Lesson Fifty-Two

Medical Imperialism on the Korean Peninsula

Welcome to this edition of Roundabout History, where we will be diving into the intricate history of medical imperialism on the Korean Peninsula. This newsletter discusses the evolution of healthcare in Korea, from traditional medicine to modern practices, and examines the profound impact of Japanese colonization, the Korean War, and the subsequent division of the peninsula on health equity.

Colonization and Division: A Fractured Foundation

The Korean Peninsula has long been shaped by foreign domination and internal upheaval. Among the most consequential periods was the Japanese occupation from 1910 to 1945, during which Koreans were stripped of autonomy and relegated to second-class citizens in their own land. This colonial rule fractured a unified Korean identity—an identity still struggling to recover.

Healthcare, a basic human right, was deeply affected during this era. The Japanese colonial government prioritized the health of Japanese settlers while neglecting the well-being of Koreans. This disparity became painfully evident during the Spanish Flu pandemic, when Korean mortality rates far exceeded those of the Japanese population. While some efforts were made to address public health issues like leprosy, most healthcare initiatives served imperial interests rather than local needs.

This period of systemic neglect laid the groundwork for the vastly different healthcare systems that would later emerge in the North and South. When Korea was forcibly divided along the 38th parallel in 1945—splitting the peninsula into Soviet-backed North Korea (DPRK) and U.S.-backed South Korea (ROK)—it did so not on equal footing, but on the fractured remains of a colonized nation.

The Rise of Traditional and Western Medicine

Before Western influences, Korea relied on Traditional Medicine (TM), introduced from China through Buddhism. TM focuses on prevention and maintenance using methods like acupuncture and herbal remedies. Even today, TM remains popular in Korea, with 69% of the population having used it as of 2012.

The late 19th century brought Western medicine to Korea, primarily through Christian missionaries. The first Western hospital, Chejungwŏn, was established in Seoul in 1885 by U.S. doctor Horace N. Allen. This institution marked the beginning of Western medical practices in Korea, integrating meticulous record-keeping and patient care.

Post-War Division and its Aftermath

The division of Korea after World War II created two very different nations: the Soviet-backed North Korea (DPRK) and the Western-backed South Korea (ROK). This division set the stage for the Korean War (1950-1953), which devastated both countries but hit the North particularly hard. The war's aftermath left the DPRK's infrastructure, including healthcare facilities, in ruins.

The South Korean Miracle: The Minnesota Project

South Korea's rapid recovery and development can be attributed in part to significant foreign aid, particularly from the United States. The Minnesota Project (1954-1961) was a joint initiative between the ROK and the U.S. aimed at rebuilding South Korea's healthcare system. This project provided training, advisory services, and medical equipment, significantly advancing South Korea's medical infrastructure and education.

Today, South Korea boasts a robust healthcare system, with universal health coverage achieved in just 12 years (1977-1989). Life expectancy has soared from 52.4 years in 1960 to 78.5 years in 2005. South Korea's effective management of infectious diseases, such as tuberculosis and COVID-19, further underscores its healthcare prowess.

North Korea's Struggle: Isolation and Dependency

In contrast, North Korea's healthcare development has been hampered by isolation and limited foreign aid. The Korean War destroyed much of its infrastructure, including approximately 1,000 hospitals. Despite some aid from communist allies and international organizations, North Korea's healthcare system remains underdeveloped and reliant on external assistance.

The North's healthcare infrastructure is vast but inefficient, with many hospitals lacking basic supplies and heating. The country continues to battle high rates of tuberculosis and malnutrition, exacerbated by recurrent natural disasters and a lack of sustainable agricultural practices.

Closing Thoughs: Health as a Measure of Power

As we've explored, public health is more than a domestic concern—it's a key indicator of a nation's development and global standing. South Korea, bolstered by early international support through initiatives like the Minnesota Project, transformed from a struggling post-war state into a global leader in healthcare, technology, and diplomacy. In contrast, North Korea, isolated and under-resourced, remains dependent on external aid to meet even basic health needs.

A nation's ability to care for its people is deeply tied to its influence on the world stage. While the South engages as a collaborative power, the North’s presence is often marked by crisis and threat. For North Korea to move beyond survival and claim a constructive global role, investment in sustainable healthcare and agriculture will be essential. The lessons learned from Korea's past can guide future efforts to address health inequities worldwide.

Until next time, remember to embrace the lessons of history, but never get caught up in its cobwebs.

Warm regards,

Hugh