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Engineering Social Visions: Crafting Developmental Visions in South Korea / Manchester

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1 Reinventing the Biomedical: Emerging Public Health Priorities in South Korea, 1948-1963 1 John DiMoia, National University of Singapore [email protected] Max Planck Institute for the History of Science, 2014-2016 j[email protected] I. Reshaping Developmental Visions The majority of the images of South Korean medical diplomacy shaping the nation’s public face tend to derive from the unusual circumstances of the new nation’s origins—declaring its independence in August 1948, following U.N.-sponsored elections held earlier that same year (May)—during the early stages of the Cold War. Labelled “Freedom’s Frontier” as the recipient of considerable “Free World” technical assistance for the duration of the 1950s, Syngman Rhee’s South Korea rapidly became a developmental model bordering on the Communist World, and, along with KMT (Kuomintang) Taiwan and LDP (Liberal Democratic Party) Japan, shaped a loose but unmistakable set of defined boundaries, a broad cluster of like-minded, anti-communist nations straddling 1 The emphasis placed on biomedicine after 1945 corresponds to earlier efforts —late Chŏson Korea and colonial Korea—but I am interested here in exploring its renewed mobilization under an independent South Korean government.
Transcript

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Reinventing the Biomedical: Emerging Public Health Priorities in South Korea, 1948-19631

John DiMoia, National University of [email protected]

Max Planck Institute for the History of Science, [email protected]

I. Reshaping Developmental Visions

The majority of the images of South Korean medical diplomacy

shaping the nation’s public face tend to derive from the unusual

circumstances of the new nation’s origins—declaring its

independence in August 1948, following U.N.-sponsored elections

held earlier that same year (May)—during the early stages of the

Cold War. Labelled “Freedom’s Frontier” as the recipient of

considerable “Free World” technical assistance for the duration

of the 1950s, Syngman Rhee’s South Korea rapidly became a

developmental model bordering on the Communist World, and, along

with KMT (Kuomintang) Taiwan and LDP (Liberal Democratic Party)

Japan, shaped a loose but unmistakable set of defined boundaries,

a broad cluster of like-minded, anti-communist nations straddling

1 The emphasis placed on biomedicine after 1945 corresponds to earlier efforts—late Chŏson Korea and colonial Korea—but I am interested here in exploringits renewed mobilization under an independent South Korean government.

2

the Asian mainland.2 These origins, however, conceal a much more

complicated history. The relationships previously established by

Chŏson Korea at an earlier stage (19th century and earlier), not

to mention the more recent ties established under Japanese

colonial rule (1910-1945), did not simply disappear. In many

cases, these ties continued, albeit in reconfigured form, even as

the ROK (Republic of Korea) sought to establish itself as the

“legitimate” Korea, the dominant partner in the Cold War

ideological competition.

This paper takes up the subject of South Korean medical

diplomacy, not as configured exclusively through external

political or diplomatic relations, but framed primarily in terms

of the nation’s developmental ambitions for itself, whether as

structured for a domestic or an international audience. In its

formative stages as an independent nation, the ROK had to learn

how to position itself within a dense nexus of American and

international aid resources, while seeking to portray itself as

an emerging, thriving national community, and moreover, one with2 The label “Freedom’s Frontier” appears to be a product of the USIS (UnitedStates Information Service), and the label appears frequently in Korea War-erapublications, across several languages. See Greg Brazinsky, “From Pupil toModel: South Korea and American Development Policy during the early Park ChungHee Era,” Diplomatic History, Volume 29, Issue 1, January 2005, pp. 83-115.

