Facts and Figures

The People’s Republic of China is the third largest country in the world with a population of more than 1.3 billion people and a land area of 9.6 million square kilometres.

China is located in the east of the Asian Continent and its eastern coast runs along the Yellow Sea, the East China Sea and the South China Sea. 

The country shares its border with fifteen other countries including North Korea, Russia and Mongolia to the north, Kazakhstan, Kyrgyzstan, Tadzhikistan, Afghanistan, Pakistan, India, Nepal, Sikkim and Bhutan to the west and southwest, and Myanmar, Lao PDR and Vietnam to the south.

The country is divided into more than 2,000 counties, 23 provinces, five autonomous regions (including Tibet), four municipalities under the control of the government and two special administrative regions (including Hong Kong and Macau).

Economically, China has been progressing steadily since the late 1970s with annual growth rates averaging 8-9% in recent years. Over the past two decades, China’s poverty rate has fallen from 31.6% to 3.5% and per capita disposable incomes have increased.

Much of this development has been in the eastern, coastal and urban regions. As a result the gap between the rich and poor has widened.

China’s administration system starts at the country/state level and then progresses to provinces, prefectures, counties, townships, administrative village committees and villages.

Jiangxi Province

Jiangxi Province, where The Fred Hollows Foundation works, is located inland in the south east of the country, on the southern bank of the Yangtze River. The landscape of the province is dominated by mountains and hills with high levels of rainfall and a sub-tropical monsoonal climate. 

Jiangxi is one of the poorest provinces of China and is divided into 11 prefecture cities, which are further subdivided into 99 counties (19 districts, 10 county-level cities, 70 counties and one autonomous county). The majority of Jiangxi's population live in rural areas outside of major cities.

According to the National Statistical Yearbook, the public revenue of Jiangxi Province in 2006 ranked 23rd amongst the 34 provincial level administrative regions in China.

Nanchang is the capital of Jiangxi Province and is where The Foundation’s office is located.

Sources: China Internet Information Centre, Human Development Report 2006, National Statistical Yearbook 2006, UNDP

Population: 1.3 billion
Urban population: 39.5%
Life expectancy: 71.9 years
Literacy rate: 90.9%
Percentage of population living on less than $2 a day: 46.7%
Infant mortality rate (per 1,000 births): 26
Percentage of population which is undernourished: 12%
Number of doctors (per 100,000 people): 106

China has made significant steps towards improving its population’s standard of living and health, particularly over the last two decades of the country’s strong economic growth.  

Life expectancy has risen from 63 years in 1970-1975 to 71.9 years in 2004 and infant mortality rates have dropped from 85 per 1,000 live births in 1970 to 26 in 2004. 

While the country’s general health situation has improved, this is not reflected across the whole population and varies considerably from region to region. For example, the under-five mortality rate is more than two times higher in the western provinces than in the more developed eastern provinces.

Since the outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003, there has been
much more focus on the structure of China’s public health system and its ability to manage health emergencies.

Health care in China is based on a ‘user-pays’ system and there is a gradual move towards the privatisation of hospitals.

While most government workers receive state-subsidised health care, the vast majority of the population is not covered by health insurance.

Sources: Human Development Report 2006, UNDP, World Health Organization

Number of blind people: 9 million
National blindness prevalence: 0.64%
Main causes of blindness: Cataract (42%), childhood blindness (23%), corneal blindness (15%), trachoma (11%) and glaucoma (9%)
Number of people with cataract blindness: 2.5 million backlog of cases and an annual incidence of 400,000 cases
Number of cataract operations performed annually: 500,000 - which equates to a cataract surgical rate (CSR) of approximately 400 operations per million population per year
Number of ophthalmologists: 24,000
Reasons for low cataract surgical rates and backlog: Cost and quality of cataract surgery, public fear and misconceptions about surgery, lack of awareness about cataract blindness, attitudes to health (particularly towards elderly people), access to services and lack of health insurance for rural populations
Percentage of blind population with Glaucoma: 9%
Percentage of blind population with Corneal Scarring: 15%
Percentage of blind population with Childhood Blindness: 23%

Approximately nine million people in China live with blindness, of which just under half are affected by cataract blindness. Each year an additional 400,000 people become cataract blind.

Jiangxi Province, where The Foundation works, has one of the highest rates of blindness in China with approximately 451,500 (1.05%) blind people and a further 249,400 (0.58%) people with low vision.

The number of people cataract blind patients in Jiangxi Province is approximately 184,900 (0.43%) with an additional incidence of 29,500 cases annually. There are approximately 546 ophthalmologists, 628 ophthalmic nurses and 3,000 village doctors delivering eye health care services in Jiangxi Province.

China’s ever-increasing blind population equates to 20% of the world’s blind population and surpasses the total population of countries such as Denmark, Finland and Norway.

The main factors which have led to the growing number of blind people in China are an ageing population, high population growth, limited resources, a lack of eye health personnel and the rising cost of eye care services.

The number of people in China over 60 years of age is expected to increase by 90%, to around
240 million, by 2020. In the Jiangxi Province approximately 19% of people are aged 50 years and over.  

As cataract is a disease linked to ageing, China’s ageing population will substantially add to the number of cataract blind cases in the future.  The Ministry of Health in China estimates that based on current trends, the number of people affected by blindness will increase four times over and that the number of cataract blindness cases will more than double - reaching more than five million by 2020. 

Orbis International estimates that 70-80% of the country’s 24,000 eye doctors work in urban hospitals and that 70-80% of the nine million blind people in China live in rural areas.

Travelling to cities for surgery is very costly for most people in China. Road conditions in some
provinces is also very restrictive.

Depending on a person’s geographical location the cost of cataract surgery also varies. At the county level it costs approximately US$207, at the provincial level it costs between US$300-$800 and in the bigger cities of China the cost is increases to US$400-$1,000. 
 
The Foundation’s China-Australia Cataract Surgery Training Cooperation Program is aiming to bring this cost down to approximately US$65 per patient.

In addition to the prohibitive cost and limited access to services, there are many misconceptions by the Chinese community about how safe cataract operations are. In most areas there is also little awareness of cataract blindness and treatment methods. 

Many people in China are wary of the safety or success of cataract operations, which is a fear borne from previous poor outcomes for patients, in the time before modern cataract surgery, using an intraouclar lens, was available. 

Efforts to improve eye health care in China have steadily increased the cataract surgical rate (CSR) over the past decade. In 1994, the CSR was estimated to be 136 per million population per year, increasing to the current CSR of 400 today. 

The national average is now 400 operations per million population per year, however this rate is lower than many other developing countries, such Vietnam with a rate of 1,203 operations, per million population per year.

Less than 5,000 eye doctors in China are trained in modern cataract surgery. It is also estimated that 20-30% of China’s counties have no eye care services available and less than 30% of county hospitals have the capacity to perform safe modern cataract surgery. 

Although China is one of the countries which signed the Vision 2020 agreement in 1999, little progress was made until 2005. A concerted effort is now underway after a collaboration of non-government organisations issued a statement to China’s Ministry of Heath in early 2005, agreeing to support the government in getting back on track with the Vision 2020 targets. 

A number of workshops with China's Government and various NGOs were held in 2005 and 2006 and as a result a National Blindness Prevention Plan 2005-2010 has now been developed for China.

Sources: Orbis International, National Statistical Yearbook 2006, World Health Organisation