Published online Mar 13, 2024.
https://doi.org/10.3349/ymj.2023.0445
Ssangcheon, Life of Lee Young-Choon (1903–1980)
Lee Young-Choon was born in Yonggang-gun, South Pyongan Province in 1903, and experienced Korea’s modern and contemporary history firsthand. His lifetime included the change from the Korean Empire to the Japanese colonial period, the U.S. military administration, the Korean War, and the Fifth Republic after the establishment of the Republic of Korea (Fig. 1).
Fig. 1
(A) Lee Young-Choon around 20 years old. (B) Lee Young-Choon around 50 years old.
Lee Young-Choon entered public elementary school at age 10 and completed primary studies at age 14. Two years later, he entered Pyongyang High School. In April 1923, he was appointed as a teacher at Byeolchang School in Seongcheon-gun, South Pyongan Province, where he first encountered rural life, and worked there for one year.1
In 1924, Lee was transferred to Gyeongbuk Daegu Elementary School. While working at Daegue Elementary School, he contracted recurrent tenosynovitis and was forced to retire and stayed with his older brother in Sinmak, Hwanghae Province. There, he received treatment from Kim Chan-du, a practicing doctor and graduate from Severance Union Medical College (SUMC), and became interested in becoming a medical doctor himself.1 At last, Lee passed the medical school entrance exam and was admitted to SUMC in April 1925.
In 1929, Principal Olive R. Avison’s graduation admonition became Lee’s motto2, 3: “From now on, you will be entrusted with a noble and useful job. Treat your patients with the best of your ability. But remember, the prevention is better than a cure. There will be fewer opportunities for you to be ignored for prevention, but you will stand in a high position as a person of public interest. Christ purified sinners, but his greater work was the provision of power to keep men and society pure. Public health is the ultimate goal of medical research and effort. This goal will be promoted by educating the public about the laws of health. Only medical doctors can do this, and it is their natural duty. It would be a great honor for SUMC if our graduates took the lead in this great mission for our society.”
In 1930, by the recommendation of his older brother and father, Lee Young-Choon was appointed as a community doctor at Pyeongsan Hot Springs in Hwanghae Province, where he treated about 150 residents of mountain villages. He worked as a medical practitioner for three years, but was discontent and stressed. His experience with patients in extreme poverty was difficult.1 He returned to the Department of Pathology of SUMC in April 1933.
Professor Watanabe of Keijo Imperial University introduced Lee Young-Choon to a farm owner (revised; Kumamoto Rihei) who was looking for a medical doctor to provide a free medical treatment service to Korean farmers.1 Though most of Lee Young-Choon’s family discouraged him from moving to the countryside, his senior coworkers encouraged him to accept the worthy challenge. However, the impoverished rural community again depressed Lee Young-Choon.
LIFE IN GUNSAN
In April 1935, the true path of young Lee Young-Choon began to unfold when he moved to Gunsan, Jeollabuk-do, where performed free medical care to 20000 families of 3000 tenant farmers belonging to Kumamoto farm.4 For 10 years, before Korea’s liberation from Japan, Lee Young-Choon worked at the Gaejeong Jahye (which means charity) Clinic, treating a total of 212000 patients for an average of four times per year. The total cost of this care was estimated to be about 800000 won, approximately 5%–10% of the farm’s profits.3, 4
Lee Young-Choon next served as a medical doctor at Gaejeong Elementary School in 1938, providing physical examinations, including temperature measurement and tuberculosis tests, to students. A health room was built at Gaejeong Elementary School in 1939, Daeya Elementary School in 1941, and Hwaho Elementary School in 1942. With the cooperation of the Jeollabuk-do authorities, school nurses were hired in each school. The student hygiene lecture emphasized the mission of personal hygiene. A total of 40 teachers from Okgu-gun held a three-day school hygiene lecture in 1941.
In 1936, rice balls were provided as school meals for 340 undernourished children due to severe drought for three months. Then, in 1940, 560 Gaejeong students were vaccinated with T.A.C., a tuberculosis immunization, to prevent tuberculosis (Fig. 2). Cepharanthine was obtained for the tuberculosis treatment from Japan, and the clinic also provided open treatment to both tenants and outpatients in 1942.3 An X-ray device for diagnosing tuberculosis was purchased, but not put into use. In August 1952, Korea began its first prevention measure against mass tuberculosis, known as the BCG vaccination project, at the request of the Ministry of Health and the World Health Organization.3
Fig. 2
(A) Students gathering at the playground to receive BCG vaccination. (B) Medical staff training before BCG vaccination.
In May 1951, the plans were made to open a nursing school, and in July, the Minister of Health approved the establishment of the Gaejeong Advanced Hygiene Technology Training Center. In March 1952, Hwaho Girls’ Middle School received approval, and Hwaho Girls’ High School was established in May 1961.3
RESEARCH PAPERS AND RURAL HYGIENE
Lee Young-Choon published his first paper on menstruation of Korean female students4, 5 under the guidance of James D. Van Buskirk (1881–1969) in the Department of Physiology at Severance Hospital. During his one year of research, Lee published eight papers in academic journals in Korea and Japan.
In 1935, Lee Young-Choon wrote his thesis, “Study on the Effects of Nicotine on Sex Hormones,” and five short papers in English and submitted them to Kyoto University, Japan, as a doctoral thesis. He received his doctoral degree in medicine on August 30 of that year.4
THE INSTITUTE FOR RURAL HEALTH (IRH) AND GAEJEONG RURAL HEALTH CENTER (GRHC)
Gaejeong Central Hospital opened with six departments, and the long-awaited Institute for Rural Health (IRH) opened in November 1948.4, 6, 7 Lee Young-Choon was convinced of the national potential in rural areas, and focused on rural society and peasant life in his research. His goal was to improve rural health and culture by enhancing people’s living conditions. The IRH researched rural society and farmers’ lives in general, published 47 research papers, and published Rural Hygiene as an academic journal (Fig. 3).