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viable economic prospects.3 If North Korea was able to rebuild

(1954-early 1960s) with aid from its “fraternal nations,” a story

outlined first by Ruediger Frank, and more recently, developed

further by Charles Armstrong, Cheehyung Kim, and Suzie Kim, South

Korea’s developmental story had to contend with the surrounding

forces of contrasting Japanese and American developmental

visions, external ideals imposed upon it to various degrees.4 By

the early 1960s, however, the ROK was beginning to export its

newly skilled doctors and nurses, first to West Germany in 1963,

and later to the Vietnam War theatre (1964-1973) as part of a

project of providing medical welfare. In the latter case, Korean

medical personnel even treated Vietnamese civilians along with

wounded Korean soldiers.5 How did the nation begin to

3 For the aid context, both financial and technical, see the forthcomingedited volume, Engineering Asia, which I am co-editing, along with Hiromi Mizunoof the University of Minnesota and Aaron S Moore of Arizona State University.See also Greg Brazinsky’s Nation Building in South Korea; Koreans, Americans,and the Making of a Democracy. Chapel Hill, NC: University of North CarolinaPress, 2007.4 Ruediger Frank, Die DDR und Nordkorea :der Wiederaufbau der Stadt Hamhungvon 1954-1962. Aachen: Shaker Verlag, 1996. Charles Armstrong, The NorthKorean Revolution, 1945-1950. Ithaca, NY: Cornell University Press, 2004.Cheehyung Kim, The Furnace is Breathing: Work and Everyday Life in NorthKorea, 1953-1961. Ph.D. Dissertation, Columbia University, 2013. Suzy Kim,Everyday Life in the North Korean Revolution, 1945-1950. Ithaca, NY: CornellUniversity Press, 2013.5 ROK Forces in Vietnam. Seoul: Ministry of Public Information, (ROK), 1966.Medical relief work in Vietnam began as early as late 1964.

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reconfigure its medical institutions and begin this mobilization

in a compressed period of slightly under two decades (1945-1963)?

Nation-Building: Identifying Resources for Development?

Figure One: Spraying returning Koreans with DDT was a common formof quarantine control during the USAMGIK occupation of 1945-1948(source: 한한 한한한 한한한한한 / Pictorial History of Modern Medicine inKorea, 1879-1960, p. 288).

In terms of the newer scholarship, the position closest to

where this paper begins is the one outlined by Park Tae-gyun of

Seoul National University, who asks numerous questions about the

5

formative role of South Korean economic planners and strategists,

especially for the decade of the 1950s, and carrying into the

early 1960s.6 Set against the framework established by Carter

Eckert in Offspring of Empire (1991), Park argues that ROK

bureaucrats and state planners played an important role in

crafting economic policy as new forms of aid came to Korea.7

Moreover, he continues this project for the Park Chung Hee

period, tracing the reception of Walt Rostow’s modernization

ideas in the Korean context, while preserving an independent

space for the articulation of a specifically Korean version of

events.8 Similarly, I hope to acknowledge the intellectual debt

to both Japanese and American developmental forms of discourse,

while also recognizing that Korean technocrats and health

officials clearly had their own visions of how the nation might

achieve its goals. This project is particularly interesting and

6 Park Tae-gyun, “Different Roads, Common Destination: Economic Discourses inSouth Korea during the 1950s,” Modern Asian Studies, Volume 39, Issue 3,August 2005, pp. 661-682.7 Park develops these ideas extensively in his other writings, including thebook, 원원원 원원: 원원 원원 원원원원원 원원 / Archetype and Metamorphosis: The Origins ofKorea’s Economic Development Plans. Seoul: Seoul National University Press,2007.8 Similarly, I hope to develop the perspective of the Ministry of PublicHealth, along with the ground-level perspective of actors such as doctors andpatients.

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important for the Syngman Rhee period (1948-1960), as it is often

skipped over by historians, who tend to credit Park Chung Hee

(1961-1979) almost exclusively with the successful transformation

of Korean society and the economy.

In terms of its public health, basic infrastructure, and

economic and social planning policies, the Rhee period holds far

more of interest than has been explored to date, especially as

many of the first generation of Korean techno-bureaucrats held

ambitions for the nation well beyond those envisioned by its

Western aid donors. In the interests of time, this paper will

focus on public health as a case study (1945-1963), attempting to

sketch out the various means by which the Rhee government reached

out to its public, especially in the second half of the decade

(1954-1960). Public health was a particularly problematic area

of concern, as the majority of the training and expertise lay

with those who possessed some experience of Japanese higher

education. This created an identity problem for the Koreans who

held these positions, and it was an issue frequently noted by

Western partners, who tried to understand and sometimes minimize

the perceived effects associated with Japanese training.

