"Ilha Formosa", or Taiwan, is a healthy island as well as a beautiful one. Ratio of trained medical personnel to population is one of Asia's highest. Some 12,000,000 people are served by more than 12,600 registered physicians, dentists, herb practitioners, pharmacists, nurses, and midwives. Hospitals total 175 and health stations 400. Additionally, many organizations operate their own clinics, and mobile health units make regular rounds of rural areas.
The Department of Health Administration of the Ministry of the Interior and the Taiwan Provincial Health Department administer health services and supervise medical institutions and personnel. Special projects have been carried out with the help of the World Health Organization and other international organizations. Control of most communicable diseases has been achieved. Pharmaceutical plants are licensed and subjected to close inspection.
In 1963, Taiwan had one physician for every 2,322 persons. This is better than the 1-to-3,000 of Korea but inferior to Japan's 1-to-1,000.
A Chinese doctor of medicine must have at least six years of higher education plus a year's internship. His qualifications then are scrutinized by the Ministries of Examination and Interior. He must have certificates from both before applying for a license. Finally, after admission to the local medical society, he is eligible to begin practice.
Medicine is one of the most popular courses of study in Taiwan universities. One reason is respectability and potential earnings. Another is unique to Taiwan. From 1895 to 1945, the Japanese discouraged college attendance by Taiwan Chinese. Those few islanders who did manage to get into institutions of higher learning found doors of the social science departments closed. Only Japanese could study such subjects as political science. So, of the 219 islanders graduated from college in the years before 1945, more than half - 131 - majored in medicine.
Taiwan was restored to the Republic of China in 1945 but medicine has remained a favored course of study. Many high school graduates still regard it as their first choice. In 1963, there were about 4,000 medical students enrolled in four different schools, excluding those at the National Defense Medical Center. The four are the Medical School of National Taiwan University, Taipei Medical College, Chungshan Medical College, and Kaohsiung Medical College.
Nurse Services
The four and the National Defense Medical Center also have popular departments of dentistry and pharmacology. Dentists are in steady demand, perhaps because Taiwan produces lots of sugar to satisfy the perennial Chinese sweet tooth. As for pharmacists, at least one is required for every drug store. Today, there are 814 registered dentists and 1,003 pharmacists. All seem to have plenty of business.
Veterans General Hospital is Taiwan's largest and most modern facility for medical treatment. (File photo)
Four schools and one college of nursing and midwifery graduate hundreds of students annually. Registered with the Taiwan health authorities are 1,595 nurses and 1,990 midwives. Nurses serve the cause of public health with visiting and rural services that include training in environmental hygiene. Nurses also are intensively involved in prenatal care and pediatrics.
China herb medicine still has little scientific validation. Even so, millions of people place their trust in the odoriferous and bitter brews of the herb doctors. The faith may be stronger than the medicine, but results are forthcoming in a surprisingly large number of cases.
In 1963, there were 1,634 registered herb practitioners. Most of them do not have any academic qualifications. Their skills were learned as apprentices. The first attempt at formalization is the Chinese Herb Medicine College, established at Taichung in 1958. It is bringing the scientific method into Chinese medicine. The first class will be graduated next year.
There are 67 public and 108 private hospitals. The Taiwan University Hospital and the Taiwan Veterans General Hospital are the largest.
Taiwan University Hospital has 15 departments: internal medicine, surgery, gynecology and obstetrics, pediatrics, neurology and psychiatry, dermatology, urology, ophthalmology, otorhinolaryngology, dentistry, radiology, experimental diagnosis, pathology, anesthetics, and pharmacology.
Kitchen and food carts of Veterans General Hospital are of the latest design. (File photo)
Medical Research
TUH has 240 doctors, 341 nurses, 27 pharmacists, and 734 beds. It treats an average of 700 out-patients and 600 inpatients daily. It also conducts extensive research. Specific subjects are thyroid gland disease in Hsinchu county, blackfoot disease in Tainan and Chiayi counties, and trachoma in coastal areas.
Taiwan Veterans General Hospital was established primarily for retired servicemen. However, it is partly open to servicemen on active duty and to civilians. With ultra-modern facilities and the latest equipment, the hospital is one of the best in Southeast Asia. It has 700 beds and accepts 5,000 patients a year. It is the first Chinese hospital to have allergy and geriatrics wards.
Other large hospitals are those of the Army, Navy, and Air Force, Shunshan Sanatorium and Hospital, the Central Clinic, and the provincial establishments. Also contributing to a healthy island are 22 county and municipal health departments, 331 urban and rural health stations, and 441 mobile village units. There are 30 stations in aboriginal areas, 12 on the seacoast for salt workers, and 17 for evacuees from Tachen Island.