Fig. 3
(A) Journal of Rural Hygiene published by the Institute for Rural Health. (B) The contents of Journal of Rural Hygiene.
The IRH was headed by Lee Young-Choon and operated by a general affairs manager and 20 research doctors in the areas of public hygiene, maternal and child hygiene, environmental hygiene, epidemiology, menstrual hygiene and nutrition, and a testing laboratory. The area of public hygiene studied and practiced the prevention of infectious diseases, prevention of parasitic infections, tuberculosis, sexually transmitted diseases, maternal and child health, nutrition, environmental hygiene, and public health education.
The preventive medicine guidance project began in August 1954 in Gaejeong-ri as a pilot program for maternal and child health in local villages. In March 1956, the program was expanded to the entire Gaejeong-myeon region with the opening of the Gaejeong Rural Health Center (GRHC). The GRHC provided care for maternal health, infant health, children’s health, prevention of sexually transmitted diseases, tuberculosis, acute infectious diseases, environmental hygiene, health education, and testing. According to a weekly timetable, midwives were on-call at the center to provide various examinations, treatments, local guidance, and home visits at any time of day. Midwives were also assigned to visit each patient every day until one week postpartum (Fig. 4). Research and activities at the IRH and GRHC were often reflected in government policies.
Fig. 4
(A) Lee Young-Choon making home visits to perform health checks. (B) Making a visit to patient's home with nurses.
MEDICAL DELIVERY SYSTEM AND CLINIC
Starting with Jahye Clinic in 1935, eight clinics were opened around Gaejeong Central Hospital and Hwaho Central Hospital (Okgu Jigyeong, Okgu Impi, Okgu Haeseong, Gimje Cheongha, Gimje Juksan, Gimje Gwanghwal, Iksan Palbong, and Wanju Jochon).3 These clinics were operated according to the needs of the villagers and their economic status (Fig. 5).
Fig. 5
Korea after liberation (1945–1958). Scope of Lee Young-Choon’s medical activities (Gaejeong, Hwaho Central Hospital, 8 clinics).
Each clinic primarily treated farmers and transferred difficult patients to the secondary institutions Gaejeong Central Hospital and Hwaho Central Hospital. Severe cases were transferred to larger hospitals in Jeonju or Seoul.3
DEVELOPMENT OF A KOREAN WELFARE MODEL
Centered on Lee Young-Choon, Gaejeong Central Hospital and Clinic, Gaejeong Nursing School, and Gaejeong Church operated cooperatively (Fig. 6). For 45 years, Lee Young-Choon dedicated himself to serving in Gaejeong, focusing on health hygiene, welfare, school education, talent training, and church planting. These areas are emblematic of the traditional Korean welfare model.3 Starting in 1896, Western missionaries from the U.S. Southern Presbyterian Church were active in Sudeok Mountain, Gunsan, focusing on schools, hospitals, and churches (Gunsan Station). Lee Young-Choon worked at the Gaejeong Station, a similar organization to the Gunsan Station.
Fig. 6
Gunsan (Okgu-gun), Jeollabuk-do in the 1970s. Panoramic view of Gaejeong Hospital, Psychiatric Hospital, College of Nursing, and Infant Home.
CONCLUSIONS
Lee Young-Choon, born in 1903, profoundly impacted Korean healthcare, particularly in rural regions. He began his journey as a teacher, and transitioned to medicine after an inspiring encounter. He received his medical degree from Severance Union Medical College in 1925. Lee’s dedication to rural health was unwavering; he established the Institute for Rural Health in 1948 and tirelessly worked in the Gaejeong area, where he provided free medical services, conducted vital research, and contributed significantly to public health education. His legacy includes pioneering efforts in preventive medicine and rural healthcare, setting a foundation for future healthcare advancements in Korea.
The authors have no potential conflicts of interest to disclose.
AUTHOR CONTRIBUTIONS:
Conceptualization: Kang-Hyu Lee and Chang-Seop Lee.
Data curation: all authors.
Formal analysis: all authors.
Investigation: all authors.
Methodology: all authors.
Project administration: Kang-Hyu Lee.
Resources: Kang-Hyu Lee, Joo-Min Lee, and Soon-Jae Yoon.
Supervision: Soon-Jae Yoon.
Validation: all authors.
Visualization: Kang-Hyu Lee.
Writing—original draft: Kang-Hyu Lee and Chang-Seop Lee.
Writing—review & editing: all authors.
Approval of final manuscript: all authors.
References
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Lee BH. [Dr. Ssangcheon Lee Young-Choon, a humanist who devoted himself to farmers for 77 years]. Gunsan Culture 1989;3:22–42.Korean.
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Park YJ. [The foundation of the Institute for Rural Health, and its activities in the 1940-60s]. History and Reality 2009;72:253–287.Korean.
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Yoon SJ. The life and significance of Lee Young-Choon, a model of Korean rural welfare missions; Proceedings of the 8th Spring Conference of the Academy of Korean Social Welfare History; 2019 June 14; Gunsan, Republic of Korea. Seoul: The Academy of Korean Social Welfare History; 2019. pp. 25-42.
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Yeo IS. [Basic science education and research at Jejungwon and Severance Medical School]. Yonsei J Med Hist 2009;12:43–58.Korean.
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Choi WG. [Ssangcheon Lee Young-Choon’s understanding of foreign health and social policies through my affiliate book]. J Soc Welf Hist 2020;3:36–56.Korean.
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