7

In the period immediately following liberation / haebang in

August 1945, these issues were less obvious, and have often been

overlooked in a historiography seeking to establish patterns of

continuity between Chŏson Korea and the post-1945 era.9 In

contrast to such an approach, I aim to identify the diverse

resources from which an emerging South Korean public health

network might remake itself, recognizing that some of these

elements do not necessarily fit a nation-centered paradigm. The

traces of Japanese training are the obvious example here, but

this observation also holds for the conspicuous presence of

traditional medicine, which represented a problem for both the

American occupying forces, and subsequently, for the first

generation of South Korean public health practitioners.10 In

particular, rural public health represented a problem for the

Japanese, who tended to the large cities primarily, and it was

9 I recognize that the emphasis on South Korea as “new” does not necessarilyfit the narrative of Korean Studies as articulated in its North Americanversion. For the USAMGIK context, see Shin Jwa Sup, “Kunchŏngki ŭibokŏnŭiryŏngchŏngch’aek, “Policy of USAMGIK toward Public Health and Medicinein Occupied South Korea,” Korean Journal of the History of Medicine, December2000, (9.2), pp. 212-232.10 The emphasis on identity appears in the context of the Minnesota project(1954-1962) at Seoul National University Hospital, as well as the ScandinavianProject (1958-1968) at the National Medical Center.

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not clear what form of practice could adequately meet the needs

of rural communities.

With the set-up of a repatriation scheme following August

1945, the occupying authority, USAMGIK (United States Army

Military Government in Korea, or ) established a quarantine

system focusing upon four major port cities—Inchon, Kunsan,

Mokpo, and Pusan–to handle the receipt of returning Koreans, with

the majority of these individuals coming from Japan and nearby

parts of northeast Asia. At the same time, the repatriation plan

also called for the return of thousands of Japanese soldiers,

settlers, and functionaries, with some of these individuals based

in the east and northern regions of China. In short, the Korean

peninsula served as a vast point of entry and departure for much

of late 1945, and well into 1946, placing a severe strain on its

already limited resources, creating conditions suited to a major

outbreak of disease. Arguably, these are the circumstances

representing the origins of a “South Korean” public health, and

along with the Korean War to follow, brought dramatic change to

the medical profession.

9

During the period leading up to formal independence (Sept-

1945 to Aug 1948), the two major issues for setting up a public

health system involved the identity of practitioners. As noted,

those with Japanese training held the majority of the senior

positions, and this trend continued, although not without a good

deal of internal struggle and pressure behind the scenes.

Second, the number of hanuihak (traditional Korean medicine)

practitioners peninsula-wide vastly outnumbered doctors with

Western training, and this trend also held for the near future,

at least for another decade.11 In the short-term, the combined

effect of these two trends was a quarantine system with very

different effects depending upon where one lived and traveled.

At the height of a major cholera outbreak taking place in the

spring and summer of 1946, for example, a patient might be

treated by a traditional practitioner in the countryside, or11 Thomas Turner, “Chapter XVIII: Japan and Korea,” in CIVIL AFFAIRS /MILITARY GOVERNMENTPUBLIC HEALTH ACTIVITIES,” (PREVENTIVE MEDICINE IN WORLD WAR II : Volume VIII),(Ed: John Lada), Office of the Surgeon General, Department of the Army,Washington, DC, 1976, pp. 659-707. See also Military Government Organization- Korea (Historical Summation); Report on Public Health Problems of SouthKorea (Draft Proposal ECA Program - Korea), Brig. Gen. Smith - USPHS, 1945 -1953 ARC Identifier 504011 File Unit from Record Group 331: Records ofAllied Operational and Occupation Headquarters, World War II, SupremeCommander for the Allied Powers. Medical Section. Public Health and WelfareDivision. Administration Section. Smith Report, "Some Problems in PublicHealth in Korea.”

