전후 식민지 홍콩의 보건의료 — 1946~1964년 새로운 과제와 보건당국의 대응을 중심으로 —

Abstract

Since the 1894 plague epidemic, Hong Kong’s colonial medicine had improved, which in part accompanied by the economic growth given Hong Kong being an import node of the British Empire’s Asian trade network. Yet, colonial medicine has emphasized the ‘prevention of infectious diseases’ and ‘quarantine’ strategy and ‘medical service’ was left to the medical market. Charitable organizations, especially that of Chinese elites, devoted themselves to meeting the shortage of public medical services; such an approach aligned with the British’s intention that minimizes intervention on Chinese society. Some people also relied on traditional Chinese medicine as an alternative.<BR> The Chinese civil war and the establishment of the People’s Republic of China during late 1940s led to a rapid increase in population in Hong Kong, leading to the extreme shortage of public medical services. The Chinese society in Hong Kong has continuously demanded authorities solve medical problems such as high medical costs and the lack of doctors. So far, the colonial authorities only introduced temporary measures, for example, letting unregistered “refugee doctors” who migrated from the mainland work for the government medical services and charity clinics.<BR> The government’s approach to public health care, however, had a major turn from the political and societal pressure. China’s renewed policy toward Hong Kong, the so-called ‘united front’ strategy, raised an awareness of the internal security of Hong Kong. The colonial authorities needed to curb the encroachment of the Chinese Communist Party (CCP) and consolidate colonial rule. Coupled with political considerations to solidify morale or the public sentiment, many public health issues which were previously overlooked were to be handled.<BR> From the late 1940s to the early 1960s, one of the key issues in public health was to keep ‘unregistered’ doctors and ‘charity clinics’ as well as Traditional Chinese Medicine(TCM) practitioners under government control. For this purpose, the government revised the Medical Registration Ordinance, and enacted Clinic Ordinance. In the process of the amendment and the enactment of ordinances, the health authority allowed unregistered doctors to sit in special medical license exams in 1957, 1958, and 1959 without exception, although it was planned for governmental employees initially. It was a gesture of the colonial authority to embrace ‘refugee doctors’ as a member of Hong Kong society to serve for Hong Kong people. Besides, these ordinances provided the colonial government chance to estimate the scale of unregistered doctors and clinics. Furthermore, since these two ordinances illegalized former medical practices of unregistered doctors who worked for charity clinics for the poorer section of the public, except for exempted clinics, it became the inescapable responsibility of the government to provide sufficient public health care services to meet the people’s demand for affordable medical services. A medical white paper of 1964, entitled The Development of Medical Services in Hong Kong which includes medical development plans for the next 10 years, describes how medical care policy was redefined to meet the basic medical needs of Hong Kong people who could not afford private medical care.<BR> In summary, Hong Kong developed these ordinances part as a tool for social/political control and but also a measure to serve the public by refining public health scheme. By taking lens that takes into account changing relations between Hong Kong and the Mainland China, this paper expands previous limited understanding of how the Hong Kong’s colonial medicine had developed during 1940s to 1960s.