The title "doctor" may be common in Shanghai, but far away in China's remote mountainous areas, it's a rare badge of honor. It signifies hope. Eight young doctors from Shanghai, all comfortably off, volunteered six months of their time prescribing health and hope to the inspiringly beautiful but impoverished Shangri-la region in Yunnan Province. They have just returned.

"We may only serve once in Yunnan, but we will care about Shangri-la for the rest of our lives," goes their slogan. It rhymes in Chinese.

The eight returned just before the Chinese New Year after providing free basic medical treatment, surgery and medicine, and training local "doctors" and health workers to carry on their work.

"Sometimes we had to create something out of nothing," says Dr Liu Danzheng, from the Ear, Nose and Throat Department of Shanghai Zhongshan Hospital.

They made do with inadequate equipment, knocked together wooden operating tables in hamlets, carried anesthetic, portable room heaters and all their supplies. They even carried out brain surgery on trauma victims in the simple Diqing Prefecture Hospital.

Diqing at around 3,000 meters above sea level is a 50-minute flight from Kunming, capital of Yunnan. Doctors then drove over treacherous roads to 14 remote villages, treating around 12,000 patients over six months. Many patients had trudged to the villages from even more remote hamlets.

The volunteers' task is ongoing: in Shanghai they are still seeking equipment and supplies and arranging for Shangri-la doctors to receive training in Shanghai.

Their ongoing project, Shanghai Youth Volunteers for Yunnan Anti-Poverty Work, is supported by Amway (China) Co Ltd, which provided 1 million yuan (US$140,000) from 2005 to 2007.

This group included one woman, a pediatrician. Doctors come from varied specialties. They performed surgery on cleft lips and palates, cataracts caused by ultraviolet radiation at high elevations, as well as orthopedic and other operations. Much of their mission was basic medicine.

Since 1998, 254 volunteers from education, medicine, business and other fields have gone to Yunnan in 10-group relays. Each group stays six months until the next arrives.

"Before leaving I had expected a much more difficult life there. I was prepared for altitude sickness and poor food," says Dr Liu. "To my surprise, life was not that tough, but the work was."

Liu was one of five doctors who spoke to Shanghai Daily in a group interview. The complete group of doctors comprised Ms Zhang Jifeng, from Shanghai Children's Hospital; Le Yongchang, from the Minhang Center for Disease Control and Prevention; and Chen Taiyao, from the Shanghai Center for Disease Control and Prevention.

Despite initial discomfort, they quickly acclimated, made do and even started regular basketball games with local doctors.

The poor medical facilities, however, did astonish the cosmopolitan doctors and the primitive knowledge of local medical workers presented a problem.

For example, many health workers didn't sterilize and disinfect instruments after examining one patient-they wiped them down and moved on to the next person.

Doctors washed their hands in freezing water in cold rooms before examinations and surgery. "It was real suffering in winter, but you had to do it every time as there's no heating system or hot water," says Dr Wang Jianhua, from the Orthopedics Department of Shanghai No. 6 People's Hospital.

Wang wore many layers of clothes under his surgical gown. He carried a portable heater for every procedure at the Diqing Prefecture Hospital.

The cold, however, was nothing compared with lack of equipment and supplies. The doctors carried everything, including anesthetic, to villages. Most items were donated and they are appealing for more. They made do with what they had.

"If we didn't have an operating table, we made one out of ordinary tables; if we didn't have a special wire to hold bone fragments in place, we just used our hands," says Wang. "As long as we could find a way, we performed surgery."

Some technically demanding cases were referred to Kunming or Shanghai for surgery.

According to Wang, most people are too poor to go to the hospital unless they are seriously ill or injured. They often walk for days.

The volunteers carried out around 380 operations, including 12 successful brain surgeries performed by Dr Cao Xiaoyun from Shanghai Huashan Hospital. Before his arrival no patients had survived brain surgery for traumatic brain injuries.

Basic healthcare is a priority; specialists provided the basics. Many people needed simple medication widely available in Shanghai but not in Shangri-la. That included common medicine for stomach ailments and herbal oil for sprains and muscle pain.

According to team leader Dr Guo Tao, from the Ophthalmology Department of Yangpu Central Hospital, teaching was their most important work.

More than 90 percent of "doctors" in Shangri-la are only health school graduates who know little about advanced practices and surgery. Doctors from Yunnan's provincial hospitals occasionally visit to perform essential surgery. When they leave, local doctors are on their own.

"For example, blood transfusions help but never cure," says Guo. Only by treating problems and ensuring a patient can produce their own blood cells can doctors help them lead a healthy life.

And practice is always the best teacher. Local doctors attend Shanghai volunteers at every surgery, to both assist and learn. Gradually they are able to do it on their own.

"They learn fast, but lack confidence," says Guo. Two of his apprentice doctors in ophthalmology were able to carry out cataract surgery on their own after Guo's six months of teaching.

Though they are back in comparatively warm Shanghai from freezing Shangri-la, the doctors are busy seeking help for the region.

"We are and always will be free consultants," says Wang. "We are ready to help any time they call."

(Shanghai Daily February 16, 2008)