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similarly, be treated by either a Korean or American (Western-

trained) doctor closer to a major city. The same individual

might easily be detained at a number of points, as travel

restrictions were enforced as part of the quarantine regime,

which at its height, even limited the number of individuals

permitted to assemble for public gatherings, including weddings

and funerals.

Some historians have taken hold of this last point to note

the occupation’s similarities with the preceding Japanese period.

In both cases, Koreans found themselves policed, regulated,

inspected, and treated by foreign medical professionals, quite

often with little explanation of the contextual circumstances,

leading to the expression of resentment and confusion. If the

Japanese health authority placed its control under the police

bureau, the occupation was careful to end this practice, aware of

the problems it caused when health representatives came to

quarantine a tubercular patient, for example.12 Still, the

degree of intervention and the lack of information made for an

uncomfortable period of transition, and the image of medicine,

12 The removal of the police authority over public health was one of USAMGIK’sfirst measures.

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especially Western biomedicine, was an ambivalent one for much of

the period preceding the outbreak of war (see Figure One). In an

effort to transform this image, Korean doctors began to form

links with international organizations as early as the late

1940s, sending representatives to W.H.O. (World Health

Organization) conferences beginning in 1946.13 In turn, such

organizations, including W.H.O. and the Rockefeller Foundation,

began to perform inspection tours of the peninsula to survey its

circumstances.14

II. The Korean War: Ideology, Propaganda, and Biomedicine

(1950-1953)

13 “Public Health in Korea,” p. 18. Provided by Seoul National University,PHPS.14 In turn, the Rockefeller visit proved to be enormously influential for theformulation of population policy. See Rockefeller Foundation Survey Trip to the Far East, 1948.

12

Figure Two: Young children receive medical treatment under theauspices of the United Nations. The text reads, “The UN istreating / handling disease.” (Source: Hoover Institute, Stanford University).

With the transition to the Korean War, the importance of

biomedicine was reinforced, taking on an even greater role than

the one it held in terms of disease prevention during the

occupation. The various actors in the war—China, North Korea,

South Korea, The United States, and a diverse array of

international participants—each utilized images of medicine in

some fashion as part of the corresponding propaganda and

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ideological war.15 Again, with time and space constraints, we

cannot look at every possible nuance here, but a survey of the

major actors shows that biomedicine / medicine figured

prominently in the imagination of the various parties, especially

in terms of the ideological package provided if one were to

choose the “right” side in the conflict. The United Nations, for

example, frequently offered images of war relief in its

materials, often with images of young children and orphans under

its care (see Figure Two).16 Similarly, it depicted the

technologies of vaccination and medical care as part of its core

strength, conquering disease, and by extension, the enemy

combatant. Appealing to the individual soldier, the UN offered

skillfully crafted images of loss and regret, asking the North

Korean (and Chinese) GI to consider the costs of participation in

the war.

Such images invoked not only the possibility of physical

injury—the loss of a hand or a limb—but also, the additional

absence of the home and family, with these placed at a distance15 References to the possibility of biological warfare, drawing upon Japanese,Chinese, and North Korean sources, continue to make for a fascinating subtext to the story of medicine during the Korean War. See 16 The National Rehabilitation Center was established with UN assistance afterthe war at Tongnae, near Pusan.

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because of military obligations (see Figure Three). These types

of materials mobilize medicine to locate personal circumstances

in a narrative of incommensurable regress, without the

possibility of return, or any kind of reconciliation. Unlike the

postwar, the emphasis is not on the future and growth, but

rather, on an unrecoverable past, one lost through poor choices.

