Once dreaded poliomyelitis is largely conquered in Taiwan. A survey conducted by the Taiwan Provincial Health Department in 1968 reported 168 possible cases of polio compared with the 760 of 10 years before. The rapid decline in the number of cases was the result of widespread use of Salk vaccine beginning in 1963. The Taipei area alone reported 3,523 post-polio children in 1966 but only 2,579 in 1969.
Children were given Salk vaccine annually until this year. Beginning last July, the Taiwan Provincial Health Department implemented new regulations in polio prevention. A child is given Salk vaccine when he is three months old and again at four months and five months. The three inoculations provide immunity.
By 1964, some 48,000 Taiwan children aged up to 14 had been disabled by polio. Little attention was given the problem until 1953, when extensive but unofficial surveys were conducted. Unlike the blind, deaf and dumb, who now have educational opportunities and social acceptance polio-crippled children were neglected until very recently. Some have been overprotected but most have been ignored. Schools have not provided special facilities.
As of May, 1969, a total of 52 governmental and private organizations were assisting the disabled in Taiwan. Taipei City had 10 such establishments and Changhua County had 6. Most of these rehabilitation operations are private. Financial assistance comes from government and religious and charity organizations. Yet the scope of the rehabilitation effort is still inadequate to the need.
In 1964, Madame Chiang Kai-shek inspired the first all-island survey of the crippling effects of polio. More than 3,200 of the 48,000 victims counted were from the families of those in military service. General Chiang Ching-kuo, then the Minister of National Defense, asked Madame Chiang to consider establishing facilities for military family victims at the Hua Hsing Children's Home. Hua Hsing had been opened in 1955 for 78 orphans of the Yi Chiang Shan martyrs and for refugee children evacuated from Tachen Island and was not intended to accommodate crippled children. Madame Chiang decided that a separate hospital-school should be established.
In the fall of 1964, a preparatory committee was organized. Madame Chiang chose Shihpai in suburban Taipei as the site. Area is 25,000 ping (900,000 square feet). Part of the land was donated by the Ministry of Defense and the rest purchased. First-stage construction was completed in March of 1967. A nine-member board of trustees was organized with Madame Chiang as chairman and the institution named the Chen Hsing Rehabilitation Center. The late Dr. Chang Hsien-lin, former head of surgery and later general adviser to the Veterans' Hospital in suburban Taipei, was named director and Dr. Peng Ta-mou, chief of medical re search at the Veterans' Hospital, as deputy director. In February, 1969, Dr. Peng succeeded Dr. Chang and Dr. John Chen, professor of internal medicine at the National Defense Medical Center and specialist in chest diseases, was named deputy director.
The original plan of caring only for children was expanded to provide services to disabled adults. The enlarged concept includes corrective surgery and the training of medical and rehabilitation personnel.
Chen Hsing gives treatment, rehabilitation and education to 410 post-polio children. On the staff are 57 therapists, 12 doctors, 12 teachers, 1 consultant, 3 supervisors, 1 clinical coordinator, 7 limb and brace shop technicians, 4 social workers, 9 general nurses, 3 operating room nurses and 2 registrars. Employees total 130.
Admission is granted after an individual case study. Preference is given military dependents. The treatment period is from three to six months. Periodic check-ups are given after discharge.
Patients will reach a total of 500 with the inclusion of cerebral palsy victims. Assistance is given post-polio children registered with local health bureaus. An average of 40 are treated weekly.
The building complex includes a main office, four medical departments, operating room, wards, activity center, kitchen, living quarters for employees, in-service training center and workshop for making artificial limbs, braces and crutches.
Children attend school for half a day and receive medical and therapeutic treatment during the other half. The social service department conducts surveys and family interviews. The education department operates a kindergarten and elementary school. The in-service class trains therapists.
In-patients are admitted after a medical examination. They take a bath and are given hospital clothing. The education department enrolls children in their proper grade.
The medical therapy department gives speech therapy to cerebral palsy children as well as routine physical therapy, rehabilitative therapy, occupational therapy and hydro-therapy. Polio victims receive massage treatment. They lie on elevated beds while therapists revive crippled muscles. The heated indoor swimming pool provides recreation for therapists as well as treatment for post-polio children.
Box-like tables dot the occupational therapy room. Crippled children are taught to stand or sit inside the cubicles and make handicrafts. Many articles are of marketable quality. Facilities for adults include an exercise room, kitchen for instruction in cooking and small workshop.
Liao San-san is a typical post-polio patient. Stricken at the age of 7 months, he is now 14 and reached Chen Hsing in 1968. After a few months in braces, he could stand up. In six months he could walk and even run a little.
Before Liao San-san arrived at Chen Hsing, he did not know how to take care of himself. He began training in daily living as soon as he became a patient. He learned how to take a bath, make his bed, open doors, use electric switches and control his bodily functions.
Liao couldn't even use crutches when he was sent to the rehabilitation room. He leaned against the wall and tried. He took a step. He took another step. He fell. He got up on his own without crying and tried again. Soon he was able to walk. He proudly watched himself in the large mirror as he tried to follow the straight line on the floor.
The day came when Liao walked into the classroom, greeted his teacher, put his crutches underneath his little desk and sat down. The teacher then told him to go to the blackboard. Liao got up, supported himself on the crutches and edged his way to the steel bars lining the blackboard. Proudly he stood there in front of the class. He returned to his seat the same way.
Chen Hsing rehabilitated 220 post-polio children in 1968. However, some 3,000 are waiting to be treated.
Many private and religious organizations are helping polio victims. They include the Yi Kuang Orphanage in Taipei, the Norwegian Missionary Alliance's Christian Hospital at Pingtung in southern Taiwan, Gladys Aylward's Home for Children in Taipei, St. Benedict's Home for Children at Tamsui in northern Taiwan, the Mennonite Hospital at Hualien and St. Mary's Hospital at Lotung.
There are two important outpatient rehabilitation centers in Taipei. That at Mackay Memorial Hospital was established in 1965. Family interviews are conducted before the start of rehabilitation. Occupational therapy, training for daily living and pre-school education are offered.
The Taipei Rehabilitation Center also was founded in 1965 under the joint sponsorship of the National Society for the Rehabilitation of the Disabled and the National Rehabilitation Center of the Ministry of the Interior. It was reorganized as a private institution in 1967. Services include therapy, vocational assistance and family re-education. A four-story vocational rehabilitation building is planned.
A whole new industry has grown up to manufacture artificial limbs, braces and other equipment for the crippled. Taiwan has about 10 such manufacturers turning out wheelchairs, crutches, walkers and other items.
Technology is not yet up to making all the parts for artificial limbs, hands and joints. But interest in rehabilitation is such that the technological lag won't be long. Similarly, the crippled are fast winning acceptance and their rightful place in society.