorly equipped, the reality is grim. As Wei himself puts it, "If we'd lived in the city, he might have had a chance."