An Aboriginal patient receives a prosthetic leg at Tri-Service General Hospital in 1974. Photo: CNA
– By Jane Rickards and Don Shapiro
The soldiers of the Ming and Qing dynasties described Taiwan as a place where “the disease is endemic”. Yet by the time large numbers of Han began arriving in the mid-17th century, the island’s indigenous peoples had managed to lead generally healthy lives. Japanese researchers then documented how Austronesian people used local herbal remedies to treat a variety of ailments, including headaches and snakebites. Much of this traditional knowledge has since been lost as medical treatments have been passed down orally from generation to generation.
Chinese medicine came to Taiwan when rebel Ming Zheng Chenggong, known as Koxinga, drove the Dutch out of Taiwan in 1662 to establish his own regime. The official Ming Sheng Guang-wen arrived in 1673 and established an institute in Tainan which provided medical assistance. After the annexation of Taiwan by the Qing Dynasty, Taiwanese merchants imported all kinds of traditional Chinese herbs and medicines from the mainland.
Christian missionaries also brought Western medicine to Taiwan during this period. The most notable example is that of George Leslie Mackay, who was sent to Taiwan by the Canadian Presbyterian Church as a medical missionary in 1872. Eight years later, Mackay founded a Western Medical Clinic in Tamsui, the first western medicine clinic in northern Taiwan. Before his death in 1901, Mackay was joined in his practice by many foreign physicians who treated patients for a multitude of ailments, particularly malaria.
Some of today’s major medical institutions in Taiwan, including the Mackay Memorial Hospital and Taiwan Adventist Hospital in the Taipei area and Changhua Christian Hospital in central Taiwan, are products of this missionary heritage. .
When Taiwan was ceded to Japan in 1895, one of the biggest challenges for Japanese settlers was to avoid contracting the communicable diseases that were widespread with high death rates. Malaria even killed a Japanese prince who was part of the invading force.
“Modern medicine was adopted after the Japanese takeover in 1895,” says Andrew Huang, director of the Sun Yat-sen Cancer Center at the Koo Foundation. Determined to bring public health under control in Taiwan, the colonial regime introduced Western medical practices and improved sanitation throughout Taiwan. Modern water purification facilities, for example, have helped fight cholera and other diseases.
At the start of colonization, the Japanese also acted to isolate patients infected with diseases such as bubonic plague, smallpox, cholera, typhoid fever and dysentery. A 20-year-old plague epidemic was not suppressed until 1918. Malaria, once a very serious problem, was attacked by a campaign to eliminate conditions where mosquitoes could breed, such as improved drainage. and the cutting of bamboo forests.
Medical education was one of the few disciplines open to Taiwanese for higher education during the Japanese period. During the first year of Japanese rule, what later became the National Taiwan University Hospital was established as the Taipei Medical Hospital Training Institute in Taipei. In 1937, the hospital was annexed to the Faculty of Medicine of Imperial Taihoku University (now National Taiwan University). Over the decades, it has continued to be one of the leading teaching and research hospitals in Taiwan.
Following the transfer of power from Taiwan to the Republic of China in 1945 and the arrival of around 1.5 million mainland soldiers and civilians in 1949, institutions originally designed to serve the military and veterans have played an important role in the medical development of Taiwan. What is now the National Defense Medical Center, incorporating the Tri-Service General Hospital, evolved from what was originally the Taiwan Army Hospital. The Taipei Veterans General Hospital in the Shipai region of Taipei was established in 1958 and is today one of the leading national medical centers, with branches or affiliated institutions in other parts of the Isle.
Other government-run institutions have been established in various places. One of the strongest networks is the Taipei Municipal Hospital System, which consists of nine branches.
As the Taiwanese economy grew in the last decades of the 20th century, some of the major business groups established affiliated hospitals. A prime example is the Chang Gung Memorial Hospital, established in 1973 by Formosa Plastics founder Wang Yung-ching and his brother Wang Yung-tsai, and named after their father. Chang Gung now operates hospitals at eight sites, with a total of more than 10,000 beds.
Other business groups that have established large hospitals include Cathay, Far Eastern and Shin Kong in the Taipei area and Chi Mei in Tainan. The Koo family, from companies such as Taiwan Cement and CTBC Bank, funded the founding of Taiwan’s leading cancer center.
Religious hospitals are not limited to Christian institutions. Tzu Chi, a leading Buddhist organization well known for its disaster relief, has long run a leading hospital in Hualien and now also has branches in New Taipei City and Taichung.
While Western medicine has long been predominant in Taiwan, traditional Chinese medicine also continues to flourish. It is covered by the national health insurance program and is widely available at specialist clinics and some hospitals.