Tracking Taiwan’s Medical History

An Indigenous patient receives a prosthetic leg at Tri-Service General Hospital in 1974. Photo: CNA

— By Jane Rickards and Don Shapiro 

Ming and Qing Dynasty soldiers described Taiwan as a place where “disease is rampant.” Yet before large numbers of Han people began arriving in the mid-17th century, the island’s indigenous peoples had managed to live generally healthy lives. Japanese researchers later documented how the Austronesian peoples used local medicinal plants to cure various ailments, including headache and snake bite. Much of that traditional knowledge has since been lost as medical treatments were passed down orally from one generation to the next.

Chinese medicine came to Taiwan when Ming rebel Zheng Chenggong, known as Koxinga, drove out the Dutch in Taiwan in 1662 to set up his own regime. Ming official Sheng Guang-wen arrived in 1673 and set up an institute in Tainan that provided medical assistance. After the Qing Dynasty annexed Taiwan, Taiwanese merchants imported all kinds of herbs and traditional Chinese medicines from the mainland. 

Christian missionaries also brought Western medicine to Taiwan during this period. The most outstanding example is George Leslie Mackay, who was sent to Taiwan by the Canadian Presbyterian Church as a medical missionary in 1872. Eight years later, Mackay founded a Western medical clinic in Tamsui, the first Western medicine clinic in northern Taiwan. Before his death in 1901, Mackay was joined in his practice by many foreign doctors who treated patients for a host of diseases, especially malaria.

Some of the leading medical institutions in today’s Taiwan, including the Mackay Memorial Hospital and Taiwan Adventist Hospital in the Taipei area and the Changhua Christian Hospital in central Taiwan, are products of that missionary legacy.   

When Taiwan was ceded to Japan in 1895, one of the biggest challenges for the Japanese colonists was avoiding contracting the widespread communicable diseases with high death rates. Malaria even killed a Japanese prince who was part of the invading force.

“Modern medicine was adopted after the Japanese takeover in 1895,” says Andrew Huang, head of the Koo Foundation Sun Yat-sen Cancer Center. Determined to bring public health in Taiwan under control, the colonial regime introduced Western medical practices and improved sanitation across Taiwan. Modern facilities for water purification, for example, helped curb cholera and other diseases. 

In the early colonial days, the Japanese also acted to isolate patients infected with diseases such as bubonic plague, smallpox, cholera, typhoid fever, and dysentary. A 20-year plague epidemic wasn’t suppressed until 1918. Malaria, once a very serious problem, was attacked through a drive to eliminate conditions where mosquitos could breed, such as improving drainage and cutting down bamboo forests.  

Medical training was one of the few disciplines opened to Taiwanese for higher education during the Japanese period. Within the first year of Japanese rule, what later became National Taiwan University Hospital was established as the Taipei Medical Hospital Training Institute in Taipei. In 1937, the hospital was annexed to the Medical School of Taihoku Imperial University (now National Taiwan University). Over the decades it has continued to be one of the leading teaching and research hospitals in Taiwan.

Following the transfer of governing power in Taiwan to the Republic of China in 1945 and the arrival of some 1.5 million troops and civilians from the mainland in 1949, institutions initially designed to serve the military and veterans played an important role in Taiwan’s medical development. What is now the National Defense Medical Center, incorporating the Tri-Service General Hospital, evolved from what was originally the Taiwan Army Hospital. The Taipei Veterans General Hospital in the Shipai area of Taipei was established in 1958 and is now one of the leading national medical centers, with branches or affiliated institutions in other parts of the island.

Other government-run institutions were established in various locations. One of the strongest networks is Taipei’s municipal hospital system, consisting of nine branches.

As the Taiwan economy developed in the latter decades of the 20th century, some of the leading business groups set up affiliated hospitals. A prime example is Chang Gung Memorial Hospital, established in 1973 by Formosa Plastics founder Wang Yung-ching and his brother Wang Yung-tsai, and named after their father. Chang Gung now operates hospitals in eight locations, with a total of over 10,000 beds.

Other business groups that have established major hospitals include Cathay, Far Eastern, and Shin Kong in the Taipei area and Chi Mei in Tainan. The Koo family, from such businesses as Taiwan Cement and CTBC Bank, provided funding to found Taiwan’s leading cancer center.

Religious-based hospitals are not limited to Christian institutions. Tzu Chi, a prominent Buddhist organization well-known for providing disaster relief, has long run a leading hospital in Hualien and now also has branches in New Taipei City and Taichung.

While Western medicine has long been predominant in Taiwan, traditional Chinese medicine also continues to flourish. It is covered under the National Health Insurance program and is widely available from specialized clinics and in certain hospitals.