As for the Communist side, English and Korean language materials

designed to appeal to American and Korean soldiers sometimes

contained such images, but the most dominant themes here focus on

a theme of subsistence: warmth, food, and cigarettes. The

American soldier learns that “his” war is actually one shaped by

the needs of the industrialists, the Rockefellers and the Fords,

and that he need not become invested in such matters. Along

these lines, both sides regularly provided leaflets with “safe

passage” certificates, often rendered in several different

languages, enabling the bearer to cross enemy lines and

surrender. To date, there is not a literature exploring the use

of these documents in the field, but their appearance in multiple

archives attests to the fierce propaganda war taking place.

15

Figure Three: A NK soldier regrets the loss of his right hand,and by extension, the loss of his home and family (Source: HooverInstitute, Stanford University Library). The text above markshis regret, “If only I could hold my child once more . . . ”

With this propaganda war, it becomes extremely difficult to

posit a single or unitary “Korean” viewpoint on the shifting

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image of biomedicine, as there were multiple sources providing

images, posters, and fliers as part of the hotly contested

information war. The ideological gap between North and South

Korea marks the obvious reference point here, but even for South

Korea, for example, there were multiple authorities contributing

to the growing body of discourse on medicine and its possible

benefits. The United Nations and its various sub-bodies—UNKRA

(United Nations Korea Reconstruction Agency) and UNCACK (United

Nations Civil Assistance Command, Korea), among others—provided

the largest volume of materials, but related information

continued to circulate under the labels of various national

bodies, most prominently, the United States (see Figure Four).17

In general, images were meant to be warm, comforting, reassuring

the civilian population that they would be taken care of, despite

the chaos of the surrounding conflict. It is also useful to

recall that many Koreans would not yet have had extensive

experience of contact with Western biomedicine, so the images

17 If The United States was prominent in this activity, there were a number ofother actors, and this is true for the post-war as well. See The National Medical Center in Korea: A Scandinavian Contribution to Medical Training and Health Development, 1958-1968. Oslo: Universitetsforlaget, 1971.

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also offered an introduction, forming part of a process of

familiarization.

Figure Four: NORMASH in Korea (source: author’s collection).Along with the United States, a number of Western partnerscontributed to medical relief work.

III. Postwar Medical and Relief Work (1954-1960)

Balancing Strength and Weakness

The recovery process continued after 1953, and famously,

many of the UN-backed organizations—formed in late 1950 to begin

the work of consolidating a unified Korea—continued their wartime

work as part of reconstruction for South Korea. Here again, the

images and materials circulating offer a wide range of views,

depending on the intended audience, international or domestic,

and also varying a good deal with the medium of language. In

general, though, the use of medicine in the post-war sought to

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present South Korea for the first time as a sovereign nation, no

longer a temporary arrangement. Moreover, especially for an

international audience, keeping prospective donors and patrons in

mind, this was a nation interested in compliance with emerging

mid-century standards of health and hygiene. The pre-war surveys

and tours now became valuable as a form of baseline metric, and

sometimes Japanese-language materials from the 1920s and 1930s

were consulted in the interest of understanding the extent of the

damage brought by war.

In shaping a developmental narrative, the images and

language used to portray post-war South Korea embodied a curious

paradox. On the one hand, the devastation and destruction had to

be represented as severe, a sign of Communist aggression,

justifying the intervention and assistance offered to a neighbor

in need. At the same time, South Korea had to be represented as

resilient, emerging from the problematic situation, as it took

its place as the one, legitimate Korea, in stark contrast to its

unspoken neighbor to the north. In this version of events, the

Japanese colonizer played a minimal role, and the vast majority

of the damage was inflicted with the invasion of June 25th, 1950.

19

Traditional practice was rendered nearly invisible, and

biomedicine took on the burden of providing relief in a variety

of forms. Moreover, the relative shortage of Korean

practitioners was sometimes an issue, and sometimes not,

depending upon whether a particular image was being used to

mobilize funds for scholarships. In any case, these alternating

patterns of strength and weakness offered a paradox as South

Korea began to find its way in early 1954, establishing new

institutions and patterns of health.