Special emphasis on public health is laid on areas inhabited by aboriginal peoples. The health administration, in cooperation with some medical institutes, has sponsored free medical training for aboriginal students. Recent graduates are encouraged to serve in mountain areas.
Mental Health
A maternal and child health committee was set up in 1952. World Health Organization and United Nations Children's Fund provided technical assistance and medical supplies. In 1959, the Maternal and Child Health Institute was established to give in-service training research, demonstration, and nutrition education. Eighty-eight free milk bars have been established throughout the island to feed undernourished expectant mothers and pre-school children. A health contest is sponsored annually for children between six months and six years.
Treatment of contagious disease is stressed. Since 1954, 362 trachoma teams have been established in Taipei. In addition to treating children, it conducts seminars for primary schools teachers and for mentally retarded children.
Treatment of contagious disease is stressed. Since 1954, 362 trachoma teams have been organized in local health stations and primary schools to give free examination and treatment. The province is divided into areas of low, medium, and high infection according to the results of a survey. Patients in areas of low and medium infection receive home treatment. Those in areas of high infection, as in the Penghus (Pescadores), receive group treatment without preliminary examination.
Last year, in areas of low and medium infection, 1,059,236 persons in 186,079 households were examined and 555,598 persons in 123,632 households treated. In communities of high infection, 40,969 persons in 8,054 households were under treatment. In addition, about two million primary school children were examined and half of them given treatment.
Malaria Control
Four provincial and 14 county and municipal tuberculosis control centers have been established. They give tuberculin tests and BCG vaccinations to infants and children. Mobile X-ray examination teams make regular visits to villages, schools, military camps, and civic organizations. Health stations undertake treatment of active cases. In 1963, some 449,000 persons received X-ray examinations and laboratory tests, and 21,600 persons were treated.
A venereal disease control center was set up in 1953. It has trained and organized 435 teams at local health stations. With the assistance of midwives, it enforces blood tests for pregnant mothers and new-born infants. Free treatment is given. In 1963, 527,722 persons and 18,032 expectant mothers received blood tests. Results were positive in 4.7 per cent of the cases. Of those treated, 74 per cent were pronounced cured.
Malaria once was serious in Taiwan. A house-to-house DDT campaign was started in 1952 with outstanding results. Preventive work is still carried on through examination of blood smears, house-to-house surveys, and follow-up of old cases. According to the annual report of WHO's Western Pacific Regional Office, total eradication of malaria is expected by the end of this year.
Since a cholera epidemic in the summer of 1962, annual inoculations have been mandatory for the general population. Eighty-four per cent of the population was inoculated last year. Evaders are fined.
Taipei blood bank serves 43 medical installations. (File photo)
Inoculation against diphtheria and pertussis (whooping cough) are compulsory. Children between six months and two years receive DP (diphtheria and peruses) vaccine in three injections. Those between two and six receive two injections against diphtheria. Smallpox vaccination and plague prevention measures are carried out by local health department.
Taiwan has increased its vigilance against epidemic diseases with improved environmental sanitation. This includes rural sanitation, demonstration and experiment in disposal of garbage and night soil, demonstration of improved sanitation in handling foodstuffs, better industrial hygiene, training of sanitation workers, and analysis and purifying of drinking water. The Taiwan Provincial Foodstuff Sanitation Commission was set up to supervise the purity of ice cream and popsicles, beverages, fresh fruits, and canned goods.
Eight quarantine stations are in operation. Three are at the international seaports of Keelung, Kaohsiung, and Hualien, and one at the international airport of Taipei. The remaining four are domestic stations at Putai, Anping, Tainan, and Makung.
A new pharmaceutical industry is keeping pace with demand for medicines and reducing the cost of better health. In 1950, Taiwan imported most of its pharmaceuticals. Today some 650 plants are turning out more than 2,000 products. According to a survey conducted by the Ministry of Economic Affairs last year, 174 plants are Class A, which means they can manufacture drugs for inoculation. Because of the industry's growth, imports of pharmaceuticals that can be made locally are controlled by the government.
Medical advances and improved sanitation have steadily reduced the death rate. In 1963, it was 6.26 per thousand, down 3.14 in a decade. The infant mortality rate dropped dramatically from 155.36 per thousand in 1934 to 31.41 per thousand in 1963 despite a high birth rate (36.01 per 1,000 in 1963). Life expectancy of men was 63.10 in 1963, compared with 62.19 in 1950. Women advanced from 65.66 to 67.24 in the same period.