II. Public Health Policy
 Timeline of communicable disease epidemics and issuances of health-related decrees in Taiwan (1895-1920)
After the Meiji Restoration, Japan implemented comprehensive Westernization policies. Its medical and public health systems were gradually developed in accordance with European and American countries. In 1874, a modern medical system was instituted; and in 1875, the Health Bureau was formally established under the Ministry of Education, Science, Sports, and Culture as a specialized agency for public health administration. Influenced by the prevalence of miasma, the emphasis of modern public health till the mid-19th century had been on the improvement of environmental sanitation for disease prevention. Then from the end of the 19th century to the beginning of the 20th century, the development of bacteriology, immunology and preventive medicine became the basis for prevention and control of communicable diseases. In April 1896, the Government-General of Taiwan appointed Gotō Shinpei, the then Head of the Medical Bureau of the Home Ministry, as consultant to devise plans for Taiwan’s public health system. During his tenure, he first dealt with the problem of opium addiction among Taiwanese and formulated a series of policies for a gradual ban on opium. In line with opium prohibition measures, Gotō, a medical doctor himself, recommended establishing a public medical system and building government hospitals. To improve sanitation infrastructure in Taipei City, Gotō recruited William K. Burton, a professor of engineering at the Tokyo Imperial University, as project consultant for the Government-General of Taiwan (Office of the Governor-General). Burton’s ideas of urban planning, besides sewage removal, also included provision of clean filtered drinking water, well-ventilated residences with proper shade and cities with good planning and management for better sanitation. In March 1898, Kodama Gentarō, the new Governor-General of Taiwan, and Gotō Shinpei, the Head of Department of Civil Affairs, assumed office in Taiwan. Gotō regarded Taiwan as an experimental ground for colonial rule according to biological principles. He first conducted scientific investigations and then adopted gradual measures corresponding with the actual situation. His work plans targeted at understanding the natural environment of Taiwan, helping Japanese adapt to Taiwan’s living conditions, and improving sanitation. In 1899, a committee was established to investigate endemic and communicable diseases in Taiwan. In 1901, the Provisional Council for the Investigation of Old Habits of Taiwan was created to carry out a decade-long investigation into folk medicine and healthcare. In 1906, Institute of Research of Government-General of Taiwan was set up to conduct preventive medicine research for reference when formulating colonial healthcare measures. In June 1898, the Government-General of Taiwan introduced reforms of the official system, promulgated medical regulations and established a health administration and medical system according to the principles of scientific colonial policy. The new medical system comprised government hospitals, doctors and medical schools with Japanese doctors as the core and doctors with western medical education gradually replacing traditional Chinese medicine doctors.
Figure 3: Rules for Communicable Disease Control in Taiwan
Source: Identifier: 000000610160112, 000000610160113, Official Documents of Government-General of Taiwan (1895-1947) In October 1896, the Government-General of Taiwan promulgated the first health-related legislation – the Communicable Disease Control Act. The rules stipulated eight communicable diseases, namely bubonic plague, smallpox, cholera, typhoid fever, paratyphoid fever, dysentery, diphtheria and scarlet fever. The rules also specified basic epidemic control measures, including setting up quarantine stations, isolating patients, blocking traffic routes, disposing of corpses, and doctors’ obligation to report the epidemic; that is, isolation and blockade are the main methods of epidemic control.
 Figure 4: External view and laboratory of Institute of Research of Government-General of Taiwan in 1912
Source: Identifier: C0069_19120310_0006_a01-0001, C0069_19120310_0005_a01-0001, Reports from Institute of Research of Government-General of Taiwan The Institute of Research of Government-General of Taiwan had two sections: Chemistry Section and Health Section. The Health Section conducted basic research on prevention of general and special diseases in Taiwan, its natural conditions and climate, public health facilities, bacteriology, epidemiology, and parasitology.
 Figure 5: Regulations for Public doctors Source: Identifier: 000000610100070-000000610100072, Official Documents of Government-General of Taiwan (1895-1947) In June 1896, the Government-General of Taiwan formulated regulations for public doctors, stipulating that public doctors were required to assist in medical care related to communicable, epidemic and endemic diseases, quarantine and disease control, autopsy, public health and medical statistics. The Government-General of Taiwan regarded hospitals and doctors as basic medical facilities for colonial healthcare, and public doctors should collaborate with local police to promote public health.
 Figure 6-1: Medical School of Government-General of Taiwan (Left) Figure 6-2: The Government-General of Taiwan appointed Tsai Chang-sheng public doctor in Keelung (Right) Source: (6-1) Identifier: C0032_19150215_0003_a03-0001, Taiwan Photo Albums. (6-2) Identifier: 000014400310143, Official Documents of Government-General of Taiwan (1895-1947) In 1897, the Government-General of Taiwan set up the “Taiwanese Doctor Training Institute” in Taipei Hospital, and selected Taiwanese who could speak Japanese as teachers. After Gotō Shinpei became the Head of Department of Civil Affairs in 1898, he persuaded the Japanese Diet to pass the budget for this institute. In March 1899, the Medical School of the Government-General of Taiwan was formally established. Graduates of this school were required to take up appointments designated by the Government-General of Taiwan for 5 years, serving as assistants and undergoing one to two years of internship in government hospitals. Tsai Chang-sheng, son of Tsai Sheng, a traditional Chinese medicine doctor, was among the first batch of graduates of 1902. Since graduation, he had served as an assistant in Taipei Hospital, and a medical staff in Taipei Prison. From 1908-1911, he was appointed public doctor in Keelung. |