This dynamic was further complicated by the relative

position of the nation within an emerging international system,

and scholars are just now beginning to recognize that Korea

represented one of the first test cases for the United Nations

and its stated mission. Along these lines, Eleanna Kim, in

Adopted Territory (Duke University Press, 2010) and Arissa Oh, in the

forthcoming To Save the Children of Korea (Stanford University Press,

2015) have each looked at the development of an international

system for adoption, and at how Korean adoptees were often placed

within a narrative where they were seen as a good fit with white,

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“Christian” families.18 For medical relief, similarly, the power

differential between donor nations and the Korean recipient

sometimes created tensions, and it took considerable time and

effort to translate the various aid packages into tangible

results. In many cases, Koreans needed familiarization with

biomedicine and its possible benefits, as the lingering images

from colonial rule and the occupation left an uncomfortable

legacy.

To begin overcoming the unease, the South Korean government,

especially those bodies specifically tasked with addressing

public health issues, had to generate a new set of images and

associations. This work took place in a context where the Bureau

of Public Health and Welfare had to simultaneously reach out to

its domestic public, while also matching the criteria expected by

its international partners. Not surprisingly, the language of

many of the posters, pamphlets and print materials circulated at

about this time corresponds to this set of needs, including a

number of new phrases presumably translated into Korean.

Similarly, there is a highly visual rhetoric, with a minimum of

18 For more on this context, see the famous memoir from the Holt family: Bertha Holt, Seed From the East, Holt International Children’s Services, 1956.

21

hanja (Chinese characters rendered in Korean usage) in the text

provided, opting instead to render phrases in hangul almost

exclusively. Other materials, available only in English, were

likely designed to reach out to funding agencies and partners,

and presumably had little purchase with a domestic audience.

Creating a Public Health Network

For much of the second half of the 1950s, the priority for

public health consisted of meeting the material needs to get an

effective network up and running. This involved training Korean

doctors and nurses in quantity, which for this period, frequently

involved overseas training and scholarships.19 With this

increase in the number of available personnel, there was a

corresponding effort to place these individuals in settings where

the public could access their skills. However, the problem here

lay with a regional bias continuing to the present day, with the

vast majority of medical personnel preferring to attach

themselves to facilities based in major cities, especially Seoul.

This led to an uncomfortable gap between the urban and the rural,

and again, there is a lengthy history to this trend. As a means

19 Again, the United States was among the most popular destinations, but many others went to Europe as well.

22

of minimizing this problem, the Bureau of Public Health tended to

concentrate on the specific diseases it wanted to target, using

these as its metric to satisfy its patrons.

In selecting its targets, the emerging public health

apparatus identified a set of common issues, and perhaps not

surprisingly, many of these same themes had cropped up previously

with the Japanese, roughly two decades earlier. In particular,

chronic or endemic disease conditions like leprosy, tuberculosis,

and parasites became the core of a program that sought to

remediate these problems in a visible fashion. This type of

problem-centered approach was useful in that it attracted the

attention of donors and supporters, foreign and domestic. And,

at the same time, it offered a form of material testimony to a

program of recovery from the war, with easily quantifiable

metrics in terms of numbers of patients, funds utilized, and

materials purchased. The Japanese context rapidly faded into the

background, with the war remaining as the major explanatory

factor for any issues of lack or deprivation. This elision of

the pre-1945 context was not only convenient in terms of defining

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the material context, but also in terms of handling any identity

issues for Korean personnel.

As for these personnel, training and pedagogy formed the

core of the effort for much of the next decade, carrying well

into the Park Chung Hee period (1961-1979), and arguably beyond.

The post-war generation of Korean nurses and doctors was the

first to benefit from a large-scale infusion of external funding,

providing for new equipment, training, and especially, overseas

study opportunities. For those with prior Japanese training,

here was an opportunity to experience firsthand the latest in

clinical training, and one could return to South Korea with a

“new” professional identity, if successfully negotiated.

