This study examines how modern hygiene concepts spread among the deeply impoverished population in an ethnic minority relocation community in the Nujiang Lisu Autonomous Prefecture in Yunnan Province, where modern hygiene concepts have yet to take root and the knowledge, attitudes and practices model of health communication is difficult to activate. The study shows that, in the first stage, foreign poverty alleviation cadres helped the recipients by going to their homes and creating an obligation to “pay back”, which resulted in the majority of the population’s knowledge of hygiene and short-term behavioural change. In the second stage, community committees linked hygiene to household livelihoods by signing employment responsibility agreements, solving the problem of sustained hygiene management for most households. In the third phase, minority groups used hygiene “refusal” as a counterbalance to officials, and grassroots cadres were able to “clean up” the persistent attitudes of marginalised groups by appeasing households in need and punishing those who were at the centre of the problem. Community A’s health communication suspends medical and scientific knowledge, integrating “hygiene” with the daily “small justice” of human exchange, responsibility contract, and support for the strong and the weak, so that the residents’ health actions are mobilised in the absence of scientific concepts.This alternative health communication practice is not only different from the emotional mobilisation strategy of the Republican period, which resorted to “great righteousness”, but also different from the scientific “seeding” strategy of the modern society, which is based on the model of knowledge, attitudes and practices.