Numerous programs of exchange, based primarily in the United

States and Western Europe, established networks for Korean nurses

and doctors in training, with periods of international training

extended to as long as twenty-four months in some cases.20

Collectively, this activity was represented as contributing to a

20 The Minnesota Project, for example, allowed for a period of two years in some cases.

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rapidly recovering nation, and migration was rarely an issue, at

least not publicly.21

Domestically, the effects of this mobilization were felt

primarily in terms of the availability of new resources, although

there remain numerous questions as to how much the average

individual knew of this possibility, and whether he or she cared

to access the facilities. Ministry records for tissue sampling

remain extremely low for the duration of the decade, a testament

to the relative lack of biological work being done in Korean

hospitals.22 Autopsies, similarly, were rarely performed, most

likely due to storage / preservation issues, along with the

considerable cultural baggage associated with the procedure.23

What public health officials could celebrate was the conspicuous

material growth, the visible signs of the incoming funds

translated into sites including new clinics, hospitals, and

health centers. Linking these to disease conditions was helpful

as well, implying that there might be a causal relationship

between the two. 21 At least officially, brain drain did not become a problem for Korean healthprofessionals until after 1965 changes to US immigration law.22 Ministry of Public Health, Annual Report, 1955, 1956, 1957.23 The autopsy has a history dating to the Japanese colonial period, assuming one accepts a biomedical conception of the autopsy.

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The construction of a nascent health network was not

restricted to this period, of course, and continued well into the

Park period, overlapping with the Family Planning (1964-early

1980s) and Anti-Parasite (1969-mid 1990s) campaigns of succeeding

decades. Still, the public health apparatus of the Rhee period,

as thin as it was, provided some semblance of a reporting

mechanism for outbreaks of disease. If there were clear

historical precedents to this, the system now being set in place

could at least claim novelty for itself, poised between two poles

of a tentative narrative. For its origins, the link in the past

was placed with the arrival of missionary medical efforts in the

19th century. The mid-century mobilization then built upon this

activity, and again, was justified in terms of the destruction

caused by war. Biomedicine became a condensed means of telling a

teleological story about the fulfillment of the past, and the

prospects of a bright future lying ahead.

In material terms, medical conditions on the ground by the

late 1950s were probably not substantially different from about a

decade early, the period following the end of the American

Occupation. The number of Western-trained practitioners had

26

increased certainly, but access to such individuals was highly

mediated, to say the least. A combination of factors, including

physical distance, cultural associations, and a lack of easy

access, meant that many individuals continued to use some form of

traditional practice, and this would remain the case through at

least the decade of the 1970s. Drug markets, unregulated from a

present-day standpoint, flourished in many places alongside such

practice, and in effect, health was a matter for self-regulation,

not yet perceived as a concern of the state as a regulatory

matter. This would begin to change in the early 1960s with the

introduction of the first national health insurance scheme (1963)

—although it would evolve dramatically over the next three

decades (1963-1989)—and with the interventionist style of

governing associated with the Park Chung Hee state.24

What changed during these two decades was more a matter of

perception and subtle dgrees of shading. For all of the

criticism it receives, much of it deserved, the Rhee government

initiated many of the practices and reforms which would only come

to their full realization under Park. For medicine specifically,

24 Joseph Wong, Healthy Democracies: Welfare Politics in Taiwan and South Korea. Ithaca, NY: Cornell University Press, 2006.

27

the establishment of new networks of medical exchange meant the

formation of key relationships, many of which carried on through

the early 1970s. The return of large numbers of overseas-trained

Korean doctors and nurses meant a new emphasis on clinical

practice, and this made both sides happy, translating aid dollars

into a menu of routinized behaviors in the hospital. By the late

1950s, the image of medicine placed its emphasis on youth, both

in terms of the relative novelty of the new forms of care, and

specifically, in terms of the patient demographic (see Figure

Six). The Korean War was labelled as past, and recovery and

rehabilitation were tangible, to be accomplished through specific

sets of practices conveyed with international assistance, and

made available to the individual.

28

Figure Six: President Rhee visits a young patient at the NationalRehabilitation Center, recognizing the symbolic importance ofmedicine as a form of recovery in the aftermath of the Korean War(Source: The National Rehabilitation Center).


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